If it becomes necessary to place your family member in a nursing home, counseling or coaching services may help you and your family deal with feelings of guilt, grief, anger, depression, and anxiety,. Support can be obtained through family and group counseling, support groups, and individual therapy. If needed, your physician can help you evaluate your options, though planning for long-term care should be discussed well before in becomes necessary.
Patient Directed Treatments: An individual with Alzheimer’s disease may exhibit difficult behaviors such as severe mood swings, verbal or physical aggression, combativeness, repetition of words, and wanderings. Efforts to maintain or improve the patient’s behavior can help improve the quality of life for the patient, your family, and you.
The following techniques are designed to manage the functional and behavioral deterioration of a patient with Alzheimer’s disease. These strategies have worked for many families, often delaying institutionalization. Talk with your physician about strategies that may help you.
Pharmacological Treatments: Several medications are currently on the market that help to delay the severity of cognitive impairment as well as treat the behavioral symptoms of Alzheimer’s disease. Talk to your family member’s physician to discuss drug therapy, and consult the American Association for Geriatric Psychiatry for more information.
Independence Promoting Strategies: Interventions designed to improve patients’ functioning also have been shown to improve Alzheimer’s disease symptoms. Such strategies help the patient retain mental and physical abilities and help with daily activities of hygiene, dressing, grooming, and eating. The techniques use incentives, verbal and physical prompting, and physical guidance. For example, having an Alzheimer’s patient choose the specific activity to engage in for the day promotes independence.
Strength/Mobility Enhancement: The well-known benefits of exercise apply to the person with dementia as well. Simple stretches, scheduled walking, or peddling a stationary bicycle all can help prolong mobility, decrease agitation, and improve sleep in the mild to moderately diseased patient.
Sleep Management: Sleep problems associated with Alzheimer’s disease can be a major source of caregiver stress and fatigue. Studies have shown that a period of brihgt light may decrease an individual’s agitation and improve sleep patterns. Other strategies for enhancing nighttime sleep include maintaining a darkened environment at night, providing an early evening warm bath, and limiting daytime napping.
White Noise: White noise, a continuous, monotonous, soft background noise, has been shown to modestly decrease verbal agitation in some patients. In addition to white noise generators, recordings of ocean waves, flowing streams, or other nature sounds may be soothing for the patient. Music therapy may also help by stirring memories and emotions.
Lighting: Dimming lights at mealtime may decrease mealtime agitation and increase food consumption.
Visual Cueing: Visual cueing, such as posting a picture of a bed on the door of the patient’s bedroom, can help a person with dementia find his or her way around a home as memory begins to fade. Pictures may provide more effective cues for direction than words.
Incontinence Management: Monitoring incontinence, scheduling bathroom time, and providing reminders are techniques that can help caregivers manage incontinence at home.
Providing a Supportive Environment: Individuals with Alzheimer’s disease are highly sensitive to their environment and have a decreased tolerance for stress. Your physician or geriatric care manager can help you identify the environmental triggers (for example, lights that are too bright or uncomfortable room or water temperatures) that may cause behavioral problems and work with you to eliminate them.
Traditional Psychosocial Therapy: Counseling can help patients in mild states of dementia reduce anger, anxiety, fear, suspiciousness, frustration, and depression. A mental health professional can provide advice and encouragement and help the patient interpre his or her feelings.
Reminiscence Therapy: By receiving encouragement and support from peers, patients can draw upon their long-term memory to recall and share events from their past. Reminiscence therapy often is conducted in group settings but can be used on an individual basis.
Validation: As dementia progresses, caregivers may find that attempts to correct their loved one’s misstatements or delusion do more harm than good. Validation is a technique in which the family member or caregiver affirms the patient’s attempts to communicate, even if the patient is engaged in a false sense of reality.
Simulated Presence: A person with moderate to severe dementia may find comfort in simulated conversations with a close friend or family member when the individual cannot be there in person. A simple audio or videotape recording of the individual recounting past events, with pauses to allow the patient to respond, provides a temporary companionship and allows caregivers to attend to other things.
Pet Therapy: Petting or watching small pets can improve the mood and behavior of dementia patients. Pets can be introduced in both group and individual settings.
Recreational Therapies: Recreational therapies include drawing, collage, coloring, sculpture, dance, and listening to music. These activities provide a creative outlet for the patient to express emotions without talking. Other benefits include mood improvement, sensory and intellectual stimulation, decreased agitation, and improved motor skills.
To learn more, call us anytime at
Caregiver Crisis Line 855-476-7600
and remember, you are not alone.