By Michelle L. Webb, EdD, OTD, OTR/L, CAPS, Post-Professional OTD Program Director and Elective Track Director for Education at Rocky Mountain University of Health Professions
One of the most difficult situations people can experience is watching a loved one progress through the symptoms of Alzheimer’s disease, which is the most common cause of dementia. We can often feel helpless watching as our loved one forgets the most basic things of life, forgets the names and faces of family and friends, and creates a potentially difficult situation as they forget where they are or how to return home.
It is important to remember that once you’ve seen one person with Alzheimer’s disease, you’ve seen one person with Alzheimer’s disease. Everyone is different. And though it can be difficult, we need to remember not to treat a person with Alzheimer’s disease as a child. We can witness what appears to be a regression of types, as we start seeing people in the latter stages of the disease reverting to what seems comparable to childhood or childlike behavior.
It is important we do not speak to these individuals like children, admonishing them with phrases such as, “I told you a million times not to touch that door.” What can we do? If someone is trying to get out of a door, one idea is to cover it. Put a mural there so it appears less like a door. There are places where people can find such items to help manage and support people with Alzheimer’s disease.
People in the early stages of the disease generally know when they are affected. There are several stages of progression of the disease. There can be someone who is in the early stage of the disease who certainly has awareness that something is going on. They know that they are losing memory and are having difficulty recalling things that they never had a problem with before. At that point, in the early stages, a lot of planning needs to be done – living wills, advanced directives and such that can be discussed while the person can make their needs known.
People who are newly diagnosed and their family members should reach out for support in their community, such as the Alzheimer’s Association. They provide support available for families 24-hours per day, 7-days per week. They should also start becoming aware of respite care and other benefits that can help them.
The key risk factors that can lead to Alzheimer’s disease include age, family history, and genetics. We all want to live long, healthy lives, but the reality is as we get older there is a higher risk of the disease. Once a person reaches age 65, the risk of Alzheimer’s disease doubles every five years.
If you had a family member with the disease it puts you at a higher risk. It does not mean you will get the disease; it just means you are at a higher risk and you should look for symptoms. Genetics is another risk factor. If someone has a deterministic gene, they will develop the disease – called Familial Alzheimer’s disease. The positive thing about that is that it happens in very few cases – less than one percent of documented cases.
Some of the risk factors are within our control. For instance, head injury or repeated head injury can increase the risk for the disease. If people are in competitive sports, they need to make sure they wear a helmet. Everyone can wear a seatbelt in the car. If you’re living at home, make sure the home is fall proof, which is really important for senior citizens, so they don’t fall and hit their head or sustain injury. Occupational therapists can perform a home assessment or home evaluation to make sure the environment is safe.
Some ethnic groups are at higher risk for Alzheimer’s disease than others. Latinos are one and half times more likely to develop the disease and African Americans are twice as likely to develop the disease as compared to their Caucasian counterparts, but the risks apply to all people as they age.
Early detection of Alzheimer’s disease is critical because symptoms of other conditions can mimic dementia. Sometimes you think about things like urinary tract infections which can cause some temporary confusion or memory loss. More severe pathology such as a brain tumor may also cause similar symptoms. When people start having memory loss and related issues, the first thing they should do is go to the doctor to rule out any other conditions.
Alzheimer’s disease is fatal, but how does that happen? When you think about the brain, there are approximately a billion neurons and a trillion synaptic connections within. These connections are altered and affected by Alzheimer’s disease. The disease creates an overproduction of certain proteins within the brain that begin to destroy neurons. Over time, this can greatly affect your body systems, which will eventually shut down.
Someone who feels they are beginning to have significant memory loss should have an evaluation. This doesn’t need to be done by a neurologist right away, a general practitioner can conduct a cognitive assessment along with blood work to determine what is going on.
To summarize, to help those with Alzheimer’s disease, it is important to use communication strategies that help a person to feel comfortable and safe. Most importantly treat people with respect, dignity, and love. Remember this is a disease that has a global reach, with an estimated 47 million people affected worldwide. While we wait for a cure, we must remember to advocate for those who have been impacted by Alzheimer’s disease.
For more information listen to RMUpload podcast: The Role of Occupational Therapy In Treatment Of Patients With Dementia.
