Mental Preparation

You must be mentally prepared for caring for an Alzheimer’s patient. Care giving will:

• Be physically tiring.
• Be mentally exhausting.
• Will involve the not very pleasant chores of supervising (and even cleaning up after) the patient’s visits to the lavatory.
• Seem like an increasingly difficult and never ending job. (Unless you are a professional caregivers). Unlike caring for an infant where the child learns and quickly progresses from helplessness to independence, the AD patient slowly loses his skills.
• Often seem like a job without rewards. Though the AD patient may love you and may feel secure with you and miss you when you are not there, he might rarely express this in a heart warming way.

You may be a close relative or you may be a professional caregiver. The important thing is to have affection for the patient without feeling emotionally involved with him or her. For instance, if he refuses to recognise you or has an aggressive fit, you must not take it as a personal failure or punishment. You must recognise it as an aspect of the disease.

Care giving is easy to talk about but difficult to do. We are aware of this and deeply appreciate those who have volunteered to take care of AD persons.

Attitude that works best with AD patients

Maintain routines but keep things normal.

If the patient has a reasonably orderly routine, help him follow it.

You may be a close relative or you may be a professional caregiver. The important thing is to have affection for the patient without feeling emotionally involved with him or her. For instance, if he refuses to recognise you or has an aggressive fit, you must not take it as a personal failure or punishment. You must recognise it as an aspect of the disease.

A routine can decrease the decisions that you will need to make and bring order and structure into an otherwise confused daily life. A routine may come to represent security for the person with AD.

Although a routine can be helpful it is important to keep things as normal as possible. As much as the changing condition will allow try to treat the person as you did before the disease.

Support the person’s independence.

It is necessary that the person remains independent as long as possible. It helps to maintain self respect and decreases the burden on you.

Some caregivers treat the AD victim like a baby and insist on doing everything, like dressing him up or combing his hair when he is capable of doing it himself. Some caregivers are perfectionists and prefer to do everything themselves because their ward doesn’t do these things very efficiently. Both attitudes are wrong.

Help the person maintain dignity.

Remember that the person you care for is still an individual with feelings. What you and others say and do can be disturbing. Avoid discussing the person's condition in his or her presence.

When helping him change clothes or perform ablutions give him a sense of privacy. Do not treat your ward like a vegetable, although he may seem like one.

Avoid confrontation.

Any type of conflict causes unnecessary stress on you and the person with AD. Avoid drawing attention to failure and maintain a calm composure. Becoming upset can only make the situation worse.

Remember it is the disease and not the person’s fault.

Keep tasks simple.

Try to make things simple for the person with AD. Don’t offer too many choices.

Maintain a sense of humour.

Laugh with but not at the person with AD. Humour can be a great stress reliever.

Make safety important.

Loss of physical co-ordination and memory increase the chance of injury and so you must make your home as safe as possible.

Encourage fitness and health.

In many cases this can help maintain the person’s existing physical and mental abilities for a time. The appropriate exercise depends upon the patient’s condition.

Help make the best of a person’s existing abilities.

Some planned activities can enhance a person’s sense of dignity and self worth by giving purpose and meaning to life. You can ask a lady with AD to help with simple kitchen chores, if she is used to it. (Avoid giving her knives or cutters or electrical devices). Men can give a hand with simple tasks in the house and garden, especially these relate to their past hobbies or profession.

Remember however that because AD is progressive the person’s likes, dislikes and abilities may change over time. This will require you, the caregiver, to be observant and flexible in planning activities.

Maintain communication.

As the disease progresses communication between you and the person can become more difficult. Take the following precautions:-

• Make sure that the person’s senses such as eyesight and hearing are not impaired (Spectacles may no longer be of the right prescription or a hearing aid may not be functioning properly.).
• Speak clearly, slowly, face to face and at eye level.
• Show love and warmth through hugs if this is comfortable for the person.
• Pay attention to the person’s body language. People whose language is impaired communicate through non verbal means.
• Be aware of your own body language.
• Find out what combination of word reminders or prompting words and demonstration is needed to communicate effectively with the person.
• Make sure that you have the person’s attention before speaking.

Use memory aids.

In the early stages of AD memory aids can help the person to remember and they can help prevent confusion. The following are successful examples:

• Display large, clearly labelled pictures of relatives so the person can keep track of who is who.
• Label doors of rooms with words and bright distinctive colours.
• Memory aids will not be so useful in the later stages of AD.