Alzheimers Disease

The sad thing about Alzheimer's disease it is often misunderstood. You know the crazy old lady who has lots her marbles. My Mom's neighbor actually said to me once, "Your Mom has lost the plot." That certainly upset me!
The "Hollywood" version, as I like to call it, that is portrayed in films, of the well dressed, elderly lady who has just forgotten what day it is.

It is a terminal disease just as some forms of cancer are. It is a disease that slowly creeps up on people and robs them of their memory, co-ordination, their ability to look after themselves and finally their life.

There is two main types of symptoms associated with Alzheimer's disease.

Cognitive signs and symptoms of Alzheimer's disease include:
* Loss of memory
* Loss of language skills
* Loss of motor function
* Loss of ability to recognize familiar things

The there are psychiatric symptoms of Alzheimer's disease which include:
* Personality changes
* Depression
* Hallucinations
* Delusions

I found this great article from the Queensland University of Technology. It state "Better targeted education is needed to prevent misconceptions held by the general public about Alzheimer's disease."

The study they undertook looked at the public's view of Alzheimer's disease, as well as the views of carers and patients too.

The main misconceptions were:

* under-estimating the life expectancy of a patient diagnosed with the condition,
* the causes of Alzheimer's
* not understanding how to handle wandering patients * how a diagnosis of Alzheimer's is confirmed
* the prompt treatment of Alzheimer's could prevent the worsening of symptoms

Further educations programs are needed to help people have a better understanding of Alzheimer's.

Here is a link to the article.
Study Outlines Misconceptions About Alzheimers, Australia

Here are the main Alzheimer's symptoms and my view of how they related to my Mom.

Changes in memory: Repeating things; Being forgetful;Losing valuables; Getting lost in familiar places.

My Mom would often tell me the same story over and over and over. You just have to say politely, "Yes, Mom you told me, wasn't that great that Melissa had a baby girl." then quickly change the subject or you will hear the full story for the tenth time.

My mom would often blame my father for moving things, like her purse or keys. She got lost one night when a friend was giving her a lift home and Mom couldn't give her direction to her house. Another lady, I know, got a taxi home from the shopping mall because she thought someone had stolen her car. She was looking on the wrong level of the car park! She did this twice before her family decided she shouldn't drive anymore. Very sad.

Changes in orientation: Trouble remembers the year, month day, date, names of people and places.

Looking back I think the first time sign that there was something wrong, was Mom forgetting my son's 8th birthday. She had known what the date was, so I rang her to ask if she was coming over for dinner that night. She said no it not his birthday today it's next week. I had to point out that is was in fact today and she could come over for dinner. I helped Mom write her Christmas cards a month before she was diagnosed with Alzheimer's. I would go through her list, write the card and address it for her and get her to add her own message and sign it. She had forgotten some of the people on her list and got annoyed at me for wasting a card on someone she didn't know.

Changes in behavior: Showing poor judgment, planning and organizing ability. Changes in appearance and hygiene.

After Mom was diagnosed I cleaned and tidied up her wardrobe. It was a disaster area. I moved all her winter clothes to another room and just had the clothes she needed hung up with blouses together, skirts, pants etc. all together.
I put her underwear on open shelves in the wardrobe so see could see them. My Mom was a highly organized and always looked lovely in her appearance. In the 6 months before she was diagnosed, I noticed she would wear something that needed to be washed or the same thing for days. She would get very offended if I mentioned she might like to change before she went out.

Changes in emotions: Changes in moods, getting stressed or agitated easily, unable to stand noise, withdrawing socially, losing interest in club and hobbies.

My Mom gave up her craft classes where she taught for 20 years. She just wasn't interested and said it was too noisy there. She would cry easily and became depressed. She was treated, at first, by the doctor for depression. It was only me insisting, she was sent to a specialist doctor at the memory clinic at the local hospital for further test and a brain scan.

Changes in thinking: Less flexible, trouble managing new tasks, difficulties finding the right word, difficulties following conversions.

My dad bought a new car a year and a half before Mom was diagnosed. She hated it! She said she liked the old car better and would only drive when she had to. I noticed at family gatherings she had trouble, where previously she would chat to everyone and following all the conversations. Now, she would withdraw and choose to sit away from everyone and only talk one on one with anyone. She also didn't start conversations. People would have to go and talk to her first.

I hope you found my thoughts on Alzheimer's Symptoms, helpful. They will be different for other people and it is easier to look back and see the signs you missed than see it as it happens. I found the symptoms had a gradual build up effect and showed up more and more over time as the disease progressed.

The Complete Guide To Treating and Coping with Alzheimer's
With more than 18 million known cases of Alzheimer's Disease world-wide, the odds are that you have had some contact with someone who is close to this horribly degenerating disease.
It may be a victim or a family member of a victim.

