Aging is associated with a growing number of health problems, from bone loss to mobility problems. In particular, cognitive decline is a serious problem that affects older adults.
Nearly 10 percent of people over the age of 65 will deal with Alzheimer’s disease in their lifetime, reports the Alzheimer’s Association. In Chile, some 180,000 people have Alzheimer’s or other dementia and it is projected that by 2050 this figure will reach 626,000 people.
“Dementias are a group of diseases that are characterized by the acquired and persistent deterioration of one or more cognitive capacities, such as memory, language and visuospatial abilities, accompanied by behavioral alterations; decreased autonomy, which interferes with work performance and social interactions; and the patient’s need for assistance to carry out their daily activities,” says Alvaro Rojas, Abbott’s medical director. Within this group of diseases, Alzheimer’s constitutes 56%.
Planning for cognitive decline and caring for elderly parents is like an insurance policy. Whether it happens or not, it’s best to be prepared. A discussion can help understand how parents would want to be cared for, if they are unable to make those decisions for themselves.
When to speak?
Having a conversation with mothers and fathers about their possible physical deterioration is a situation that you easily want to postpone indefinitely, thinking of them as people who need your care.
However, the best time to create an Alzheimer’s disease plan is even before symptoms begin. Indeed, it is much easier to have a clear-headed discussion now than an emotionally charged confrontation later about forgetfulness, poor judgment, and irritability, all symptoms of the disease.
If symptoms have already begun to appear, it may be a good idea to include the doctor in the conversation.
It is important that, to the extent that they can make decisions for themselves, it is the parents who direct their care. To do this, they can define a document with advance instructions, in which they express their wishes. This will help maintain their autonomy, even if they get sick.
Once this advance directive is complete, the conversation can turn to who will help them with the activities of daily living. For example: Who will take you to checkups and be the primary contact with the care team? Who will help with bathing, cooking, toileting, and laundry?
Communicate with people with Alzheimer’s
One of the difficulties that occur during the course of the disease, and which is increased by the presence of these symptoms, are communication difficulties, both for the person with Alzheimer’s to express themselves and for their environment to make themselves understood.
“Communication problems in people with dementia begin in the early stages of the disease and this progresses as it progresses. Therefore, it is important that both family members and caregivers can adapt to facilitate the communication process”, says Jorge Valdés, director of the Diploma in Speech-Language Neurorehabilitation in Adults at San Sebastián University.
To do this, the speech therapist delivers the following recommendations:
- Have patience
- Repeat the message whenever necessary
- Give enough time to respond
- Give 1 or 2 simple instructions
- Use a calm and friendly tone
- Do not use negative tone or words
- Name people you don’t recognize
- Help find words and verbal expression
- Use non-verbal language
- Don’t try to convince
- Catch his attention by looking him in the eye
- treat them like adults
- Avoid arguing and correcting
- Environmental Modifications
It is also important to make certain modifications in the environment, which allow contributing to effective communication, such as:
- keep tidy
- avoid new objects
- Remove unnecessary doors for the user
- Use signs (names, arrows, symbols)
- Paint rooms in soft colors
- remove distractors
- Use objects for orientation
- Break tasks down into simple steps
- Maintain a structured and predictable routine.
Following these suggestions can help improve the quality of life of the person with Alzheimer’s, since it will facilitate the process of communication and social interaction with their families and caregivers.
Effects of the pandemic
The confinement due to the Covid-19 pandemic to reduce the risk of contagion and death of the elderly, inevitably affected the very people it was intended to protect, with the appearance of neuropsychiatric symptoms such as Alzheimer’s and other dementias.
Formerly known as senile dementia, because its prevalence doubles after 65 years, Alzheimer’s is a neurodegenerative disease that manifests itself progressively, with the deterioration of cognitive functions, memory and spatial and temporal location.
In Chile, the Professional Corporation for Alzheimer’s and other Dementias estimates that the number of people suffering from a neuropsychiatric disorder such as Alzheimer’s will increase to 626,000 by 2050.
According to Jorge Valdés, among the main symptoms of this dementia are behaviors such as agitation, aggressiveness, anxiety, depression and apathy, “which becomes a real public health problem, which is why it is necessary to have a multidisciplinary team that allows address these difficulties in order to improve the quality of life, both for the person diagnosed with dementia and for their family”.