Caring for a Loved One Who - American Pharmacists Association for a... · Caring for a Loved One Who…

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  • Caring for a Loved One Who Has AlzheimersDiseaseAlzheimers disease (AD) gradually destroys brain cells. It is theleading cause of dementia. If your loved one has dementia, you maynotice that his or her memory is getting worse and that he or she:

    Has difficulty thinking, making decisions, or finding theright words

    Can be confused and disoriented

    Has trouble learning

    Can no longer do everyday tasks

    Brain cells die at various rates in different people, so predictingthe course of the illness is impossible. AD may last for 3 yearsfor one person and 20 years for another. On average, people withAD live 8 years after the first symptoms appear. Memory andthinking skills are lost first. Eventually, the disease destroys allbrain function and can be fatal in an otherwise healthy person.The cause of AD is unknown.

    Nearly 3 out of every 4 people who have AD live at home andare cared for by their families and friends. Caregivers not onlyhelp with the loved ones daily activities but also may beresponsible for making important legal decisions and monitor-ing changes in behavior.

    Understanding Your Loved Ones MedicationsAD has no cure. Doctors prescribe medication to lessen thesymptoms, slow the progress of the disease, and perhaps delaythe need for nursing home care. Four medications are currentlyavailable to treat AD:

    Donepezil (Aricept),

    Tacrine (sold as Cognex),

    Rivastigmine (Exelon), and

    Galantamine (Reminyl).

    These drugs are from a family of medications called cholinesteraseinhibitors, and they work to prevent the breakdown of a brainchemical that is needed for memory and thinking skills. Of thesefour, only donepezil (Aricept) has been shown to work in con-trolled 1-year studies. Aricept is given just once a day.

    Any of these drugs can cause the side effects of nausea, vomiting,loss of appetite, and increased frequency of bowel movements.

    AD patients may refuse to take medication or, in the later stagesof the disease, have trouble swallowing. Ask yourpharmacist if a liquid form of medication is availableor if the medicine can be crushed and mixed withapplesauce or pudding. Avoid giving your loved oneantihistamines because they can prevent the AD med-ication from working as well as it should. The care-giver should consult with a doctor or pharmacist tosuggest an alternative to antihistamines.

    Future Medications and AlternativeTreatmentsResearchers are exploring the use of vitamin E toslow brain cell damage and medications to manageagitation and other behavioral problems your lovedone may exhibit.

    Although a number of alternative treatmentsforexample, ginkgo biloba, huperzine A, and phos-phatidylserinehave been suggested to treat AD,none has been proven to be safe and effective. Thepurity of such substances is not guaranteed, and sideeffects have not been adequately studied. Even seem-ingly harmless dietary supplements can cause bad reac-tions or interact with prescribed medications. Nevergive your loved one an alternative therapy without firsttalking with his or her health care professional.

    Special Challenges for the ADCaregiverAn AD patients behavior can make your life as acaregiver difficult. Your loved one may no longer rec-ognize you and may act strangelyyelling, hitting, swearing, orwandering away from home. Such changes may make it hard foryou to think of your loved one as the same person he or she wasbefore becoming ill.

    As a caregiver, you may to need become your loved ones memory.You may help him or her remember family and friends, read orwatch TV, understand what others say, and find the right words.You can help your loved one hold on to his or her personal dignity.

    Caregiving Recommendations

    Caregiver StressAs you care for your loved one, you also need to take care ofyour own emotional and physical needs. You wont be able tohelp your loved one if you dont take care of your own mentaland physical health. Watch for signs of depression, changes inyour other relationships, and exhaustion. Allow others to helpyou, or seek out respite care in your community.

    Staying InformedLearning as much as you can about AD will help you care for yourloved one and meet your own needs as a caregiver. The followingorganizations are good sources of both help and information:

    Alzheimers Association, 800-272-3900, www.alz.org

    U.S. Administration on Aging, 202-619-0724,www.aoa.dhhs.gov

    Alzheimers Disease Education and Referral Center, 800-438-4380, www.alzheimers.org/adear

    American Association of Retired Persons, 800-424-3410,www.aarp.org

    Children of Aging Parents, 800-227-7294, www.caps4caregivers.org

    Eldercare Locator, 800-677-1116, www.eldercare.gov

    National Family Caregivers Association, 800-896-3650,www.nfcacares.org

    National Institute of Neurological Disorders and Stroke, 800-352-9424, www.ninds.nih.gov/health_and_medical/disorders/alzheimersdisease_doc.htm

    National Institute on Aging/Information Center, 800-222-2225, www.nia.nih.gov

    Family Caregiver Alliance, 415-434-3388, www.caregiver.org

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    Caring for a Loved One Who

    Has Alzheimers Disease

    Developed by the American Pharmacists AssociationImproving medication use. Advancing patient care.

    This information is developed and made available by the AmericanPharmacists Association through an educational grant from Eisai Inc.

    What to Do What to Avoid Doing

    Observe your loved ones behavior closely.Actions may replace words.

