What are the steps beyond diagnosis?
Once the suspicion of Alzheimer's disease has been clinically confirmed, the person's family, caregiver, or paid providers may need to make changes in the person's daily routine.
First and foremost, the person must feel safe and secure in his or her environment. As a result of the complications associated with Alzheimer's disease, what may have been comfortable and familiar for the individual will become unrecognizable and result in unpredictable behavior. For example, some persons may have changes in behavior that make them seem suspicious and delusional.
To help with the changes in behavior, consider the following:
~Emphasize maintaining abilities, particularly those affecting dignity (e.g., toileting, eating), rather than trying to teach new skills.
~Keep changes in environment and daily routine to an absolute minimum.
~Simplify routines and reduce choices to minimize feelings of anxiety and frustration.
~Use patience and redirection, keep verbal requests simple, and provide general supportive care.
~Maintain self-awareness by using reminiscing and talking about past experiences, when appropriate.
Help the person maintain his or her orientation by naming events for the day, reminding him or her of the day, time and place, and repeating the names of others around him or her. Try not to "force" him or her back to your reality, but also don't allow a move into a delusion that you may be inadvertently reinforcing.
Reassure the person daily, even when there is no response.
Try to understand the words and symbols the person is using in communicating. Be patient, and don't try to force the person to understand your means of communicating; adapt to his or hers.
Provide appropriate foods and liquids to maintain nutrition and hydration.
Respond to suspicions and delusions with reassurance.
Consult a physician about stopping nonessential medications and, when appropriate, assume responsibility for giving the person his or her needed medications.
Minimize toileting accidents by establishing a toileting routine.
Convey affection and protection by a quiet voice and use touch for reassurance and praise.
To help with changes in program practices, consider the following:
~Provide a familiar and safe environment, and provide closer supervision to minimize confusion and disorientation.
~Maintain present level of independence by increasing staff supervision, prompts, and hands-on care.
~Modify the individual's program or support plan to anticipate changing activities of daily living (ADLs) and supervision needs.
~Monitor and document increased episodes of confusion, disorientation, or memory lapses to become more prepared as they repeat in the future.
~Continue assessments for mobility, safety, and ADL needs.
~Inform staff, family members, and caregivers close to the person of changes and strategies in the plan of care.
~Seek to identify "triggers" that result in inappropriate or dangerous behavior and try to minimize the likelihood that they will occur in the future.
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