Maybe you even suspect that a loved one is exhibiting early stage symptoms of Dementia and/or Alzheimer's Disease. If you think that may be the case, The Complete Guide to Treating & Coping with Alzheimer's Disease is just what you need.

Learning what you need to know to understand the disease gives you a definite roadmap for how to cope, not only with the disease but with caring for your loved one.
The Complete Guide To Treating and Coping with Alzheimer's

Diagnosing Alzheimer's is more about a process of elimination. Sometimes symptoms of dementia and Alzheimer's can resemble other problems which are reversible and treatable.

They can include:
some vitamin and hormone deficiencies
problems with the thyroid gland
medication clashes or over use of some medication
depression.

It is important to get the right diagnosis of Alzheimer's.
My Mom had a series of test to rule out everything else before being diagnosed with Alzheimer's. The process eliminates every other possible cause.

The tests Mom had included:
Full blood tests, to rule out, hormone and vitamin deficiencies or thyroid problems.
She had a memory test. See the description below on this.
A CT scan to rule out stroke or blood clots on the brain.

There are 3 main stages of Alzheimer's and Dementia
Here is some of the main Alzheimer's symptoms of each stage.

Early Alzheimer's

A person:
Appears to lose that sparkle
Loses interest in hobbies and activities
May be unwilling to try new things
May be unable to adapt to change and be slower to grasp ideas
Can show poor judgement and make poor decisions
Take longer with routine jobs
Blame others for "stealing" lost items
Become more self-centred and less concerned with others and their feelings
Become more forgetful of details of recent events
Be more likely to repeat themselves or lose the thread of their conversation and have trouble following conversion.
Be more irritable or upset if they fail at something
Have difficulty handling money

Moderate dementia

At this stage the problems are more obvious and can cause more problems in daily living.
The person may:
Be more forgetful of recent events.
Memory for the distant past generally seems better, but some details may be forgotten or confused
Be confused regarding time and place
Become lost if away from familiar surroundings
Forget names of family or friends, or confuse one family member with another
Forget saucepans and kettles on the stove.
May leave gas unlit
Wander around streets, perhaps at night, sometimes becoming lost
Behave inappropriately, for example going outdoors in nightwear
See or hear things that are not there
Become very repetitive
Be neglectful of hygiene or eating
Become angry, upset or distressed through frustration

Advanced dementia

At this third and final stage, the person is severely disabled and needs total care.
The person may:
Be unable to remember occurrences for even a few minutes, for instance forgetting that they have just had a meal
Lose their ability to understand or use speech
Be incontinent
Show no recognition of friends and family
Need help with eating, washing, bathing, toileting and dressing
Fail to recognize everyday objects
Be disturbed at night
Be restless, perhaps looking for a long-dead relative
Be aggressive, especially when feeling threatened or closed in
Have difficulty walking, eventually need a wheelchair
Immobility will become permanent, and in the final weeks or months the person will be bedridden.

My mother had Alzheimer's for four and a half years. Looking back before she was diagnosed, it was a trying and distressing time. We wondered what was wrong with her. My father has been in hospital 5 time that year. The doctor said Mom was suffering from depression. But I knew it was more than that.

Each time Dad was in hospital, Mom would come to stay with me. There was so many little things I noticed. She would have her blouse buttoned up wrong and didn't notice. She would put on clothes that didn't quite match. This worried me as Mom was always dressed beautifully. She would cry a lot too.

You have to look at the person and decide what could be causing these changes. If the mediation the doctor gave her for depression worked and Mom went back to her happy self then I wouldn't have worried. The medication did help and Mom was happier and my Dad was well again but there were other signs that told me it could be a memory problem like dementia.

Mom forgot my son's birthday. A doting Grandma forgetting her grandson's birthday. No, not my Mom. On the phone she would tell me the same thing every time I rang or ask the same questions. My neighbor who is a nurse, told me to get an aged care assessment done on Mom.
Two specially trained nurse came to Mom's home and interviewed Mom and Dad separately. They did a memory test on Mom. She scored 20 out of 30. This was a sign she could have dementia or Alzheimer's. She was referred to the local hospital's memory clinic. After further tests and a CT scan to rule out stroke or blood clots on the brain, she was diagnosed with Alzheimer's. It was very hard for the family but a relief at the same time. Now we knew what was wrong and could deal with it.
The wonderful and amazing thing about my Mom was she still knew who we all were right to the end. Alzheimer's had robbed her of her abilities to walk, her co-ordination, and made swallowing and eating difficult. She still had strong family memories which amazed everyone
Betty 12th December 1930 to 8th July 2008. Reunited with Dad.

