Caring for Someone with Alzheimer’s Disease

Are you caring for someone with Alzheimer’s disease? Here’s what you should know.

 

Caring for someone with Alzheimer's diseaseIt is common knowledge that Alzheimer’s disease affects a person’s memory, cognition and ability to reason. People with Alzheimer’s disease can however also become listless, agitated, stubborn, depressed, anxious and even violent. Furthermore, they may suffer from hallucinations – experienced as pleasant and/or frightening. During the final stages of the disease, Alzheimer’s patients need full-time care and supervision, as they aren’t able to perform even relatively simple tasks, such as taking a bath, dressing, shopping, cooking or using the phone.

Are you caring for someone with Alzheimer’s disease? The tips below will help you with what can be a challenging journey. Just remember that each person with Alzheimer’s is as unique as a snowflake – which means that the tips given here may not work for everyone.

Tips for caregivers:

  • If the person becomes angry or present with combative behaviour, give them space by leaving the room. Only return when they have calmed down.
  • Don’t try to argue. People with Alzheimer’s disease have lost their ability to reason.
  • Allow strange behaviour if it doesn’t affect others. It’s their way to make sense of their “new” environment among “new” people. Typical behaviour may include repeatedly packing and unpacking a suitcase, sorting out a wardrobe, or hiding a handbag under the bed. Always ask yourself, “Does it matter?”
  • Be aware that strange behaviour could be their way of telling you, the carer, that something is wrong. The person might suddenly shout, hit something, swear, cry or laugh out loudly. Try to work out what is wrong, respond to possible emotions they’re feeling at the time of the incident, and then try to distract them.
  • If you can determine what triggers these reactions, you can try to prevent it or keep the person calm when the trigger occurs. This can be anything – from a hallucination to being thirsty or wanting to go to the toilet.
  • People with Alzheimer’s disease often get agitated because they struggle to complete simple tasks. When you show or tell them how to do something, it’s important that you relay the steps one by one, allowing enough time between each step for the person to absorb the information. Be patient!
  • Don’t give the patient too many choices. Rather ask, “Do you want to wear this dress?” instead of “Which dress would you like to wear?”
  • Don’t change familiar routines.

 

If the person with Alzheimer’s disease tends to wander or walk away:

  • Try to find a solution to let them do so safely, for example allow then to wander into a secure garden.
  • If the person is determined to leave, don’t confront them, as this could cause extreme anxiety, which may result in aggression. Rather accompany them for a short way, then divert their attention so you can both return.
  • Make sure the person carries some form of identification such as a MedicAlert bracelet, or a card with a name and contact details.
  • Attach a little bell to outside doors to alert you when they’re opened.
  • Tell your neighbours about the situation and ask them to give you a call if/when they spot the patient outside.
  • Lock the door, if absolutely necessary, but never lock a person with dementia alone in the home. The decision must be taken in the best interest of the patient. A too restricted environment causes boredom with resulting frustration that may lead to aggressive outbursts.
  • Encourage friends and family to come and visit. Alzheimer’s patients often walk away in the hope of getting to see their loved ones. These visits also help to allay boredom.

 

Source: http://www.health24.com/Medical/Alzheimers/Looking-after-your-loved-one/Caring-for-someone-with-Alzheimers-disease-20130909

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Caffeine Withdrawal a Mental Disorder?

By Gina Ulery

caffeine-withdrawalCaffeine is the most widely used behaviorally active drug in the world and is present in many different types of beverages, foods, energy aids, medications, and dietary supplements. Because caffeine ingestion is often integrated into social customs and daily rituals, some caffeine consumers may be unaware of their physical dependence on caffeine. It is estimated that more than 85% of adults and children in the US regularly consume caffeine.

For anyone who has ever tried to quit drinking their favorite caffeinated beverage (my guilty pleasure is fountain soda), you know the associated pains. Headache, fatigue, difficulty concentrating, moodiness, irritability, etc.

The new DSM-5 classifies caffeine withdrawal as a potential disorder (page 506-507 if you don’t believe me). Symptoms usually begin 12-24 hours after the last caffeine dose and peak after 1-2 days of abstinence. Caffeine withdrawal symptoms typically last for 2 to 9 days, with the possibility of withdrawal headaches occurring for up to 21 days.

Gradual reduction in caffeine is suggested to reduce the incidence and severity of withdrawal symptoms.

