Alzheimer's Disease: Introduction (02:27)

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The neurological disease is not a normal part of the aging process; learn about its discovery. This film will cover how to communicate with patients, recognize symptoms, manage behaviors, maximize daily function, and work with families and caregivers.

Understanding Alzheimer's Disease (03:15)

The progressive, degenerative disorder attacks the brain's nerve cells—causing memory loss, language deterioration, and behavioral changes. Hear a definition for dementia. Types include vascular, mixed, fronto-temporal, Lewy bodies, and dementia associated with Creutzfeldt-Jakob or Parkinson's disease.

Alzheimer's Pathology (07:20)

Alzheimer's disease dementia affects four million Americans and typically lasts two to ten years. Learn about brain function, beta-amyloid plaques, and neurofibrillary tangles. Symptoms include short-term memory loss, declining language skills, and declining motor function.

Alzheimer's Symptoms (04:47)

Early symptoms may be confused with the aging process. From age 30, the hippocampus and frontal cortex begin declining. Alzheimer's impairs the ability to retrieve and create new memories; patients are unaware of their forgetfulness. See a symptom list.

Conditions Mimicking Alzheimer's (02:35)

Early symptoms can mimic hypothyroidism, vitamin deficiencies, niacin deficiency, folic acid deficiency, hypocalcaemia, neurosyphilis, depression, delirium, or poisoning.

Alzheimer's Stages (04:19)

The "forgetfulness" stage lasts two to four years. The "confusional" stage lasts two to ten years after diagnosis. The late stage lasts one to three years. Learn about symptoms of each stage.

Stage 1 Client Interaction (02:45)

Early stage Alzheimer's patients experience forgetfulness and language decline. Hear ways to improve communication, including using body language.

Stage 2 Client Interaction (02:20)

Moderate stage Alzheimer's patients have decreased attention spans. Hear ways to improve communication, including using sensory stimuli and body language.

Nonverbal Communication Techniques (06:22)

Body language is especially important for late stage Alzheimer's patients. Hear examples of using touch, music, books, and outdoor activities to help clients relax. See sensory stimulation examples.

Improving Alzheimer's Quality of Life (03:47)

Ted Wolfendale shares how his high school English teacher helped him through a crisis. Later in life, he visited her regularly at a nursing home, improving her mood and outlook.

Non-Memory Alzheimer's Symptoms and Behavior (03:22)

Patients also experience language decline, problems with executive tasks and perception, motor skill loss, inability to carry out ADLs, and personality changes. All behavior has meaning, cause, and effect.

Problematic Behavior (03:07)

Stage 1 individuals may blame others and react angrily when confronted with memory deficits. Stage 2 patients may exhibit paranoia, diminished verbal communication, and sleep disturbances and wandering. Stage 3 patients may yell inappropriately, resist ADL assistance, and struggle to communicate.

Changes in Abilities (03:00)

Medications for challenging behaviors have side effects; non-drug approaches are preferred. Declines in functional and communication abilities begin during Stage 1. Home health professionals can remind family caregivers to appreciate the good days.

Denial of Memory Problems (01:08)

Many patients deny, make excuses for, or project their memory deficits onto family members. Forcing confrontation of memory loss causes anger and frustration. Home health professionals can help family members understand the coping strategy.

Personality Changes (03:26)

In Stage 1, patients often withdraw from challenging situations to hide deficits. Disease acceptance promotes understanding between clients, caregivers, and healthcare providers. See ways to help family members accept changes and help patients remain social.

Repetitive Questioning (01:43)

See ways to manage preservative behavior in Alzheimer's patients.

Storytelling (00:39)

In Stages 1 and 2, patients create detailed stories that they believe. Hear ways to manage fantasy behavior.

Restlessness and Agitation (00:51)

Stage 1 patients are aware of their inability to perform executive function tasks—causing internal restlessness. See coping strategies.

Incomplete Tasks (02:11)

Stage 1 and 2 patients will have difficulty completing tasks requiring multiple steps. See ways to manage this challenging behavior and help patients maintain independence.

Accusations Involving Money and Finances (02:11)

Patients lose executive functions of managing bills and accounts. With consent, family members should make legal arrangements to oversee finances in the early disease stages. A credit card or second checking account can help them maintain a sense of independence.

Clinging Behavior (01:14)

In mid to late Stage 2, patients can experience fear of abandonment. Diversion and a daily schedule can help minimize feelings of isolation.

Sexual Inappropriateness (02:23)

Some patients experience increased sexual interest or disinhibition, or use vulgar language. Home health professionals can remind individuals that such behavior is inappropriate, use distraction techniques, and increase appropriate physical attention.

Poor Hygiene (01:51)

Patients may believe they have just showered or become frightened by the shower. See ways to promote good bathing habits.

Wandering (03:13)

Restlessness and sundowning increase during Stage 2. Some patients become more impulsive and disoriented due to decreased nighttime stimuli or medication side effects. See techniques to minimize wandering and ensure safety.

Hallucinations and Delusions (02:26)

Sensory experiences can seem real to patients. Supportive, calming behavior helps comfort them, rather trying to convince them they are imaging things. Home health professionals should consult a physician about hallucinations.

Refusal to Eat (02:20)

Home health professionals can use comfort food and aromas to increase patient appetite. Small, frequent meals can assist in maintaining weight. Swallowing can become impaired in Stage 3; see tips for appetite stimulation.

Failure to Recognize Familiar People and Things (01:34)

Patients lose their recognition abilities in Stage 2. See tips for helping to manage this behavior.

Promoting Independence and Working with Family Caregivers (01:52)

Care goals include maintaining independence as long as possible, encouraging participation in daily activities, and maintaining dignity and self-worth.

Promoting Independence at Stage 1 (03:05)

Patients become forgetful but are generally able to manage self-care. Home health professionals can help them establish designated places for important information; post visual cues and answers to common questions; and implement bathroom safety measures.

Promoting Independence at Stage 2: Bathing and Grooming (03:40)

Patients are generally diagnosed and require supervision during Stage 2. Family caregiver stress becomes evident as abilities fluctuate; patients become unaware of their decline. Hear ways to provide assistance with bathing and grooming.

Dressing at Stage 2 (01:47)

Patient ability to sequence diminishes during Stage 2. Hear ways to provide assistance with dressing.

Eating at Stage 2 (02:51)

Taste and smell may diminish; selecting food and using utensils may become difficult. Hear ways to provide eating assistance and maintain weight and nutrition.

Toileting and Incontinence at Stage 2 (03:08)

It is important to identify possible incontinence causes, other than Alzheimer's disease progression. Hear ways to reduce incontinence and maintain patient dignity.

Promoting Independence at Stage 3: Bathing and Grooming (02:48)

Patients become dependent and require total physical care. Falls and difficulty eating are common. Hear ways to provide assistance with bathing and grooming, including bathroom safety measures and observing for skin changes.

Dressing, Eating, and Toileting at Stage 3 (02:23)

Hear ways to provide assistance with dressing, stimulate chewing and swallowing, and manage incontinence.

Developing Skills for Working with Families and Caregivers (06:41)

Learn about family reactions and concerns during the Alzheimer's stages, including the grief process as loved ones deteriorate. Home care professionals can provide them with ongoing support, education, and advocacy.

Credits: Alzheimer's Disease and Related Disorders For Home Health (00:42)

Credits: Alzheimer's Disease and Related Disorders For Home Health