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Tips to Help Manage Behavioral Challenges in Older Adults with Alzheimer's

Learn how to navigate the challenging behaviors associated with Alzheimer’s.

Your usually calm loved one suddenly starts shouting and swearing at you. You wake up in the middle of the night to find your father wandering down the street. Your mother suddenly feels confused and has trouble sleeping at night.

It is common to see changes in behavior in a loved one with Alzheimer's. Still, scenarios like these can be deeply upsetting for family members. It is important to remember that these changes, while challenging, are typical as the Alzheimer’s progresses. And while it’s easier said than done, caregivers should try not to take these episodes personally.

Another vital thing to remember is that all behavior is triggered by something. If a loved one with Alzheimer’s has recently become aggressive, this change is occurring for a reason. Perhaps it is loud noises or something else in his or her environment that causes the aggression. Maybe someone said or did something that triggered the behavior. At American, Advocate and Whitsyms In-Home Care, we know that getting to the root of the behavior can help family caregivers manage and potentially avoid many behavioral challenges associated with dementia.

Wandering

A common behavior for people with dementia, wandering poses a number of potential safety hazards. Boredom, medication side effects, or the urge to look for something or someone are often triggers for wandering. If a loved one is wandering, try these tips:

  • Help the older adult get regular exercise and participate in enjoyable activities to reduce boredom and restlessness.
  • Camouflage doors with removable curtains or use safety covers on door knobs.
  • Install an in-home monitoring system that can alert you if a loved one is moving around or attempting to leave the home.
  • Have the older adult wear an ID bracelet and/or a GPS tracking device that will help with identification and location tracking if wandering occurs.
  • Alert neighbors about a loved one’s propensity for wandering and make sure they know how to contact you if needed.

Sundowning

Sundowning consists of restlessness, disorientation, sleeplessness, and agitation around nighttime. This behavior can be caused by a number of factors, including exhaustion and changes to a person’s biological clock. These steps can help ease sundowning behaviors:

  • Discourage inactivity and napping during the day.
  • Cut back on sugar, caffeine, and other foods that may contribute to sleeplessness.
  • Plan for calm, quiet activities in the afternoon and evening hours.
  • Turn on lights before sunset and close curtains. This can eliminate shadows and help reduce confusion.
  • Consider talking to the older adult’s doctor about medication side effects if you feel that may be an issue.

Agitation

Agitation can be a particularly troubling behavior to witness in a loved one with Alzheimer’s. This can include irritability and verbal and physical aggression. Agitation may be triggered by environmental factors such as loud noises or clutter, fear, and fatigue. It can also be the result of the person feeling as though they are losing control of their own lives. These tips can help:

  • Reduce noise and clutter in the home.
  • Follow routines as much as possible and keep commonly used household objects and furniture in the same place.
  • Allow the person to do as much as he can for himself to support a sense of independence.
  • Play soothing music, read, or take a walk to soothe agitation.
  • Do not confront or argue with a person experiencing agitation. Instead, distract him or her with a calming activity.

Alzheimer’s disease gradually changes loved ones in a number of different ways, and everyone experiences the disease differently. If you have a loved one with dementia who is exhibiting challenging behavioral changes, remember, you are not alone.

The referred care providers at American, Advocate, and Whitsyms In-Home Care are always on hand to help reduce restlessness or boredom, and they are highly skilled at creating calming environments that allow older adults with Alzheimer’s to feel relaxed and peaceful. For family caregivers overwhelmed by new behaviors and caregiving duties, our referred caregivers also provide respite care services to ensure you get a chance to rest and recharge yourself.

Contact us today at the location nearest you and let us help find the perfect care provider to meet your needs.

 

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Five Lifestyle Factors That Can Reduce Your Risk for Alzheimer’s

Alzheimer's Disease

Roughly 6 million people of all ages in the United States are currently living with Alzheimer’s - this includes mostly people over the age of 65 but also 200,000 people under the age of 65 with an early onset version of the disease. One in every ten people over the age of 65 develops Alzheimer’s, which is a very large percentage. So what can you do to decrease your, or a loved one’s, risk for developing Alzheimer’s?

New research presented at the Alzheimer’s Association International Conference 2019 suggests there are 5 critical factors that you can change about your lifestyle that will significantly decrease your risk for developing the disease. This research is incredibly important because it shows that risk factors for the disease can be modified and that you can truly make a difference with lifestyle changes, regardless of genetics or predisposition for the disease. See what 5 lifestyle factors you can change below.

