Lately, my 84-year-old mother, who lives in an Alzheimer’s disease center, will rest her head on the table for very long periods of time, but she is not sleeping. Her head is resting on the table for such a long time that she gets lines in her forehead. Why does she do this? [ 07/29/10 ]
Alzheimer's disease can often cause a person to become apathetic or depressed, which can also lead to the person becoming lethargic and easily tired. It is possible, for instance, that your mother is mildly depressed, and therefore prefers to sit in this position. It is equally possible that your mother simply finds this position peaceful or calming, and may rest her head on the table as a way to relax or even “meditate,” sort of like a coping mechanism. Maybe if there are people or commotion around her and she does not feel like being social, she may just put her head down as a way to communicate her desire to be left alone. Sometimes, however, Alzheimer's disease simply causes people to have odd behaviors that they did not have before the disease—this may be one of those unexplained behaviors.
Try talking to your mother when she is in the head-on-table position. Does she communicate with you readily or is she non-responsive? Does she keep her head on the table or pick it up when you start talking? Ask her about it. Is it something that is enjoyable to her (the smoothness or coolness of the table) or is it because she is bored, tired, afraid, etc.? She may not tell you directly, but there may be some emotion underlying her response which can help you determine why she does this.
If you think that she seems depressed or apathetic, speak to her primary care physician. A doctor's evaluation could help to determine whether or not she is truly depressed, and whether she could benefit from anti-depressant or anti-anxiety medication.
My father-in-law is in the early stages of Alzheimer’s disease. He and my mother-in-law are in their mid-seventies and currently live in a beautiful condo, but are now thinking of purchasing a home. Their children are concerned that a change of residence and all the added responsibilities of owning a house again will only aggravate the disease. What do you think? [ 07/28/10 ]
The condo is probably better for an older couple who do not need the added responsibilities of maintaining a home and yard. However, is there a reason why they do not think the condo is appropriate for them anymore? Are they worried about noise issues (from them or from their neighbors)? Is it a safety issue (e.g., too many stairs or balconies, too close to a busy highway, etc.)? Do they want something more aesthetically pleasing (e.g., a garden and small yard of their own)? Or do they want to be closer to family? Try to determine what the true reason is for their desire to move. There may be a way to fix their concerns without them having to move homes.
If there is no real way to fix the issue, or if they are determined to move out of their current condo, you may want to suggest an alternative: an assisted living community. Residences in these communities come with the piece of mind that there is always someone around to help out with your father-in-law if your mother-in-law is unavailable or if he requires more care than she can reasonably provide (particularly as the disease progresses). Plus, there is the added benefit of having many of their peers around to socialize with.
If they are going to move, it is best that they do so sooner rather than later, while your father-in-law is still in the early stages. While it is possible to move someone in the later stages of the disease, it is certainly more challenging and upsetting to the individual.
My wife suffers from Alzheimer's disease, but is still very mobile. We have lived in our home for 28 years and she never gets lost. My concern is that she may walk away from home while I am in another room. Is there some type of keypad or combination lock that could be installed to a common passage door or sliding door? I have checked the local stores and have not found anything. [ 07/20/10 ]
There are many such keyless devices available that range in price from under $100 to over $700 depending on the features. You can search for them through an online shopping site such as eBay or NexTag, or simply search for “keypad door lock” or “keyless door lock” in your favorite search engine. Alternatively, you can contact a locksmith in your area who can provide recommendations and install the device for you.
My wife, who is 84 years old, has had Alzheimer’s disease for about 6 years. She is still living at home and I am her primary caregiver. I also receive help for about 5 hours each day from an independent caregiver. Lately, my wife seems to stay in bed for 16 hours each day (8 p.m. until noon the next day). She then sits and watches TV most of the time when she is awake. She eats well and has no other medical problem. She takes Namenda, Aricept, Vesicare, Lexapro and Crestor. Should I be concerned? [ 07/18/10 ]
Alzheimer's disease can cause a patient to have decreased energy, such that they sleep quite a lot and still feel tired all the time. Some patients tire much more easily, and find that they no longer can be as active as they once were. Patients can also become apathetic or depressed, which can cause them to lose interest in daily activities. Sometimes, however, this lethargy can be a side-effect of one or more of the medications being taken. For example, one of the commonly reported side effects of Lexapro is sleepiness. Therefore, you may want to contact your wife's primary care physician to let him or her know what is going on. Perhaps an adjustment to her medications may help.
In the meantime, make sure your wife gets exposure to bright light (or sunshine) during the day and dim, calming lighting in the late afternoon and evening. This can help to keep her internal clock set correctly so that, ideally anyway, she will want to sleep at night and stay awake during the day. You can also encourage your wife to perform some sort of physical activity during the day, as exercise can aid in establishing good sleep patterns.
I am stressed, depressed, anxious, exhausted and feeling guilty from taking care of my husband, who has Alzheimer’s disease. Where can I find help for my poor sleeping patterns, aching body, stomach problems and my foul mood? I already exercise, read, have friends and take anti-anxiety medications. Could it be physical? Am I going crazy? Should I seek the help of a psychiatrist, psychologist or hypnotherapist? My medical doctor wants me to take more medications but I am concerned that I will become addicted. [ 07/16/10 ]
Being a full-time caregiver can be a difficult job that is oftentimes frustrating and thankless. You are not going crazy, you are just feeling overwhelmed. It is great that you do find some time to exercise and do some things for yourself, but it sounds like you could benefit from some more help and time off.
