Living with Alzheimer’s disease

Reducing the side effects. Medication side effects can be prevented or reduced by initially prescribing a progressive dose of the given drug. This method will mean patients are less likely to develop side effects such as those associated with gastrointestinal problems. Nevertheless, if they appear, then either the dose of the drug must be reduced and subsequently increased more slowly, or it should be changed for another medication. With respect to patches, which can trigger skin reactions, the likelihood of developing erythema and itchiness can be reduced by taking care of the area where the patch is placed, by ensuring that the skin is clean and dry and above all by rotating its location, i.e., each new patch should be positioned in a different site from the previous one.

Alcohol, tobacco and recreational drugs have a very negative impact on overall health and particularly on the brain. Such habits can reduce blood flow and increase the risk of suffering a stroke or brain haemorrhage. Their continuous consumption causes deterioration in certain cognitive functions which may increase the brain’s susceptibility to develop Alzheimer’s disease or other cognitive problems. Therefore, everyone should avoid abusing these substances. In the specific case of Alzheimer’s patients, they are advised not to consume alcohol, or should at least reduce consumption, because it can produce disorientation and impair cognitive function while under its effects.

Diet. People with, or at risk of suffering, cognitive impairment should follow a healthy lifestyle and therefore consume a balanced diet. There is no evidence to suggest that patients with Alzheimer’s need to take dietary supplements, so long as they follow a balanced diet. It is important to ensure that patients in the early stages of Alzheimer’s who live alone eat correctly because their disease often means they repeat the same meal frequently, only eat easily prepared meals or develop an excessive craving for sweet products.

Exercise. People with Alzheimer’s disease are advised to remain active, not just mentally but also physically. Hence, gentle exercise, such as walking for 45 minutes a day (or any equivalent activity), three days a week, can help keep patients in good shape, decrease the risk of cardiovascular disease, increase their sense of wellbeing, improve their mood and reduce the incidence of altered behaviours.

Rest. Poor quality sleep can reduce the cognitive function of people with Alzheimer’s disease. A bad night’s sleep means the patient will feel drowsy the next day which interferes with their ability to pay attention and concentrate. Therefore, patients are advised to practice healthy sleeping habits. The normal sleep–wake cycle is often disrupted in moderate to severe stages of the disease and may need to be controlled with specific medication.

Sexuality. Alzheimer’s disease often affects sexual expression and desire. Sometimes there is a loss of sexual desire or impotence. While on other occasions, patients may become less inhibited, even with people who are only acquaintances, or find it hard to identify the signs of rejection. In more advanced stages, displays of affection may be uncomfortable for the patient if they now find it hard to recognise their partner.

Viajes. En fases muy iniciales de la enfermedad, los viajes pueden llevarse a cabo con normalidad, dado que el paciente es capaz de adaptarse a los cambios. Pero, poco a poco, esta capacidad se va perdiendo y las personas con la enfermedad pueden desarrollar mayores dificultades a la hora de poder procesar toda la información del nuevo entorno y la nueva organización del día que comporta un viaje, motivo por el cual tienen que tener supervisión continúa. Por otro lado, debido al cambio de rutinas, los viajes pueden suponer un trastorno y provocar confusión y alteraciones de la conducta. Habitualmente, este empeoramiento es reversible, en gran medida, cuando la persona afectada vuelve a casa y sigue su rutina habitual.

Social and emotional support. The diagnosis of Alzheimer’s disease has a significant impact on both the patient and the people immediately around them. The emotional impact on the patient is greater if the diagnosis is made early on, as when it is made in more advanced stages they often deny the symptoms and “forget” or disagree with the diagnosis. On one hand, the diagnosis of Alzheimer’s comprises a medical factor, so in subsequent appointments the medical team will explain information about different aspects of the disease and assess the patient’s state of mind and the need for any specific emotional support. While on the other hand, the prognosis of progressive dependence associated with Alzheimer’s means that decisions have to be taken in order to protect the patient and plan their treatment. Ideally, patients in an early stage of the disease will be able to make their own decisions about their future treatment. If this is not possible, then their family or the relevant authorities will have to make these decisions. Social workers will assist in the decision-making process by providing information about social resources available in each case and helping with the procedures required to gain access to them.

As the disease progresses, the caregiver transforms into the central figure regarding the patient’s treatment. Two thirds of caregivers for Alzheimer’s patients are women. The increasing demands of caring for the patient take their toll on the caregiver’s mental and physical health, an aspect that must be monitored by the healthcare team. Support programmes have been shown to provide a beneficial effect for the caregiver and indirectly for the patient.

Apart from the public resources, which are often insufficient, it is worth mentioning the work of associations for relatives of people with Alzheimer’s disease that can offer social and emotional support tools.