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What is Alzheimer's disease?
Alzheimer's disease is a progressive, degenerative disease that affects the brain, causing impaired memory, thinking and behavior. It is the most common form of dementia, a general term referring to loss of memory and the ability to think, reason, function and behave appropriately. As the disease progresses, people become unaware of their condition and find it extremely difficult to perform even the simplest everyday tasks. The risk of Alzheimer's disease increases with age and most people affected are over 65, although it can affect people in middle adult life. The course of the disease usually progresses over a span of 8 years from the onset of symptoms.
What are the disease symptoms?
Alzheimer's disease has a progressive onset; symptoms appear gradually during the first 2 to 4 years and are often mistaken for the early signs of normal aging. Not everyone will experience the same symptoms in the same order of progression - symptoms progress at different rates and in different patterns in each person - although there are similarities in everyone with Alzheimer's disease. Being aware of what to expect will help you understand the changes that may be occurring to you or your friend or relative.
There is a clear difference between the memory loss seen with normal aging and Alzheimer's disease. Symptoms of Alzheimer's disease fall into three main areas: cognitive difficulties (memory loss), behavioral changes and a decline in intellectual abilities severe enough to interfere with work and activities of daily living. These symptoms can be best understood in the context of the three stages in the development of the disease - early, middle and late. In the early phase, symptoms may be so slight that they go unnoticed, but as the disease progresses into the middle and late stages, they become more noticeable and start to interfere with everyday activities. Eventually, symptoms become so severe that the individual is entirely dependent on someone else to function normally.
What causes Alzheimer's disease?
The causes of Alzheimer's disease are currently being researched, but no definitive answers exist as yet. Alzheimer's disease is a disease of the brain and characteristic changes can be seen in the brain at post-mortem. These include death of cells, accumulation of protein deposits and brain shrinkage. The trigger for these brain tissue changes are not known.
Much research has been done on the genetics of Alzheimer's disease. Alzheimer's disease occurring in people in middle to late life (known as early-onset Alzheimer's disease) may be caused by specific genes. Late-onset Alzheimer's disease, occurring in the over 60s, may be influenced by the person's genetic make up, but is not caused by it. Environmental factors are also suspected to play a role in the development of the disease.
Who gets Alzheimer's disease?
Approximately 10 million people worldwide are affected by Alzheimer's disease. It is the fourth leading cause of death behind cardiovascular disease, cancer and stroke. Approximately 5 to 8% of people 65 years of age or above are affected by the disease. While the disease is most common in the elderly, it has been diagnosed in patients in their 40s and 50. Early-onset Alzheimer's disease is a very rare form of the disease and accounts for fewer than 10% of all reported cases. People who have a relative with Alzheimer's disease are more likely to develop the disease themselves. Other risk factors associated with Alzheimer's disease include head injury, diabetes, hypertension and sex - women appear to have a slightly higher risk of developing the disease than men.
Who does the disease affect?
Alzheimer's disease not only affects the person with dementia, it affects the entire family and also their friends. As the disease progresses into the later phases, and the person with the disease becomes unable to function normally, the greatest burden is placed on the caregiver. This causes the caregiver great distress; caring for a person with Alzheimer's disease wields high emotional, social and financial costs.
C. S. Lewis once wrote: 'No-one ever told me that grief felt so like fear.' Living with Alzheimer's disease brings a lot of grief and fear so this quote seems particularly relevant as it expresses how the two are so inextricably linked.
LIVING WITH AND CARING FOR A PERSON WITH ALZHEIMER'S DISEASE
Caring for someone with Alzheimer's disease can be extremely difficult at times. In your role as caregiver, it is important to bear the following in mind, in order to avoid conflict and unnecessary stress, on you and the person with the disease:
Maintain dignity. The person you care for may feel embarrassed that they can no longer perform the everyday tasks they once found easy. Remember that what you do, and say to others in their presence, can be disturbing.
Establish routines. A daily routine can provide security for the person with Alzheimer's disease and can bring order and structure to a confused daily life.
Support independence. A person with Alzheimer's disease should be encouraged to retain their independence for as long as possible. If the person likes to go shopping on their own and can still go out and return home without getting lost, let them do so. This will help maintain their self-respect and decrease the burden on the carer.
Avoid confrontation. People with the disease will invariably forget or deny that they have done something wrong or will behave badly. Do not forget that this is a problem caused by the illness; try and stay calm and avoid confrontation.