Whether you loved one is still living at home, with you or in aged care planning their environment to keep them safe and prevent falls is so important.
Alzheimer's symptoms are many. Some are disorganization, forgetfulness and the loss of co-ordination. Here is some helpful tips for you to help you loved one stay safe and to prevent falls.

Vision:
Get your loved one eyes tested first. They may need new glasses.
Use brighter lights around the home. Try to have the same level of lighting throughout since changes in light levels can be confusing for some patients.
Use night lights, especially on the route from their bed to the bathroom or kitchen.
Consider a sensor light in the bathroom they comes on automatically when a person enters the room. Often Alzheimer's disease will make the person forget where the light switches are placed.

Home safety:
Rails in the bathroom, down front and back steps of the house.
Non slip mats in bathroom and wet areas.
Remove clutter. Don't make the living room an obstacle course of sofas, rugs, and coffee tables for your loved one to move in and around just to get a drink from the kitchen.
Close off any areas that can be a danger to the patient. You can use child safety latches and locks to make many areas inaccessible, such as knife drawers in the kitchen.
Limit the use of some equipment in the home, such as the oven/stove, toasters, and knives.
Look for appliances that come with an automatic shut-off device. This can prevent fires and burns.
Check to make sure that smoke alarms are working correctly. Keep fire extinguishers throughout the home.

Food:
Make sure that the food in the refrigerator is fresh and not spoiled. People with Alzheimer Disease will often eat whatever they find regardless of the taste or condition of the food.

Shoes:
Sorry this may be the time for ladies to get rid of those higher heeled shoes. Non slip shoes with a good grip on the soles are best.

Aids:
Walking stick, shower chairs, walking frames, wheelchairs and one of those tools for picking up things without bending down.
Standing up correctly:
You loved one may need to learn to stand up more slowly with support of a walking stick or frame. Especially getting out of bed or a chair. They need to do it in steps. Sitting forward first or sitting up in bed for a moment before standing up. They need to stand next, get their balance before moving forward.

Medication Check:
Check with your loved ones doctor to see if the medication they are taking may cause dizziness or tiredness at certain time of the day. Always make sure your loved one takes their medication while you are watching. You want to make sure that they are taking it and not missing a dose. Or worse taking two doses because they forgot that they had taken their medication.

Personal Alarm:
This might be a good idea if the person is living alone.

Phone:
A cordless telephone your loved one can have next to then in bed or watching television is a great idea.

I hope you found these safety tips helpful.

One of the main ways to check if a person is showing signs of Alzheimer's is the Mini Mental Status Examination.
I requested an Aged Care Assessment done on both my parents to see what was happening to Mum and to get the some form of assistance in the home. The two specially trained nurses came out to talk to Mum and Dad in separate rooms. I sat with Mum as she was more agitated.
The nurse gave Mum the Mini Mental Status Examination (MMSE). It only takes a few minutes, and is a simple test to do. It is detailed test that covers memory to mathematics ability.
It is used as a tool to determine if a person may have Alzheimer's but it is used in other ways too.
It can also show changes in memory over time.
The test is out of 30 points. My father got 30 out of 30. He always had a sharp mind! My mum on the other hand got a score of 20. One of the questions was to draw a clock and put the numbers on it then draw the hands on it for a certain time. I watched as Mum put all the number on the look backwards and all bunched up one side of the clock.

In general, a score of 26 or less indicates cognitive impairment and the need for further evaluation.
In my Mum's case these further test were, blood test and a MRI scan of her brain to rule out strokes as being the causes of her memory loss.
Over time my Mum's results in this test went from 20 down to 19, 17, then a low 11.

The test comprised of questions from five areas of memory:
Orientation (the date, season, area and specific address)
Registration (identifying and memorizing objects)
Attention and calculation (counting I had $100 and spent $7 how much money do I have left?)
Recall (the ability to remember what was memorized earlier)
Language use and comprehension (naming items, following a simple command, writing a sentence and copying a design)
Ask you doctor about the MMSE for your loved one.

When my mother moved into aged care they asked us to fill in a life history book for her. This is a great idea when a person is diagnosed with Alzheimer's. It is a great idea to look back at their life and the contribution they have made to family, friends, work and the community.
My mother taught craft at the local community centre for 20 years and before that she was a chief supervisor at the Reserve bank of Australia. Writing this down is a great way for everyone to see what a person has done through their life. It also was a good resource for the carers at the aged care home to start discussions with Mum and for them to understand what Mum was talking about when she started talking about her past.

If you would like to do the same for your loved one you can find the Life History book from Alzheimer's Australia.

Life History Booklet