Alzheimer’s and Dementia in Seniors
Alzheimer’s and Dementia in Elderly
As people age, changes in the brain cause some decline in short-term memory and a slowing down in learning ability. This section deals with changes in the older person’s brain, which affect their cognitive powers including:
- judgment and
By being knowledgeable about what is normal and what some of the more common neurological conditions, which inflict the elderly are, you will better understand the reasons for their thoughts and actions. You and caregivers will become familiar with confusion and dementia and recognize the impact these conditions have and they will understand that delirium, dementia and severe memory loss are not part of the normal aging process but are, instead, indicative of degenerative brain disorders, such as Alzheimer’s Disease. You will also learn that confusion can be attributed to other causes such as infections and fluctuations in glucose levels. This is important, as often people are too easily (and wrongly) categorized as being “senile”.
- Nervous System Changes Due to Aging
- Acute Confusion (Delirium)
- Chronic Confusion (Dementia)
- How Home Care Assistants Can Care for Confused Seniors
- Alzheimer’s Disease
- Stages of Alzheimer’s Disease
- Behavioral Patterns Found in Alzheimer’s Disease
- Caring for Seniors With Alzheimer’s Disease and Other Dementias
Nervous System Changes Due to Aging
The aging process causes a number of changes in the nervous system:
- memory shortfalls
- slower reflexes
- loss of brain cells
- decreased hearing and vision
- decreased blood supply to brain
- slower nerve conduction
- slower response and reaction times and
- reduced sensitivity to pain
Confusion is a state of unstable awareness, which results in disrupted thoughts and affects decision making. Often orientation is affected in terms of person, place and time. Confusion is not a diagnosis in itself, but rather it is a symptom, which is the reason that assistance or intervention is sought in the first place.
Confusion can be divided into two categories:
- Acute Confusion (Delirium)
- Chronic Confusion (Dementia)
Acute Confusion (Delirium)
- has a fast onset; and,
- may be recognizable by a combination of inappropriate behaviors.
Chronic Confusion (Dementia)
Dementia is characterized as being:
- progressive; and,
- possibly degenerative.
Dementia is a slow, progressive decline in mental function in which memory, thinking, judgment, and the ability to learn are impaired. Dementia is a much more serious decline in mental ability than confusion is. With time, it becomes worse. Seniors who are aging normally may become forgetful or misplace objects, but those with dementia, may forget entire events. Individuals with dementia have problems conducting regular tasks such as driving, cooking, and handling finances. Dementia progresses at different rates, depending on the cause. Generally it takes from two to ten years before death occurs, which is often attributed to an infection, such as pneumonia.
How Caregivers Can Care for Confused Seniors
Encourage the elderly perdon to lead a healthy lifestyle which includes:
- Do one thing at a time i.e. Have the senior complete one task before starting another.
- Keep instructions simple and try to ensure senior understands what is wanted.
- Tell the senior everything that will happen before it happens, regardless of his/her state of alertness.
- Avoid startling the senior.
- Pay attention to complaints of hunger, thirst or pain.
- If a senior seems agitated, distract him/her by asking a question.
Alzheimer’s Disease is the commonest form of dementia. It is a progressive and relentless loss of mental function revolving around memory, language and thought.
|The cause is not known but theories are:|
There is no cure but it can be managed by:
Stages of Alzheimer’s Disease
Alzheimer’s Disease has three stages. Signs and symptoms become more severe with each stage and eventually death occurs.
Individuals in Stage 1 can generally manage their daily activities themselves, but they may require some assistance with organization. Traits common to Stage 1 are:
- loss of memory
- problems finding the right words
- problems exercising good judgment;
- problems making good decisions;
- becoming lost in familiar places;
- problems carrying out multi-task activities;
- feeling sad, depressed, & anxious;
- avoiding social interactions;
- problems remembering appointments, names or recent events; and.
- misplacing items
Individuals in Stage 2 may have more problems taking care of themselves, but they can still be involved in their daily care and follow a routine.
