The Pains and Truths on Alzheimer’s Disease

Alzheimer’s disease is one that affects the mind, body and soul of its victim. By its middle and final stages, this disease has taken the dignity, control, and hope from its victim. It leaves the person unable to do little, if anything, for themselves.

Worse, the disease is so cruel that it gives fleeting vague flashes of memory to the person, just enough so that the person can almost remember what they were like before this killer took them. In some cases the victims actually live in their own memory, cannot move forward or remember any new information, just their past. This disease doesn’t only affect the victim of the disease itself, but the loved ones watching their loved ones suffer and lose themselves to the ideas.

Alzheimer’s disease was first discovered by a German doctor named Alois Alzheimer. The doctor discovered the disease when he was performing an autopsy on a woman who died of a mysterious, unknown form of mental illness. When Alzheimer studied the brain of the woman, he was shocked to find the presence of abnormal lumps of plaque and twisted fibers present in her brain that were unlike anything he’d ever seen before. These two odd parts of the woman’s anatomy proved to be the basis for Alzheimer’s disease, with the lumps becoming known as neuritic plaques and the fibers are the way that doctors could confirm the presence of Alzheimer’s disease.

Unfortunately, these symptoms could only be seen via an autopsy performed after a patient’s death. One discovery that changed our knowledge of Alzheimer’s disease is when Familial Alzheimer’s disease was discovered. This subset of the disease occurs in approximately ten percent of all patients with Alzheimer’s, and it is a particularly aggressive form of the disease. It occurs early in almost every case, with most becoming afflicted with the disease before the age of sixty-five. One of the most unfortunate aspects of Familial Alzheimer’s disease is the fact that it can be passed down genetically from parent to child.

If one parent has Familial Alzheimer’s the child’s risk of getting the disease rests at an even fifty-fifty. Familial Alzheimer’s, is the only type of disease that can be traced to a genetic abnormality; late-onset Alzheimer’s may appear randomly without just cause.

Physically, what happens is that a small peptide called B-amyloid accumulates in the brain. This begins as many as ten to twenty years before the first symptom appears. Normally, everyone has these peptides, floating, around in the bloodstream and spinal fluid but in an Alzheimer’s patient, the B-amyloid molecules clump together form a loose mesh that becomes increasingly a more dense mesh of filaments that locate themselves among the delicate nerve endings of the brain. They are called senile plaques. The other change in the brain has to do with the neurofibrillary tangle. These tangles form when a highly resistant protein becomes concentrated in the nerve cells. The nerve cells eventually choke as the tangle crowds out the cell’s contents. The parts of the brain most affected by the tangles are those that affect memory and emotion.

In the early stage, individuals experience short-term memory loss. They may be unusually forgetful. They have a hard time concentrating or coming up with the right word to express what they feel. They may make poor choices or show impaired judgment. They may have difficulty adapting to changes in routines. At the same time, they may experience vague personality changes. They may seem sadder, quieter, or more negative than usual. They may be easily angered. The individual and family members may have the feeling that “something is not right,” yet the individual may be able to do most things with a small amount of help.

As the disease progresses, it becomes increasingly difficult for the person to handle basic daily tasks such as paying bills, using the telephone or shopping. The affected individual may try to hide the problem by writing reminders and detailed descriptions of how to do routine tasks. The family may begin to notice changes in personal grooming. Individuals may forget to brush their teeth, put on deodorant, or to wash their hair.

Distant family members sometimes first become aware of a dementia problem when they discover telephone or utilities have been disconnected due to lack of payment. Depression is one of the more common symptoms in the early stage. The depressed individual may exhibit sadness and a more negative attitude toward life. The individual may sleep too much or too little or experience an unusual weight loss. You may notice an increased consumption of alcohol. The depression may be accompanied by a withdrawal from church or social functions and excuses not to participate in family activities.

In the middle stage of Alzheimer’s, people can’t organize thoughts or follow logical explanations. They lose the ability to follow written instructions and often need help choosing proper clothing for the season or occasion. Eventually, they’ll require help getting dressed because their confusion may cause them to put their pajamas on over their daytime clothes or their shoes on the wrong feet. They may also have episodes of urinary or fecal incontinence. It’s usually during this stage that people start having problems recognizing family members and friends. They may mix up identities thinking a son is a brother or that a spouse is a stranger. They may become confused about where they are and what day, season or year it is. They become unable to recall their address or phone number.

There is noticeable difficulty communicating. Eventually, the individual’s speech is reduced to repetitious questions, words and sounds. The person may exhibit levels of anger, paranoia, frustration and nervousness that may be very difficult for others to tolerate. It is during this stage that some people become aggressive or uncooperative when performing personal care. The individual also becomes more susceptible to infections. The individual needs help performing routine tasks such as dressing, eating and using the restroom. The individual also needs protection from household hazards, such as stairways, medications or poisonous substances.

Because they lack of judgment and tend to wander, people with moderate Alzheimer’s disease aren’t safe on their own. They may exhibit restless, repetitive movements in late afternoon, or continually repeat certain stories, words or motions, such as tearing tissues.

The requirements of providing care twenty-four hours a day, seven days a week can become burdensome and stressful for the caregiver. At this time many caregivers and families find that they must get help in the home, utilize adult day care, or place the individual in an adult care facility.

People in the last stage of Alzheimer’s require help with all their daily needs. They lose the ability to walk without assistance and then the ability to sit up without support. Individuals in the last stage become bedridden. They lose a sense of who others are and are unable to respond to friends, family or their surroundings. There is usually a weight loss, no control of bodily functions and physical health declines They are usually incontinent and may no longer speak coherently. They rarely recognize family members. Swallowing difficulties can cause choking, and they may refuse to eat.

