ASOCIACION DE ALZHEIMER DE PUERTO RICO

 

TAKING CARE OF THE ALZHEIMER'S PATIENT

Understanding the Caregiver

Frequently the caregiver has had a bad day or night, and the first person they see can receive the brunt of their frustrations. Just as frequently, the caregiver displays his anger with words.

If we are treating families that have a heavy emotional and/or financial burden, we must be ready and have the ability to accept these reactions. We know that the their anger is not necessarily directed at us, but they have to vent out their frustrations because of "the situation that they find themselves in".

 MENU 

Speaking to an Alzheimer's patient. Do no speak with a loud voice.  A loud voice may alter the patient's patient behavior. Too many words add to the confusion of an already confused person. Say what is necessary, but do not repeat the same sentence, or use additional words when it is not necessary.

Actions and movements must be unhurried. If some members of the family are worried or tense for whatever reason, they must go to another area, away from the sick person, until they feel calm again. The classic Alzheimer's patient reacts to a person under tension, as if they feel the tension. On the other hand, they react calmly with pleasant and happy people.

Frequently the patient accuses the caregiver or family member from stealing something from them. They are very untrusting of new people, and sometimes even to members of their own family.

One of the symptoms of the patient with Alzheimer's is the development of a special close relationship to a certain person. Frequently the caregiver cannot leave the patient alone not even to use the restroom. This symptom is evident when a patient follows a member of the staff constantly throughout the facility.

A patient with Alzheimer's has lost the capacity to know how to determine if there is something on the other side of the wall; such as a baby. They believe that the caregiver has left forever whenever they don't see him/her, even if it is for a moment.

Communication

The typical Alzheimer patient never uses proper names in his conversation. He will refer to "her, him, that thing, that one, above over there, down over there, you know what I mean". Instead of referring to his wife, for example, he will say "that lady" or "mother" and if it is his daughter he might say "that little girl". Sometimes it is as if he were in a riddle. Don't loose patience. Don't correct him. Don't show surprise or worry. If you don't understand what the patient is saying, focus on what you do understand.

If a patient leaves his home (facility, house or other)

Do not react too quickly, or get too excited. It is important to remember that if a staff member reacts this way, the patient may walk even faster. Remember that the patient is looking for something. (Some investigators believe that subconsciously, what they are looking for is their mind that they had before being affected by Alzheimer's) What to do: Walk after him. Do not shout. Do not grab him. Try to go two or three steps in front of him, that way you can look him straight in the eyes, and then, using a calm voice and in low tones, speak to him until you convince him to come back with you into the building. Sometimes, in cases where care has been in the nursing home for a prolonged period, you must walk two blocks before getting the patient to come back and return. Do not touch him unless he lets you take his hand, while you walk back. This last point is very important.

Improper Sexual Conduct

Professional caregivers sometimes find themselves in this situation. Do not react against the patient, it doesn't matter what he or she is doing. Slowly, take him to another area, without calling attention to his behavior. If a staff member sees that he approaches someone in such a way that it indicates sexual conduct, distract him and change the scene.

Catastrophic Reactions

If a patient becomes very difficult, leave him alone. If he appears anxious or hostile (for example, when they change his pad for incontinence), leave him alone for about five minutes and later come back to him. Usually by then he will have forgotten the earlier incident and can finish the task.

Remain calm if the patient becomes aggressive, do not react. Do not argue, and do not hit him back. Not reacting is the most difficult task asked of the caregiver. Normally, what he wants to say is "You hit me, don't do it again!" But we know that that person never would have done such a thing, if they were normal.

Maintain visual contact and do not touch him. If it is necessary, leave the room. The catastrophic reaction usually occurs when the patient feels overwhelmed and is being asked to do more than what he can.

If you have not yet tried to see what is happening to him, or you don't know what is causing the hostility or the bouts of anger, check around the area. Sometimes there may be something as simple as a radio with the volume too high, or with salsa or merengue music, and since he cannot put into words his distaste, he becomes hostile.

Another possibility is the room. Bright colors are not good for the Alzheimer patient, except for things to do by hand. Primary colors are good for infants, but not for the Alzheimer patient. Calm colors are preferable. Take the patient to a peaceful room and try to calm him down. The only thing you have to do is look around and listen. Usually you can find the cause of the agitation in the patient. It is very important that the caregiver never get excited. Always maintain a calm voice.

Going around in circles around the room or the house is normal for the Alzheimer patient. You must not worry about this.

Always remember that the patients are very important people. In many cases, they have been productive citizens. They were "someone" and they earned the respect of the community. They deserve that respect now. THEY ARE NOT CHILDREN OR BABIES. They are adults and it is important to remember that, because they have to maintain their self-esteem, their dignity, and they must not be treated in a condescending way.