1. Diet

One of the biggest factors that affects our health is what we eat. People have known for ages that what we put in our body impacts our health, our chance of disease, and our longevity - and now, that it can decrease our risk for the development of Alzheimer’s and dementia. So what changes can you make in your diet? Scientists recommend a combination of a DASH and Mediterranean diet. The DASH diet is prescribed by doctors to prevent and treat high blood pressure and blood cholesterol. The foods in a DASH diet are low in sodium and high in other nutrients that lower blood pressure like potassium, calcium, and magnesium. The DASH diet includes lots of whole grains, fruits, vegetables and low-fat dairy products, fish, poultry and legumes, and encourages a small amount of nuts and seeds a few times a week. You can learn more about the DASH diet and its recommendations here - (https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456).
The Mediterranean diet is more of a long-term lifestyle diet, while the DASH diet is for losing weight or changing blood pressure levels in a short amount of time. The Mediterranean diet, as the name suggests, is based off of a typical diet found in Mediterranean countries. This diet consists of large amounts of fruits, vegetables, and whole grains, medium amounts of fish, dairy and healthy fats, and small amounts of meat and sweets. The important fact about the Mediterranean diet is that it is plant based instead of meat based. Meals are built around vegetables, fruits, herbs, nuts, beans and whole-grains with sides of dairy, seafood, poultry and eggs. Red meat is only eaten on occasion. You can learn more about the Mediterranean diet and its recommendations here - (https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801).

2. Exercise

Regular exercise is important to stay physically and mentally fit. People who are active and fit are less likely to have a decrease in mental function and less likely to develop Alzheimer’s disease later in life.

Exercising is important because it can:
• Sharpen reasoning skills in healthy individuals
• Improve memory and judgment skills in healthy individuals
• Delay the onset of Alzheimer’s for people at risk or with a genetic predisposition
• Slow the progress of the disease in people who already have Alzheimer’s

So how much exercise is enough to make an impact? The World Health Organization (WHO) recommends that “individuals aged 65 and above engage in 150 minutes of moderate-intensity aerobic exercise every week, or 75 weekly minutes of vigorous-intensity aerobic exercise.” Examples of aerobic exercise are brisk walking, running, swimming, tennis, cycling (inside or outside), dancing, taking a spin class, using the elliptical machine, etc. Many of these, like swimming, are low impact and good for people who are already over the age of 50 or who have had previous injuries.

3. Smoking

Alzheimer’s specifically is known to be linked with problems of the vascular system, i.e. your heart and bloodstream. Smoking increases your chance of vascular problems, strokes and mini bleeds in the brain - all of which are also risk factors for dementia. Chemicals in cigarettes can also cause inflammation and oxidative stress, which both increase your chance of developing Alzheimer’s, as well as a plethora of other diseases. Some research says that 14% of dementia cases can be attributed to smoking. But don’t worry, stopping at any point in your life will still have an impact on your Alzheimer’s risk. It’s never too late to adopt healthier lifestyle practices.

4. Drinking

Don’t worry - we’re not about to tell you to stop drinking altogether. Thankfully, drinking in moderation has no significant impact on your risk for developing Alzheimer’s. However heavy drinking and binge drinking will lead to brain damage over time, reducing the amount of your brain’s white matter - the material that provides synapse connections between different sections of your brain. It can also lead to a lack of vitamin B1, eventually affecting short term memory.

So what is moderate alcohol consumption? The NCS says that 1-14 units of alcohol per week for women and 1-21 units a week for men is considered light to moderate.
• A typical glass (175mL) of (12%) wine = 2 units
• A pint of lower (3.6%) alcohol beer or cider = 2 units
• A pint of higher (5.2%) alcohol beer or cider = 3 units
• A single shot (25mL) of spirits such as whisky, gin or vodka (40%) = 1 unit
5. Cognitive Activities

Increased cognitive activity in early life is known to be associated with decreased cognitive decline and a decreased risk for Alzheimer’s and dementia. The new research presented at the Alzheimer’s Conference shows that increasing your cognitive activity at any point in your life can decrease your risk for Alzheimer’s. So what can you do to increase your cognitive activity? Anything that keeps your brain active like crossword puzzles, sudoku, reading books, puzzles, playing card games, etc. “Your brain is like any other muscle in your body — the more you strengthen it, the more resistant it will be to environmental and physical stress,” Tousi explains.
A new study by Ko et. al published in the Frontiers in Aging Neuroscience Journal also shows that increased childhood cognitive activities, like taking music lessons or learning a new language, could greatly decrease the risk of developing both Alzheimer’s and dementia. Encouraging your kids to stimulate their brains will help them further down the road. But it’s also important to know that any cognitive activity increase at any age will help reduce your risk for Alzheimer’s. So it’s never too late to pick up a new brain stimulating activity.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875443/

So what does this all mean for me?

