Alzheimer’s Disease: Effects On The Impaired Individual & Caregiver

By Al Mayer LCSW and Gail Mayer MSW

Although there are many diseases that create memory problems, Alzheimer’s is probably the most familiar. Over a period of approximately ten years, the progressive loss of memory resulting in impaired thinking and abnormal behavior is devastating to the individual. But simultaneously the caregiver is grieving over the loss of that person who was but no longer is and then must learn lovingly to accept the impaired person as he or she is.

The first stage symptoms include confusion, getting lost, personality changes including anxiety and withdrawal, poor judgment and bad decisions, taking longer with routine chores and having trouble managing money and paying bills and finally loss of spontaneity of zest for life.

The second and longer stage requires full-time caregiving. Symptoms include repetitive speech, afternoon and night restlessness or wandering; increased memory loss and confusion; shorter attention span; inability to recognize familiar people; problems with reading, writing numbers, organizing thoughts, and thinking logically; may be suspicions, fidgety, loss of impulse control and appropriate hygiene and manners.

The inability to communicate verbally or nonverbally can be very frustrating and can cause agitation. Factors that also contribute to agitation include sensory impairment (loss or change in one of the five senses, mostly vision or hearing), physical discomfort (hunger, wet), overstimulation or understimulation (too noisy or boring).

Caregivers must find effective ways to communicate and assist the impaired person. A caregiver can show how the task can be done and then help the individual follow instructions through pictures or gestures. Useful memory aids include a prominent clock, larger wrist watch, a calendar with days marked to keep track of time.

A list of the day’s activities including meal times and menus can be posted on a bulletin board. Assisting and dressing can include laying out underwear first, then outer clothes, and finally socks and shoes.

At meal time, present one course at a time and when finished offer the next. When the person can no longer use utensils, finger foods such as sandwiches cut into small pieces help.

Caregivers can assist with group activities including gardening and music. Shuffleboard is a simple adult game. At social gatherings conversations can revolve around reminiscence about past events. If a word is lost supply a gentle cue.

Tips on communication include the following: use a slightly louder than usual tone of voice, speak to the person at eye level, break down your request into one or two-word instructions. Whatever method is used and whatever activity is attempted remember the impaired individual has a short attention span, usually less than 30 minutes.

Caregivers should learn all they can about the disease because they face enormous challenges that can create emotional, physical, social, and financial stress. It requires sacrifices, changes in priorities, and changes in roles.

Caregivers must forgive themselves for their own mistakes or outbursts because the impaired person has already forgotten. Caregivers must remind themselves that they are only human. Caregivers must maintain relationships. They must take care of their own health: rest, exercise, nutritional diet, respite time away from the individual. Although impaired individuals have gone through drastic changes it is the caregivers who must alter their own expectations and reactions. Above all caregivers should maintain a sense of humor and a compassionate flexible nature. Those qualities will empower the caregivers and enable them to provide quality care to their loved ones.

Gail and Al Mayer are social workers and also managers of Griswold Special Care in Stratford, an international nonmedical 20-year-old home-care agency committed to providing compassionate, affordable quality care to elderly and disabled individuals in their homes.