Alzheimer’s care – Salmax Healthcare

Alzheimer’s care - everything you need to know

What is Alzheimer’s disease?

Alzheimer’s disease is the most common type of dementia.

There are over half a million people living in the UK, with Alzheimer’s disease (AD).

Alzheimer’s can affect different parts of the brain, but mostly impacts the hippocampus, the area responsible for our day-to-day memory.

Alzheimer’s will steadily degrade neurological capability by blocking connections between nerve cells with protein buildup in the form of amyloid plaques and tangles. As the connections between cells are lost they die, the brain tissue and function also dies with them.

Being a progressive disease, it gets worse over time and as for now it’s incurable.

Those living with this condition can still live a long, happy and fulfilled life.

Care options for those with Alzheimer’s

In this guide we discuss the different available options. The option you choose with vary, depending on the stage and your personal journey with Alzheimer’s.

Residential Alzheimer’s care

Alzheimer’s Research UK have found, only 39% are living in a care home. The remainder live in the community, using services such as live-in care.

There are advantages of a care home, they are quicker to access and to organise as local authorities are experienced towards using them. Making the process of getting everything in place easier.

Those who have acute, late-stage symptoms may benefit from specialist facilities. Medically-led care services like a nursing home will have a medical professional assisting your loved one at all times. It is best to look at the care plan to determine if this is right for your loved one.

Care home fees for people with Alzheimer’s

Care homes’ with specialist Alzheimer’s care facilities, tend to be more expensive and are harder to find, although there are a good option depending on the level of care needed.

The cost of residential care facilities can vary too. The average cost can be around £845 per week, this can increases too as there is a difference in regional costs. For example, you may pay over £1500 in South East England and in London.

Alzheimer’s home care

We can provide specialist Live-in care for Alzheimer’s or dementia, having a experienced and trained carer live in your home to take care of you. They will provide help and support with everything as the condition progresses. The level of support and care received depends what is needed at early stages, to more intensive support in the later stages.

Remain part of the community – Reducing the risk of cognitive decline and depression, is key by maintaining routines and being part of your social network.
Support with Mobility – We want to encourage being active, getting out and about. Live-in care reduces being housebound, reduction of physical and mental health problems, and mortality. Research show’s this could have an impact on the speed in which Alzheimer’s progresses.
Keep pets and animals – With more research carried out, having your pets with you can reduce loneliness and associated health risks, such as a stroke and heart disease. Pets and animals often provide continuity for those living with Alzheimer’s.
Tailored nutrition – Meals can be individually tailored to a person’s nutritional requirements. Maintaining this can help prevent and delay the onset of dementia.
Remain with the same GP – When you are familiar with a GP and have spent years building trust, you would want to continue this for you loved one. . If you move to a care home, this relationship is put at risk, again, a lot of research suggests this can reduce mortality rates. Alternatively receiving care in your own home, it’s continued to remain.

Early-stage Alzheimer’s care

In the earlier stages you may want to start considering care options.

On the onset of any condition, it would be beneficial you get as much information as possible. Speaking to your loved one’s GP and there are many established charities, such as the Alzheimer’s Society, Dementia UK and Independent Age you can contact and learn more.

You might start noticing your loved one’s forgetfulness and lack of orientation on a daily basis. This is when you might want to plan and understand the help available to you and changes that would be needed to make.

Alzheimer’s drug treatments

Your loved one may be prescribe a number of treatments, that will help them to live a longer, happier and more fulfilled life. Life expectancy can be up to 20 years following diagnosis.

Current drug treatments for early-stage Alzheimer’s are focused on a temporary easing of symptoms such as memory problems and lack of concentration.

These drugs are:

• Donepezil — brand names Aricept, Donepezil common drugs used to treat confusion associated with Alzheimer’s, usually taken before bed. This can help with improved focus, awareness and cognitive ability. .

• Rivastigmine — brand name, Exelon Rivastigmine taken twice a day. Prescribed for early-stage symptoms of Alzheimer’s, also for Parkinson’s and Dementia for cognitive ability and awareness.

Alzheimer’s treatments without drugs

Further evidence also shows the below can help slow the onset:, living well with any form of dementia is not just about potential drug treatments. It’s also about taking a holistic perspective towards wellbeing. There is an increasing body of

• Regular exercise — It doesn’t have to be intensive training. Keeping active can mean simply taking a walk around the local park or neighbourhood. Or is it could be going for a light weekly swim, or doing simple yoga or tai chi exercises.

• Staying sociable — Is increasingly linked with reducing the impact of memory loss and may slow neurological degeneration. Keeping current social networks or meeting new people by joining community clubs could help.

• Mental activity — Using your brain is proven to reduce cognitive decline, slowing the impact of Alzheimer’s Disease. From reading the morning paper, completing puzzles such as crosswords or sudoku, or doing arts and crafts.

For more information, read our guide on living well with dementia.

