My brother was diagnosed with Stage 1 Alzheimer's disease about 18 months ago, and his wife put him in a home. He has never been violent until the one time he shook her. He has suffered from depression for many years, and he is again talking about suicide. He says that he doesn’t want to go on with life. I live 6 hours away from my brother, but try to visit him once every few months and email him once a week. I love him very much. Are the depression and suicidal thoughts typical symptoms of the Alzheimer’s disease? [ 01/04/11 ]
Depression is a fairly common problem in Alzheimer's disease patients, particularly those in the early stages of the disease who are aware of their own cognitive decline. One study found that a diagnosis of Alzheimer's disease by itself increases the risk of both depression and suicide in elderly patients. This study reported that people who had a higher level of daily functioning (that is, they generally had mild symptoms or were in the early stages of the disease) and had previous suicide attempts were at an elevated suicidal risk. In agreement with these findings, a more current study (Draper et al. Alzheimers Dement. 2010 Jan; 6(1):75-82) also indicated that early diagnosis of Alzheimer's disease or other dementia may actually increase the risk of suicidal thoughts.
Therefore, if you have not already done so, please talk to your sister-in-law about your concern for your brother. You or your sister-in-law should also alert the staff at his care facility that your brother has been having thoughts of suicide. The staff may already be aware of this, but it won't hurt to relay your concern. Talk to his doctor as well; your brother's antidepressant medication may need to be adjusted. You or your sister-in-law may also consider insisting that your brother see a mental health professional who has experience with the elderly and with dementia.
Finally, continue to visit, write or call your brother as much as possible. In addition to the weekly emails, consider calling him once or twice a week and sending him a hand-written letter. A paper letter is something he can actually hold, touch, and re-read whenever he wants, not just when he has access to a computer. And when you speak to him, be sure not only to seem genuinely interested in what he has to say, but also tell him that you love him and are concerned about him. Additionally, you might consider contacting a suicide hotline on behalf of your brother for more assistance and advice.
My mother keeps asking about her children and thinks that they are still young. How can I help to calm her down when she wants to be with them? [ 12/22/10 ]
The fact that your mother thinks that her children are still young is not that uncommon for an Alzheimer's disease patient, who often confuse the past with the present. Your mother may be remembering a time when she felt needed and valued, and therefore may have a desire (a subconscious one, granted) to return to this “happier” time in her life. This is probably why, when you inform her that her children are grown now, she becomes upset. There isn't much point trying to reason with or use logic on a dementia patient—they often are so far into their own reality that arguing with the patient will only serve to agitate them even more. In this instance, therefore, it might be best to play along with your mother's questions for a while, then try to change the subject to something less distressing.
Additionally, you might want to consider doll therapy as a means to help your mother. Doll therapy involves giving a doll baby or teddy bear to a dementia patient and allowing them to interact with the doll in whatever way they want (i.e., dressing the doll, feeding it, rocking it to sleep, etc.) One formal study found that patients given dolls to “care for” tended to be more communicative with caregivers and less prone to negative behaviors, such as agitation or anxiety. Doll therapy seems to bring out the nurturing instinct in many dementia patients, particularly females, who may be reliving memories of being a mother of an infant, a time in their lives when they were very much needed and useful.
Non-formal observations by caregivers recommend that the doll be as lifelike as possible, and be introduced to the patient while he or she is still in the early stages of the disease to allow time for bonding with the doll. Given in the later stages, the doll may be less effective.
My mother was diagnosed with Alzheimer's disease 5 years ago. She has lived with me for the past 4.5 years. She takes Namenda, Aricept, Singulair, Amatiza, Mucinex, a multivitamin, a B complex capsule, vitamins C and D, calcium, melatonin, magnesium, potassium, an omega 3 supplement, 81 milligrams of aspirin, and a probiotic. Her physician is aware of what she takes. For the past year, several times a week, she complains of body aches. She states she aches from head to toe. I took her to the doctor and she suggested that we take her off all of the supplements. I did and nothing changed, she still ached. She does not have a history or any other signs of arthritis. She has become less active, so I have her going to adult day care 2 times a week. At day care, she exercises and moves around the room. At home, her normal routine is to get up in the morning and head to the couch and lie down. Are the body aches a normal Alzheimer's symptom? [ 12/20/10 ]
Alzheimer's disease is not typically associated with body aches, so it is most likely something else that is causing your mother's pain. Vitamin B12 deficiency can sometimes cause body aches, but since your mother is on a vitamin B complex supplement, this probably is not the cause. Low progesterone levels are also a culprit in some instances, and a routine blood test could determine her hormone levels. However, based on your description, it is possible that your mother might have depression, chronic fatigue syndrome, or possibly even fibromyalgia. It is not uncommon for dementia patients to suffer from depression, and depression can provoke symptoms such as fatigue and chronic pain. In fact, chronic pain and depression are so interrelated it is sometimes difficult to determine which condition started first. It would be prudent to ask her doctor to review her medications and possibly give her another check up regarding the body aches and pains, and to check for signs of depression as well. Only he or she can help to narrow down the causes of your mother's pain.
