The goal of treatment is to improve the day-to-day functioning of the individual with Alzheimer’s and also to give the best quality of life possible for as long as possible through a combination of treatment methods based on symptoms and the severity of the symptoms. Treatments address slowing down the progression of the cognitive symptoms and managing the behavioral symptoms.

Part of treatment involves educating the patient and the patient’s family, friends and caregivers about the disease because when those around the patient can understand why they behave the way they do it is easier to help them and to have compassion for them.

Medications are used to treat the cognitive and the behavioral symptoms of Alzheimer’s. Non-medicated methods are also used to treat Alzheimer’s such as psychiatric therapy, relaxation exercises and physical therapy to help improve mobility. Research is constantly being conducted and clinical trials are being offered to help with new drugs.

Medications used for cognitive symptoms include memantine, galantamine, rivastigmine, donepezil and also tacrine.

Therapeutic activities may vary and are designed based on the symptoms the individual is experiencing. Activities may include music therapy, walking and other light exercise, relaxation techniques and pet therapy.

Treatment may also include exercise and diet recommendations to help maintain overall health and may include asking for a consultation with a nutritionist or registered dietician, a fitness instructor, an acupuncturist, or massage therapist.

Part of treating a person with Alzheimer’s disease is learning about how to communicate with them as the disease progress. Because the individual will lose ability to communicate it becomes even more important for all those caring for the individual to make every effort to communicate with the individual by trying to eliminate any potential communication problem in advance, use memory clues such as photographs and by leaving notes to remind the individual about routines or tasks that need to be accomplished like taking medication on time. Make use of various communication techniques to help improve the communication between patient, family and caregiver by using reality therapy, validation therapy, redirection, and memory cueing where appropriate.

When designing a treatment plan keep in mind that Alzheimer’s patients do well when there is structure in their lives and consistency in routine. Make sure there is a combination of both active and passive activities in the individual’s daily life.

Treatment options will change as the individual’s disease progresses. The plan will then need to be updated to include current needs and to address the symptoms that are currently being experienced. As the disease progresses the treatment will become more restrictive and involve more care.

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When treating a patient with Alzheimer’s the treatment plan will need to address the cognitive symptoms, behavioral symptoms, traditional medicated treatments, alternative treatments, being able to monitor carefully the progression of the symptoms, educating the patient, family and close friends as well as educating and caregivers. Care must be coordinated between all involved parties and end-of-life decisions must be made and incorporated into the treatment plan.

The cognitive symptoms of the disease are treated with cholinesterace inhibitors and NMDA receptor antagonists and sometimes vitamin E supplements. Commonly prescribed cholinesterase inhibitors include donepezil, rivastigmine, and galantamine.

Another drug used to treat Alzheimer’s is memantine, which is an uncompetitive low-to-moderate affinity N-methyl-D-aspartate (NMDA) receptor antagonist.

The behavioral symptoms of the disease are treated with non-drug therapies and strategies such as taking steps to identify the problem behavior, changing the living arrangements to be less disruptive, to monitor behavior and educate individuals living with them what to expect and how to monitor the behavior and how to safeguard the individual and all other parties living with them. Other therapies include redirecting the attention of the individual, simplifying tasks and daily routines of the individual, encourage the individual to take frequent rests and to see to the safety of the individual and all involved by installing safety locks and gates, removing all guns or knives from the environment and reducing the risk for fire by installing and monitoring closely smoke alarms and monitor usage of stove.

Alternative treatments that have been explored by the scientific and medical communities have been Gingo biloba, Huperzine A, Omega-3 fatty acids, Coenzyme Q10, phosphatidylserine, and coral calcium.

The caregiver must be involved in the treatment plan design, and in implementing the treatment plan because it is the caregiver who must be responsible to implementing the plan.

The doctor is an intricate part of the treatment plan not only because he/she designs it but also because it takes a real commitment to understand, and to stay on top of the changes concerning Alzheimer’s disease. The treatment plan must understandably change as the symptoms worsen.

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The usual first sign of Alzheimer’s is very mild forgetfulness and complaints of memory problems such as not remembering where something was placed, or not being able to remember where you parked the car, or not being able to remember the names of individuals that you recently met.

After the mild initial stage, which by the way is before the disease is usually diagnosed; the individual will slowly progress into the next stage of Alzheimer’s where others will start to notice that there is something “off” about the individual such as the person becomes easily confused, gets lost while driving or walking in familiar areas, work performance declines and the individual has difficulty reading or following instructions. The individual may deny these things when confronted.

The next stage is when the symptoms become obvious to the individual and to others and is when diagnoses usually take place for Alzheimer’s disease. Now that there is a diagnosis, there is a reason for the signs and symptoms and plans can be made to accommodate the individual and keep them safe.

