Alzheimer’s disease, dementia and hypothyroidism in the elderly

Hypothyroidism causes Alzheimer’s disease.

Working in a nursing community devoted to persons with Alzheimer’s disease and related dementias. I have had an interest in tracking resident diagnoses. The percent of diagnosis of hyperthyroidism has been consistently about 30% in our population of persons with Alzheimer’s disease.

Diagnosis of hypothyroidism difficult to get.

Taking into consideration that unless you have the “correct” lab values, you won’t be diagnosed with hypothyroidism. The real percent of our residents having hypothyroidism must be much higher. In 2002 the health care community realized that the lab values then set were not catching all the hypothyroid cases. So they changed the criteria. However this still leaves out all those people who can only be diagnosed by symptoms.

Hypothyroidism is treatable and when caught early can prevent dementia.

The use of thyroid replacement therapy can address the mental sluggishness that can progress to signs of early dementia.

Symptoms of hypothyroidism:

  • Intolerance to cold
  • Chronic fatigue
  • Hair loss (especially eyebrows)
  • Overweight
  • Arthritis
  • Dry skin
  • Decreased perspiration
  • Muscle weakness
  • Nervousness
  • Headaches
  • Constipation
  • Brittle/ridged nails
  • Slow movements

This is only a small amount of signs and symptoms of hypothyroidism. For a complete list as well as before and after pictures of persons with hypothyroidism after treatment. See:

Hypothyroidism, Type 2 – the epidemic by Mark Starr, M.D.

Available at: www.type2hypothyroidism.com

Caregiver Tips: Alzheimer’s disease, when he realizes he can’t drive anymore

Elderly Driver

He’ll never drive a car again.

He’s taken such good care of our cars. More than just being able to drive, giving it up symbolizes a lot of things he’ll never do again.

He was a skilled driver, moving efforlessly through crowded lanes while he talked or listened to the radio. A few months ago I saw how upset he became when he had to drive in heavy traffic. He forgot a turn, and a car almost hit us. Fortunately he made the transition easy for me. “You’d better drive,” he said, trying to sound casual. “Downtown traffic gets on my nerves.”

He tried to smile, but I knew what it cost him to turn the driving over to me. Other wives have had trouble making the change. They took over when they realized that it involved human safety-theirs and others’.

God, give both of us strenght to accept what we can’t change. Help us make these transitions with grace and dignity.

Excerpt from: Daily Encouragement – When Someone You Love Has Alzheimer’s
by: Cecil Murphey and Beacon Hill Press of Kansas City

Virginia Garberding R.N.
Director of Education, The Wealshire
Author: Please Get To Know Me – Aging with Dignity and Relevance
With Cecil Murphey
(For related information see also other blogs in this category)

Caregiver Tips: When caring for the confused elderly who is taking numerous medications, suggest a “drug holiday” to the doctor

Elderly Medications

For the elderly, many times we just keep adding more drugs.

Ann was in the late stage of Alzheimer’s disease. She no longer recognized her family or even herself in a mirror. She did not know her caregivers or even where she was. Over the years she had been diagnosed with a heart condition as well as having many negative behaviors. As time went by more and more medications were added to her day. Medications for her heart as well as her dementia.

Medications many times have a way of building and being added to and multiplying. Until the confused elderly are taking so many medications you no longer really know how the person would function without all those pills.

For Ann a defining moment came when her husband became ill and the family decided that it was just too much for him to continue going to the nursing home everyday to visit Ann. So with the blessing of her doctor and because of her end stage Alzheimer’s disease they all agreed to a “drug holiday” for Ann.

“Drug Holiday” or when the doctor gives the elderly a vacation from drugs.

To everyone’s surprise Ann blossomed. She was more wide awake, smiling, greeting everyone who came within ear shot of her. She now was singing all the time, very happy and responsive. She still no longer recognized anyone, but she sure enjoyed seeing you. Ann continues on her “holiday” some 3 years later.