You are right to encourage your mother stay active both socially and physically, as well as to drink plenty of fluids to stay hydrated—these are both excellent ways to keep muscles and joints healthy and (hopefully) prevent more serious aches and pains. Also, you say that you are at work all day. It is possible on these days your mother is simply bored at home. On the days your mother is not at adult day care, perhaps you can arrange for an in-home visit by a nursing assistant or family friend to check in on her and encourage her to move around, along with providing social stimulation.
Why does my father keep saying he is going home to see his mother? What do I say to him? [ 12/19/10 ]
The desire to return “home”—be it their last residence or their childhood homestead—is very common in patients with Alzheimer's disease. Patients also often confuse the past with the present. You father may be saying that he wants to go home to see his mother because that is a place he may have felt safe or needed. Sometimes, Alzheimer's disease patients feel like they are a burden to their caregivers, or else they may feel like they are no longer a valued member of the family or of society in general. They feel as though they have lost their definition of who they are.
So the next time your father says he is going to see his mother, try to get him to talk about it a bit more to see if you can determine the underlying emotion behind his repeated statements of returning home. You can draw him out by asking him to tell you more about his favorite memories of home and of his mother and family, etc. Even if you've heard the stories before, just let him talk. Does he feel threatened, scared or lonely in any way? Does he feel useless or depressed? Really listen to what he is telling you and try to read between the lines. Once he is finished telling his stories (and once you think you might have some idea about the emotion stemming from his statements) be sure to reassure him that he is loved and valued, and that he will be loved and well-cared for no matter what happens. Repeat this as necessary, continuing to reassure him and soothe his anxieties and fears.
I am a 49-year-old woman and have Alzheimer’s disease. My dad, his mother, and six brothers and sisters all died from this disease. I know what I went through when I took care of my dad. He was once a man and twice a child. I don’t want my kids to go through what I did as a teenager. Please help. [ 12/18/10 ]
If you have not done so already, now would be a good time to sit down with your family lawyer and work out your finances and end-of-life planning. Although it may be very difficult to discuss with your family, this is something that needs to be dealt with now. I understand your desire to not want to burden your family, and therefore the sooner you have this conversation with your family, the better for all involved. Your family may not have any idea about how you want to be taken of, so you will need to inform them of your desires while there is still opportunity to plan. At the very least, you need to make some tough decisions to sort out your finances, establish a living will, and put in place any other advanced directives. These are things that you can have in place now that will help your family in the future. No one wants to think about these things, but they are absolutely essential for preparing for what lies ahead.
There are treatment and care options available now that probably were not available when your father suffered from the disease. For example, there is more availability to skilled nursing care at home now, and there are drugs that can improve functionality and thus prolong the time before such skilled care is needed. There are also assisted living facilities that might be an option depending on your family situation.
In the meantime, don't beat yourself up. This is certainly not something that you asked to have happen to you and there was no way to prevent it from happening. Now that you have the diagnosis, try to be realistic and practical about your health and what you can still control. As much as you are able, stay active and healthy by eating a well-balanced diet, getting regular exercise, and going for regular doctor and dental check-ups. You may ask what the point is now. The point is about maintaining your physical and emotional health as much as you are able—think of it as one less thing your family will have to worry about. For example, regular exercise and other healthy habits can help to stave off depression, diabetes, high blood pressure, etc., which are all things that may complicate your care down the road. And be sure to talk to your doctor if you feel depressed or overly anxious—prescription medication might be of help in these instances.
It also may help to talk to others who have recently been diagnosed with the disease. Their overall situation may not be identical to yours, but they undoubtedly will be facing many of the same decisions that you will have to make and may therefore be a source of support and comfort to you.
Caring for my 86-year-old wife with Alzheimer’s disease is complicated by her obsessive fear of falling and her inability to remember anything that occurred minutes ago. She is physically able to get up from a sitting position and walk with a walker; however, she has become convinced that if she does so, she will fall. That has carried over to the point where she is now also convinced that she is physically unable to stand up. I am able to get her to stand by diverting her attention to something else, but it becomes increasingly difficult to do so each time it needs to be done, such as for bathroom visitations. I cannot point out to her that she was able to do this an hour ago because she does not remember it. Is there any way to lessen this obsession? [ 12/16/10 ]
As you have stated, it is a lost cause to try to use logic to reason with your wife, because she simply forgets the outcome of the conversation. If your wife is anxious about falling, make sure that your home is as safe as possible for her when she walks. Put away objects that could pose tripping hazards, tack down loose carpets and rugs (or remove unnecessary rugs), store unnecessary furniture, keep walkways through the house clear and wide, and install handrails and adequate lighting wherever necessary. Sometime if a person has trouble seeing, it can translate into anxiety over moving about, because he or she may fear bumping into an unseen object. For this reason, it might also be a good time to get your wife's vision examined if it has not been checked in a while.
