The Different Ways to Support and Cope With Advanced Alzheimer’s Disease
Alzheimer’s disease is progressive, which means it will get worse in stages over time. In the early stages, when it is just beginning, symptoms might be mild; however, in the late stages, people with dementia often depend completely on others for support with basic activities of daily living.
Alzheimer’s disease is a brain disorder that slowly destroys memory and cognitive skills. Over time, physical symptoms develop, and it affects the ability to carry out straightforward tasks. As it progresses and your loved one’s symptoms and abilities change, you will need different information to help you support them. By learning how the disease progresses, it can help you plan for the future.
Advanced Alzheimer’s disease can bring many changes for your loved one that you may not have thought about. Caregiving for someone in this later stage can become even more challenging.
The Different Ways You can Support and Cope With Advanced Alzheimer’s Disease
A diagnosis of Alzheimer’s can be overwhelming for both the person diagnosed and their family. There is a lot of information to take in, but you can take it one step at a time. Only you can decide when it is the right time to seek more information. Support is available when you decide to find out more.
1. Emotional Support
In the late stages, a person with Alzheimer’s may be experiencing distressing symptoms such as severe impairment in memory, the inability to process information, disorientation to time and place, and difficulty producing recognizable speech. The patient might also have difficulties recognizing family members. These all have a significant emotional impact, as the person has to rely fully on other people for support either in a long-term care facility or with full-time care at home.
When offering emotional support to someone with late-stage Alzheimer’s disease, consider their life history, feelings, likes, and dislikes. Two ways to connect with and emotionally support someone with advanced Alzheimer’s are:
You can reminisce with someone by sharing stories, photographs, and videos of past events. Remember the good, the happy, and the enjoyable times. Reminiscing is a way of giving a person validation. It shows them that you see them. It validates their being and their history.
- Engage their senses
Verbal communication can become challenging in the late stages of Alzheimer’s. However, there are other positive ways to communicate and connect through the senses:
- Talk to them about everyday things. Just let them hear the sound of your voice and include them in your daily news.
- Putting on music is also a great way to comfort someone. Pick the music they have always loved and enjoyed listening to.
- Television or videos can be soothing to watch.
- Getting outside stimulates all the senses. Sitting in the garden together is time well spent, especially if they can smell their favorite flowers nearby and hear the birds singing.
- Use the sense of touch. Hold their hand or help them stroke their beloved pet.
2. Physical Support
When reaching the advanced stages of Alzheimer’s, people cannot communicate and will rely on others for all their care. Physical symptoms such as being unable to walk, unable to sit without support, and difficulty swallowing develop in the latter stage of the disease.
Due to the extensive care requirements faced, it may not be possible to provide the required level of care at home, even with additional support services. To ensure your loved one gets the care they need, a long-term care facility may end up being the best option for your family.
This can be a tough decision and may differ from the plans you had decided on in earlier stages. Regardless of where the care takes place, the decision is about ensuring the person with Alzheimer’s receives the right level of care to meet all their needs.
Whether care takes place at home or in a facility, the main objective should be enhancing the quality of life. If you decide that care at home, with assistance, is the best option, it’s useful to consider the following physical problems:
- Movement and Comfort
When a person with Alzheimer’s loses the ability to move independently, it is important to speak to the medical team about the support available to you. The doctor can organize referrals to relevant healthcare professionals such as a physical therapist, nurse, home health aide, or occupational therapist. They can advise you on:
- How to move a person safely without hurting yourself or them
- How often you should help them change position
- Special mattresses and pillows that help with positioning and reduce the risk of bedsores
- Special chairs and wheelchairs for sitting
- How to do range of motion exercises to prevent stiffness and bedsores
- Nonverbal Signs
During all caregiving activities, it is essential to pay attention to nonverbal signs. Signs of pain or discomfort might manifest in hand gestures, spoken sounds like groaning or shouting, or facial expressions like wincing.
- Eating and Swallowing Problems
In the advanced stages of Alzheimer’s disease, a person can lose interest in food and develop swallowing problems. A dietitian can help you understand their dietary needs, meal planning, and how to maintain nourishment.
When encouraging eating, the following tips might help. However, everyone is different, and different tips work for different people. You might have to try a few things to find what helps with mealtimes:
- Ensure the mealtime environment is calm, quiet, and free of distractions.
- Serve meals at the same time every day when possible.
- Ensure the person eating is upright, comfortable, and has appropriate support.
- Make foods you know the person enjoys.
- Check that dentures are fitted properly.
- Don’t rush mealtimes; leave plenty of time for the person to eat.
- You may find that several smaller, snack-size meals are easier for the person to eat than three full-size meals.
- Encourage fluids (and thicken them if necessary).
- Try not to overload the plate with too many options.
- If swallowing is difficult, ask your dietitian or speech and language therapist for advice on the easiest and safest foods to provide.
- Monitor the person’s weight so you can track if weight loss or malnourishment occurs.
- Swallowing Difficulties Can Be Serious
Chewing and swallowing problems can lead to other serious concerns such as choking or breathing food/liquid into the lungs. When food/liquid reaches the lungs, it can cause pneumonia, which can lead to death in someone who is weak and battling Alzheimer’s.
If you notice chewing and swallowing problems beginning to occur, seek help early from a medical professional. They can assess the person’s swallowing and advise you on the safest way to manage swallowing problems.
- Personal Care, Dental, and Skin Concerns
When a person loses the ability to move around, paying attention to their personal care, dental, and skin needs is vital. If left unattended, dental problems or pressure sores can lead to infection. Personal health tips include:
- Change the person’s position every two hours to help avoid pressure sores and improve circulation.
- Protect at-risk, bony areas with pads or pillows.
- At this stage, skin can become fragile and easily damaged. Therefore, when washing the skin, be very gentle and dab/blot dry rather than rubbing roughly.
- Check areas prone to pressure sores regularly, including the buttocks, heels, shoulders, elbows, hips, and back.
- Ensure the feet are regularly cared for with gentle bathing, moisturizing, and nails filed/trimmed.
- Pay attention to oral hygiene and check for mouth sores, decayed teeth, lumps, and food that has been pocketed in the mouth.
- Ensure adequate hydration, but limit liquids closer to bedtime.
- Monitor bowel movements and set a toileting schedule.
- Use incontinence pads and mattress covers if required.
- Treat any cuts and scrapes immediately, however small, to prevent infection.
Remember, healthcare professionals are available to support and advise you. Whether it be foot care, support with swallowing, advice on seating, or help with movement, your doctor can refer you to a range of specialists to assist you with any physical care concerns you have. You are not alone.
3. Social Support
Being the caregiver for someone with advanced Alzheimer’s disease can be emotionally and physically tiring. You will need support for yourself, so it is worth considering the following advice:
- Join an Alzheimer’s support group for caregivers, friends, and family members.
- Read up on Alzheimer’s so you feel prepared for what is ahead at every stage.
- Try to keep up with social activities you enjoy to help prevent loneliness and isolation.
- Monitor your own physical and mental health.
- Use respite care options to take time for yourself.
- Be aware that grieving can happen at every stage of Alzheimer’s as you grieve the losses caused by the disease.
- Try to find the humor and fun in situations.
- Seek professional support if it all becomes too overwhelming.