First, please find a caregiver support group in your area and talk to them. Other caregivers have experienced, or are experiencing, similar problems, stress and emotions, and therefore are in the best position to relate to your situation. You can search for Alzheimer's caregiver and patient support groups in your area by visiting our "Resources" section, such as under the Caregiving and Caregiver Support heading in "Helpful Organizations." It is fairly common for caregivers to feel guilt that they are not doing enough, or that they should be giving more or being more tolerant, etc. Just keep in mind that you are only human and you are doing your best. Caregiving, though overall rewarding in the respect that you are caring for your loved one, can be very challenging on a day to day basis, and sometimes it's hard to keep the big picture in focus.
Therefore, I would strongly recommend that you consider getting some respite care help for your husband. Respite care workers can come to your home for a few hours a week (or whatever you arrange) and relieve you of your caregiving responsibilities. Use this time to relax and recharge in whichever way you like best. Alternatively, if your husband is still capable of leaving the house and interacting with others, there may be senior centers in your area which can take your husband for a few hours a day. Don't be afraid to ask for help from family and friends as well. Be specific about what you might want help with—they may be willing but aren't sure how best to help, so you will need to let them know exactly what it is that you could use help with.
Your local Area Agency on Aging (AAA) Eldercare Locator can connect you to helpful services in your area, including respite care options. Click on the above link to find the phone number of your local AAA or call 1-800-677-1116.
Finally, it couldn't hurt to be evaluated by a therapist, psychiatrist or psychologist independent of your medical doctor. It is possible that you could be suffering from mild depression, which could be causing your sleep problems, body aches, and mood swings. While there are antidepressants that could be helpful, there are also non-drug options such as talking therapy. If you don't feel comfortable talking to a therapist, then find someone whom you can “unload” on when you feel fed up at home—such as a friend, clergy, or close relative.
My father has Alzheimer’s disease and when he is attracted to someone he licks his lips repeatedly. Can you explain this? Thank you! [ 07/14/10 ]
Alzheimer's disease (AD) can cause a person to have decreased inhibitions for inappropriate behaviors, which is why some AD patients might go so far as to undress in public. AD can also cause persons to have repeated behaviors or mannerisms. So in your father's case, he may repeatedly lick his lips (a repeated inappropriate mannerism) in response to when he sees someone who is attractive.
My husband, who is 75 years old, has dementia of the Alzheimer’s type and vascular disease. He has some very strange habits, such as picking up every leaf in front yard or street, and picking up everything that I lay down and placing it somewhere else. When I’m not using the dryer, he brings in the clothing off of the line, while it is still wet, and rearranges it all, even though I have requested that he not do so. He gets belligerent if I try to correct him. Are these behaviors normal and approximately how long does each stage of the disease last? Would he be better off to take Namenda and Aricept together rather than just Namenda alone, which is his current treatment regimen? [ 07/12/10 ]
Repetitive behaviors and strange habits such as your husband's are characteristic of Alzheimer's disease, particularly in the moderate stages of the disease. Unfortunately, there is no way of knowing how long this stage—or his behaviors—will last because every patient is different and follows his or her own disease course. But every time you start getting frustrated with your husband, just keep in mind that he is not doing these things to purposely upset or annoy you. If he could help himself, he would not be this way. So even if you remind your husband not to do something, chances are he will forget what you have told him—this is the nature of the disease.
Perhaps your husband feels like he needs to keep his hands busy, or he may think that he is helping you by picking up leaves or rearranging the laundry. Rather than struggle with him over these behaviors, you can try to redirect his energy toward a useful action, such as folding laundry, peeling vegetables, vacuuming, dusting, or any other simple job he might be capable of doing. Maybe the clothes will end up being folded oddly, or the potatoes won't be peeled very well, but don't let it bother you. What matters is that your husband will be kept busy and, more importantly, he will feel that he is needed.
The combination of a Namenda (generic name: memantine) and a cholinesterase inhibitor (such as Aricept) is commonly prescribed for Alzheimer's disease patients. This combination of medications is generally well tolerated, though of course, there are some common side effects associated with Aricept such as nausea, vomiting, diarrhea, and weight loss. Additionally, a few reports have indicated that this combination of agents might have a greater therapeutic effect than taking a cholinesterase inhibitor alone. However, these studies have yet to be confirmed.
My father, who is 83 years old, has recently moved in to a care facility for Alzheimer’s disease patients. In the last five weeks he has become incontinent and is wearing adult diapers; however, he has been going in the closet to urinate. We have put a sign on the washroom in his room and added a night light, but he continues to use the closet as his bathroom. Can you think of any reason why he is doing this and do you have any suggestions to help modify this behavior? Other than this particular issue, he has settled in to his new home better than we had expected. [ 07/09/10 ]
Unfortunately, urinating in inappropriate place is not uncommon in Alzheimer's patients. There are several reason why this might be happening with you father. Most often the problem lies in the patient's perception of the bathroom, toilet or both. Due to the confusion or anxiety created the patient will then seek out an alternative. Being in a care facility, it is most likely that precautions have already been taken to eliminate these issues but it is worthwhile ensuring this is the case.
Starting with the toilet itself, make sure there is a strong contrast between the toilet and the surrounding wall and floor. Due to changes in perception it can sometimes be difficult for Alzheimer's patients to perceive objects or gauge depths and distances. Handrails and anti-slip strips on the floor of the washroom will also help to make your father feel more secure, in case he is anxious about falling or not being able to lift himself from the toilet. It may also help to install a lock on the closet door that the facility can lock each night and unlock in the morning. At least this way he will not be able to use the closet as at toilet at night. Finally, even if he does not need to go, try taking your father into the washroom as much as possible and getting him comfortable with it and with using the toilet. He may just be apprehensive of the room and may need reassurance that there is nothing to fear or be anxious about.