Simplify tasks. To avoid confusion and stress, keep thing simple; limit the number of choices you offer the person with the disease. This may be over simple matters, such as what they eat or even what they wear.
Improve safety. Alzheimer's disease affects physical co-ordination and memory, and the home will become a potentially hazardous place for someone with the disease. It is important that you make your home as safe as possible.
Keep active. Planned activities, such as taking daily walks or going to restaurants, can enhance a person's sense of dignity and sense of worth by giving purpose and meaning to life, as well as maintaining their existing physical and mental capabilities. This will become much harder to do as the disease progresses.
Keep communicating. Verbal communication will become increasingly difficult as the disease progresses and a person with Alzheimer's disease will begin to rely on other senses such as touch and sight. It is important that you communicate as effectively as possible during this time.
Memory aids. One of the main problems with Alzheimer's disease is the failure of short-term memory and a useful way of helping someone cope with memory loss is to create personalized 'memory joggers', such as message boards, handy lists and instruction sheets, although these will not be so useful in the later stages of the disease.
As Alzheimer's disease progresses, your loved one may not be able to function as well as he/she used to. This may cause some added frustration for both you and the person in your care. As symptoms progress, it can be difficult to know when you should step in and take over ... and how much you should take over. It can also be painful to take away the symbols of your loved one's independence. Telling them that they can no longer go to work, drive a car, or manage their own finances is very hard. And dealing with the emotions of your loved one at this time can be even harder.
The first step in deciding whether the time has come to make some changes is to get a professional evaluation. This will tell you what the person is still able to do and what they are no longer able to do. It can also stand as an 'authority,' making it a bit easier to insist on necessary changes. If a professional evaluation is not available, you and your family must thoroughly analyze each task at hand. You must think to yourselves, 'Can our loved one still do the specific task completely, safely, and without becoming upset?'
As your loved one starts to lose their ability to remember and function, it is natural for them to cling even more tightly to the things that remain. This is why many patients with Alzheimer's disease respond to these additional changes of a 'take-over' with resistance, denial, and anger. They feel that these things are being unfairly taken away. To accept that they can no longer drive a car, or take care of their finances, would mean that they would have to face the extent and finality of their illness ... something they may not want to do.
"CAN OUR LOVED ONE STILL DO THE SPECIFIC TASK COMPLETELY, SAFELY, AND WITHOUT BECOMING UPSET?"
Below you will find some ways of handling these situations. We hope that they will help you in your discussions with your loved one and with other family members when making such difficult decisions.
When your loved one needs to give up their job.
Deciding when your loved one should give up their job depends on two factors: the type of job they have and whether they need to drive to their job. If your loved one is in a job that is too demanding for their current level of functioning, they may need to retire. And sometimes, your family may need to make this decision.
"IF YOUR LOVED ONE HAS TO GIVE UP THEIR JOB, YOU WILL NEED TO PAY ATTENTION TO THE EMOTIONAL AND PSYCHOLOGICAL DURESS THAT WILL BE INVOLVED"
Think about this... your job is a main part of who you are. And by maintaining a job, you feel that you are a valued member of society. Now, imagine being told that you need to give it all up. If your loved one has to give up their job, you will need to pay attention to the emotional and psychological duress that will be involved, not to mention the financial changes as well. The person with Alzheimer's disease will not let go lightly, and being forced to adjust to retirement will be a painful and distressing time. If it is requested that your loved one retire, you may want to consider bringing them to a counselor or social worker - they can be invaluable in helping you and helping the person in your care.
Financial planning also needs to be considered when your loved one must leave their job. Individuals who need to retire early may suffer a loss of income and financial planning may be necessary. You may be able to get assistance from the government.
When your loved one can no longer manage their finances, When your loved one is diagnosed with Alzheimer's disease, it may be wise to inquire about their financial resources. Knowing where the bank books, check book, insurance policies, stock certificates, real estate property, and retirement or disability benefits are located will help you handle things more effectively in the future.
As the disease progresses, your loved one may become anxious or suspicious about their finances. If they are no longer able to manage their checking account, and you need to take it away against their wishes, they may accuse you of 'stealing' from them. It may help to leave a note where your loved one keeps their checkbook that reads, 'My daughter Christina now takes care of my checkbook.' This will help refresh the patient's memory of why the checkbook isn't in its place.
My Daughter takes care of my checkbook now!
