What is Alzheimer's disease?
Alzheimer's
disease is a progressive, degenerative disease that affects the
brain, causing impaired memory, thinking and behavior. It is the
most common form of dementia, a general term referring to loss of
memory and the ability to think, reason, function and behave appropriately.
As the disease progresses, people become unaware of their condition
and find it extremely difficult to perform even the simplest everyday
tasks. The risk of Alzheimer's disease increases with age and most
people affected are over 65, although it can affect people in middle
adult life. The course of the disease usually progresses over a
span of 8 years from the onset of symptoms.
What are the disease symptoms?
Alzheimer's
disease has a progressive onset; symptoms appear gradually during
the first 2 to 4 years and are often mistaken for the early signs
of normal aging. Not everyone will experience the same symptoms
in the same order of progression — symptoms progress at different
rates and in different patterns in each person — although
there are similarities in everyone with Alzheimer's disease. Being
aware of what to expect will help you understand the changes that
may be occurring to you or your friend or relative.
There
is a clear difference between the memory loss seen with normal aging
and Alzheimer's disease. Symptoms of Alzheimer's disease fall into
three main areas: cognitive difficulties (memory loss), behavioral
changes and a decline in intellectual abilities severe enough to
interfere with work and activities of daily living. These symptoms
can be best understood in the context of the three stages in the
development of the disease — early, middle and late. In the
early phase, symptoms may be so slight that they go unnoticed, but
as the disease progresses into the middle and late stages, they
become more noticeable and start to interfere with everyday activities.
Eventually, symptoms become so severe that the individual is entirely
dependent on someone else to function normally.
What causes Alzheimer's disease?
The
causes of Alzheimer's disease are currently being researched, but
no definitive answers exist as yet. Alzheimer's disease is a disease
of the brain and characteristic changes can be seen in the brain
at post-mortem. These include death of cells, accumulation of protein
deposits and brain shrinkage. The trigger for these brain tissue
changes are not known.
Much
research has been done on the genetics of Alzheimer's disease. Alzheimer's
disease occurring in people in middle to late life (known as early-onset
Alzheimer's disease) may be caused by specific genes. Late-onset
Alzheimer's disease, occurring in the over 60s, may be influenced
by the person's genetic make up, but is not caused by it. Environmental
factors are also suspected to play a role in the development of
the disease.
Who gets Alzheimer's disease?
Approximately
10 million people worldwide are affected by Alzheimer's disease.
It is the fourth leading cause of death behind cardiovascular disease,
cancer and stroke. Approximately 5 to 8% of people 65 years of age
or above are affected by the disease. While the disease is most
common in the elderly, it has been diagnosed in patients in their
40s and 50. Early-onset Alzheimer's disease is a very rare form
of the disease and accounts for fewer than 10% of all reported cases.
People who have a relative with Alzheimer's disease are more likely
to develop the disease themselves. Other risk factors associated
with Alzheimer's disease include head injury, diabetes, hypertension
and sex — women appear to have a slightly higher risk of developing
the disease than men.
Who does the disease affect?
Alzheimer's
disease not only affects the person with dementia, it affects the
entire family and also their friends. As the disease progresses
into the later phases, and the person with the disease becomes unable
to function normally, the greatest burden is placed on the caregiver.
This causes the caregiver great distress; caring for a person with
Alzheimer's disease wields high emotional, social and financial
costs.
C.
S. Lewis once wrote: 'No-one ever told me that grief felt so like
fear.' Living with Alzheimer's disease brings a lot of grief and
fear so this quote seems particularly relevant as it expresses how
the two are so inextricably linked.
LIVING WITH AND CARING FOR A PERSON WITH ALZHEIMER'S DISEASE
Caring for someone with Alzheimer's disease can be extremely difficult
at times. In your role as caregiver, it is important to bear the
following in mind, in order to avoid conflict and unnecessary stress,
on you and the person with the disease:
Maintain
dignity. The person you care for may feel embarrassed that they
can no longer perform the everyday tasks they once found easy. Remember
that what you do, and say to others in their presence, can be disturbing.
Establish
routines. A daily routine can provide security for the person with
Alzheimer's disease and can bring order and structure to a confused
daily life.
Support
independence. A person with Alzheimer's disease should be encouraged
to retain their independence for as long as possible. If the person
likes to go shopping on their own and can still go out and return
home without getting lost, let them do so. This will help maintain
their self-respect and decrease the burden on the carer.
Avoid
confrontation. People with the disease will invariably forget or
deny that they have done something wrong or will behave badly. Do
not forget that this is a problem caused by the illness; try and
stay calm and avoid confrontation.
