July 31, 2010

The primary goals of treatment for Alzheimer’s are to improve the quality of life for the person suffering and for his or her caregiver(s). Treatment typically comprises three interrelated approaches:

1.) Slowing the progression:
In most cases, treatment will involve methods of slowing cognitive decline and treating specific symptoms and/or co-occurring conditions with drug therapies.

2.) Managing the behavioral symptoms of Alzheimer’s:
Non-drug approaches are used by families and caregivers in consultation with social workers, nurses or support-group facilitators. Specific strategies that might be recommended for managing these symptoms include:

• Teaching caregivers how to communicate and interact with the person in ways that improve functioning and reduce behavioral problems
• Involving the person with Alzheimer’s in structured therapeutic activities
• Modifying the home environment to make it safer and easier for the person to function
• Maintaining overall health through regular medical care, proper diet and exercise, and using complementary health approaches as appropriate to address specific health needs

If non-drug approaches fail to adequately manage behavioral problems, talk to your physician about medications that may help. You might want to use a journal to keep track of day-to-day changes in behavior and note when symptoms arise, what might precipitate them, and what, if anything, helps resolve them when they do arise.

Your doctor may recommend medications, depending on what the symptoms are, from a group of drugs generally referred to as “anti-agitation drugs”. The types of medications that might be used include antidepressants (if the patient has depression); anti-anxiety drugs (also called anxiolytics), anti-psychotic medications (some of which are also called neuroleptics); sedatives, and sleep medications. There are many different drugs within each of these classes of medication. Each acts in a somewhat different way and has different side effects, some of which may be severe. As a rule, doctors generally prescribe the lowest dose possible to alleviate symptoms and then adjust the dosage as necessary.

3.) Support and education for the family and caregiver:
Caring for a person who has Alzheimer’s poses tremendous challenges — emotional, physical and financial. Caregivers are subject to high levels of chronic stress, and caregiver burnout is a significant factor in the inability to continue caring for Alzheimer’s patient at home.

Research shows that when families and caregivers are educated about Alzheimer’s disease and have the appropriate support, care of the person with Alzheimer’s is improved. There are many educational and support programs available. Good programs can equip the caregiver with the skills and support necessary to care for a loved one at home and can significantly delay the time when placement in a nursing home becomes necessary. Taking advantage of these programs will improve not only the quality of life of the person with Alzheimer’s, but also that of the family and caregivers.