So what does this actually mean for you? How much will changing these factors actually impact your risk of developing Alzheimer’s? Research shows that people who changed at least 4 of these habits had a 60% decrease in risk, and even people who only changed 2-3 of these habits still had a 37% decrease in risk. While most people would probably assume that not smoking or drinking would have a positive impact on your body, this research emphasizes the magnitude of these small changes. Even people with an increased genetic risk can still decrease the chance of developing the disease if they change these 5 lifestyle factors.

“What we are starting to see, across the board, whether you inherited a genetic predisposition to dementia or live in a place that increases your risk, is that you may be able to overcome some of this with lifestyle,” Carrillo says. “Even more exciting, even a little bit counts.

If you are looking for a provider for live-in care in Florida with experience caring for individuals with Alzheimer's, American In-Home Care and our family of caring companies, Whitsyms In-Home Care, Advocate In-Home Care and Douglas In-Home Care can help. We refer qualified and compassionate care providers that are matched directly with your loved one's personality and needs. We can refer care providers that specialize in Alzheimer's and dementia care, and who have training and continuing education in this area to ensure they provide the highest quality of care to your loved one, and that you and your loved one are in the best hands.

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Gifts For Alzheimer's Patients

Alzheimers Care With over 5 million Americans living with Alzheimer's disease, and more than 10 million people providing care for them, it is highly likely that you will be buying gifts for a loved one with Alzheimer's, or someone that has been touched by the disease, this holiday season or at some other time. As such, it is important to know what gifts are appropriate - gifts that can help ease stress, confusion, and depression, and actually aid the memories of those suffering.

The key is to look for gifts that your loved one is interested in, and that will keep them actively engaged and at ease. Gifts for Alzheimer's patients should be fun, yet stimulating in some way - be it cognitive stimulation, sensory stimulation, or physical stimulation. Special DVDs can be a good alternative to television, and games and puzzles can not only be fun and interactive, but can help you keep tabs on how your loved one's disease is progressing.

Keep in mind that certain gifts, like new electronics, might seem like a fun or helpful gift, but could actually cause added stress or embarrassment for an Alzheimer's patient because it creates another thing to be remembered. If you decide you want to give a tech gift or electronic, be sure to go over the instructions with your loved one slowly and more than once, so that they have a good understanding,  and keep a copy of the instructions for yourself.

Gifts for Alzheimer's Patients

1. Early Stage: When in the Early Stage of Alzheimer's, people can still live healthy, active lives for the most part, and might only notice subtle changes in their memory and body. For these individuals, gifts that aid cognitive stimulation are beneficial, and can include some of the following:

  • Magnetic reminder pads for the refrigerator
  • Labeled baskets or file folders to keep documents and other misc. items
  • Designated hanger or jar for keys
  • Family calendar with important dates written in - birthdays, anniversaries, holidays, etc.
  • Dial-by-picture telephone system
  • Automated pill dispenser
  • Night light for bedroom or bathroom
  • Crossword puzzles related to 20th Century events or history
  • "Spot the difference" photo games
  • Large playing cards or index cards
  • Puzzles with places they have gone, or art they enjoy
  • Stimulating DVDs, such as nature or history documentaries
  • "Classics" CD from their favorite musician
  • A collection of their favorite movies
  • Plan a special outing - go to a play, a movie, a museum, shopping with family and friends
  • Do fun hands-on activities together such as painting or scrapbooking

2. Middle/Late Stage: People in the later stages of Alzheimer's generally need assistance with most of their daily activities as their state continues to deteriorate. Gifts that provide sensory stimulation, and that bring back pleasant memories are beneficial for individuals suffering from moderate or late stage Alzheimer's, such as:

