Special to IFN
More than 55 million people worldwide are living with some form of dementia. Being a caregiver for someone with this disease can feel like uncharted territory.
Ben Yeager, program manager for the Greater Triad Region of the Alzheimer’s Association, recently shared strategies for caregivers and other helpful information on the latest episode of Iredell Health System’s latest podcast, “Inspire Iredell.”
Q: What is Alzheimer’s disease?
A: “Alzheimer’s disease is a form of dementia, which is an umbrella term for all different kinds of cognitive diseases,” Yeager explained. “It’s thought that about 65 to 80 percent of all dementia cases are Alzheimer’s disease.
Other types include Lewy Body, Vascular, and Frontotemporal dementias.
“As testing becomes more common, we are seeing more mixed dementia. This is where an individual is diagnosed with multiple different kinds of dementia,” Yeager said.
Q: What are the symptoms of Alzheimer’s?
A: As you age, it’s common to have memory issues. You may forget a word or misplace your keys. When memory loss begins to interfere with daily life, it could be a warning sign for dementia.
“If a retired accountant all of a sudden can’t balance a checkbook, that would potentially be a warning sign,” Yeager said.
In addition to memory loss, symptoms may include confusion with time and place, difficulties with familiar tasks or problem solving, and social isolation or withdrawal. The biggest risk factor for Alzheimer’s is age.
“Once an individual turns 65, the risk of Alzheimer’s doubles every five years after that.”
Q: What does Alzheimer’s look like in the brain?
A: Plaques and tangles build up in the brain, interfering with brain functionality. The plaques are sticky beta-amyloid protein that’s found in the membrane surrounding nerve cells. In a healthy brain, these plaques clear away naturally.
The tangles are tau proteins that help transport nutrients. In a healthy brain, these paths are straight. In a brain affected with Alzheimer’s disease, these proteins are twisted and tangled, preventing nutrients from traveling and causing death to cells.
Q: What are the risk factors of Alzheimer’s disease?
A: Although dementia is not 100 percent preventable and age is the primary risk factor, research shows there are modifiable risk factors that go into Alzheimer’s.
“Whatever is good for your heart is good for your brain. A lot of the modifiable risk factors are heart health related such as cardiovascular exercise, a healthy, balanced diet that’s heavy in whole grains and legumes and lower on unhealthy meats, quitting smoking, getting good sleep, and taking care of your mental health.”
Q: How does Alzheimer’s disease progress?
A: Alzheimer’s is a progressive disease consisting of five stages. The first is asymptomatic.
“Biological changes can be happening without any warning signs appearing. A person may have no idea they are progressing toward Alzheimer’s disease,” Yeager said.
The second stage is mild cognitive impairment, or MCI.
“That’s the tricky stage because it gets confused with normal aging. You have to truly know the person and see the behavior changes to identify if it’s normal aging or potentially Alzheimer’s or another form of dementia.”
After these, there are three stages that begin to interfere with daily life ranging in severity from mild, moderate, and severe.
“In these stages, people begin struggling with familiar tasks like going to the restroom, dressing themselves, and bathing. In the most severe stage, simple functions like breathing and swallowing become impossible,” Yeager explained.
Q: What should you do if you suspect Alzheimer’s disease in yourself or others?
A: “We at the Alzheimer’s Association encourage people to get tested. The first step is to schedule an appointment with your doctor. Likely, they would perform a cognitive test in the office, and if there were concerns with the results, they can refer to other specialists for other tests like a PET scan or MRI.”
The FDA recently gave approval for blood tests to screen for Alzheimer’s.
“These tests have been around for a while for use in clinical trials, but just a few weeks ago, the FDA gave official approval for them. We are thinking they may be the future. Right now, a blood test alone would not diagnose Alzheimer’s, but we are hopeful it can advance us into the next decade.”
If you notice symptoms of Alzheimer’s in yourself, it’s important to take action early.
“Early diagnosis allows you to have conversations with your caregiver that you might not be able to have if the disease progresses,” Yeager said.
This could include conversations on when to consider stopping them from driving or when they should consider an assisted-living facility. Early diagnosis could also mean taking advantage of cutting-edge treatments.
“We have treatments on the market that attack the underlying biology of the disease. They target the amyloid plaques and prevent more from forming. They aren’t cures for the disease, but they do slow down the progression.”
Q: What are some tips for being a caregiver?
A: From diagnosis to end of life, the average period of time is 10 years. This can be difficult for caregivers, and some may neglect their health, sleep, and relationships during this time. It’s also important to remember loved ones may be exhibiting emotions that are different than usual.
“When someone doesn’t know if they’re in a safe environment or they are confused, that can lead to irritation, anxiety, anger, and aggression,” Yeager said. “At the Alzheimer’s Association, we see these dementia-related behaviors as alarms telling you that a need is not being met. What can help a caregiver is to take a step back, breathe, and remember this is caused by the disease and not the person.”
Caregivers have to put their “detective hat” on and figure out what could be triggering this behavior. The behavior and the need could be completely unrelated.
“Someone could be angry, but it might be because they need to use the bathroom. It might be because they’re too cold and need a sweater, but the disease is interfering with their ability to say that. It can turn into outbursts,” Yeager said.
Frequently, those living with dementia may not remember people or things they once did, but it’s important to validate their reality.
“If someone doesn’t know who you are, it’s better not to say something like ‘I’m not that person, I’m this person, don’t you remember?’ This can sound like an attack and might put them in a defensive state. It can be better to say, ‘Hey, I’m here to help and I’m so happy to see you’ in a calming way.”
Later stages of Alzheimer’s may bring about suspicions and delusions. Correcting those behaviors can sometimes be more harmful than letting them play out.
“If they say something that seems outlandish, respond with a phrase like, ‘That’s really scary. I’m so sorry. Is there anything I can do to help?’”
Removing things in the environment they could potentially harm themselves with, such as weapons and knives, and securing things such as doors and oven knobs, is essential in keeping your loved one safe. To help them feel comfortable, try introducing activities they enjoy.
Need Help?
Remember that you aren’t alone if you are living with dementia or if you are a caregiver. The Alzheimer’s Association has a vision for a world without Alzheimer’s or other forms of dementia through research, treatments, prevention, and someday, a cure. If you or a loved one has concerns related to dementia, the association staffs a 24-hour helpline with master’s level clinicians. You can reach them at 1-800-272-3900.
LEARN MORE
Visit endalz.org to learn how to support The Alzheimer’s Association or access resources related to Alzheimer’s and other forms of dementia.
About Iredell Health System
Iredell Health System includes Iredell Memorial Hospital; Iredell Davis Medical Center; Iredell Davis Behavioral Health Hospital; Iredell Mooresville; Iredell Home Health; Iredell Wound Care & Hyperbaric Center; Community and Corporate Wellness; Occupational Medicine; the Iredell Physician Network and more. Iredell Memorial Hospital is the largest and only nonprofit hospital in Iredell County. The comprehensive healthcare organization has 391 licensed beds; more than 2,000 employees; and has approximately 365 healthcare providers representing various specialties. Centers of excellence include Women’s and Children’s; Cardiovascular; Cancer; Surgical Services and Wellness & Prevention. The health system’s Iredell Mooresville campus is home to the area’s only 24-hour urgent care facility, as well as an ambulatory surgery center, imaging center, rehabilitation services, and physician practices. The mission of Iredell Health System is to inspire wellbeing. For a comprehensive list of services and programs, visit www.iredellhealth.org.