Simplify
tasks. To avoid confusion and stress, keep thing simple; limit the
number of choices you offer the person with the disease. This may
be over simple matters, such as what they eat or even what they
wear.
Improve
safety. Alzheimer's disease affects physical co-ordination and memory,
and the home will become a potentially hazardous place for someone
with the disease. It is important that you make your home as safe
as possible.
Keep
active. Planned activities, such as taking daily walks or going
to restaurants, can enhance a person's sense of dignity and sense
of worth by giving purpose and meaning to life, as well as maintaining
their existing physical and mental capabilities. This will become
much harder to do as the disease progresses.
Keep
communicating. Verbal communication will become increasingly difficult
as the disease progresses and a person with Alzheimer's disease
will begin to rely on other senses such as touch and sight. It is
important that you communicate as effectively as possible during
this time.
Memory
aids. One of the main problems with Alzheimer's disease is the failure
of short-term memory and a useful way of helping someone cope with
memory loss is to create personalized 'memory joggers', such as
message boards, handy lists and instruction sheets, although these
will not be so useful in the later stages of the disease.
As
Alzheimer's disease progresses, your loved one may not be able to
function as well as he/she used to. This may cause some added frustration
for both you and the person in your care. As symptoms progress,
it can be difficult to know when you should step in and take over
... and how much you should take over. It can also be painful to
take away the symbols of your loved one's independence. Telling
them that they can no longer go to work, drive a car, or manage
their own finances is very hard. And dealing with the emotions of
your loved one at this time can be even harder.
The
first step in deciding whether the time has come to make some changes
is to get a professional evaluation. This will tell you what the
person is still able to do and what they are no longer able to do.
It can also stand as an 'authority,' making it a bit easier to insist
on necessary changes. If a professional evaluation is not available,
you and your family must thoroughly analyze each task at hand. You
must think to yourselves, 'Can our loved one still do the specific
task completely, safely, and without becoming upset?'
As
your loved one starts to lose their ability to remember and function,
it is natural for them to cling even more tightly to the things
that remain. This is why many patients with Alzheimer's disease
respond to these additional changes of a 'take-over' with resistance,
denial, and anger. They feel that these things are being unfairly
taken away. To accept that they can no longer drive a car, or take
care of their finances, would mean that they would have to face
the extent and finality of their illness ... something they may
not want to do.
"CAN OUR LOVED ONE STILL DO THE SPECIFIC TASK COMPLETELY,
SAFELY, AND WITHOUT BECOMING UPSET?"
Below
you will find some ways of handling these situations. We hope that
they will help you in your discussions with your loved one and with
other family members when making such difficult decisions.
When your loved one needs to give up their job.
Deciding
when your loved one should give up their job depends on two factors:
the type of job they have and whether they need to drive to their
job. If your loved one is in a job that is too demanding for their
current level of functioning, they may need to retire. And sometimes,
your family may need to make this decision.
"IF
YOUR LOVED ONE HAS TO GIVE UP THEIR JOB, YOU WILL NEED TO PAY ATTENTION
TO THE EMOTIONAL AND PSYCHOLOGICAL DURESS THAT WILL BE INVOLVED"
Think
about this... your job is a main part of who you are. And by maintaining
a job, you feel that you are a valued member of society. Now, imagine
being told that you need to give it all up. If your loved one has
to give up their job, you will need to pay attention to the emotional
and psychological duress that will be involved, not to mention the
financial changes as well. The person with Alzheimer's disease will
not let go lightly, and being forced to adjust to retirement will
be a painful and distressing time. If it is requested that your
loved one retire, you may want to consider bringing them to a counselor
or social worker - they can be invaluable in helping you and helping
the person in your care.
Financial
planning also needs to be considered when your loved one must leave
their job. Individuals who need to retire early may suffer a loss
of income and financial planning may be necessary. You may be able
to get assistance from the government.
When your loved one can no longer manage their finances
When
your loved one is diagnosed with Alzheimer's disease, it may be
wise to inquire about their financial resources. Knowing where the
bank books, check book, insurance policies, stock certificates,
real estate property, and retirement or disability benefits are
located will help you handle things more effectively in the future.
As
the disease progresses, your loved one may become anxious or suspicious
about their finances. If they are no longer able to manage their
checking account, and you need to take it away against their wishes,
they may accuse you of 'stealing' from them. It may help to leave
a note where your loved one keeps their checkbook that reads, 'My
daughter Christina now takes care of my checkbook.' This will help
refresh the patient's memory of why the checkbook isn't in its place.
My
Daughter takes care of my checkbook now!
If your loved one is losing their wallet or purse, you may want
to replace their credit cards and money with a small amount of spending
money, such as some small change or low currency bills. This way
your loved one will feel that they have money, and it will help
with conflicts between the two of you.
