February 04, 2012

Alzheimer's Disease

Coping With Alzheimer Disease

Alzheimer Disease is a progressive, degenerative disease of the brain, often associated with old age. Although the majority of Canadians affected are over the age of 65, Alzheimer Disease can, and does, develop at a younger age.

No matter when a person is affected, the process is always progressive and degenerative, which means that formerly self-reliant men and women become dependent upon others.

The caregivers, usually family members, must cope with long periods of emotional, financial and physical stress. The health and well-being of the family caregiver is vital and becomes as important a concern as that of the person with the disease.

Though there is still no cure, our understanding of Alzheimer Disease is increasing as both bio-medical and caregiving research progresses and brings new information on the disease.

Symptoms

The first indications of Alzheimer Disease are often subtle changes in behaviour. The person may have difficulties with short-term memory. Adjustments to new places or new social situations may prove very stressful. Learning, calculating, deciding or handling finances become problematic. Controlling emotions becomes more and more difficult.

The fact that a person has these symptoms does not automatically mean he or she is suffering from Alzheimer Disease. The symptoms could be caused by other treatable conditions, such as depression, malnutrition, dehydration, heart disease or pulmonary problems, to name a few.

This is why a complete medical assessment is critical. A diagnosis of Alzheimer Disease is made by ruling out other conditions. Currently the only definitive method of diagnosing Alzheimer Disease is through a post-mortem examination of brain tissue.

The Effects

Alzheimer Disease eventually affects all aspects of a person's life: how he or she thinks, feels and acts. Individuals are affected differently. It is difficult to predict each symptom a person will have, the order they will appear or the speed of the disease's progression. The following can be affected by the disease:

Mental abilities: A person's ability to understand, think, remember and communicate is affected. The person begins having difficulty learning and deciding. Simple tasks the person has performed for years will be forgotten. Confusion and memory loss increases, though the memory of past events may be maintained for a long time. Problems understanding what is said or making oneself understood will escalate. Eventually all difficulties increase, and the past is forgotten as well. Despite these losses, the person with Alzheimer Disease will still be able to hear, respond to emotion and be aware of touch.

Emotions and mood: An individual with Alzheimer Disease has less expression, is less lively and is more withdrawn. The ability to control mood and emotion is gradually lost, and reactions to situations may be extreme or inappropriate. Frequently individuals become suspicious of people around them. As the disease develops, they have little or no reaction to people or surroundings.

Behaviour: Changes in mental abilities and mood will bring about changes in behaviour. The kinds of behaviour changes and their duration vary and will be influenced by an individual's physical abilities. Challenging behaviours may include: pacing or wandering, repetitive actions, hiding articles, constantly searching, physical outbursts, swearing, restlessness and inappropriate sexual advances. For the caregiver, any of these behaviours can increase stress.

Physical abilities: Coordination and the ability to move around are affected by the degenerative process. The resulting changes impair the individual's ability to perform activities of daily living independently. Bowel and bladder control are eventually lost. Over time, the person will become completely dependent.

Theories About Causes

No one knows for sure what causes Alzheimer Disease. To date, researchers have been unable to pinpoint one reason. Researchers feel that Alzheimer Disease may be the result of a slow virus, an autoimmune reaction or a biochemical imbalance in the brain. Other researchers are studying an "amyloid" theory that suggests when abnormally organized protein get deposited into brain tissue Alzheimer Disease is created. Elevated amounts of aluminium have been reported in brain tissue, but there is no evidence that aluminium is the cause of Alzheimer Disease. There is evidence of a genetic link because a rare form, called familial Alzheimer Disease, appears to be inherited. While hereditary factors may play a role, the extent of their role is unclear.

An increasing amount of research is being carried out on many fronts. Some scientists believe that the cause will prove to be multifactorial.

Treatment

Currently no medical treatment exists to reverse or slow down the progress of Alzheimer Disease. Secondary symptoms, such as depression, anxiety, sleeplessness and paranoia, may be lessened with appropriate drug treatments, though such intervention must be carefully monitored.

It is well recognized that the physical and social environment in which a person with Alzheimer Disease lives can influence disease symptoms and quality of life. Supportive physical settings, whether the home or a facility, compensate for failing abilities and help maintain independence. A caregiver can reduce difficult behaviour by understanding the disease process, being sensitive to emotions and feelings and learning to communicate in a variety of ways.

Remembering the Caregivers

Providing care can put a great strain on family members. Hence, caring for the caregiver becomes as important as caring for the person with the disease. Anger, resentment, nervousness, tension, sleep problems, feelings of worry and guilt are all normal for the Alzheimer caregiver. It's not surprising that caregivers are more prone to illness than non-caregivers.

Living with someone with Alzheimer Disease is a challenge, but many Canadians are proving that it can be done. What they need is information, support, and services in the home and in facilities that provide both short term and long-term assistance.

The Alzheimer Society, through its local and provincial organizations, is helping the caregiver cope with the devastation of this disease by providing information and support, establishing necessary services and encouraging and financing research.

Brochure produced through a health education grant from: Eli Lilly Canada Inc., Pfizer Canada Inc., and SmithKline Beecham Inc.