  • Scented lotions in their favorite scent
  • A bathrobe or slippers in their favorite color
  • A warm throw blanket
  • Comfortable clothes that are easy to put on and take off, and easy to wash - such as sweats, knits, and wrinkle-free sleeping garments
  • A CD or compilation of their favorite songs or musicians
  • Family photo album with pictures of every family member, and their name
  • An illustrated family tree
  • Puzzles of favorite places or art works
  • Games - color stimulation, size and shape games, brain-game books
  • Color-by-number activities
  • Nature or animal DVDs or documentaries
  • Stress ball, or sensory hand-held toys
  • Do fun hands-on activities together such as painting or scrapbooking

Gifts for Family Caregivers 

Caring for an Alzheimer's patient, especially if it is a loved one, can be extremely taxing on a person, both physically and mentally, and can often lead to caregiver depression. To avoid this, truly the best gift you can give an Alzheimer's or dementia caregiver is the gift of respite care. By having someone else relieve caregiving duties temporarily, you will help the family caregiver reduce stress and have a necessary and deserved break over the holiday season.

  • Gift certificates - to salons or spas, favorite restaurants or hotels, favorite clothing stores, maid or lawn services, personal wellbeing such as yoga or gym membership, or technology support
  • Books - informational about caregiving and Alzheimer's disease, and also purely fun, entertaining books from a genre that you know the caregiver enjoys
  • TIVO or DVR subscription - allows the caregiver to record their favorite shows and movies on television that they might miss due to caregiving duties
  • Respite Care - finding a company that can refer a professional, qualified, and compassionate respite care provider to temporarily relieve the family caregiver of their duties is probably the most valued gift you can give. It gives your caregiver the gift of personal time and rest.

American In-Home Care always refers qualified, credentialed, screened, care providers that can assist with a wide variety of services in-home or in facilities. The care providers we refer to perform Respite Care can assist with overnight respite, in-home respite, Alzheimer's respite, travel care, and a number of other services to assist with daily activities. Contact us at 1-844-505-0004 to schedule your free consultation to assess your care needs.

Recognizing The Physical Signs Of Alzheimer's Disease

Alzheimer's Disease is the 6th leading cause of death in the United States. With statistics like this, it is important to recognize the signs and symptoms so that you can get the proper help and treatment for a loved one that is suffering. Because of the unfortunate commonness of the disease, most people recognize the usual cognitive symptoms - memory loss, inability to remember names or places, difficulty speaking, and mood swings - however, the physical signs are not as well known, but recognizing them is equally, if not more important to catching Alzheimer's in its early stages.

The physical signs of Alzheimer's Disease are important to recognize because often the cognitive symptoms are much more discreet and hard to determine, especially if your loved one is naturally forgetful, or if you aren't able to spend time with them regularly. By becoming familiar with the physical signs, it is easier to recognize Alzheimer's, even in its early stages, allowing you to get your loved one the help they need as soon as possible.

1. Repeating Actions

Keep an eye out to see if your loved one is repeating unusual actions. You might be able to carry on a coherent conversation with them, but repeating actions such as opening and closing the refrigerator repeatedly, aimlessly walking back and forth between rooms, or continually looking for an item that they have already found might alert you that they are suffering from Alzheimer's.

2. Wearing The Same Outfit

If you notice that your loved one has been wearing the same outfit the past several times that you have seen them, this could be symptomatic of Alzheimer's. Another sign associated with the disease is lack of personal hygiene - including doing laundry - either from forgetfulness or apathy. So if you notice that they haven't changed their clothes or dressed for the occasion, especially when that is uncharacteristic, this is an alerting factor.

3. Unexplained Bruising

This is an especially important physical sign to be aware of, especially if you aren't with your loved one every day. If when you see them and they have fresh bruises and cuts, and can't remember where or how they got them, this could be symptomatic of Alzheimer's. Common cognitive symptoms of Alzheimer's are sundowning and wandering, both of which are very dangerous. These habits could be where the bruises and cuts are coming from, and it is important to get under control so that your loved one doesn't get hurt or taken advantage of.

4. Loss Of Fine Motor Skills

Fine motor skills are what is required to hold on to small objects and make precise movements, and are affected by adverse brain activity, such as a stroke.  This is particularly noticeable at dinnertime when your loved one is trying to grip the utensils. If they are having a very difficult time grasping or holding on to these, that could be a sign that something isn't right.

