Alzheimer’s disease is the most common form of dementia (around 60% of diagnoses in the UK), although it is comparatively rare for under-65s.
What causes Alzheimer’s disease?
The exact cause is unknown but we do know that ‘plaques’ and ‘tangles’ form in the brain due to two proteins called amyloid (plaques) and tau (tangles).
Amyloid is a naturally occurring protein which for a reason that is not yet understood begins to malfunction, creating beta amyloid which is toxic to the brain cells. Plaques form consisting of dead cells and amyloid protein.
Tau protein naturally occurs in the brain and helps brain cells communicate with each other but for a reason that is not yet understood it can become abnormal and “clump together” leading to death of the brain cells affected.
People diagnosed with Alzheimer’s may additionally have a reduction of a chemical in the brain (called acetylcholine). This functions as a chemical messenger to take information to and from brain cells (neurons), so a reduction in this chemical leads to information not being transmitted effectively.
How does Alzheimer’s develop?
Research suggests that changes in the brain can occur up to ten years before a person starts to show symptoms of Alzheimer’s disease. The symptoms are usually mild at the beginning and gradually worsen over time. These may include:
difficulty remembering recent events while having a good memory for past events
difficulty recognising people or objects
poor organisation skills
slow, muddled or repetitive speech
withdrawal from family and friends
problems with decision making, problem solving, planning and sequencing tasks
Managing the effects of Alzheimer’s disease
Medication is available which may help slow progression but it does not prevent or cure Alzheimer’s disease.
People with Alzheimer’s may be prescribed a type of medication called cholinesterase inhibitors. There are three options: Donepezil, Rivastigmine or Galantamine
These medications may improve concentration, which helps with memory, thinking and language. These effects can last for approximately 6-12 months, although there is now some evidence showing they can benefit a person for much longer. They support the communication between the nerve cells in the brain by preventing the breakdown of acetylcholine
Memantine can also be prescribed in the moderate to severe stage of Alzheimer’s disease alongside one of the above medications. This medication blocks the effects of excess glutamate in the brain. Memantine can help with memory, reasoning, language and attention
What kind of care do people with dementia need? Dementia can cause a range of changes in mood, including frustration as abilities decline, confusion as memory deteriorates, and other knock-on effects as such as changes in diet and interests. Read on to discover some of the key things to take into account when caring for people with dementia.
Helping with Day to Day Tasks
When a person develops dementia, it can make a big change to how they go about their day to day tasks. They’re likely to notice they’re forgetting things, for example where the teacups or plates are kept in the kitchen, people’s names, or even where the bathroom is. Other effects include decreased coordination, which can make it much harder to perform daily tasks like preparing food, washing or getting ready for bed.
How Can You Help?
As people living with dementia see how their skills are deteriorating, are unable to express themselves or forgetting things they’re sure they used to know, they can become frustrated, helpless or less self-confident. It’s important that you help them tackle these feelings of a lack of self-worth by offering them support in a sensitive manner, without criticising their efforts. This helps your loved one feel that they’re still useful and can still do the things that used to come naturally to them.
You can also help them with their memory by putting memory aids around the house. This might include putting a picture on each kitchen cupboard door of what’s inside, or photos of what’s inside each room in the house, making it easier to find what they’re looking for.
Another way to keep them engaged is to let them take part in everyday tasks, which helps your loved one feel useful. This might include involving them in preparing meals, help with the shopping, hovering or laying the table.
Food and Nutrition
It’s important that your loved one continues to eat healthily, despite their illness. A good diet is essential to boost the immune system, especially for those with dementia, as illness can cause added confusion.
Mealtimes can become more difficult in a number of ways due to the effects of dementia. Commonly, people with dementia can forget what foods they like, refuse to eat, stop recognising familiar foods, or ask for unusual food combinations.
Not all this behaviour is down to confusion, though. Dental problems can cause irritation in the mouth, leading to your loved one resisting eating, so it’s a good idea to speak to your dentist or GP if you have concerns about their oral health.
How Can You Help?
When helping your loved one to eat, it’s important that they’re involved as much as possible. Let them help you prepare food, giving them some continuity with how they used to live their life. Let them choose what they want to eat based on sight, as this can add a visual prompt to remind them about their favourite foods.
Try to keep mealtimes as calm and stress-free as possible too. For example, your loved one’s eating habits may change over time, such as wanting to eat at different times of day. Try to accommodate this, ensuring you have plenty of time for meals allowing you to deal with any problems that may arise. Above all, remember to stay calm, as this can ensure your loved one doesn’t feel overly anxious.
Don’t Neglect Your Own Wellbeing
It’s only natural to put your loved one first, but it’s also important you also pay attention to your own wellbeing. It can be very stressful and difficult to stay positive when caring for people with dementia, especially for a prolonged period of time. As a carer, it’s important to consider your own physical and mental wellbeing, and a great way of doing this is ensuring you’re able to take a break from caring.