Middle-stage Alzheimer’s care

When it comes to care, this time of the diseases progress is all about being adaptable, calm and patient with increasingly difficult circumstances. This can severely impair someone’s ability to remain independent, meaning they can become increasingly reliant on someone helping them out.

For family carers, the middle stages can spell the start of frequent personal care requirements. These are generally characterised by support with washing, dressing and occasionally toileting – although this can vary significantly from person to person.

If you’re looking after a loved one, you may start to notice individual quirks related to their cognitive decline. In response, you’ll likely have developed strategies to cope.

However, with the support and advice from a medical professional or GP, the middle stages are the best time to put a professional carer in the home.

This will allow your loved one to begin to accept them into their routine for the most acute stages that are unfortunately yet to come. That aside, they can simply be a great support, offering lots of practical help.

Household tasks – At this point in the progression of Alzheimer’s, it’s likely a person will be less able to undertake those all-important daily household tasks. Those necessary to ensure the home is a safe and comfortable environment to be in. This includes duties such as household cleaning and laundry.
Preventing wandering – As symptoms become more acute, it can become unsafe to leave your loved one by themselves. They may begin to wander round, seemingly aimlessly, which can be a danger to themselves and others. A live-in carer is able to give someone a reassuring hand when this happens, gently guiding them back to a safe place.
Relieving loneliness – Loneliness among the elderly can be as damaging to health as smoking 15 cigarettes per day. This can lead to depression, which is likely to accelerate the onset of symptoms. A carer can spark conversation and, over time, may even become a friend.
Driving them to where they need to be – If your loved one’s condition has deteriorated to the extent they’re unable to drive around safely on their own, this is something a carer can do. It can be a vital way to ensure social occasions and routines are met — particularly vital for those who live in rural areas. It can also be important to have someone there who can remind them about appointments, and ensure they get there on time.
Supporting with activities – A large body of research indicates that mental stimulation can help reduce the onset of Alzheimer’s symptoms. A live-in carer is able to help promote valuable hobbies, interests and activities. This could be everything from board games and jigsaw puzzles to cooking together and spending time in the garden.
Continence support – At middle-stage Alzheimer’s, it’s unlikely that someone will need constant support with toileting. However, intermittently and increasingly, trouble going to the toilet will become more acute. This can be for a number of reasons, including sensory impairment and losing orientation. A carer can support someone to get to the loo, or help clean up if they don’t quite manage it.

Late-stage Alzheimer’s care

As the symptoms become increasingly acute, so does the level of care that’s required. The later stages can be identified by a steep deterioration in someone’s condition. This can be an incredibly distressing time, and not one in which one family member should be left to cope caring alone.

Realistically, even if you’ve held off on getting outside help, as the disease intensifies you should really assess getting support. A live-in carer can help your loved one feel as comfortable, safe and supported as possible throughout this difficult and extraordinary time. This support can also give you the time to enjoy their company for the rest of the time they have.

Here is a run through of the kind of tasks your carer may undertake during the later stages of Alzheimer’s:

Eating and drinking

A vital component of late-stage Alzheimer’s care is ensuring the person being cared for is sufficiently fed. Clearly, as a person becomes increasingly inactive, the amount of they food required is reduced. However, it’s still vital they are well sustained and get to enjoy their favourite meals as much as is possible.

During the later stages of Alzheimer’s, the following could be required to support healthy eating and drinking.

The right posture – This is all about helping your loved one to sit in a position in which they’re able to easily digest food. It’s recommended that they sit upright for 30 minutes after meals, although this can be different depending on someone’s frailty.
Tailored meals – With a live-in carer, meals can always be adapted to someone’s individual tastes. But at this stage of Alzheimer’s disease, they can be adapted to someone’s individual needs. Usually that means choosing softer foods that are easier to chew and swallow, as well as thickening liquid that may represent a choking risk. Sensory changes can also mean that certain foods may not taste the same.
Support with eating – As well as specific meals, someone living with symptoms of advanced dementia are likely going to need a bit of help with feeding. This will generally be the encouragement of them to eat themselves. This can be done by putting a spoon into someone’s hand and then guiding it into their mouth. For those with more acute symptoms, this could be following each bite with fluids, reminding the person to chew and swallow, as well as making sure they’ve eaten everything.

Promote hydration – Those with advanced dementia often will find it difficult to remember that they need to remain hydrated. This is of particular concern for the elderly, as they can become dehydrated more easily. They may also need someone there to ensure they’ve properly swallowed all of the fluid.
Checking for weight loss – It’s not unusual for those in the later stages of advanced dementia to experience weight loss. However, this needs to be closely monitored to ensure it’s not a side effect of medication, or even a sign there’s something else wrong.

Continence care

In the later stages of neurological degeneration, trouble toileting is likely to become an increasing problem. This is for a variety of reasons.

