Practical tips for Alzheimer's
Caregivers
(c) 2005 Mayo Foundation for Medical Education
and Research. All rights reserved.
Each person with Alzheimer's disease experiences its symptoms
and progression differently. Consequently, caregiving techniques
also should vary. The following tips may work for you as you adapt
them to your specific situation.
Assess independence
In the early stages of Alzheimer's, your loved one may still
be able to perform the tasks that allow a person to live and function
independently. Inevitably, though, as the disease progresses and
cognition declines, these responsibilities increasingly will fall
to you.
Frustration, agitation and even aggression are common reactions
when tasks that once came easily become difficult for someone
with Alzheimer's. As you help your loved one with eating, bathing,
grooming, dressing and going to the bathroom, find ways to make
his or her limitations less frightening and frustrating for both
of you. Try to:
Involve your loved one in tasks as much as possible. Some people
can still choose an outfit if they're given only two choices,
rather than a closet full of clothes.
Reassess the level of assistance that's required daily. For example,
can your husband shave by himself if you set out his supplies?
Or can he shave by himself if you turn on an electric razor and
put it in his hand? Or does he need you to provide assistance
with the entire task?
Strive for balance between periods of rest and activity. Minimize
activity later in the day when your loved one is more likely to
be tired.
Create a safe environment
Alzheimer's disease impairs judgment and problem-solving skills.
You can modify the home environment to help your loved one maneuver
within it as easily and safely as possible. Here are some suggestions:
- Remove throw rugs, extension cords and any clutter that can
cause your loved one to trip and fall. Avoid rearranging the
furniture.
- Install locks on cabinets that contain medicine, alcohol,
guns, toxic substances, dangerous utensils and tools. Install
handrails to prevent falls.
- Make sure there is a first-aid kit, a fire extinguisher and
working smoke alarms in the home. If your loved one is a smoker,
don't allow him or her to smoke alone, and control the matches
or lighters yourself.
Remove plug-in appliances from the bathroom to avoid the risk
of electric shock, and set the temperature on the water heater
no higher than 120 F to prevent burns.
- To reduce the risk of wandering, put a slide bolt high on
every door that leads to the outside or to a stairwell, or use
a deadbolt that requires a key. Never leave your loved one alone
when you use these measures. If your relative can no longer
drive, control access to car keys and keep the car out of sight.
Adjust your expectations
It's important to have realistic expectations of your loved
one's abilities and behavior. Consider these tips to help you
modify your expectations:
- Allow more time to accomplish everyday caregiving tasks. Simplify
the tasks and provide instructions one step at a time.
- Try not to worry about the way things "should"
be done. If no danger results from your loved one's actions,
refrain from correcting them.
- Try to stay flexible. If your loved one refuses to do something,
back off and try again later using a different approach. Most
tasks don't need to be done immediately. You're more adaptable
than is the individual with Alzheimer's.
Limit distractions
Along with a sense of routine, a serene environment can reduce
some behavior problems. Noise, large groups of people, changes
in surroundings or pressure to perform a task can cause anxiety
and further compromise your loved one's ability to think clearly.
To help limit distractions:
- Shut off the television and limit background noise to soft
music without commercials.
- Encourage visitors to call before they come, and limit the
number of people at gatherings. You may want to encourage short
visits so that your loved one doesn't feel overwhelmed.
- If your loved one attends a large gathering, reserve a quiet
room for him or her to relax in. Keep track of the stimulation
from music, television, conversation and meal preparation. If
it's getting too noisy, tone things down or encourage your loved
one to rest in the quiet room.
Promote communication
Your loved one's ability to use language to communicate decreases
as the disease progresses. You may have difficulty understanding
what he or she says. You may also find it difficult to speak to
your loved one in a way that he or she can comprehend. Either
of these situations can be frustrating and may make your loved
one agitated or even aggressive.
Behavior often becomes the route by which people with Alzheimer's
communicate their feelings and needs. To understand a behavior,
consider what your loved one may be feeling. For example, if your
wife is in a care center and is asking to go home, imagine what
home may symbolize to her. Home is often associated with comfort,
familiarity, safety and belonging. If you can make her surroundings
at the care center more homelike, she may calm down. If your wife
is pacing, it might mean she is tired, feels hungry or needs to
use the bathroom.
Above all, your approach to communication should include patience,
understanding and listening.
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