Living A Normal Life With Alzheimer's

Living with Alzheimer's disease is a challenge for anyone. It's difficult to remember things, make decisions, and find your way around the way you used to. It can be frustrating a good deal of the time, but there are good days and bad days. Here are some helpful tips and things you can do to make things easier for yourself -- to make things feel a bit more normal again.

How Do I Cope With My Memory Problems?

To help cope with memory problems:

• Always keep a book with you to record important information, phone numbers, names, ideas you have, appointments, your address, and directions to your home.
• Place sticky notes around the house when you need to remember things.
• Label cupboards and drawers with words or pictures that describe their contents.
• Place important phone numbers in large print next to the phone.
• Ask a friend or family member to call and remind you of important things that you need to do in the day, like meal times, medication times, and appointments.
• Use a calendar to keep track of time and to remember important dates.
• Use photos of people you see often labeled with their names.
• Keep track of phone messages by using an answering machine.

What's the Best Way to Plan the Day?

In planning your day:

• Find things to do that you enjoy and are able to do safely on your own.
• It will be easier to accomplish tasks during the times of the day when you feel best.
• Allow yourself the time to do the things you need to do, and don't feel rushed or let other people rush you.
• If something gets too difficult, take a break.
• Ask for help if you need it.

How Do I Avoid Getting Lost?

To keep from getting lost:

• Ask someone to go with you when you go out.
• Ask for help if you need it and explain that you have a memory problem.
• Always take directions for where you're going with you.

What Will Make Communicating Easier?

Communicating with others will be easier if you:

• Always take your time, and don't feel rushed.
• If you need to, ask the person you're speaking with to repeat what he/she is saying or to speak slowly if you do not understand.
• Avoid distracting noises, and find a quiet place to talk.

What About Driving?

Driving can be of particular concern for Alzheimer's patients. Here are some things to consider:

• Have someone else drive you where you need to go.
• If you tend to get lost or confused easily, consider alternative modes of transportation.
• Drive only in areas that are familiar to you.
• Contact organizations like the Alzheimer's Association to learn what local transportation services are available.
• The Department of Motor Vehicles will assess your driving skills if you're not sure whether you should drive.
• At some point, it may no longer be safe for you to drive.

How Do I Take Care of Myself at Home?

To make sure you are well taken care of at home, put some of these measures into place early so they become routine:

• Local Alzheimer organizations or your doctor will be able to tell you how to get help with things like shopping, housekeeping, meals (including home-delivered meals), and transportation.
• Ask a neighbor you trust to keep a set of house keys.
• Ask a friend or family member to help you to organize your closets and drawers to make it easier for you to find things.
• Ask a family member to check things out around the house, such as electrical appliances, mail, and perishable food items.
• Keep a list of important and emergency numbers by the phone.
• Have family, friends, or a community service program call or visit daily to ensure that everything is all right.
• Ask someone to check your smoke alarm regularly.

How Do I Maintain My Responsibilities?

• Arrange for direct deposit of checks, such as your retirement pension or Social Security benefits.
• Inform your bank if you have difficulty keeping track of your accounts and record keeping. They may provide special services for people who have Alzheimer's.

It is important to realize that at some point, it will become too difficult or dangerous for you to live by yourself. But, in the earliest stages of the disease, many people do manage on their own -- with support and help from friends, family, and community programs and with simple adjustments and safety practices in place.

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Understanding and Handling Emotional Outbursts

When it happens

Some individuals go through most of dementia with few uncharacteristic emotional outbursts. Among those who have them, they tend to increase over time.

Why it happens

When outbursts happen infrequently, they're most likely to be caused by some unexpected frustration, such as trying to remember how to do something once easily mastered, especially if the person is already under some other emotional or physical stress, such as a move or an illness.

What you can do

• Help the person feel secure. This is the number-one way you can ward off unpredictable emotional states.
• Know that transitions of all kinds can be difficult: a new caregiving aide, a move, a change in routine, a shift from one activity to another. Provide extra time and reassurance.
• Be empathetic without talking down to the person: "This is a hard day, isn't it?"
• Keep to a routine schedule; predictability is very soothing.
• If you sense agitation mounting, try stepping back. Count to 10 or 15 from another room or somewhere apart where you can keep an eye on things, and then try again.
• Try distracting an upset person with tried-and-true favorites: a tape of preferred music, a cherished blanket or other comfort object, a sweet snack such as ice cream.

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How Alzheimer's Progresses

Changes in the brain of someone with Alzheimer's may start a decade or more before they have any symptoms of the disease -- long before anyone realizes there's a problem.

As the disease causes more damage in the brain, symptoms begin to appear. Forgetfulness is often the first symptom of mild Alzheimer's disease. Often, people with mild Alzheimer's get lost in familiar settings, have trouble finding their keys and other items, and ask the same questions repeatedly.
The disease becomes worse over time. The person with Alzheimer's moves to a moderate stage of the disease and then a severe stage. This decline often takes several years.

Signs of Moderate Alzheimer's

During moderate Alzheimer's, the damage affects parts of the brain that control different functions.

You may notice these things when someone you care about has moderate Alzheimer's:

Memory. He or she may forget details about their past.

Difficulty with chores. Someone with Alzheimer's may have trouble doing tasks with multiple steps, such as:

• Cleaning the house
• Getting dressed
• Using the telephone

Communication problems. Your friend or relative might:

• Have trouble finding the right word
• Lose track of what they were planning to say
• Struggle to understand what other people are saying to them

Behavior issues. People with moderate Alzheimer's may:

• Become frustrated or angry more easily
• See or hear things that aren't really there
• Seem paranoid about unreal threats
• Act impulsively
• Wander away from home and get lost

During the moderate stage of Alzheimer's, people with Alzheimer's can still remember details about their lives and the people around them. They can take care of some tasks on their own.
But at this stage, they will need help from a caregiver -- such as a friend or family member -- to keep them clean, safe, and calm. Although they can be somewhat independent, they may no longer be able to live on their own.

They are not able to drive at this point, so they will need someone to take them to doctor visits and do other errands with them.

Signs of Severe Alzheimer's

In the severe stage of Alzheimer's, the damage from the disease becomes widespread through the brain. At this stage, your loved one may have these symptoms:

Memory and communications problems. He or she will have trouble remembering the names of people they care about. They may not be able to communicate with others. They may stop interacting with their surroundings -- for example, not noticing when someone is speaking to them.

Problems with self-care. Your relative or friend might have a hard time with basic tasks such as:

• Feeding themselves
• Using the restroom
• Getting dressed

Eventually, they may lose bowel and bladder control and have trouble swallowing.

Physical problems. Someone with severe Alzheimer's could develop other health issues, including:

• Weight loss
• Skin infections
• Pneumonia

They may find walking becomes more difficult. In time, they might not be able to walk at all.
Sleep changes. They may spend more time sleeping during the day but sleep more lightly at night.
In the severe stage, people with Alzheimer's disease need a great deal of help from caregivers. Often family members can no longer take care of them at home.
Some families choose to move their loved ones to a facility such as a nursing home so they get the level of care that they need.

For end-of-life care, a hospice may be a good option.

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