Caring for Someone with Alzheimer Disease

The National Institute on Aging says that, although Alzheimer disease usually affects people older than age 65, it’s not a normal part of aging. Early onset Alzheimer disease is rare. It may affect fewer than 1in 10 people with Alzheimer. It typically occurs in those ages 30 to 60.  Early onset Alzheimer disease is more likely to be genetic and affect other family members.

People with Alzheimer disease often have trouble remembering things. At first, it may be something as small as the date or day of the week. Later, as the disease gets worse, they may not recognize their loved ones.

Alzheimer disease has no cure. But some medicines that may slow the symptoms in some people. Most people live an average of 4 to 8 years after their diagnosis. But some people can live as long as 20 years, depending on other factors.

At first, the symptoms of Alzheimer disease may be subtle. They may be dismissed as simple forgetfulness. But over time they get worse. Here are common symptoms of Alzheimer disease:

• Often forgetting something you just learned

• Trouble concentrating and resolving problems on your own

• Trouble doing things you've always known how to do, like driving to familiar places or using simple electronics like the TV remote

• Obvious confusion about dates, the time of day, and even the time of year

• Problems recognizing colors or reading

• Trouble with speech, words, and communicating with others

• Losing items and not being able to remember where they are

• Being careless with finances and personal hygiene, often showing poor judgment

• Becoming more isolated and spending less time with family and friends

• Having emotional outbursts or reacting inappropriately in some situations

• May lead to hallucinations or delusions, including paranoid ideation

A healthcare provider can generally diagnose Alzheimer disease by asking questions about symptoms and doing a few tests. These tests can include:

• Health history and review of all current medicines

• Review of any family history of dementia and Alzheimer disease

• Mental status test, which uses standard questions to test a person's awareness, such as the date and time and simple directions or lists of objects (sometimes more detailed neuropsychological testing is done)

• Physical exam, including a neurological exam, to look for other causes of symptoms

• MRI scan of the brain

• PET scan (with a new tracer agent)

• Tests of other family members. In rare cases, Alzheimer disease is genetic.

Researchers continue to look for ways to find Alzheimer disease earlier. But it remains a challenge to identify relevant data that can find Alzheimer disease very early. 

Several medicines are available to help slow and manage the symptoms of Alzheimer disease, but no medicines can cure it. These are commonly prescribed medicines:

• Cholinesterase inhibitors, like donepezil

• Memantine

These two types of medicines work differently. But they both affect chemicals in the brain related to memory and learning. Some people respond very well to these medicines. But some don't see any improvement. If there is improvement with these medicines, it will usually last for 6 to 18 months.

When you're a caregiver for someone with Alzheimer disease, you can help make sure that your loved one does things to stay as emotionally and physically healthy as possible. According to the Alzheimer's Association, a person with Alzheimer disease needs to:

• Learn how to manage and understand their diagnosis

• Cope with fear and frustration as symptoms get worse

• Maintain a healthy diet and exercise regularly

• Get plenty of sleep

• Limit alcohol intake

• Take all medicines prescribed by the healthcare provider

These are other tasks you might assist with:

• Grocery shopping, cooking, and feeding

• Bathing and getting dressed

• Paying bills, picking up prescriptions, and driving to healthcare provider's appointments

• Planning for long-term care (such as a nursing home or special memory care unit) when it becomes necessary

As you care for someone with Alzheimer disease, keep these things in mind:

• It's important to take care of yourself. Stay healthy and ask for help from others when you need it.

• Be kind, slow, concise, and clear when talking with someone with Alzheimer disease.

• Alzheimer disease can cause anger, hostility, violence, and wandering away. You will need to be prepared to deal with these situations.

• A time will come when it's no longer safe for a person with Alzheimer disease to drive. You will need to have a difficult conversation about giving up the car keys.

Experts don't know how to prevent Alzheimer disease because they don't know exactly what causes it. But exercising your brain by learning new things and challenging yourself may help to keep your brain sharper. A healthy diet and plenty of regular exercise is also thought to help keep your brain healthy.

Alzheimer disease can be devastating for the person who has it, family members, and other caregivers. You can get more information, including finding support groups, through the Alzheimer's Association.