Two Issues at the Heart of Alzheimer's Caregiving

Source: John Hopkins Health Alert - Caring for a loved one who has Alzheimer's is challenging and often perplexing. In this excerpt from a recent Memory Disorders Bulletin, clinicians from Johns Hopkins provide valuable insight and advice ...

Q. My wife (81 years old) is in the early stages of Alzheimer's, but even so, she is demonstrating some strange habits that she never had before. Unfortunately, I don't know what to do about them. Here are some examples: At nighttime, she now wants all the lights on in our bedroom. I put on a special sleep mask and I am able to sleep, but sometimes she will put the television on, which awakens me immediately. I try to turn down the volume, but she gets upset because she can't hear. As for my desire to sleep, she is not cognizant of that at all. My question: What can I do about the lights and TV so I can continue to help Irene and still maintain my own health?

A. Some people find that sleeping in separate bedrooms becomes a necessity when a spouse develops Alzheimer’s. If this would be safe, perhaps you should give it a try. Your wife is probably not able to understand or remember the fact that you have on a sleep mask unless she is looking at you and may not remember or comprehend why you need it. I am guessing that you have already tried to remind her of these facts but that she does not remember or understand them.

Q. I have started caring for my mother, who has had Alzheimer's for the past six years. After the second day at my home, I recommended that she take a shower but she adamantly refused. Now, it's the end of the first week and still no shower. Do you have any special tips on how to coax a reluctant person with Alzheimer's to bathe?

A. Keep in mind that bathing is an intensely personal activity. We generally do it alone once we become an adult and do not do it with a stranger unless we are at a health club or with a person of the opposite gender unless he or she is a spouse. As a result, people with Alzheimer’s often see being bathed by someone else as an invasion of privacy, particularly because they do not realize that they are ill.

Second, bathrooms and showers are usually small, enclosed spaces. Having another person in the bathroom probably feels uncomfortable for this reason as well.

Third, the shower process itself frightens many people with Alzheimer’s. They are naked, water starts falling on them for no clear reason and they may feel unsteady. Some spouses and family members report that showering goes better if they are in the shower with the person with Alzheimer’s. Talking their loved one through the process, hiring an aide of the same gender as the Alzheimer’s patient, switching to sponge baths or greatly decreasing how often the person bathes also are approaches worth trying.