What you should do and know at the different stages:
Stages II and III
- Decide who will be the primary caregiver.
- The primary caregiver needs to realize that the job ahead will be
hard and help will be needed.
- Decide which of the family members will help the caregiver and decide
how much help they will be able to give.
- Talk to other family members (brothers, sisters, etc.) and ask if they
will be able to help with the patient in some way. Maybe they can
help one day a week or one weekend a month.
- Obtain an identification bracelet for the patient.
- Remove important identification, hospital, and credit cards from the
patient's purse or wallet so that those items will not get misplaced.
- Establish a good relationship with the patient's medical doctor.
- Talk to the doctor about the patient's ablility to drive.
- Meet with a lawyer to get legal advice on decisions that need to be
made about health care and finances.
- Learn all you possibly can about the illness so you can deal with it in
the best possible way.
- Try to teach family and relatives about the illness so they will
understand what is happening to the patient and be of some help
to the primary caregiver.
- Find a good support group in your area and attend the meetings.
- Reassure and comfort the patient, repeatedly, with words or hugs.
- Give the patient time alone if he or she needs it.
- Keep your sense of humor.
- Don't take what the patient might say or do personally.
- Be patient and make an effort to guess what the person is telling you.
- Read the patient's body language.
- Ask questions that offer choices (For example: ask "Do you want
orange juice or coffee?" not "What do you want?").
- Help the patient save face or avoid being embarrassed.
- Ignore wrong answers. Don't argue.
- Keep the anxiety level down to prevent catastrophic reaction.
- Stay with the patient during an activity.
- Expect to have to reengage the patient in the activity frequently.
- Don't try to get a restless patient to sit still or lie down.
- Seek respite for your own health and well-being.
- Do not use logic or try to reason with the patient.
- Never assume the patient does not understand what is being said or done.
- Be prepared to help the patient judge distances, find chairs when
sitting down, and keep his/her balance.
- Keep a watchful eye and step in gracefully when the patient needs
assistance with feeding, dressing, and day-to-day activities.
- Ask questions that include answers.
- Replace worn-out items in the patient's wardrobe with clothes that are
easy to put on and take off -- such as pullover shirts, pants
with elastic waistbands, shoes with Velcro straps.
- Make sure shoes are a good fit.
- Patients sometimes cannot tell when the water temperature is too hot.
Therefore, check the temperature setting on your home's hot water heater to prevent scalding.
- Make a safe sleeping area because patients may get up confused during
the night. Keep objects out of pathways to the bathroom and other rooms.
- Let the patient eat with his or her fingers and cut food into pieces he or she can easily eat.
- Be sure tea or coffee is not too hot.
- Learn the Heimlich maneuver and also CPR.
- Include exercise in the patient's daily routine.
- Choose outings that do not require concentration and that don't last too long.
- If you are unable to have a live pet, fill the vacancy with a stuffed animal.
- Do crafts, one step at a time with the patient. The easier the craft, the better.
- Make sure anything you leave lying about is harmless.
- Remove or cover mirrors and other reflecting objects.
- Allow rocking and repetitive behavior. It helps to relieve stress in
the patient. If it distresses others, distract the patient with
an activity or remove him or her to another room.
- Recgonize the good that comes from even the simplest things you do.
- Do not attempt full care without assistance.
- Exercise the patient by moving each part of the body gently.
- Allow children and pets to play with the patient.
- Take the patient outdoors several times a day.
- Give the patient pleasure with music.
- Dance with him or her or move his or her arms gently to the music.
- Be alert for signs of developing physical problems.
- Provide the patient with a twin bed or hospital bed.
- Bathe the patient daily and give a bed bath if necessary.
- Keep the patient's hair short for easy care.
- Lubricate and massage the skin to prevent bed sores.
- Cushion sensitive areas of the body with pillows.
- Move a chair or bed-bound patient every hour or two.
- Talk with the patient's doctor about whether the patient should be
kept in bed and about problems with toileting.
- Always have assistance when trying to lift the patient.
- Establish a routine to avoid bowel and bladder problems.
- Wear rubber gloves if you must come in contact with body fluids.
- Provide partial adult diapers or full diapers as needed.
- Always accompany the patient when he goes to the bathroom.
- Keep patient's fingernails and toenails clean and trimmed.
- Watch for dental problems, clean the patient's dentures, and/or assist
the patient in brushing after meals.
- Check glasses and hearing aids to make sure they are clean, they fit, and they work.
- Provide food that can be eaten with little effort.
- Be careful about choking. Give the patient food a little at a time to prevent him from eating too quickly.
- Watch for signs of dehydration (not enough fluids in body).
- Provide frequent snacks to make sure that the patient is getting enough food and drink.
The above lists are adapted from the book Alzheimer's: A Handbook for the Caretaker by Eileen Driscoll.
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