When your loved one can no longer drive
A
diagnosis of Alzheimer's disease does not mean a person has to stop
driving at once. The loss of driving skills may be gradual. The
person with Alzheimer's disease may recognize this and limit driving
to familiar places or choose to stop driving if he or she feels
a decline in ability. This, however, is often not the case. Driving
means independence and mobility, and most people find it difficult
to give up. Therefore, you may be the one who will need to monitor
the person's driving ability and determine when driving becomes
unsafe.
When
deciding whether or not the person should continue to drive, let
the person with Alzheimer's disease participate in the discussion.
Discuss the problem frankly and present your view in a way that
will not cause the person to lose face or become defensive. A person
with Alzheimer's disease is less likely to accept criticism as well
as he or she did before the illness. If you are having difficulty
stopping the driver, get support from their doctor. Having the doctor
write, 'Do not drive' on a prescription pad may make the patient
more receptive to the idea, and will take the pressure off you.
If
the patient continues to drive, even after their driver's license
has been revoked and they were told not to, you might want to try
some of the following strategies:
• Park the car down the street or where it will not be seen
• Keep car keys with you at all times or hide them
• Leave your extra set of keys with a friend or neighbour
• Change the ignition key to prevent access
• Ask a mechanic at your local service station how to disable
a car.
Autism
Topic
Overview
What is autism?
Autism is a type of pervasive developmental disorder (PDD). It interferes
with a person's ability to communicate with and relate to others.
Autism is a lifelong condition that results in some degree of social
isolation.
Autism affects how a person perceives and processes sensory information.
Signs of autism almost always develop before a child is 3 years
old, although the condition is frequently not diagnosed until later.
Typically, parents first become concerned when they notice their
toddler does not respond or interact like other children of the
same age. Toddlers with autism do not usually babble or talk normally,
and may seem to have hearing problems.
The severity of autism varies. Some individuals need assistance
in almost all aspects of their daily lives, while others are able
to function at a very high level and can even attend school in a
regular classroom. Although it is difficult to determine, studies
show that below-normal intelligence occurs in about 70% of autistic
children.1 In addition, the social functioning of autistic children
is less than what is expected for their intelligence quotient (IQ)
levels.
What
causes autism?
Most research suggests that people with autism have irregular brain
structures. More study is needed to determine the cause of these
irregularities, but current research indicates they are inherited.
Parents who have had one child with autism are more likely than
other couples to have a second child with autism.1
What
are the symptoms of autism?
All people with autism have difficulty with social interactions
and relationships. Parents often describe their child with autism
as preferring to play alone and making little eye contact with other
people. Other symptoms of autism include:
• Difficulties with verbal and nonverbal communication. Language
development in children with autism is almost always delayed.
• Limited, repetitive, and overused (stereotyped) patterns
of behavior, interests, and play. Many typical behaviors—such
as repetitive body rocking, unusual attachments to objects, and
holding fast to routines and rituals—are driven by the need
for sameness and resistance to change.
There is no standard or “typical” person with autism.
Although autism is defined by the above characteristics, people
with autism can have many different combinations of behaviors in
mild to severe forms.
Do
any other conditions occur with autism?
Many people with autism also have other conditions, such as below-normal
intelligence or mood problems. Teenagers with autism often develop
depression, especially if they have average or above-average intelligence.
In addition, about 1/3 of children with autism develop a seizure
disorder (such as epilepsy) by their teen years.2
How
is autism diagnosed?
A health professional will evaluate a child suspected of having
autism or another developmental delay using the diagnostic guidelines
established by the American Academy of Child and Adolescent Psychiatry
(AACAP). These criteria are generally used to evaluate a child for
autism who does not interact with or socialize normally for his
or her age. A child may also have hearing and other tests to make
sure developmental delays aren't the result of another condition
with similar symptoms. Early diagnosis and treatment of autism is
important to make the most of the child's potential.
How
is autism treated?
Behavioral training, specialized therapy, parent education and support,
and sometimes medications can often improve an autistic child's
problem behaviors, communication skills, and socialization. A child
with autism responds best to a highly structured, specialized educational
program tailored to his or her individual needs. However, specific
treatment varies depending on the range of individual symptoms,
which can combine in many different ways and change over time.
Parents, school staff, and health professionals are usually all
involved in planning a child's treatment.
Early diagnosis and treatment helps young children with autism develop
to their full potential. And LifeSource’s Memory Enhancer
& Brain Connector has shown great results for Autism in children.
It helps the blood flow to the brain, which strengthens the brain,
and it’s functionality.
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