Family members often ask if keeping the Alzheimer patient active involved, and stimulated can stop the progression of the disease. While such intervention cannot “cure” or halt the dementing process, patients who are kept active and encouraged to take responsibility for themselves may experience a greater sense of physical well-being, self-control, and involvement in the family. It is clear that people with Alzheimer’s disease cannot learn as well as before, because of the damage that has occurred to their brains. However, Alzheimer patients may be able to learn simple tasks and facts if they are repeated often enough. For example, demented persons who feel lost and confused in a new place can eventually “learn” to find their way around.What is important is that family members keep their expectations of the patient reasonable and accept that certain skills may be lost forever. Pressuring the patient to learn, or providing too much stimulation and activity, can result in an inappropriately intense negative emotional reaction and cause guilt and anxiety.

Individuals who do not have brain impairment are able to focus their attention on the most relevant information in their environment, ignoring what is unimportant. We are able to scan a room quickly to see who is in the room and what is happening. We note pieces of furniture and knickknacks, and we may be able to read a book and watch television at approximately the same time. Simultaneously, we take in information with our ears. We can listen to three kids, each asking for something different, be aware of the television show we are watching, and know that the baby is crying in the back room. All of this information can be taken in by focusing attention on what we are most interested in seeing, hearing, feeling, or tasting, and ignoring most of the other sources of stimulation.

For Alzheimer patients, who have difficulty focusing their attention, who forget even the most familiar of objects, and who have difficulty understanding speech and what is being asked of them, it is not surprising that going to a new place (or even familiar places) would be stressful and confusing. Imagine suddenly finding yourself in Hong Kong, where you know no one and cannot speak the language. Imagine how frightening that could be. What would you do in such a situation? Wander through the streets looking for something familiar? Perhaps find yourself asking the same questions over and over again? You might even become so frustrated that tears flow or you become angry.

What would help you feel more in control? Perhaps getting off the subway, going to a quiet park, getting away from all the strange sights and sounds would help reduce the anxiety and the restlessness. It would be reassuring if someone would communicate with you by slowly providing gestures, simple words, and maybe even pictures to help you understand where you are and what is happening.

Sometimes the most help we can provide the Alzheimer patient is finding ways to reduce unnecessary, unimportant stimulation, and providing very clear and focused information at an optimal level of intensity for the patient’s level of functioning. At times the Alzheimer patient may withdraw from stimulation and actually become under stimulated. The caregiver must become sensitive to providing appropriate levels of stimulation, drawing the patient in at times for active engagement, but being aware when the patient is becoming over aroused.

In the sections to come, we will attempt to show how to assess the patient’s strengths and weaknesses so that caregivers may determine what levels and type of stimulation and communication are appropriate. Our goal is to work within the patient’s range of capability, balancing stimulation, and breaking down (i.e., simplifying) activities so that the Alzheimer patient may continue to feel involved and somewhat in control of his or her destiny.

No comments yet.

RSS feed for comments on this post. TrackBack URI

Leave a comment