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Sleep Less, Eat More, Gain Weight

By Carrie Gann

Obesity linked to hormonal changes, lack of sleep

We’ve all heard about the importance of getting a good night’s sleep, and now scientists offer more evidence to back that up. A new study found that people who get less sleep may be inclined to eat more, move less and gain weight.

Scientists at the Mayo Clinic in Rochester, Minn., studied a group of 17 healthy volunteers between the ages 18 and 40 for a week in their homes, monitoring how much each one typically slept and ate. Then, they brought the volunteers into the clinic’s research lab for eight days: Half of the volunteers were allowed to sleep according to their usual pattern, and the other half got only two-thirds of their usual shut-eye.

All the volunteers were allowed to eat as much food as they wanted from the hospital cafeteria or from outside the research center. The researchers also measured how much energy each volunteer expended each day.

The sleep-deprived participants wolfed down an average of 549 calories beyond their usual intake but burned no more calories than their well-rested peers.

“A lot of people have this idea that if they’re up late, working hard, they’re burning more energy. But we found no change in how much they moved when sleep deprived,” said Dr. Andrew Calvin, lead author of the study and an assistant professor of medicine at the Mayo Clinic. “They’re consuming an additional 549 calories per day, but not burning any of them off.”

Those excess of unburned calories is a surefire way to gain weight, which numerous studies have connected to a variety of chronic health problems.

The volunteers who got less sleep also had higher levels of leptin, a hormone that suppresses appetite, and lower levels of ghrelin, a hormone that stimulates appetite, in their blood. The findings seem counterintuitive to what researchers would expect in people who are hungrier, but Calvin said the hormones were most likely an outcome, rather than a cause of people eating more.

Scientists have previously studied the physical downsides of getting too little sleep.

In 2011, Australian researchers found that adolescents and teenagers were more likely to be slimmer if they went to bed earlier, while those who stayed up late were more likely to engage in sedentary activities.

Previous studies have also found that workers covering late and overnight shifts were more likely to be obese and have type 2 diabetes, which may be associated with unhealthy eating habits, according to an editorial published in December.

The connection between sleep and weight may be important for the more than one-quarter of Americans who get six hours of sleep or less every night. Calvin said the future research on how sleep affects eating habits may give scientists useful insights into two of America’s biggest health problems: sleep deprivation and obesity.

“This study, while small, suggests that these two may indeed be linked, and if the findings are confirmed, they may suggest that sleep is a powerful factor in how much we eat and our chances of gaining weight,” he said.

Source: http://abcnews.go.com/blogs/health/2012/03/14/sleep-less-eat-more-gain-weight/

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Skin Cancer Drug Reverses Alzheimer’s in Mice

Skin cancer drug reverses Alzheimer's in miceScientists say they “serendipitously” discovered that a drug used to treat a type of cancer quickly reversed Alzheimer’s disease in mice. “I want to say as loudly and clearly as possible that this was a study in mice, not in humans,” he said. “We’ve fixed Alzheimer’s in mice lots of times, so we need to move forward expeditiously but cautiously.”
Via edition.cnn.com

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Alzheimer’s Caregivers: Sandwiched Between Parenting Your Kids and Your Parents

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Caring for kids and a loved one with Alzheimer’s, too? Here’s how to make it easier — for everyone.
Via www.webmd.com

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Drugs That Fight Herpes May Thwart Alzheimer’s Disease

Via Scoop.itHealthcare Continuing Education

The herpes simplex virus type 1 (HSV1), the virus that causes most cold sores, has previously been tied to the development of Alzheimer’s disease. Antiviral drugs used to combat herpes virus infections could slow the progression of Alzheimer’s disease, a new study suggests.
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Will We Cure Alzheimer’s?

Via Scoop.itHealthcare Continuing Education

At first, Alzheimer’s was regarded as a subcategory of dementia. But, more and more, the label came to apply to ALL older people who “lost their wits,” as the experience used to be described. And, with the greater diseasification, came the hope–the belief–that senility was on the verge of being cured.
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No Health Without Mental Health

By Thomas R. Insel, MD (NIMH Director)

Mental Health in US

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Five years ago, Colton and Mandersheid surveyed mortality data from eight states and concluded that, on average, Americans with major mental illness die 14 to 32 years earlier than the general population. The average life expectancy for people with major mental illness ranged from 49 to 60 years of age in the states they examined — a life span on par with many sub-Saharan African countries, including Sudan (58.6 years) and Ethiopia (52.9 years). Average life expectancy in the United States is 77.9 years. It would appear that the increase in longevity enjoyed by the general U. S. population over the past half century has been lost on those with serious mental illness (SMI). In fact, this drop in life expectancy due to mental illness would surpass the health disparities reported for most racial or ethnic groups. Yet this population is rarely identified as an underserved or at-risk group in surveys of the social determinants of health.

