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
neighbour
• Change the ignition key to prevent access
• Ask a mechanic at your local service station
how to disable a car.
Autism
Topic
Overview
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 it’s functionality.
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