Caregiving in Early Alzheimer's Disease

Learn about the early stages of Alzheimer's disease and how caregivers, friends, and family can help.

By Chris Iliades, MD

Medically reviewed by Pat F. Bass III, MD, MS, MPH

A caregiver’s role often starts with the diagnosis of early-stage Alzheimer’s disease. At this juncture, it’s important to deal with both long-term planning and with immediate medical and psychological issues in order to make life as normal as possible for your loved one. To begin, it’s helpful to become familiar with some of the more common symptoms of early, or Stage I, Alzheimer’s disease. These often include:

·         Misplacing items and/or storing them in odd places. A person with Stage I Alzheimer’s, for instance, may put things in strange places, like a wallet in the freezer.

·         Repeating the same phrase or story, completely unaware of the repetition and having difficulty finding the right words when talking.

·         Resisting decisions, even of the simplest sort.

·         Taking longer with routine chores and becoming upset if something unexpected occurs.

·         Forgetting to eat, eating only one kind of food, or eating all the time.

·         Neglecting hygiene and wearing the same clothes day after day, and insisting they are clean.

·         Becoming obsessive about checking, searching, or hoarding things of no value.

 

Lisa Gwyther, MSW, the director of the family support program at Duke University Medical Center, in Durham, N.C, notes that depression is also very common in early Alzheimer’s. “A depression that comes on later in life, especially in someone without a prior history of depression, is often the first symptom of Alzheimer’s,” she says. Once the diagnosis of Alzheimer’s disease has been made, it is a difficult time for the person and the family. In addition to feeling depressed, the person with early Alzheimer’s may go through periods of anger, fear, and anxiety.

What Can Family, Friends, and Caregivers Do to Help?

There are a number of measures that can be taken to help a loved one cope better with the challenges presented by early Alzheimer’s disease.

·         Get a complete medical evaluation. The first step in caring for a loved one with Alzheimer’s disease is to make sure the diagnosis is accurate. Some possible treatments depend on a precise diagnosis, and your health care provider may recommend a number of tests. Because people with early Alzheimer’s are often not aware of their own forgetfulness and can get quite adept at hiding it from others, family members and caregivers can help the doctor take a good medical history. The doctor will do a functional status assessment to determine if it is safe for the person to live alone, drive a car, or do their own finances. “The ability to do financial calculations is lost early in Alzheimer’s disease. The person may pay bills twice or neglect to pay bills and get themselves in a financial mess. A trusted family member and financial advisor can be a big help at this point,” says Gwyther. Finally, your doctor may recommend a number of possible treatments or referral to an Alzheimer’s specialist.

·         Don’t shut the person with early Alzheimer’s out. “One of the most common mistakes that family and caregivers make is to marginalize the person with Alzheimer’s. As time goes on, the family and the caregivers will have to take over more and more decisions for the person. But in the beginning, let them participate as much as possible,” says Gwyther.

·         Help the person with early Alzheimer’s stay active and healthy. Research shows that social and mental activity may slow the progression of the disease. A diet high in natural fats such as fish, nuts, and olive oil can help too. Vitamins such as B, C, and E have all been recommended for early Alzheimer’s disease.

·         Provide a stable environment. People with early Alzheimer’s do better if their day is very structured. Help them by creating routines around eating, bathing, and sleeping. Keep the environment familiar by making sure things stay in their usual places. Avoid surprises and confusion as much as possible. Sometimes the most helpful thing to do is to just be nearby.

·         You can also help by getting help. Contact one of the many national organizations that help with Alzheimer’s care. Most of these organizations will have a local chapter near you. The Alzheimer’s Disease Education & Referral Center, the Alzheimer’s Association, Children of Aging Parents, Eldercare Locator, and Family Caregiver Alliance are all nationwide, nonprofit organizations that offer information and services for Alzheimer’s disease caregivers.

 

Finally, remember that although it now possible to slow down the progression of Alzheimer’s disease, it can’t yet be stopped. As a family member, friend, or caregiver, you can be a tremendous asset to the person with early Alzheimer’s by being an advocate, as well as supportive and available. While someone with Alzheimer’s may not be able to show or express it, they always feel your affection and compassion.