Connecting with Alzheimer's Patients (03:48)

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NEVCO President Ted Wolfendale tells a story of visiting his former high school English teacher in an assisted living facility and making a difference in her life.

Behavior Management (03:21)

In addition to memory loss, symptoms include language difficulties, executive function problems, perception problems, loss of motor skills, inability to carry out daily activities, and personality changes. All behavior has meaning, a cause, and a result.

Problematic Behaviors (03:08)

Stage one behaviors include anger and aggression when confronted with short term memory loss. Stage two behaviors include paranoia, difficulty identifying objects, sleep disturbances, and wandering. Stage three behaviors include inappropriate yelling, resisting ADL assistance, and decreased verbal communication.

Addressing Specific Behavior Challenges (01:46)

Agitation, vocal outbursts, wandering, and restlessness may present during Alzheimer's disease. Environmental and behavioral approaches should be attempted before medications.

Changes in Abilities (01:13)

In stages one and two, patients experience changes in functional and verbal abilities that become progressively worse. Family caregivers should be encouraged to make the most of good days.

Denial of Memory Problems (04:35)

Patients may make excuses, project their deficit onto family members, undergo personality changes, or withdraw from challenging situations. Caregivers should accept these as coping strategies, satisfy underlying behavior needs, avoid criticism, limit exposure at large gatherings, and provide emotional and verbal support.

Repetitive Questioning (01:43)

Caregivers should avoid arguing or angry responses, respond clearly and slowly to questions, and have the patient repeat what they say or write down their answer.

Storytelling (00:40)

Patients can make up stories in vivid detail. Caregivers can look for clues to determine underlying needs.

Restlessness and Agitation (00:50)

Patients are aware of their decreasing ability to perform executive functions and often become agitated. Coping strategies include reducing noise and activity, using reassuring approaches, and consulting a physician if the agitation is difficult to manage.

Incomplete Tasks (02:12)

In stage one, people have difficulty completing tasks requiring multiple steps. Caregivers should maintain a routine, keep patients focused in the present, give single-step tasks, express gratitude for their assistance, and provide assistance for complicated tasks.

Accusations Involving Money and Finances (02:11)

Late in stage one, patients begin experiencing confusion around bill paying and managing accounts. Family members should make legal arrangements to oversee finances. Families can provide a limited credit card or second checking account to maintain the perception of independence.

Clinging Behavior (01:15)

Fear of being left alone can lead to feelings of loss and insecurity. Caregivers can use diversions, maintain a daily schedule, identify fears and alleviate them verbally, and have family members call regularly.

Sexual Inappropriateness (02:23)

Some patients experience hyper sexuality or disinhibition during stage two, when frontal areas of the brain are compromised. Distraction and opportunities for appropriate physical attention can be effective.

Poor Hygiene (01:51)

Patients may think they have just showered or become frightened by bathroom sounds and sensations. Caregivers can schedule bathing routines, make bathing a relaxing experience, and be aware of fears of water, falling, being cold, or undressing.

Wandering (03:13)

Patients may become more confused or restless in the late afternoon. Caregivers should keep patients active during the day, reorient wandering patients, reduce noise levels, secure outside doors, keep a light on, and consider medication or other causes of disorientation.

Hallucinations & Delusions (02:25)

Patients may have imaginary sensory experiences during stage two. Caregivers should use supportive behavior, redirect them to a pleasant activity, provide information about their environment, and report to a physician.

Refusal to Eat (02:20)

Patients may lose desire to eat or drink. Caregivers can use comfort foods to increase appetite, introduce small and frequent meals, increase patient exercise, make mealtimes pleasant, supervise chewing and swallowing, use protein supplements, and be aware of medication interactions.

Failure to Recognize Familiar People and Things (01:12)

Calling attention to memory deficits increases patient anxiety. Caregivers should avoid arguing, use a gentle voice, avoid reacting negatively, calmly identify the person, be patient, flexible and understanding, and avoid rushing.

Promoting Independence at Stage One (03:59)

Caregiving goals include maintaining independence, encouraging participation in daily activities, and maintaining personal dignity. Patients generally manage personal care, maintain continence, and eat independently during stage one. Caregivers can mark designated places for important information, post visual cues, and install bathroom safety measures.

Promoting Independence at Stage Two (11:24)

Patients are generally diagnosed at stage two and require supervision; family caregivers may become stressed. Learn about strategies to provide bathing, grooming, dressing, eating, and toileting assistance. See additional causes of incontinence.

Promoting Independence at Stage Three (05:14)

Patients are completely dependent on caregivers and require constant supervision. They may be unable to communicate, recognize people, walk, or coordinate chewing and swallowing. Learn about strategies to provide bathing, grooming, dressing, eating, toileting, and incontinence assistance.

Developing Skills for Working with Families and Caregivers (06:42)

Family caregivers may experience depression, denial, anxiety, fear, and isolation as they gradually lose their loved one. Sleep disturbances, incontinence, and behavior changes occur in stage two. In stage three, patients require constant care and may be nonverbal; caregivers may experience anticipatory grief.

Credits: Alzheimer's Disease For Assisted Living Facilities, Level Two - A New Culture For Treatment (00:40)

Credits: Alzheimer's Disease For Assisted Living Facilities, Level Two - A New Culture For Treatment