Why is there such a profound disparity in life expectancy for those with SMI? Disorders such as schizophrenia, major depression, and bipolar disorder are risk factors for suicide, but most people with SMI do not die by suicide. Rather, the 5 percent of Americans who have SMI die of the same things that the rest of the population experiences — cancer, heart disease, stroke, pulmonary disease, and diabetes. They are more likely to suffer chronic diseases associated with addiction (especially nicotine), obesity (sometimes associated with antipsychotic medication), and poverty (with its attendant poor nutrition and health care) and they may suffer the adverse health consequences earlier.

The risks are striking. People with a mental illness are more than twice as likely to smoke cigarettes and more than 50 percent more likely to be obese compared to the rest of the population. But this only partly explains the premature mortality. Recently, when Druss and colleagues analyzed the early mortality data derived from a nationally representative survey, they found three drivers: clinical risk factors, socioeconomic factors, and health system factors.

The clinical risk factors include the frequent co-occurrence of mental illness with heart disease, diabetes or other medical conditions, generally referred to as “comorbidity.” For example, people with major depressive disorder are at higher risk for cardiovascular disease and stroke. Conversely, for those who have had a heart attack, experiencing depression increases their risk for cardiac-related death three-fold, more than any cardiovascular variable except congestive heart failure. And people with diabetes have double the risk for depression. We do not fully understand the relationship between diabetes or heart disease and depression, but current thinking attributes the increased risk to both depressive behaviors (e.g., poor diet, low activity, low adherence to treatment) as well as some common biology such as elevated inflammatory factors.

While we are still trying to understand the cause of comorbidity between mental disorders and other health problems, the health system factors may offer a better short-term target for change. Few people in the public mental health care system are receiving high quality health care.

The Patient Protection and Affordable Care Act outlines a specific model of integrated care, the patient-centered medical home (PCMH), which could improve access and quality of health care to those with multiple chronic disorders. The PCMH model includes comprehensiveness, holistic patient-centered care, and, emphasis on care in the community. The Centers for Medicare and Medicaid Services has been tasked with piloting a series of PCMHs and studying their impact over the coming years with the goal of wider dissemination in the future. Knowing that people with SMI are a high risk group for multiple chronic disorders and targeting the PCMH for their specific needs could be an effective approach to improving health outcomes for the entire population.

Short of a new health care system, there are models for improving health outcomes for people with mental illness. Collaborative care, in which primary care and mental health providers work closely together to deliver effective treatments within the primary care setting, represents a fundamental change toward addressing mental disorders in conjunction with other physical conditions. Over the past two decades more than 40 research trials have demonstrated the effectiveness of the collaborative care model. In the case of major depression, for example, studies have shown collaborative care programs to be an effective approach for treating depression alongside other conditions, and to be more cost-effective than standard treatment. A recent study indicates that implementing this approach for depression in the Medicare system would result in cost savings of approximately $15 billion annually.

Collaborative care for depression and diabetes or depression and heart disease is the proverbial low hanging fruit. What about schizophrenia and bipolar disorder, which are usually treated in specialty mental health clinics rather than primary care? Is it better to add primary care capacity to the behavioral health center or to integrate patients with SMI into primary care? Can our current system, which separates behavioral health from health care, ever be “equal” in quality or outcomes? These remain research questions of urgent importance.

The unavoidable fact is that we will not improve overall longevity or contain health care costs in this nation without addressing the needs of the nearly 5 percent of Americans with serious mental illness. This is a population that not only dies early; they have multiple chronic diseases requiring expensive care, often in emergency rooms and intensive care units. We need better strategies for dealing with this urgent public health issue and we need to ensure that whether these strategies are collaborative care for depression or an innovative medical home for those with serious mental illness, we implement these interventions where the need is greatest.