In this stage care giving frequently shifts toward nursing care where staff can provide twenty-four hour care in a nursing home. However, the responsibility of the caregiver does not end. They continue to play an important role by visiting and monitoring the health, financial and legal needs of the individual. Caregivers who maintain the person at home need to develop skills in feeding, skin care, bed baths, prevention of infection, lifting and transferring, and the performance of range of motion exercises.Family members are gravely affected when their loved one has Alzheimer’s. In fact they experience a range of emotions, one which is loss.

Very close family members will go through a grieving process that will include denial, anger, frustration, guilt, physical symptoms, feelings of helplessness, and finally, acceptance. These are especially true of the caregiver. The guilt is related to thinking you should have done something differently; you should have enjoyed life more before the loved one was stricken; feelings of failure particularly if the patient must be put in a nursing home; wishing that person’s suffering would end. Very often the guilt feelings come from unrealistic expectations. In any even, the spouse of other family member must learn to cop with these feelings and wish the fate of the beloved.

They must also adapt and change things to make life more bearable for themselves and the Alzheimer’s patient. It is a challenging and difficult journey from diagnosis to the end for everyone. Loving relatives and friends must watch their beloved deteriorate at varying rates from periodic memory lapses through bizarre bizarre behaviors to the point that this loved on is already gone and all that remains is a shell of a body that functions poorly, at best. In its middle stages, the loved ones may become excited to see their loved one able to even roll a ball with their foot. If a victim remembers who they are for a fleeting moment, it is an event that brings joy and even false hope. Alzheimer’s takes the hearts of the loved ones and crushes it because they must watch their beloved lose all control, all independence, all feeling and there is absolutely nothing they can do to make this person better.

The rate of progression varies widely among individuals. For some, severe dementia occurs within five years of diagnosis. For others, it can take more than a decade. On average, people with Alzheimer’s live for eight to 10 years after diagnosis. Some live as long as 20 years.

Most people with Alzheimer’s don’t die of the disease itself, but of pneumonia, a urinary tract infection or complications from a fall. Doctors have been trying to find medicine to slow down the process or stop it all together, so far their is still no cure for Alzheimer’s disease although they have found medicine to help. Medications called cholinesterase inhibitors may be started as soon as Alzheimer’s disease is diagnosed.

These medications which include donepezil hydrochloride (Aricept), galantamine (Reminyl), and rivastigmine (Exelon) may temporarily improve memory and thinking problems caused by the disease. Their effect usually is not dramatic, and they may not work for everyone who has the disease. While cholinesterase inhibitors may slow the progression of symptoms, they do not prevent the disease from getting worse. However, most experts agree that cholinesterase inhibitors are worth trying for most people who have Alzheimer’s disease.

A new medication, memantine (Namenda), may be used alone or with cholinesterase inhibitors to treat moderate to severe symptoms of confusion and memory loss caused by Alzheimer’s disease. Memantine works differently than cholinesterase inhibitors, but it also does not prevent the disease from progressing. If treatment with a cholinesterase inhibitor medication seems to be helping the person with Alzheimer’s disease, it can be continued until it is no longer helpful. The medication may remain effective longer in some people than in others. Treatment may be stopped at any time if the person is unable to tolerate side effects from the medication.

Memantine is a medication that was recently approved for treating moderate to severe thinking and memory problems related to Alzheimer’s disease. Ask the person’s health professional about trying memantine, which may be taken along with cholinesterase inhibitors. Regular assessment by a health professional helps evaluate the person’s response to medication, detect new problems, monitor changing symptoms, and provide continuing education to the family.

Decisions about treatment for behavior problems or other issues often need to be revisited as the disease progresses. A general guideline is that a person with Alzheimer’s should see the doctor every six months, or sooner if a problem arises. It is important to continue watching for and treating other conditions. Hearing and vision loss, arthritis, thyroid problems, kidney problems, and other conditions are common in older adults and may irritate symptoms of Alzheimer’s. Arthritis may make it harder to move around without help; a hearing or vision problem may make the person more agitated, anxious, or unresponsive.

Treating these problems can improve quality of life and ease the burden on the caregiver. Most Ongoing treatment focuses on making the most of the person’s abilities as they change and dealing with new problems as they arise. Caregiving tasks range from maintaining a safe environment and helping the person get dressed every day to finding ways to manage or minimize disruptive behaviors such as wandering and sleep problems. No single strategy works for everyone. Successful care also depends on making sure the caregiver is involved in making decisions about treatment. These decisions will affect both the person with the disease and the caregivers.

Alzheimer’s disease affects the mind, body, heart and soul of not only those afflicted but those who both look up to and love the victim. Alzheimer’s takes memories away from its victim takes everything they whole dear in their memory and crushes them. Its devastating in the early stages for them to know what’s happening and what’s to come, to look into their future and know that eventually they will be no more than a shell of who they use to be, knowing they is nothing they can do. For the loved ones of the afflicted to see someone they love look at them and not remember who they are is very devastating.

We’ve come a long way from when Alois Alzheimer first discovered the disease. We know how it affects the mind, and body. We’ve also know the warning signs and have come up with medications to help slow down the disease which means precious time for the victims, their friends and family.

Although there is still no cure, researchers are still looking for a cure and hopefully someday they will find the right medication to prevent this disease from taking so much from its victims.