AMBULATION AND HOME CARE IN ALZHEIMER S

1. AMBULATION AND HOME CARE IN ALZHEIMER’S

2. Memory is a way of holding onto the things you love, the things you are, the things you never want to lose. Alzheimer’s Disease Awareness Alzheimer’s Association

3. Care givers Family members and friends Long term care Assisted living facilities

4. Home care Regular assessment and support Decreasing clinical manifestations , preventing harm, supporting the patient and caregiver Early stage – memory aids Regular medications- depression and cholinesterase inhibitors Effective management- slow progression

5. BEHAVIORAL PROBLEMS Behaviors are not intentional and are difficult to control Pain, extremes of temperature and noise-behavior problems Redirection-activities –sweeping, dusting Distraction-snacks, listening to music, walking, family photos, sitting out Reassurance-protection from danger /harm

6. SUNDOWNING Disruption of circadian rhythms, medications, reduced sleeping and sleep fragmentation Calm, quiet environment Maximizing exposure to daylight Evaluating medications-sleep disturbance Limiting naps and caffeine Consulting with health care provider

7. SAFETY Injury, falls, self, others, sharp objects, burns inability to respond to crisis situations Well lit rooms stairs Graspable handrails Carpet edges tacked down, avoid polished floor surfaces Remove extension cords Nonskid mats

8. PAIN Cues for pain- behavior-vocalization, agitation, withdrawal and changes in function Monitor and treat

9. EATING AND SWALLOWING DIFFICULTY Pureed foods thickened liquids, nutritional supplements Reminder to chew and swallow foods Quiet and unhurried environment Distractions –avoided Easy grip utensils NG feeds PEG tube

10. ORAL CARE Inability for self oral care Pocket food in the mouth Tooth decay, tooth abscess Regular inspection and mouth care.

11. INFECTION PREVENTION UTI, Pneumonia Feeding and swallowing-aspiration pneumonia Immobility-decreased fluid intake, prostate hyperplasia, poor hygiene, catheter Fever, behavior change, cough, pain on urination-evaluate and manage

12. SKIN CARE Rashes, redness, breakdown. Keep dry and clean

13. ELIMINATION PROBLEMS Urinary and fecal incontinence Scheduled toileting Medication to decrease the bladder excitability and improve control Women –estrogen-atrophic vaginitis Constipation-fiber supplements stool softener

14. TIPS FOR CARE Explain-what you are going to do Give time for task completion –early morning/evening Explain in a clear gentle voice Smile while watching carry out the task Give praise Give simple instruction Don’t leave the person alone while doing a task Don’t make negative comments Don’t shout or raise your voice Speak directly to the person and address by name

15. Adequate lighting of all the rooms Glare on the floor can affect vision, patterned tiles may look like steps may lead to trip and fall Encourage painting or drawing Keep a daily log of events Set routines Avoid taking responsibilities away from the person Be positive and optimistic

16. Keep them active Taking a few steps forward can be confusing Do not tell to “hurry up” Think of alternative forms of exercise as throwing a ball, dancing or rhythm exercise Keep the senses alive Give them hugs Stimulate senses through art music, gardening Silence and religious practice may also help Avoid startling the person Keep routines consistent

17. MEDICATIONS Medication storage and dispensing box with 7 days of the week Name on the box Clear label Check the drug box daily

18. SOCIAL STIMULATION Regular social stimulation, reality orientation Using telephone Big press buttons and numbers Name list with big characters-important people Keep contact with old friends Visiting parks or to shops Familiarize person with money-gently ask what is bought and what is the cost Alzheimer’s Society Canada

19. REALITY ORIENTATION Sense of what is going on –enable to continue to function and respond Prepare a white board-write down daily schedules and appointments Using the calendar-note special events, festivals or appointments Using a big clock Labeling rooms-bedroom bathroom Read newspapers daily Visiting the local shops or going out

20. CAREGIVER SUPPORT Stress Depression Employment emotional and physical health Family conflict and care giver strain Elderly women/ adult children- Alzheimer’s association-educational and support systems

21. CONCERNS Safety Ethical legal Financial Stress management

22. LETS GIVE OUR HANDS IN THE CARE OF THOSE WITH ALZHEIMER’S AND THEIR CARE GIVERS. MEMORY IS A WAY OF HOLDING ONTO THE THINGS YOU LOVE, THE THINGS YOU ARE, THE THINGS YOU NEVER WANT TO LOSE.