Mild Cognitive Impairment
• Some memory problems… usually able to live independently.
Common Changes in Mild AD
• Cognitive break. • Impaired memory and thinking skills. • Requires assistants with life skills. • Loses spark or zest for life - does not start anything. • Starts to notice they are having a problem. • Loses recent memory without a change in appearance or casual conversation. • Loses judgment about money. • Has difficulty with new learning and making new memories. • Has trouble finding words - may substitute or make up words that sound like or mean
• May stop talking to avoid making mistakes. • Has shorter attention span and less motivation to stay with an activity. • Easily loses way going to familiar places. • Resists change or new things. • Has trouble organizing and thinking logically. • Asks repetitive questions. • Withdraws, loses interest, is irritable, not as sensitive to others' feelings,
uncharacteristically angry when frustrated or tired.
• Won't make decisions. For example, when asked what she wants to eat, says "I'll have
• Takes longer to do routine chores and becomes upset if rushed or if something
• Forgets to pay, pays too much, or forgets how to pay - may hand the checkout person a
wallet instead of the correct amount of money.
• Forgets to eat, eats only one kind of food, or eats constantly. • Loses or misplaces things by hiding them in odd places or forgets where things go, such
• Constantly checks, searches or hoards things of no value.
• Changes in behavior, concern for appearance, hygiene, and sleep become more
• Mixes up identity of people, such as thinking a son is a brother or that a wife is a
• Poor judgment creates safety issues when left alone - may wander and risk exposure,
poisoning, falls, self-neglect or exploitation.
• Has trouble recognizing familiar people and own objects; may take things that belong to
• Continuously repeats stories, favorite words, statements, or motions like tearing tissues. • Has a restless, repetitive movement in late afternoon or evening, such as pacing, trying
• Cannot organize thoughts or follow logical explanations. • Has trouble following written notes or completing tasks. • Makes up stories to fill in gaps in memory. For example might say, "Mama will come for
• May be able to read but cannot formulate the correct response to a written request. • May accuse, threaten, curse, fidget or behave inappropriately, such as kicking, hitting,
• May become sloppy or forget manners. • May see, hear, smell, or taste things that are not there. • May accuse spouse of an affair or family members of stealing. • Naps frequently or awakens at night believing it is time to go to work. • Has more difficulty positioning the body to use the toilet or sit in a chair. • May think mirror image is following him or television story is happening to her. • Needs help finding the toilet, using the shower, remembering to drink, and dressing for
• Exhibits inappropriate sexual behavior, such as mistaking another individual for a
spouse. Forgets what private behavior is, and may disrobe or masturbate in public.
Common Changes in Severe AD
• End-stage Alzheimer’s • Doesn't recognize self or close family. • Speaks in gibberish, is mute, or is difficult to understand. • May refuse to eat, chokes, or forgets to swallow. • May repetitively cry out, pat or touch everything. • Loses control of bowel and bladder. • Loses weight and skin becomes thin and tears easily. • May look uncomfortable or cry out when transferred or touched. • Forgets how to walk or is too unsteady or weak to stand alone. • May have seizures, frequent infections, falls. • May groan, scream or mumble loudly. • Sleeps more. • Needs total assistance for all activities of daily living.
Communication Techniques AD
• Approach from the front to prevent the “Startled Syndrome”. • Listen closely. • Maintain eye and verbal contact. • Use short, simple sentences and speak slowly and clearly. • AD patients will use a “Start Æ Æ Æ Stop Æ Æ Æ ReboundÆÆÆ Start approach to
communication. Help them to return to Start and move through the process.
• Minimize distractions – patients are hypersensitive to their emotions and the emotions of
• Do appear to be rushed or impatient – leads to increased anxiety. • Keep facial expressions warm and friendly. • Do not overwhelm with information or emotions. • Patients often respond by shutting down, anger and frustration. • Repeat your question or statement with the same phrase or wording. Remember
“Start Æ Stop Æ Rebound Æ Start”.
The Wandering AD Patients
• 4% - 26% are Nursing Home residents. • 59% of patients living in community. • Restless due to boredom or lack of exercise. • Confusion as to time of day. Internal clock. • Change in physical environment. • Over stimulated from crowds or noise. • Fear causing delusions and hallucinations. • Medication side effects.
Common Medications for AD Patients
• Aricept (donepezil hcl) – used in early stage. • Excelon (ribastigmine) – used in latter stages. • Reminyl (falantamine hydrobromide) – used in latter stages. • Namenda (mematine) – New drug waiting for FDA approva – used in latter stages.
Alzheimer’s Organization and Information
www.alzheimers.org www.mayoclinic.com www.alz.org
Alzheimer’s Safe Return Program
Safe Return Crisis Line - 800.772.1122 Provides search database for recovery, clothes tag, bracelets and caregiver bracelet.
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