It may be that mobility issues prevent someone from reaching the loo in time. It might be because sensual impairment stops someone from being able to feel they need to go. For some, it’s not being able to communicate to a carer that they need the toilet. And for others, issues with orientation can mean they’re unaware of where the toilet is.

Tracking toileting – Sometimes, it might be useful for a carer to keep a written log of the intervals between toilet breaks. This can help them monitor and adjust to the person receiving care’s individual habits and needs.
Administering laxatives – As constipation is both uncomfortable and a cause of incontinence, a carer may decide to monitor bowel movements and administer laxatives as appropriate.
Checking fluids – As has already been noted, staying hydrated is more important for the elderly. However, it’s important for a carer to ensure fluids are being consumed at the right time of day. Too much to drink before bed can increase the risk of bladder incontinence at bed time.
Apply incontinence protection – Senior incontinence pads or a bedpan can help make nighttime incontinence a little easier. The carer will replace them when required to ensure your loved one is clean and comfortable.

Bone and skin health

The less mobile a person with late-stage Alzheimer’s becomes, the increased likelihood that they’ll be bed or chair-bound. This can have significant implications for someone’s skin and bone health. Problems such as pressure sores, frozen joints and the deterioration of the skin are all fairly common for those living with Alzheimer’s.

If these aren’t kept on top of, they can lead to a serious deterioration in someone’s health. Luckily, a carer is able to spot the signs and help relieve some of these symptoms. Here’s some of the things they can do:

Reducing spot pressure – When a person remains in the same position for a long period of time, the pressure on a weakened body can restrict circulation. A carer is able to move someone’s position at regular enough intervals to stop this from happening, making them comfortable in a new position with pillows and supports.
Gentle cleaning – The skin of an elderly person in the later stages of Alzheimer’s disease may tear more easily than before. This requires a more gentle approach to hygiene. The person receiving care should be treated more delicately and milder soaps should be used. The carer can also use it as an opportunity to check for rashes and sores.
Handling with care – With frail bones and the aforementioned risk of skin tears, ease of injury is increased. This is especially true when it comes to moving someone from one position or place to another. A carer should have a good understanding of the best practices when it comes to ensuring risk of injury is reduced.

Helping to prevent infections

Staying in a sedentary position increases the likelihood of contracting pneumonia and the flu. Reducing risk is about taking a more holistic approach to avoiding infection.

Oral health – Keeping the teeth and mouth of someone living with late-stage Alzheimer’s clean is essential to help prevent infection. That means after every meal. And, because teeth can be more brittle with age, a softer, less abrasive toothbrush is ideal. Gum health is equally important.
Dressing wounds – When someone is frail, small cuts are a likely occurrence. A carer is able to identify, clean and cover minor cuts, applying antibacterial creams, such as Savlon, as appropriate. Although, if these are deep, medical attention should be sought and it’s likely an ambulance should be called.

Making life more comfortable

As people in the later stages are more prone to infection, bumps and cuts, they may occasionally feel in pain. However, this can be an issue if they’re unable to communicate that this is the case. It takes a carer with experience to understand when a person is feeling pain. They can do this by:

Recognising changing moods – Although it might not be easy for someone to let a carer know they’re feeling discomfort, a change in mood or behaviour could be a sign. A live-in carer may look for signs of a person becoming increasingly agitated, anxious, or even aggressive. Difficulty keeping a regular sleeping pattern can also be a sign of changes in mood.
Recognising physical distress – Someone doesn’t have to actively tell you they’re in pain to communicate they’re in distress. Tell tale signs include pale skin and gums, shaking, and throwing up.
Recognising ‘nonverbal’ signs – Other ways someone may indicate they’re in pain include warnings such as pained — or wincing — facial expressions, screeches and screams.

Palliative Alzheimer’s care

‘Palliative’ can be a bit of a confusing word. In short, it just means support for someone with a terminal illness. It’s a necessary step for someone with Alzheimer’s when symptoms have begun to deteriorate to the point in which they can no longer cope alone.

Palliative care may be needed for a few weeks, months or years. There are no limits. It’s all about ensuring anyone with a terminal condition is able to live out the rest of the time they have left with dignity, without discomfort or distress.

Usually, we find it’s best for families to choose a live-in carer with palliative experience when they know a loved one is facing a life-limiting condition.

For Alzheimer’s, this would be in the middle stages. As continuity is crucial, it can really bring that additional peace of mind to know you’ve someone the whole family will get used to and trust.

End of life care

This differs from palliative care because it’s focused on those very final stages of someone’s life. It’s usually additional to any long-term support you may have put in place from a live-in carer.

Realistically, this is something families will only consider in the final weeks and months of someone’s life. With that in mind, it’s about helping someone pass away in a peaceful and dignified way, in as much comfort as possible and those they love around them.

It’s at this point that any advance decisions and advance statements relating to someone’s later moments will be taken into account.