If your loved one is losing their wallet or purse, you may want to replace their credit cards and money with a small amount of spending money, such as some small change or low currency bills. This way your loved one will feel that they have money, and it will help with conflicts between the two of you.
When your loved one can no longer drive
A diagnosis of Alzheimer's disease does not mean a person has to stop driving at once. The loss of driving skills may be gradual. The person with Alzheimer's disease may recognize this and limit driving to familiar places or choose to stop driving if he or she feels a decline in ability. This, however, is often not the case. Driving means independence and mobility, and most people find it difficult to give up. Therefore, you may be the one who will need to monitor the person's driving ability and determine when driving becomes unsafe.
When deciding whether or not the person should continue to drive, let the person with Alzheimer's disease participate in the discussion. Discuss the problem frankly and present your view in a way that will not cause the person to lose face or become defensive. A person with Alzheimer's disease is less likely to accept criticism as well as he or she did before the illness. If you are having difficulty stopping the driver, get support from their doctor. Having the doctor write, 'Do not drive' on a prescription pad may make the patient more receptive to the idea, and will take the pressure off you.
If the patient continues to drive, even after their driver's license has been revoked and they were told not to, you might want to try some of the following strategies:
* Park the car down the street or where it will not be seen
* Keep car keys with you at all times or hide them
* Leave your extra set of keys with a friend or neighbor
* Change the ignition key to prevent access
* Ask a mechanic at your local service station how to disable a car.
What is autism?
Autism is a type of pervasive developmental disorder (PDD). It interferes with a person's ability to communicate with and relate to others. Autism is a lifelong condition that results in some degree of social isolation.
Autism affects how a person perceives and processes sensory information. Signs of autism almost always develop before a child is 3 years old, although the condition is frequently not diagnosed until later. Typically, parents first become concerned when they notice their toddler does not respond or interact like other children of the same age. Toddlers with autism do not usually babble or talk normally, and may seem to have hearing problems.
The severity of autism varies. Some individuals need assistance in almost all aspects of their daily lives, while others are able to function at a very high level and can even attend school in a regular classroom. Although it is difficult to determine, studies show that below-normal intelligence occurs in about 70% of autistic children.1 In addition, the social functioning of autistic children is less than what is expected for their intelligence quotient (IQ) levels.
What causes autism?
Most research suggests that people with autism have irregular brain structures. More study is needed to determine the cause of these irregularities, but current research indicates they are inherited. Parents who have had one child with autism are more likely than other couples to have a second child with autism.1
What are the symptoms of autism?
All people with autism have difficulty with social interactions and relationships. Parents often describe their child with autism as preferring to play alone and making little eye contact with other people. Other symptoms of autism include:
* Difficulties with verbal and nonverbal communication. Language development in children with autism is almost always delayed.
* Limited, repetitive, and overused (stereotyped) patterns of behavior, interests, and play. Many typical behaviors such as repetitive body rocking, unusual attachments to objects, and holding fast to routines and rituals-are driven by the need for sameness and resistance to change.
There is no standard or "typical" person with autism. Although autism is defined by the above characteristics, people with autism can have many different combinations of behaviors in mild to severe forms.
Do any other conditions occur with autism?
Many people with autism also have other conditions, such as below-normal intelligence or mood problems. Teenagers with autism often develop depression, especially if they have average or above-average intelligence. In addition, about 1/3 of children with autism develop a seizure disorder (such as epilepsy) by their teen years.2
How is autism diagnosed?
A health professional will evaluate a child suspected of having autism or another developmental delay using the diagnostic guidelines established by the American Academy of Child and Adolescent Psychiatry (AACAP). These criteria are generally used to evaluate a child for autism who does not interact with or socialize normally for his or her age. A child may also have hearing and other tests to make sure developmental delays aren't the result of another condition with similar symptoms. Early diagnosis and treatment of autism is important to make the most of the child's potential.
How is autism treated?
Behavioral training, specialized therapy, parent education and support, and sometimes medications can often improve an autistic child's problem behaviors, communication skills, and socialization. A child with autism responds best to a highly structured, specialized educational program tailored to his or her individual needs. However, specific treatment varies depending on the range of individual symptoms, which can combine in many different ways and change over time.
Parents, school staff, and health professionals are usually all involved in planning a child's treatment.
Early diagnosis and treatment helps young children with autism develop to their full potential. And LifeSource's Memory Enhancer & Brain Connector has shown great results for Autism in children. It helps the blood flow to the brain, which strengthens the brain, and its functionality.