The individual will need assistance with financial matters, and will not be able to travel alone. The individual will no longer be able to perform complex or dangerous tasks. The individual may exhibit anxiety or even denial in the face of these symptoms and signs.

As the disease progresses the individual will begin to repeat sentences or motions and may even occasionally forget family names such as the spouses or the names of sons and daughters.

In the later stages of Alzheimer’s disease the symptoms worsen to include dementia for place or time and the loss of all verbal ability or being able to perform daily self-care tasks, even the inability to swallow or sit up. This is when 24-hour care is necessary and most individual are placed in nursing homes or full-service care facilities.

Early diagnosis means that there can be more good years as certain medications prescribed for Alzheimer’s can slow the progression of the disease. There is ongoing research for new medications and for an eventual cure for Alzheimer’s disease.

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Alzheimer’s progresses from the first stage of the disease (mild) to the second stage (moderate) to the final stage (severe) in a usually slow progression. The symptoms worsen with each stage and so does the required amount of care. By the time the patient is in the moderate stage he or she is requiring a constant caregiver. The reason for the caregiver is because the person with Alzheimer’s cognitive abilities are rapidly declining by the time she or he is in the moderate stage of the disease. Cognitive functioning is necessary for all types of daily tasks from being able to plan, prepare and serve a meal to being able to bath and dress to get ready for the day. Tasks that require complex cognitive skills such as balancing a checkbook, going shopping ding housework and performing tasks required for maintaining employment are often those that are out of the reach of those in moderate stage Alzheimer’s.

The cognitive symptoms of Alzheimer’s include attention span, ability to make decisions, the ability to learn new things, memory retention, planning, perception, problem solving, being able to reason and the ability to think in terms of more than one step at a time. Daily tasks such as being able to get dressed, brush teeth, bath or take a shower, get dressed, plan the day’s activities, pay bills, prepare meals, or do household or employment tasks are all symptoms related to cognitive ability of the patient. When these cognitive symptoms get progressively worse as they do with Alzheimer’s the patient’s ability to safely function in daily tasks declines to the point where it is essential to have a caregiver for safety and health reasons.

Behavioral symptoms are perhaps the most confusing for family members and others close to the individual because they involve the attitude of the person, gestures that the individual makes that may be completely out of character, and reactions to situations may be completely inappropriate especially while out in public. Moods will completely change and baffle friends and family members.

The symptoms will define the disease from the diagnosis to the identifying of stages as the patient progresses through them. The treatment plan will be based on the symptoms and their severity. Caring for the Alzheimer’s disease patient will be largely based upon the symptoms and how they affect the health and safety of the individual. Understanding what symptoms is part of the disease and why the individual is acting the way they do allow others to have compassion for the patients and assures that the quality of care will be appropriate. It is important that all caregivers of those with Alzheimer’s be educated regarding the symptoms and the progression of the symptoms.

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In the first or mild stage of Alzheimer’s the individual is aware of not being able to remember things like familiar streets while driving or how to perform tasks at work that were once very familiar and routine to them. They may forget where they put car keys or their medicine on more than just an occasional basis. They notice a decline in their ability to speak or write when words just fail to come to them when they need them to. Not only do those suffering from Alzheimer’s lose memories that are precious to them but they lose the ability to function at work and at home in tasks that they do on a daily basis like eating, bathing, and dressing for the day.

It is frightening to know a familiar face but not to be able to put a name to it, even when you know that you should know the name of the person. It can be very confusing to not be able to think straight when balancing the checkbook and can even cause financial problems that can cause further stress.

As in most serious diseases, getting the diagnosis can be a very emotional experience as the individual faces the knowledge that all they know and hold dear will slowly disappear and that they will lose all control over what is happening to their bodies, mind and in most cases to their ability to control emotional expressions. This knowledge can be very frightening at first. Quality medical staff can help ease the transition from diagnosis towards a place where the patient can understand the stages of the disease and how treatment plans can help them to manage the symptoms so that they will be able to retain as much independence as possible for as long as possible. Symptom management is all about bringing comfort and control to the patient for as long as possible.

The patient needs to feel respected and that they have a say in what happens to them even when they lose all cognitive awareness. It is important that the patient be given a voice in treatment and to have the ability to express wishes for when they reach a stage in the disease where they are unable to express their desires. When patients are given this ability to control events later in the disease through expressing desires in the earlier stage of the disease medical professionals and family members are giving the patient the gift of respect and comfort that is so important.

