Caregivers can be ‘Alzheimer’s Whisperers’

FAIRMONT – Alzheimer’s is a frustrating and cruel disease not only for those who have it, but for the people taking care of the affected person.

Knowing which stage of the disease the person is in, along with tips to respond to challenging behaviors such as aggression and repetition, can help caregivers become “Alzheimer’s Whisperers.” The Alzheimer’s Whisperer program is available through HealthStar Home Health in Fairmont, and is being implemented in some of the assisted living facilities in the area.

“I think we need to raise the awareness of the availability of this program,” said Lisa Lange of Temperance Lake Ridge in Sherburn. “It’s an important resource to help educate and bring awareness to those caregiving for someone with dementia.”

“We will train anybody,” said Michelle Olson, of HealthStar Home Health. “In-home care, assisted living, we enjoy doing community events just to get the word out, and it’s covered by Medicare.”

Dr. Verna Carson, who specializes in Alzheimer’s and other dementia-related conditions, spoke to local health-care professionals this week and gave some insights on dealing with the Alzheimer’s or dementia patient.

“The person with Alzheimer’s does not change. They cannot change,” Carson stressed. “What we can change is their environment. Some just prefer to put them on medications, but that can be dangerous.”

Carson said it’s important to determine what stage of Alzheimer’s the patient is at.

“The first area, that is the short-term memory,” she said. “The hippocampus part of the brain is the first part that gets affected. There is also the partial lobes, which affects navigation. That is when we see the wandering or getting lost. … There are also the temporal lobes, which affects time awareness and speech and word-finding. Most dementia patients have lost their speech at the end.”

In the moderate stages, the hippocampus stops functioning altogether.

“There is no more learning,” Carson said.

The occipital lobe is affected at this stage, which leads to the misuse of common objects.

“That is why you’ll see them using the TV remote, but talking into it like it’s a phone,” Carson said. “The grandkids think they’re being funny, but they can no longer identify some common objects.”

The limbic system, which controls emotions, usually is damaged in the moderate stages of Alzheimer’s.

“Emotions are no longer under their control,” Carson said. “They could break down in tears, or become super angry, and you have no idea why. Well there was nothing to prompt it – that part of their brain is being damaged.”

Physical changes also begin due to the damage being done by dementia.

“The hypothalamus controls temperature and appetite,” Carson said. “Their internal temperatures get stuck. That’s why sometimes you’ll go into an assisted living place, and it will be so warm in there, yet there are residents with sweaters and blankets on their laps, and they’re complaining about the place being cheap and not turning the heat on.”

Finally the motor strip that helps with walking, sitting and toileting begins to fail.

“One thing we refer to is retrogenesis,” Carson said. “All we learn going forward, we repeat again going backwards. We start out as babies learning to raise our heads up, sitting, and at the very end, they are slumping over and have their head down.”

And because Alzheimer’s is a disease that comes with aging, there are usually other elements the person is suffering, but unable to tell their caregivers.

“We had one patient who was angrily lashing out every time someone tried to move her,” Carson recalled. “They were ready to turn her over to a state care facility and she was put on anti-psychotic drugs. When they contacted her son to find out more, he told us she’d had severe arthritis for many years and she treated it with Tylenol and Aleve. Because Tylenol and Aleve weren’t in her medication list, she wasn’t taking any pain medications. After they started pain medication and took her off the anti-psychotics, she was a completely different person a few months later.”

Because every person is different, every method of dealing with an Alzheimer’s patient is a little different. Some basics Carson suggested include remembering that the Alzheimer’s patient cannot remember and cannot learn.

“No quizzing them, don’t try to reason or argue with them, because you will not win, and it only draws out the problem,” she said. “There is only about five minutes in a dementia person’s short-term memory, and they will forget about it unless you keep dragging it out.”

Because of that short-term memory, occasionally caregivers can use it to their advantage.

“The truth hurts, so you don’t always have to be truthful,” Carson said. “If we have a patient who’s looking for John, her husband, but John died eight years ago, telling her, ‘He’s dead,’ will just cause her to grieve like it just happened. You can just say, ‘He went out.’ You don’t have to say how or when.”

On that note, caregivers will usually have to meet the dementia patient in their world, instead of dragging them into reality.

Most importantly, smile and be positive, even if it’s been a rough day.

“They can still sense if someone is in a bad mood, and they will think it’s because of them,” Carson said.

More information on the Alzheimer’s Whisperer program is available by calling HealthStar Home Health at (507) 235-5999.