If your wife is not already on a schedule, you can try scheduling her bathroom visits on a chart near a clock so she can clearly see when the next bathroom break will be. This might help to reduce anxiety when the time comes to visit the bathroom again. Although it may be difficult or seem tedious to you, continue to use distractions to get her to use her walker. Stay positive and encouraging, and reassure her that she is safe from harm.
My husband complains of a sore throat and sore jaw. He refuses to eat all food except for yogurt. For 2 weeks now, he's been eating yogurt 3 times a day. The doctor wants to run some tests on his throat but my husband just starts screaming and yelling. What are my options? I cannot force him and cannot convince him. Please help. [ 12/16/10 ]
You are right in that you cannot force your husband to see the doctor and, most likely, you cannot use reason to convince him otherwise. However, you can try to coax him into going. Tell him that you are worried for him and that you hate to see him in pain, that you would feel so much better if he would just see the doctor to determine the cause of his pain. Call his doctor and ask what kinds of tests might need to be performed in the evaluation. Your husband may be anxious about seeing the doctor because he thinks the tests might be painful. Perhaps there are non-invasive tests the doctor could do that would not cause discomfort or only minimal discomfort for you husband. If your husband still refuses to go, stop asking for the time being. Try again in a week or so, or if the pain intensifies or he develops any new symptoms.
In the meantime, insist that your husband eat other things besides just yogurt. At the very least, you can try giving him liquid supplement drinks (such as Ensure) served cold, which might be soothing to his throat. You can also try blending fresh fruit into the yogurt with a few ice cubes to make a yogurt smoothie, possibly along with some wheat germ or ground flax seed. This will at least provide a little fiber in his diet. There are many healthy yogurt smoothie recipes online that you can try – just be mindful of added sugar. Stick with fresh fruit over fruit juice whenever possible for the added fiber they provide. If it is a texture or consistency thing, you can also try blending other foods into a drink for him: cooked vegetables such as carrots, squash, peas, yams, beets, etc. can be blended with a little of the cooking water or some low-sodium broth for a simple “soup” which can be served warm or, if he prefers, chilled. Continue to offer a wider selection of foods. But stay positive and encouraging when you do this. If you push him too much or threaten him to eat, he might revert back to just eating yogurt.
Without a doctor examination, unfortunately, it's impossible to say what might be causing his sore jaw. It could be a dental problem, a muscle issue, anything really. Check with his doctor about what types of pain relief medicine might be helpful for him.
My mother is in the moderate stage of Alzheimer’s disease. She lives in her own home now; however, we think it's time to move her in with family during the next couple of months. Does anyone know how disruptive it would be if she lived with my brother for 3 weeks and me for 1 week each month. My sister thinks it would be best for mom if she moved into an assisted living facility. I appreciate your thoughts on this issue. [ 11/10/10 ]
If it is not possible for you or your brother to keep your mother in one location the entire time, then it might be better if she went to live in an assisted living facility. Predictable routines and environments are typically best for Alzheimer's patients because without such predictability, patients can become easily disorientated and confused, which can lead to anxiety and other behavioral issues. It is wonderful that both you and your brother plan to share responsibility for the care of your mother, but continually relocating her “home” may become a problem as her disease progresses and she becomes less able to adapt to change. Perhaps it seems overwhelming for either you or your brother to take on full responsibility for your mother's care and this is why the joint-custody situation seems appealing. Even though it may appear sensible to consider share custody, it is not ideal for an Alzheimer's disease patient.
Perhaps you and your brother can make other arrangements wherein you both are still involved in your mother's care, but she lives with only one of you full-time. For example, if you mother lived at your brother's home all the time, then you could assist in her care by running errands for your brother, providing some financial assistance, and/or providing respite care on a regular basis so that your brother can take time for himself. An overnight stay at your home might also be okay once or twice a month, but you will need to gauge your mother's reaction to these visits as to whether or not they cause her excessive confusion or anxiety. If an alternative arrangement with your brother is not possible however, then your sister may be right: it may be best to move your mother into a place where she will have a stable and consistent home environment.
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Last Review: 04/29/13