Caring for Someone Who Stays Awake During the Night
You may be caring for a parent or older person who wants to stay up all night and sleep at odd hours during the day. This behavior is known as “sundowning.” The Alzheimer’s Association states that 20% of people diagnosed with Alzheimer’s disease exhibit increased confusion and disorientation at dusk with the behaviors continuing throughout the night.
This behavior may be caused by a number of factors including: a change in medications, disruption of the normal daily routine, packing too many activities into the day or even something subtle, such as a change to daylight savings time. A combination of the following tips may help in caring for someone who stays awake during the night:
1. No coffee or soft drinks with caffeine after 6 pm. These beverages work best with breakfast or lunch. A smaller meal works best at the end of the day and a light snack before bed, such as apple slices or crackers.
2. When dusk approaches, draw the drapes and/or dim the lights in the living room and bedroom and lay out pajamas or sleepwear on the bed to remind your loved one that bed time is approaching.
3. Playing soft music sometimes helps if your loved one is agitated during this time.
4. Plan activities during the day such as walking, exercise or an outing to increase the feeling of being tired at the end of the day.
5. Stick to a routine and encourage meal times, walks, TV and other activities at the same time each day.
6. Make sure that your loved one is comfortable in the room where he or she is sleeping. Proper ventilation, familiar objects and a night light will help.
7. Discuss this problem with their primary care physician who will review their medications and may prescribe medication for sleep or agitation.
8. Bladder or incontinence problems can often cause disruptive sleep. Bedside commodes or other devices to assist with bladder control may help reduce agitation connected with getting up during the night.
Sundowning or sleep disruption can upset our own lives as well as those of a loved one. Pinpointing the cause, as well as trying the above solutions in conjunction with a conversation with the doctor, will help put them on the right road to normal days and evenings.
Source: http://eldercareanswers.com
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Alzheimer’s Better Spotted By Friends And Family Than Traditional Screening Tests
Friends and family of a person who starts showing early signs of Alzheimer’s dementia tend to become aware of those signs earlier than traditional screening tests do, say researchers in an article published in the peer-reviewed medical journal Brain. An individual is usually evaluated by a healthcare professional with a range of cognitive tasks to gauge memory, such as comparing shapes or remembering a list of words or numbers.
Investigators at the Washington University School of Medicine in St. Louis developed a different way of testing somebody’s memory and cognition – the two-minute Ascertain Dementia 8 questionnaire – it relies on somebody who knows the individual well, usually a friend or close relative. They call this person an informant, and he/she evaluates whether any alterations in the individual’s cognition have undermined their ability to carry out everyday tasks.
The two-minute Ascertain Dementia 8 questionnaire (AD8) was validated by comparing its results with patients who were found to have biomarkers (biological indicators) for Alzheimer’s disease, such as excessive levels of specific factors in the spinal fluid, or the detection of Alzheimer’s plaques from brain scans. They found that the AD8 questionnaires matched the biomarker results better than the traditional screening tests did.
John C. Morris, MD, Director, the Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, said:
It’s not economically feasible to screen everyone for Alzheimer’s disease biomarkers. The AD8 gives us a brief and very low-cost alternative that takes a few minutes of the informant’s time to screen for dementia and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer’s.
Traditional early-stage dementia screening procedures only give a snapshop, a slice of the individual’s cognitive abilities at a specific moment – the moment they are being tested, Morris says. Asking the person being tested whether their mental abilities have altered in any way does not always provide accurate and reliable results, because the patient frequently lacks insight into his/her problem during the early stages of dementia.
With the AD8 questionnaire, the informant is asked to rate any changes they have noticed in the following areas:
- Have there been any problems with judgment? An example may be a bad financial decision.
- Has the individual’s interest in hobbies or other activities diminished?
- Does the individual repeat things, such as stories, statements or questions?
- Does the person have problems learning how to use gadgets or appliances, such as the TV remote or a microwave oven?
