It is quite easy to confound someone’s propensity when they have Alzheimer’s and it can be done easily because the person with Alzheimer’s unconsciously has no way of articulating that need. Alzheimer’s is a progressive brain disease in which abnormal protein deposits build up in the brain, causing brain cells to succumb. In Alzheimer’s disease, however, tarnishing is wide spread as many of the neurons stop functioning, loose connection with other neurons and the brain shrinks and deteriorates. At first, Alzheimer’s disease typically destroys neurons and its connections in parts of the brain involved in memory, including the entorhinal cortex and the hippocampus. The brain tissue shrinks as the disease progresses causing magnificent memory calamity and loss of cognition functioning. There are seven stages to Alzheimer’s but five are important to know about. To understand the results of Alzheimer’s, you must identify with the divination and commiserate with the person at hand who is suffering from the disease because every person with it suffers differently.
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Typical progression of Alzheimer’s disease may be broken down into three, five or seven stages. Meanwhile, this includes five stages that are important in understanding the progression of Alzheimer’s and effects it has for all individuals involved. Stage one which is the first signs of impairment. Stage two is very mild cognitive decline. Stage three includes mild cognitive decline. And stage four is moderate cognitive decline. The last stage is the hardest to watch it is fifth stage dementia and the individual loses all cognitive functioning. In stage one memory loss that disrupts daily life is happening, the person forgets recent learned information. Common material the patient forgets includes important dates or events, they tend to ask for important information again and again. Patient relies on family and reminders to keep them on top the information. An example of this would be forgetting a doctor’s appointment or a name but remembering them later (Alzheimer’s association). A patient in the second stages tends to have difficulty completing familiar tasks on their own time at home or at work. The patient tends to forget how to use the setting on the microwave or to turn off the tv or a lamp in the home. The third stage tends to happen in moderate stages of Alzheimer’s and the patient has confusion with time or places. The patient can lose track of dates, seasons and the passage of time. Also changes in vision happens unfortunately for some patients, having vision problems is a sign of the disease. They may have difficult reading, judging distance, and determining color, which tends to result in problems with stability and driving. Decreased and poor judgement also occurs in the moderate stages of Alzheimer’s. For example, having worked with many Alzheimer’s patients this one is common among patients, they tend to have changes in decision making and judgment such as when dealing with money, paying less attention to grooming or keeping themselves clean. The patient withdrawals from social life in this stage as well, they feel weary of things, like social obligations and family. The patient may avoid being social because of changes they have experienced (Alzheimer’s association). Changes in mood and personality is a huge step in moderate dementia, they become confused suspicious depressed, fearful and anxious. Patients can easily get upset and discouraged, if its uncomfortable when the situation is outside of their comfort zone.
So, exactly how the patients feel, having asked a patient with Alzheimer’s questions; the response was imagine being put in front of classroom full of other students and the teacher calls upon you and no recollection of the answer happens, that is exactly how they feel. A tendency of embarrassment happens, voice faltering, palms sweat, face blushes, anger happens, and they feel like they have a loss of control. The patient was asked a question and had no idea what to say because they had no answer. Basically, in mild Alzheimer’s seems like being a functional alcoholics day as far as cognition goes. Some small things like putting a shirt on backwards but not noticing or not being able to find the sugar bowl which is in the same place as it usually is, so you start to take apart the kitchen and cupboards, finally you decide to go with out the sugar and coffee, before they are aware, the kitchen is a complete mess. Later the patient comes back and has no recollection he/she indeed made the mess and has no memory of even looking for the sugar for their coffee. The memory of that moment is gone and the more the caregiver argues that they did it, the angrier the person with Alzheimer’s gets. The entire day can go like this. Routines are easy but anything new or added is more difficult. Then as the brain deuterates more the Alzheimer’s becomes moderate and days become more moment to moment and routine is your friend. Basically, the entire day is like breakfast, lunch, and dinner. Activities like taking bathes/showers becomes difficult. The bathroom is very separate from a normal living space, seems scary or dangerous. Stimulation