Traits common to Stage 2 are:
- some assistance needed with their activities of daily living
- becoming restless, especially during the evening hours
- loss of memory increases – they may not know family or friends
- failure to recognize dangers and differentiate between hot and cold
- becoming angry or easily upset
- need to be reminded to eat
- having trouble expressing self and understanding others
- some bowel and bladder incontinence; and,
- loss of impulse control (e.g. uses foul language, poor table manners, sexually aggressive)
Individuals in Stage 3 usually require complete assistance with daily care.
Traits common to Stage 3 are:
- unable to communicate – may grunt or scream
- does not recognize self or family members
- touching or patting things continuously
- sleeping more often
- disoriented to person, place and time
- cannot sit or walk – becomes confined to bed
- total bowel and urinary incontinence
- unable to swallow
- may have seizures
- coma; and,
Behavioral Patterns Found in Alzheimer’s Disease
|Recurring Behaviors||Recurring behavior is doing the same act over and over (e.g. folding a towel).|
|Abnormal Sexual Behavior||Sexual behavior may involve the wrong person, at the wrong time, in the wrong place. Or, it may involve an inappropriate action (e.g. exposing themselves or masturbating in front of others).|
|Screaming||Screaming occurs in an attempt to communicate. It can involve screaming a name, a word or simply making yelling sounds.|
|Aggression||Aggression & combativeness often occur because of restlessness or agitation (e.g. hitting, punching, biting).|
|Agitation||An agitated individual may walk back & forth, hit or yell.|
|Disastrous Responses||Disastrous responses are extreme responses, with the individual reacting as if a major disaster has occurred.|
|Delusions||Delusions area false beliefs, even when facts say differently. (e.g. An individual may think he/she is going to be murdered.)|
|Hallucinations||A hallucination is hearing, seeing, smelling or feeling things that are not there. (e.g. Individuals may think snakes are in bed with them.)|
|Sundowning||Sundowning is the appearance of confusion, and other severely disruptive behavior coupled with inability to remain asleep. It occurs in the late afternoon & evening hours.|
|Wandering||Since Alzheimer’s Disease causes the individual to be disoriented in respect to person, place or time, they may become lost or use poor judgment, which compromises their safety/|
Caring for Seniors With Alzheimer’s Disease and Other Dementias
- create a supportive environment by:
- providing extra security measures such as posting notes to serve as reminders (e.g. turn stove off);
- keeping the environment familiar e.g. don’t move furniture around;
- establish and maintain a regular daily routine; and,
- keeping the client oriented. (e.g clock, calendar, radio, night light);
- evaluate home for safety and take corrective actions by:
- removing scatter rugs;
- storing household cleaners and harmful substances in a safe place;
- removing sharp & breakable objects from the environment; and,
- using plastic eating and drinking utensils;
- provide structure and routine;
- schedule low stress activities;
- speak slowly and clearly to facilitate their understanding of what is being said;
- provide simple explanations on everything said;
- research community resources which will benefit the client;
- encourage them to share their memories, as long as they can recall them;
- plan physical activities, as they will offset disruptive behavior;
- encourage mental activities (e.g. reading, crafts, keeping abreast with
As people grow older, changes in the brain cause some decline in short-term memory and a slowing down in learning ability. There is a general decrease in cognitive powers, which affect the individual’s memory, thinking, reasoning, judgment and behaviour. These changes, which occur throughout the nervous system, often cause an individual to become confused.
There are two main types of confusion — acute confusion, also known as “delirium”, and chronic confusion, also known as “dementia”. They each have distinct characteristics which affect cognitive abilities and behavorial patterns.
The most common form of dementia is “Alzheimer’s Disease”, for which there is no cure. It is a progressive disease and has three main stages. While it can’t be cured, it can be managed.
There are various ways a Home Care Assistant can support seniors with Alzheimer’s Disease or other dementias. This would include such measures as maintaining a safe and calm environment, making the senior feel secure and providing ongoing and increasing support with their activities of daily living