- Has the person forgotten which month or year it is?
- Have you noticed any difficulty in his/her handling of complicated financial affairs, such as balancing a checkbook?
- Does he/she forget appointments more frequently than before?
- Have you noticed any consistent problems with memory or thinking?
All the informant has to do is answer with a Yes or No. A Yes gets one point – if the questionnaire scores at least two points, it means the individual would benefit from further evaluation.
People with regular exposure to the individual usually provide the best assessments, Morris said.
Morris added:
These informants can give us the retrospective perspective we need to know that a person’s mental abilities have begun to meaningfully decline, indicating that additional testing is needed.
In this new study, the investigators:
- Collected 251 completed AD8 evaluations
- Tested the individuals using the Mini Mental State exam, a traditional dementia screening test
- Evaluated biomarkers for Alzheimer’s in the patients, this included brain plaque scans and spinal fluid assays.
Morris said:
Based on our results, the AD8 appears to be superior to conventional testing in its ability to detect signs of early dementia. It can’t tell us whether the dementia is caused by Alzheimer’s or other disorders, but it lets us know when there’s a need for more extensive evaluations to answer that question.
The AD8 is currently used in several countries – it has been translated into many languages, the authors wrote.
“Relationship of dementia screening tests with biomarkers of Alzheimer’s disease”
James E. Galvin, Anne M. Fagan, David M. Holtzman, Mark A. Mintun, John C. Morris
Brain (2010) doi: 10.1093/brain/awq204
Written by Christian Nordqvist
Copyright: Medical News Today
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Hope On The Horizon For Alzheimer’s Patients And Caregivers
Today, America’s biopharmaceutical research companies highlighted the 98 new medicines in the pipeline for Alzheimer’s disease and other dementias, either in clinical trials or awaiting FDA review. Researchers, patients, caregivers, advocacy groups and students gathered at the University of South Florida Health Byrd Alzheimer’s Institute to discuss the newest advances in Alzheimer’s research and to take a look into the future of this debilitating disease. Currently, there are only five medicines approved for Alzheimer’s. While these medicines temporarily reduce the symptoms for some patients, biopharmaceutical companies are working to develop new medicines to prevent, delay or cure Alzheimer’s.
“The American biomedical enterprise is making progress in the treatment of Alzheimer’s disease,” said Dr. David Morgan, CEO of the Institute. “The richness of the public-private partnerships between universities, research institutes, biotechnology companies and major biopharmaceutical companies is the envy of the world.”
Research facilities, like the USF Health Byrd Alzheimer’s Institute are making breakthroughs with this devastating disease. These advances have expedited the understanding of the causes of Alzheimer’s. New imaging technologies, such as positron emission tomography (PET) scans, provide scientists a glimpse into the brain, overcoming the prior inability to access brain tissue. PET scans and other biomarkers are revealing the earliest signs of Alzheimer’s even before symptoms appear.
The Honorable Johnnie Byrd, Jr., founder and board member of the Institute highlights the importance of the research conducted at the Institute and the economic impact of the disease.
“As of 2010, the estimated total cost of caring for Alzheimer’s patients is $172 billion, including Medicare, private insurance, out-of-pocket costs and uncompensated care. Families drain their life savings and lose their homes paying for care,” stated Mr. Byrd.
Today, more than five million Americans are living with dementia, and one in 40 Floridians has dementia. Alzheimer’s disease, the most common form of dementia, has become the seventh leading cause of death in America, and is the only cause of death that is moving up in the rankings. Alzheimer’s is a disease of aging, with typical onset in the late 70s and 80s. The number of Americans living with Alzheimer’s is expected to increase as the baby boomers age, and people live longer due to advances in treating infections, heart disease and cancer. It is estimated that 10 million baby boomers will die of this disease without a treatment that slows or prevents Alzheimer’s.
Source: USF Health’s Byrd Alzheimer’s Institute
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