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Scientists believe that Alzheimer’s is connected to brain nerve cell death. Individuals over age 70 have an increased risk for Alzheimer’s disease because age is the most common risk factor for the disease. Age is not the only risk factor for the disease; genetics is also a risk factor especially if you have a family member who has the disease or if you have Down’s syndrome. If your parent had early onset Alzheimer’s disease and have a genetic gene mutation they have a 50% risk for developing Alzheimer’s disease. The genetic risk can also be there for individuals for a common for of the disease that scientist say is located on chromosome 19 although no specific genetic risks have been identified by scientists as of yet.

If you have other medical conditions such as high blood pressure, diabetes, high cholesterol, diabetes or coronary artery disease or if individuals have had less than eight years of education also have an increased risk for Alzheimer’s disease.

Scientists have determined that individuals who have Down’s syndrome may also have brain changes that may occur in the brain before age 40. When those who have Down’s syndrome are aware of this risk for Alzheimer’s disease they can take extra care to have medical exams to determine their risk.

As with any disease individuals need to not only be aware of the signs and symptoms of the disease and their risk factors for the disease they must also be willing to take action if they notice any signs or symptoms. Because Alzheimer’s is not a normal part of aging, it needs to be understood that anyone exhibiting signs or symptoms of Alzheimer’s is not exhibiting normal age stuff but should receive a prompt medical evaluation to determine if they have Alzheimer’s disease. Unfortunately, doctors sometimes forget this important fact. They may assume that forgetting important things like turning off the stove, or where they put the car keys is a normal part of aging until they find out that an elderly patient’s forgetfulness leads to a fire that injures others; a fire started because they forgot yet again, to turn off the stove. It is important to take all signs and symptoms seriously.

Today, individuals are living longer lives often into there 90s and sometimes past age 100. This statistic means that more individuals are reaching these older ages, which are more likely to show signs and symptoms of Alzheimer’s disease. Signs and symptoms should not be taken for granted or overlooked simply because of advanced age.

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It is the approach of darkness that seems to trigger the sundowning to occur. When darkness approaches the individual will become increasingly agitated and confused. The individual is also greatly fatigued and easily over stimulated.

Sundowning is perhaps the single most difficult part of Alzheimer’s for others to understand because the behavior is often so bizarre that it confuses family members and friends. Communication can be difficult and safety measure must be in place because of the confused state and agitation that is likely to occur.

There are many things that can be done to minimize the intensity of the symptoms experienced by the patient. Factors that trigger symptoms tend to be low lighting, a noisy environment, fatigue and increasing shadows. To make things easier on the patient as these hours approach each day try to keep the patient in a calm and quiet environment that is well lit. It also helps to make sure that the individual has had the opportunity to rest or nap during the day so as not to be fatigued as the evening draws close.

Symptoms that the patient may exhibit during sundowning include:

* Fatigue
* Visual Hallucinations
* Agitation
* Confusion
* May easily become frightened of strangers (real or imaginary)
* Become disoriented
* Exhibit Paranoia

It is vital that anyone who cares for someone with Alzheimer’s understand the concept of sundowning. It is important to understand that the individual has a disease and that the symptoms are characteristic of the disease and they are not to be punished or ill-treated because of their aggression or other behavior that may look on outward appearances to be threatening of others. The Alzheimer’s patient must be monitored and kept safe especially from wandering during these hours when sundowning is likely to occur. Caregivers, family members and friends should be instructed as to what the symptoms are and how to address them when they occur. The environment should be set up to protect the individual from harm such as providing adequate lighting, maintaining a quiet environment as much as possible and to remove all possible hazards for when the individual becomes confused.

If the concept of sundowning is not explained to respite workers, unfortunate incidents can happen so remember to educate all staff, respite helpers and family members or others living in the same home with the patient of the aspects of sundowning as well as other symptoms of Alzheimer’s disease.

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If an individual experiences memory loss that affects the way they are able to perform daily tasks they should take notice. We all occasionally forget where we put our car keys or we forget an appointment; these things become significant when the signs affect our safety or the safety of others. When an individual is experiencing a sign of Alzheimer’s disease they forget things more often and tend to not remember then later on especially if the item they have forgot is a recent event.

The person with Alzheimer’s disease may also experience difficulty-performing tasks that have been familiar to them such as forgetting to turn off the stove, or how to clear a table and place leftovers where they belong.

Individuals who have Alzheimer’s may also have language difficulties such as having trouble coming up with the right word during the course of a conversation or forget simple words that have familiar in the recent past.

The person who has Alzheimer’s may have difficulty knowing what day of the week it is or have difficulty where they are going when out for a walk. Individuals with Alzheimer’s can easily become lost on their own street even if they have lived there for most of their adult life. Alzheimer patients can become disoriented, confused or not remember where they are and how to get home.

