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Practical Tips for Potential Alzheimer's Disease Patients


Alzheimer’s: A Journey Back to the Beginning

The trajectory of Alzheimer’s disease is similar to the developmental stages of childhood except in reverse.

For example, abstract thought is achieved during the last stage of adulthood but is affected during the first stage of Alzheimer’s disease. Seemingly simple tasks present at birth, such as chewing and swallowing, are lost in the latter stages of the disease.

Memories formed early in our lives resurface as the Alzheimer’s patient progresses further down the path of mental disintegration. Loss of short-term memory is evident in the early stages. In practical terms activities that may seem pleasurable today will eventually lose their appeal as the disease progresses.

In order to maintain quality of life, it is important therefore to re-introduce the pleasures from the days of our youth. This is how I came up with the idea of an “Alzheimer’s memory kit”: a montage of music, cuisine, experiences and imagery that will at least lessen the suffering experienced by future Alzheimer’s patients. And who better to prepare this kit than ourselves?

I will discuss music, visual images, memories of taste and smell, as well as the use of restraints, Power of Attorney for finances and personal care, the art of caring and care giving.

(Please note that this is not a scientific paper. These recommendations are a result of my personal observations of Alzheimer’s patients while managing a Dementia/Alzheimer’s unit for 8 years).

THE SOUND OF MUSIC

The memory of music lingers the longest. Although music provides the greatest enjoyment during the early stages of Alzheimer’s, I feel that the experience of music remains important until the very end. Choice of music is key. High tempo music that carries a strong beat can be detrimental to certain patients, including those that tend to be more physically aggressive.

For this reason, I believe all radios should be banned from Alzheimer’s units. The only persons capable of tuning the dial are the nursing staff whose musical taste is likely to differ drastically from that of the patients, especially if the music in question is some variation of the latest Pop.

What you need to do is begin assembling CDs of your favorite music throughout the decades all the way back to when you were a teenager. Collect only music with a slow or moderate tempo. For example, a favorite slow tune from when I was in my twenties would be Simon and Garfunkle’s: “Old Friends”. For a more moderate tempo I would choose: “April Come She Will” or “A Heart in New York”. I may not understand the words but the sound will bring back memories. My kit will mainly contain Classical and Jazz tunes (Keith Jarrett, “The Köln Concert”). Label each CD – for example: “from my twenties”, “from my thirties”, “all decades” etc., or whichever way you wish as long as the era of your life represented by the music is made apparent to your children, family or friends. Another detail you should consider is the genre or type of music you would enjoy listening to in a communal environment, such as a nursing home. Think about it.

For more information on Alzheimer’s and music see:
Music Therapy for Dementia
The Impact of Music Therapy on Alzheimer's Disease Patients
Individualized music played for agitated patients with dementia

Next: visual images.


adrena February 11, 2007 - 10:07am
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( categories: Miscellany )

Intelligent Homes

CTV.ca News
January 12

Scientists in Toronto say they have are developing artificially intelligent computer systems to help elderly people suffering from memory loss stay safely in their own homes.

"Often when a person gets moderate to severe levels of impairment, they are taken out of their home and put into a care facility," says lead scientist Dr. Alex Mihailidis, a mechanical and biomedical engineer and researcher at Toronto Rehabilitation Institute.

"We are using artificial intelligence to support aging-in-place so that people can remain in their homes for as long as possible."

Mihailidis and his research team at the Intelligent Assistive Technology and Systems Lab, a joint venture of Toronto Rehab and the University, say they are the first in the world to test home-based artificial intelligence systems in clinical trials.
More at link

adrena February 12, 2007 - 10:45am
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Predicting Alzheimers: within a few years

Scientists pinpoint diabetes genes
Say high-tech scans will also be able to test for other diseases

Monday, February 12, 2007
Ottawa Citizen

A Canadian-led team that can "read" an individual's DNA in just minutes has uncovered several genes that make people susceptible to the most common form of diabetes.

"And this is just the tip of the iceberg," says Dr. Constantin Polychronakos of McGill University, who co-led the international team that's shown the power of new scanning techniques to find genes associated with common disease.

Dr. Polychronakos says the field is moving so quickly it will soon be possible to predict from birth what ailments someone is prone to.

"You'd be able to take a drop of blood from a newborn and determine if they have genes associated with diabetes, or heart disease or Alzheimer's or any of the common health problems," says Dr. Polychronakos, acknowledging there would be sticky social and ethical issues associated with such gene profiling.

"I'm not saying we should be doing this, but I'm saying we will be able to do this in a few years. ... We will have the capability."

adrena February 12, 2007 - 2:25pm
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Continued.....

Visual images

A strong relation exists between sensory function and cognitive function; changes in sensory perception are therefore another hallmark of mental decline in Alzheimer's.

The visual images an Alzheimer's patient is exposed to may be distorted because of dysfunctional interpretive ability. Add to this mix a general decline in vision when aging as well as a possible history of problems with vision, and it is clear, that the specific accommodation required can be challenging.

As I mentioned earlier, I would ban all radios from an Alzheimer's unit. Add to this, television. As is often the case with children, a television on an Alzheimer's unit is used to baby-sit, to kill time or to provide relief for overworked caregivers. Whereas children may profit from certain children's' programs, there is nothing on television that would benefit an Alzheimer's patient. In fact, the words spoken on soap operas or on any show sound like gibberish to them and the rapid change of images, especially the advertisements, frequently cause agitation and fear.

Until such time that special programs are designed for this subgroup of patients I suggest you create your own videos with high contrast and gently morphing visual images. Include images that have a general appeal such as scenes of nature as well as images that are specific to your interests. For example, if you have always enjoyed looking at historical buildings, start collecting pictures of these. Buildings with fewer details are most suitable. When choosing or creating a nature video, avoid scenes of storms, animal chases etc. Instead, choose calming images such as a branch gently swaying in the wind, or a group of animals grazing. Naturally, any accompanying music should have a slow tempo.

That said, I cannot state with certainty that television is completely without benefit for Alzheimer's patients who are at an earlier stage of the disease. If an individual has been watching cooking demonstrations or home improvement shows every day, he/she might find comfort in continuing with this recreational activity. This however would have to be determined by the close family or friends, through observation.

Another item to prepare for your “Alzheimer's memory kit” is an album of family photos. Ensure small pictures are enlarged, of high contrast, and contain no detail. Ideally there should be one picture per page. It is important to include images of your teenage and younger years since this is the time period where the Alzheimer's mind rests, prior to the terminal stage. Collect family photographs that do not include your children as well as images of scenes in your former environment such as the house you grew up in, and the places where you used to walk or play. Next time you visit your hometown, remember to take pictures of what appealed to you in those early days. Place these in the album in chronological order. You could also add a rummage box of old objects that, when touched while looking at pictures may facilitate recall of memories.

Finally, picture books of other items that have been of interest to you in your life can also be added to the “kit”. You might enjoy looking at cars, flowers, buildings, planes, fruits, vegetables, men, women etc, Use the same principles of presentation as stated above.

Next: Memories of smell and taste and the changing perception of food.

adrena December 9, 2007 - 5:51am
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