Caregivers and the Early Stages of Alzheimer’s Disease


By Peter Ganther

Who hasn’t forgotten a name or a phone number before? We’ve all experienced that. Our lives are so full of inside (our own thoughts) and outside (information overload, honking horns, sirens, etc.) stimuli that a single incident of forgetfulness can be forgiven. But what about more frequent and more serious forgetfulness like losing your way home or forgetting to make mortgage payments. If your loved one seems more forgetful than usual or is exhibiting strange behavior, it may be time to get him or her to the doctor for a full diagnostic work-up to determine whether or not he is in the early stages of Alzheimer’s Disease (AD). This will rule out any potentially reversible causes of memory loss that may be due to a reaction to medication or depression to name just two reasons. There are others.

You might say, “Why? There’s no cure for Alzheimer’s Disease anyway.” That much is true, but the earlier the diagnosis, the more say your loved one can have in planning for his long-term care. AD affects people in different ways. The way it progresses and the symptoms exhibited are as diverse as people are. Early diagnosis is paramount to your loved one’s safety and their plan of care. It may even make things easier for you.

There are several advantages for a caregiver in the early diagnosis of AD in a loved one. You can improve your understanding of the changes that are—and will—take place in your loved one, and educate your family and friends. You can seek out community resources. You can increase your awareness of AD in general, and of local and national research projects, including clinical trials. You can improve your knowledge on safety issues and on preventative health. You can stay up-to-date on progress being made with possible treatment options. Most importantly you can become actively involved in planning for your loved one’s future whether it be financial, long-term care or end-of –life planning.

Surprisingly long-term memory is usually the least, or the last, part of the brain affected. It’s the memories of recent events that are lost. Remembering names, appointments, phone numbers, and details of a conversation are all examples of this lapse in short-term memory. There is impairment in language skills also. Your loved one may have trouble finding the right word, writing, or understanding what is being said. Another problem is doing anything that involves several steps such as shopping and cooking, taking medicine, managing money and balancing a checkbook.

Other difficult areas are problem solving and decision-making. Especially when it’s an emergency situation, your loved one may not be able to respond quickly. Spatial ability and orientation are affected also. Reading a map or following directions, judging depth perception, and feeling lost in known environments are all symptoms. Changes in behavior and mood can be expected as well. Withdrawal, anxiety, and depression are all possibilities.

There are two areas where special attention by caregivers is required: in-home responsibilities and driving. In-home responsibilities are daily living activities such as cooking and cleaning, laundry and taking out the trash. These tasks, while seeming mundane to us, are potentially dangerous to a loved one with AD. She may forget to turn off the stove, get a hand caught in the washing machine’s agitator, or get lost taking out the trash. Driving is another problem area. If your loved one is still driving, constant evaluation of her driving skills is required. In some states, physicians are required to report those patients diagnosed with AD. It’s hard to take those keys away, because it is one of the last vestiges of your loved one’s independence. However, it is not just for their safety, but the safety of all others on the road.

It seems a bit overwhelming, doesn’t it? How does one cope with all of this? Learn everything you can about AD and about your community’s resources. Involve other family members in deciding preferences for long-term care. Be patient—not only with your loved one, but with yourself. Focus on the positive as much as possible—don’t dwell on what used to be, and try to avoid worrying excessively about your loved one’s future. The desire to have close relationships does not stop with a diagnosis of AD. Find ways in which you and your loved one can relate and maintain closeness. Find healthy ways to release the frustration and anger that is often associated with giving care. Exercising—even if it’s just walking a few miles a few times a week—can help with the frustration and anger and make you feel better. Do something that is meaningful to you. In other words take a little time for you. One way to do something meaningful is to become an advocate for those suffering with AD and their caregivers. The more you give, the better you feel.

When it comes right down to it, no one can predict your loved one’s progress through this insidious disease, and no one can tell you how to deal with caring for someone with it. The best that you can do is your best. You must involve others in caring for your loved one. Enlist the help of other family members and use the resources available to you in print or via the Internet and telephone. Always remember, you are not alone.