During the early stages of Alzheimer’s disease (AD), patients often notice their own loss of skills. They may be unable to continue at a job, or may notice differences at home. Patients suffer a loss of independence and dignity. They often ask the same questions repeatedly, not remembering that the questions were already asked and answered. AD patients develop the tendency of hiding things – then, when they are unable to find the items, they frequently accuse others of “stealing” them. Patients are often frustrated and embarrassed. They can become suspicious without basis, and may curse or become angry and emotional, or may become withdrawn. It’s interesting to note that at the early stages, patients are often able to “pull themselves together” in the presence of people other than their immediate family and caregivers. However, as the disease progresses, patients are unable to continue this behavior.
Ask any caregiver how caring for an AD patient affects all aspects of one’s life and you’ll be surprised to find out just how drastic the changes in day-to-day living can be. As the patient becomes more impaired, it becomes a full-time occupation to provide appropriate care. It’s more than a matter of dressing, feeding, and toileting the patient. It’s constant, minute-to-minute care, supervision, and entertainment. Care at home is often very difficult and demanding. A spouse or adult child may be overburdened with the responsibilities of cooking, marketing, cleaning, and doing laundry for the AD patient, and the rest of the family, while keeping a constant vigil to safeguard the patient. The caregiver must also provide entertainment and social activities for the patient. And he or she must remember that although the patient is acting like a difficult, uncooperative child, he or she is an adult who was once capable and independent.
To prepare the home for an AD patient, one must imagine the things that would need to be done if a child lived there. Safety locks on kitchen cabinets, gadgets on windows and doors to limit how far they can be opened, labeling drawers and closets to indicate their contents, removing knobs from stoves, and keeping medication, cleaning and other hazardous supplies out of reach are among the things requiring attention. Additionally, caregivers should provide patients with identification bracelets, or other identification jewelry, in case the patient wanders off and gets lost. In spite of all the precautions, as the patient’s condition worsens, the family may have to consider getting outside help or moving the patient into an institutionalized setting.
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