5. Stressed or Pained Physical or Facial Expressions

Take a moment to notice your loved one's expressions when you are with them. Facial expressions such as frowning, looking frightened, grimacing, keepeing eyes tightly closed, or rapidly blinking could all be signs of Alzheimer's and physical and emotional pain that are associated with it. Physical expressions such as rigid body posture, fidegting, rocking, or changes in walking patterns are also signs of this.

Because Alzheimer's disease is easiest to manage when it is detected early, it is important to recognize these symptoms and to be able to get your loved one help as soon as you might expect something isn't right. Do not hesitate to call your doctor, as they will be able to help you get all the resources that you need.

If your loved one is diagnosed with Alzheimer's or dementia, hiring a respite, hourly, or live-in care provider to help your loved one be comfortable and safe in their home is a great idea, as taking on sole caregiving duties can be taxing on personal lives and relationships. American In-Home Care refers qualified nurses, Home Health Aides, Certified Nursing Assistants, and companions that can help you and your loved one by specializing in Alzheimer's care and other services. Contact us today at 1-844-505-0004 for a no-obligation consultation to determine what care options are best for your family.

Caregiver Depression: The Intangible Cost Of Dementia Care:

Does your mother have enough food? Does she have clean laundry? Is she eating nutritious meals? Has she been wandering? Is she safe? Does she have her medications? Are her finances in order? Who will set up her doctors appointments? Who will drive her?

Up to 50 percent of caregivers providing Alzheimer's and dementia care suffer from some sort of caregiver depression - developing major depressive illnesses and stress related to added duties and worry, according to a doctor with the Memory and Aging Center at the University of California, San Francisco. The caregiver becomes so overburdened with responsibilities, duties and worries that they aren't sure what to do next. This feeling of being overwhelmed and not knowing what to do, especially when it concerns a loved one, can lead to anxiety and eventually clinical depression.

With 80 million baby boomers getting older and needing more medical care, and estimates stating that there will be 7 million Americans with Alzheimer's disease by 2025, the concern becomes about the costs of care - financial costs, as well as the intangible mental and emotional costs on the caregiver.

Signs of Caregiver Depression

Providing dementia care and Alzheimer's care for a loved one can lead to feelings of stress, guilt, anger, sadness and isolation. Depression can affect caregivers in different ways and at different times, so it is important to recognize the signs and symptoms. It is common for depression to set in immediately after the loved one has been diagnosed with the disease, and also as the disease progresses and you start to see your loved one fade. Signs of depression include:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable
  • Overeating or appetite loss
  • Persistent aches, headaches, cramps, or digestive problems that do not cease with treatment
  • Thoughts of suicide, or suicide attempts

If you are concerned that you might be depressed, see your doctor as soon as possible. If depression is left untreated, not only can it lead to emotional and physical problems, it can also affect the quality of care you're able to provide the person with Alzheimer's or dementia.

What is the solution?

Even though providing Alzheimer's and dementia care can be difficult, caring for loved ones can truly be very rewarding if managed correctly. It is important while providing care that the caregiver takes time to his or herself  to participate in enjoyable activities  and hobbies. Another way to help cope with the added responsibilities and stress is to try keeping a journal to express both positive and negative emotions. It is also important to talk to your friends and family and let them know when you might need some assistance.

There is also major research being conducted that aims to reduce both the tangible and intangible costs of dementia care. The University of California, San Francisco, along with the University of Nebraska Medical Center, is beginning a $10 million study funded by the federal Centers for Medicare & Medicaid Innovation. Researchers plan to develop a dementia "ecosystem," which aims to reduce the cost of caring for the growing number of dementia patients and to ease the strain on caregivers.

A handful of tech start-ups have also been working to create technological solutions to ease the burden on caregivers. In San Francisco, Lively markets a system of networked sensors and a watch that can pick up on activity around the house and let family members or caregivers know if there is a worrisome change.

With increasing technology targeted to help ease the burden of Alzheimer's and dementia care, caregiver responsibilities and worries will be lessened, and depression will likely decrease as a result. However, in the meantime it is important to find outlets for emotions related to providing care, and to seek professional help when necessary. Respite care is an affordable, reliable option that can provide the additional support to keep you from feeling isolated and overwhelmed. American In-Home Care offers respite care along with other live-in elderly care solutions. Contact us today to set up a free consultation and discuss what care options are right for you.