Source: http://www.nimh.nih.gov/about/director/2011/no-health-without-mental-health.shtml

 

 

 

 

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Understanding Alzheimer’s Disease

Via Scoop.itHealthcare Continuing Education
Understanding Alzheimer's Disease
Free resource from the National Institute on Aging

Many older people forget someone’s name or misplace things from time to time. This kind of forgetfulness is normal. But, forgetting how to get home, getting confused in places a person knows well, or asking questions over and over can be signs of a more serious problem. The person may have Alzheimer’s disease, a disease of the brain that begins slowly and gets worse over time.

This colorful, easy-to-read booklet helps readers learn about Alzheimer’s disease:

  • What it is
  • Signs of the disease
  • When it is important to see a doctor
  • Treatment
  • Research studies
  • How to get help caring for a person with the disease

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Alzheimer’s Continuing Education

Alzheimer's Continuing Education

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Alzheimer’s currently affects one in 10 people over age 65 and nearly half of those individuals over 85. With such an outlook, it’s imperative that healthcare professionals stay current on the research and best practices for treatment and caregiving.

Professional Development Resources offers online continuing education courses to address this growing topic:

Alzheimer’s Disease & Related Disorders (ADRD) – This course provides an in-depth discussion of the management of Alzheimer’s Disease or Related Disorders (ADRD), including disease progression and strategies for care. It considers all aspects of ADRD, including the various stages of the disease, problem behaviors, communication issues, ethical considerations and appropriate activities. In addition, strategies are presented for working with families and caregivers of ADRD patients. 2006 | 47 pages | 27 posttest questions | 3 hours CE

Alzheimer’s Disease: Nutrition Intervention Strategies – Alzheimer’s disease is a disorder of forgetfulness that eventually impacts a person’s ability to participate in activities of daily living. It takes a devastating toll on both patients and those who care for them. Those with Alzheimer’s disease experience immense fear and frustration as they struggle with simple tasks. Family, friends, and caregivers experience pain and stress as they watch Alzheimer’s disease slowly take their loved ones away from them. Many individuals with Alzheimer’s disease and other forms of dementia are cared for in institutional settings. Nutrition plays an important role in meeting the needs of such persons. This course will familiarize readers with the early warning signs of dementia, discuss the pathophysiology of Alzheimer’s disease, identify pharmacological, environmental, and behavioral interventions used at various stages of the disease, and describe nutrition-related complications and intervention strategies. 2002 | 15 pages | 12 posttest questions | 2 hours CE

Alzheimer’s Disease – Overview – Alzheimer’s disease is an increasing concern for the aging American population. It is important for healthcare providers to have a basic familiarity with the disease, in order to provide adequate diagnosis, treatment, and referrals. This course, based on documents from the National Institute on Aging and the Alzheimer’s Association, provides an overview of the prevalence, causes, symptoms, diagnosis, treatment, and progression of Alzheimer’s disease, as well as information about caregiving and caregiver support. As such, this course is relevant to all clinicians who work with elderly individuals, their families, and their caretakers. Course #10-39 | 2010 | 34 pages | 7 posttest questions | 1 hour CE

Alzheimer’s – Unraveling the MysteryAlzheimer’s dementia is a growing concern among the aging Baby Boomers; yet, modern science points the way to reducing the risks through maintaining a healthy lifestyle. This course is based on a publication from the National Institute on Aging, which describes healthy brain functioning during the aging process and then contrasts it to the processes of Alzheimer’s disease. Full of colorful, detailed diagrams, this educational booklet describes the risk factors for Alzheimer’s disease, effective steps for prevention, strategies for diagnosing and treating Alzheimer’s disease, and the search for new treatments. Strategies for caregivers and reducing caregiver stress are also discussed briefly. Course #30-54 | 2008 | 43 pages | 21 posttest questions | 3 hours CE

Caring for a Person with Alzheimer’s Disease – This course is based on the public-access publication, Caring for a Person with Alzheimer’s Disease: Your Easy-to-Use Guide from the National Institute on Aging. The booklet discusses practical issues concerning caring for someone with Alzheimer’s disease, including a description of common challenges and coping strategies. Advice is provided regarding keeping the person safe, providing everyday care, adapting activities to suit their needs, and planning ahead for health, legal, and financial issues. Chapters also discuss self-care for caregivers, sources of assistance for caregivers in need, residential options for care, common medical issues, and end-of-life care. This course is relevant to clinicians who work with elderly individuals, their families, and their caretakers. Course #30-59 | 2010 | 146 pages | 22 posttest questions | 3 hours CE

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