becomes a burden for the patient, the patient sees him/herself doing it, taking the shower should be easy right, soap, shampoo, their wash cloth is right there, On the other hand it is terrifying for them. The water running in their eyes and ears, then someone helping them which just seems extremely weird no matter how much they understand and accept they need the help. The patient refuses showers because its over stimulation, exhausting, and to them it feels unnecessary. Moderate Alzheimer’s patients dislike showers. Severe dementia patients tend to sleep more and more often even during formally pleasurable activities. Such as familiar music they enjoy. The damage to their brain is so profound that the stimulation is not enough to keep them awake. The difference between awake and dreaming is invisible. Speech becomes very limited. Stimulation does not get acknowledged at all by this time, for example it’s like putting the patients’ hand on a puppy an she/he acknowledges her hand and not the puppy. No response to the stimulation. It is like watching someone that is brain dead wide awake. The patient no longer hears music, they have a loss of engagement. In severe dementia everything becomes moment to moment and routine means nothing anymore because there is no past or future. Most patients with severe dementia live in the right now. Patients will sleep 23 hours out of the 24 that occur in the day at end stage. When they are awake they may as well be asleep and dreaming. The person at hand will not meet your eye nor respond to any stimulation except the painful kind. Eating is no longer understood or that they are supposed to put in their mouth. Basically, your almost gone. The output of urine drops, body temperature rises, peristalsis decreases, organs begin to shut down, the patient sleeps, sleeps, and sleeps. Eventually they slip away very peacefully.
Coping with this situation and diagnoses can be difficult. When someone you care for is diagnosed with Alzheimer’s disease, the effects on the family can be overwhelming (Mayo Clinic). The reality of someone you care for getting this disease can trigger many emotions -including anger, fear, frustration, and sadness. Conflicts will arise and are common with family members who struggle to deal with the changes. Be prepared that will have an impact on the family, remember to share responsibility, meet regularly to discuss the patients care with a support group, be honest with yourself and everyone. If you find yourself as a caregiver of your family member arguing with him or her consider asking a counselor, social worker, a mediator or another professional to moderate. Plan activities with loved ones that you all enjoy and can be adapted to the persons current level of functioning. Adaptable activities include card games and walking. Simple tasks with chores like folding clothing. Remember that judging how that the person is doing it is unacceptable, give sanction that they are taking part in an activity. If the patient can no longer partake in an activity he or she liked to do, remember to relax the rules and definitions of what is “appropriate.” For instance, if the patient likes playing cards but cannot follow the rules of the game anymore, try sorting the deck into colors and suits instead. The object is to get the mind to respond to stimulation and will help slow down the progression of the disease.
Whenever it’s a possibility offer choices. Most important detail is to set a routine for daily living. Set realistic goals and attainable goals, if it’s too complicated let it go and go on. Caregivers so often try so hard to make everything all right. Often finding themselves exhausted and frustrated. Perhaps your goal is to make sure your patient is clean, comfortable, and well fed but accepting the patient’s success and your own success at 80% is going to make the day run so much smoother. If you as a caregiver make the patient comfortable and you get them fed that day, accept and move on this will allow you as a caregiver to enjoy time you might have otherwise; fighting about not getting your goals reached. With Alzheimer’s disease remember all behavior has a purpose. When a person with AD exhibits shouting and lashing out its due to them trying to tell the need that isn’t being met. Its not intentional or on purpose they just aren’t aware of how to put the right words on the table to communicate. On the contrary, having have worked with Alzheimer’s patients and as a caregiver understanding the patient is most important. These few things can help caregivers and family in all stages of the disease and family will have a better understanding of how it is for the person suffering with AD. Having patients with the family member ,showing compassion and keeping things simple will make this process go so much smoother for the person at hand.
- 2018 Alzheimer’s association “10 early signs and symptoms of Alzheimer’s. “Retrieved from https://www.alz.org/alzheimers-dementia/10_signs
- 1998-2018 mayo foundation for medical education and research.” Alzheimer’s: Dealing with conflict-mayo clinic. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers/art-20047365
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