    Call your loved one by name often. Gethis or her attention before going on.

    Speak in short sentences. Use simplewords.

    Maintain a calm and gentle tone of voice.

    Keep activities simple. Use your lovedones current abilities.

    Set up a routine for the day and stick to it.Keep your environment predictableforexample, keep the furniture in the sameplace.

    Plan ahead for all activities. For example,assemble everything youll need to giveyour loved one a bath before bringing himor her into the bathroom.

    Install childproof latches on cupboardsthat contain medications, cleaning supplies,alcohol, or dangerous utensils. Protectyour loved one from these dangers just asyou would a small child.

    Dont expect too much.Avoid criticizingfailures and mistakes.

    Try not to interrupt or hurry a response.

    Dont talk to your loved one as if he orshe were a small child. Dont talk abouthim as if he werent there.

    Dont give too much information at once.Provide step-by-step instructions if yourloved one needs prompting.

    Avoid doing too much for your loved one.Allow him or her to do as much as possible.

    Dont announce upcoming events too farin advance. For example, wait until the dayof the appointment to tell your loved onehe or she is going to see the doctor.

    Too many choicesfor example, too manyfoods on a plate or too many choices ofwhat to wearmight be overwhelming.Dont eliminate choices, but keep deci-sions simple.

    Dont wait for your loved one to ask togo to the bathroom.Take him or her tothe bathroom about every 3 hours duringthe day to avoid accidents.

  • casa. Tales cambios pueden hacer que a usted le resulte difcilcreer que se trata de la misma persona que usted conoca antesde enfermarse.

    Como cuidador, posiblemente usted se convertir en la memoriade su ser querido. Usted podr ayudarle a recordar a sus famil-iares y amigos, a leer o ver TV, a comprender lo que dicen losdems y a encontrar las palabras precisas para comunicarse.Podr ayudarle especialmente a conservar su dignidad personal.

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    Cuidando de un ser querido que padece de

    Desarrollado por la Asociacin Americana de FarmacistasMejorando el uso de las medicinas.

    Fomentando el cuidado del paciente.

    enfermedad de Alzheimer

    Esta informacin ha sido desarrollada y difundida por la AsociacinAmericana de Farmacistas mediante un subsidio educativo de Eisai Inc.

    Cuidando de un ser querido que padece deenfermedad de AlzheimerLa enfermedad de Alzheimer (EA) destruye gradualmente lasclulas cerebrales y es la principal causa de demencia. Cuando unser querido padece de demencia es posible observar que sumemoria se deteriora y que adems experimenta:

    Dificultad para pensar, tomar decisiones o hallar palabras ade-cuadas para expresarse

    Confusin y desorientacin

    Dificultad para comprender

    Impedimento para realizar las labores cotidianas

    La muerte de clulas cerebrales vara en las distintas personas,por lo que resulta imposible predecir el curso de la enfermedad.La EA puede durar tres aos en un individuo y veinte en otro.Tras la aparicin de los sntomas iniciales, las personas que pade-cen de EA viven en promedio 8 aos. Inicialmente se pierden lashabilidades de la memoria y el pensamiento. Con el tiempo, laenfermedad destruye toda funcin cerebral y puede ser fatal enuna persona que por lo dems se encuentra sana. La causa de laenfermedad es desconocida.

    Aproximadamente 3 de cada 4 personas que padecen de EAviven en sus hogares donde son atendidas por familiares y ami-gos. Los cuidadores no solamente colaboran con las actividadescotidianas sino que adems pueden tomar importantes decisioneslegales y vigilar los cambios en el comportamiento de su serquerido.

    Conozca los medicamentos de su ser queridoLa EA es incurable. Los mdicos prescriben medicamentos paraaliviar los sntomas, reducir la progresin de la enfermedad yposiblemente para retrasar la necesidad de atencin en una casade salud. Actualmente se encuentran disponibles cuatro medica-mentos para el tratamiento de la EA:

    Donepezil (Aricept),

    Tacrina (comercializada como Cognex),

    Rivastigmina (Exelon) y

    Galantamina (Reminyl)

    Estos frmacos pertenecen a un grupo de medicamentos denomi-nados inhibidores de la colinesterasa, cuya funcin consiste enprevenir la desintegracin de un qumico cerebral necesario paralas habilidades de la memoria y el pensamiento. De los cuatro

    medicamentos, nicamente el primero (Aricept) ha demostradoser efectivo en estudios controlados de un ao de duracin. stese administra slo una vez al da.

    Cualquiera de estos medicamentos puede causar efectos secun-darios que consisten en nuseas, vmito, prdida del apetito yaumento en la frecuencia de movimientos fecales.

    Los pacientes que sufren la EA pueden negarse a tomar medica-mentos o -en las etapas tardas de la enfermedad- experimentardificultad para tragar. Pregunte a su farmacutico si el medica-mento se encuentra disponible en forma lquida o si es posibletriturarlo y mezcl...

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