Someone with Alzheimer’s disease may not know what day of the week it is, or where he or she are (state, city).

You may discover that a person with Alzheimer’s will be wearing a heavy winter coat on a hot summer day, or forget to eat meals or take medications.

Individuals with Alzheimer’s have a great deal of difficulty dealing with complex tasks like balancing a checkbook.

We all can from time to time put things in really silly places when we become distracted such as putting the ice-cream in the dish cupboard when your child is distracting you as you put the groceries away; but a person with Alzheimer’s start to consistently put things in inappropriate places.

Someone with Alzheimer’s may have drastic changes in mood or behavior such as a person who is typically mild-mannered and timid may become aggressive and loud. They may become easily fearful or anxious. They can become suspicious, confused even withdrawn.

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There are many decisions that need to be made during the course of the disease, many have to be made immediately upon the diagnosis and others need to be made as the individual progresses through the stages of the disease. Decisions should be made with personal values, medical advice, and personal needs of the one with Alzheimer’s in mind. Some choices will be determined based on available alternatives or options that are possible given the residential community. Decisions can often be made as a team (patient, doctor, care facility staff) and other decisions are of a personal nature. Sometimes the decisions, especially in the beginning can be made with input from the person who has Alzheimer’s but because of the cognitive decline that is the hallmark of the disease, it will soon become impossible for the patient to have much input. This is where having a living will may come in handy if the will is made prior to the individual being diagnosed with Alzheimer’s disease.

Community resources may be available that can aid you in making many of the choices involved in caring for someone with Alzheimer’s. These community resources include the doctor’s staff, support groups, counseling programs, and volunteer Alzheimer’s groups or organizations. Many communities offer structured day programs to assist with the care of Alzheimer’s patients and are staffed by professionals. Other choices are in-home support help, short-term respite care, and professional’s set-up to help with financial and legal issues facing someone with Alzheimer’s.

Decisions need to be made about personal and daily care needs, when the individual with Alzheimer’s should stop driving or cooking on their own and even when it is safer for them to stop living on their own. It is better to discuss these issues before crisis situations arise to force the decisions.

Guidelines for making these essential and important decisions include: Focus on understanding all the needs and preferences of the one with Alzheimer’s, discussions can be sensitive especially at first – resistance is normal so be patient, allow for personal input from the patient for as long as possible, don’t be afraid to come back when the individual is having a better day for communicating, recognize that the individual with Alzheimer’s has rights and respect them as much as possible while at the same time keeping an eye out for safety and for what is best for good health.

The diagnosis can be emotionally upsetting for everyone involved so take it slowly and carefully at first until you know everyone’s individual style of communicating and until everyone has had a chance to digest the news. There are trained counselors that can help families to go through the decision-making processes so explore your options for help in this regard with the doctor in charge. Don’t ever be afraid to ask questions and seek resources! Knowledge is powerful and the more informed you are about the topic of Alzheimer’s the better capable you will be to make those all important decisions.

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Those “senior moments”, have a non-medical term of mental glitches. Being on either end of this occurrence can be bewildering and just a little frightening. To observe someone in the midst of a senior moment may have you wondering, how old is Aunt Martha? Is she old enough to be going senile? Aunt Martha is probably thinking the same thing as she scrambles to recover her dignity and change the subject. We all do dumb things from time to time. If you are in your teens, 20s or 30s these dumb cognitive moments may be referred to as “Freudian slips” and they are often met with humor or intense blushing! As we age, these mental slips demand more scrutiny especially as Alzheimer’s becomes something that has received more public awareness. No one wants to receive the diagnosis of Alzheimer’s. The realization that those memory lapses, inability to remember people, places or events is more than just a “senior moment”, can be devastating to all concerned. Many “senior moments” can be attributed to lack of sleep, being over-stressed, or being distracted but they nonetheless are little nagging events that give us cause to pause and ponder about our mental health.

We all tend to “temporarily” forget things from time to time. When these “senior moments” change from being only a nuisance to perhaps something more serious is when they start to interfere in your daily life. If this happens then those moments may be something more serious such as a symptom of Alzheimer’s.

If your “senior moments” are making life difficult for you, that is when it is time to make an appointment with your doctor to have the situation evaluated.

Your doctor will take a medical history – your personal history and those of close family members such as if any close relatives have been diagnosed with Alzheimer’s (mom, dad, siblings). You may have a physical examination to see if there are any physical symptoms that go along with the symptoms you came into the doctor’s office for. You may be asked to go to the laboratory for blood or urine testing. If the doctor feels it necessary you may need to have one of several scans to rule out Alzheimer’s.

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