Many times the accumulation of multiple medications is just taken for granted in the elderly population. Maybe as we age, the elderly should be taking away medications instead of adding to them.

Virginia Garberding R.N.
Director of Education, The Wealshire
Author: Please Get To Know Me – Aging with Dignity and Relevance
With Cecil Murphey
(For related information see also other blogs in this category)

When the family gets the diagnosis “She has Alzheimer’s disease”

Alzheimer's Diagnosis

So many times the family knows – but they don’t really know until they hear the doctor say those final words “She has Alzheimer’s disease.”

The son –youngest in the family- tells me “The doctor says she has Alzheimer’s disease.” His sister took her to the doctor after she walked out of her home twice and got lost in the community.

She had loved to cook, made everything from memory and took great pride in being a good cook. Now she was cooking using notes her daughter had written down for her. And even with those guides she was getting the recipes wrong. But recently on a visit to the youngest son and his wife, she had given the family food poisoning. When everyone got sick they began watching what Mom was doing in the kitchen. They soon realized she no longer used soap to wash her hands. She liked to lay raw meat out on the kitchen counter on paper towels before cooking. They observed her touching the raw meat and then fruit in the bowl on the counter and various surfaces, without washing her hands.

When visiting her son and his family, even though she spent time in the bathroom every night, and they heard the shower running – they found she was rinsing out her clothes every night, and not bathing. Instead of bathing the constant running water was for washing out her clothes with hand soap. She was now wearing her pajamas at all times – under her clothes during the day, and with out her clothes at night.

When shopping with the family at a department store, Mom decided to try on some pants and began removing her slacks and pajama bottoms in the aisle at Macy’s. The family realized that Mom was having some unusual behaviors prior to getting lost in her community.

Looking back, the family was providing more and more assistance to help Mom through the day. So why was everyone so shocked when the doctor said those fateful words “She has Alzheimer’s disease.”

Virginia Garberding R.N.
Director of Education, The Wealshire
Author: Please Get To Know Me – Aging with Dignity and Relevance
With Cecil Murphey
(For related information see also other blogs in this category)

Who is really at risk for Alzheimer’s disease?

 

 

 

 

 

Risk for Alzheimer's disease

 

 

 

6 -Common risk factors for Alzheimer’s disease:

Family history of Alzheimer’s disease. This is such scary information for the children of someone with Alzheimer’s disease to hear. I can recall a son saying at a care conference for his parents – both of which had the diagnosis of Alzheimer’s disease, that he spent every evening on the internet, searching to see if anyone had found a cure. He shared how concerned he was because of both his parents having the disease. However that event happened over 10 years ago. Today people are so much more informed about the known ways to prevent the disease as well as benefits of early diagnosis.
Old age. The risk of developing Alzheimer’s disease doubles every year after the age of 65. When a person reaches 85 years, their chance of having Alzheimer’s disease is almost 50%. As the country ages and we are seeing an ever increasing number of people 85 and older. (this is the fastest growing segment of the population) We will also be seeing a greater increase in the number of people diagnosed with Alzheimer’s disease.
Long-term high blood pressure/heart disease. The danger of long-term high blood pressure to the heart and circulatory system is well known. However we also know that anything that affects the heart also affects the brain. When you take care of your heart, you take care of your brain.
History of head trauma – one or more severe blows to the head may put a person at increased risk for Alzheimer’s disease. Persons with a history of boxing who received repeated blows to the head, or head trauma following an accident involving head trauma, also carry an increased risk of Alzheimer’s disease.
Down syndrome. Persons with Down syndrome are living longer just like the rest of the population due to advances in public health. With this increase, also comes the increased incident of acquiring Alzheimer’s disease. While the incident of Alzheimer’s disease is 3-5 times greater in the population with Down syndrome, than in the general population. Alzheimer’s disease also affects this population at an earlier age, in their 40’s or 50’s compared to late 60’s in the general population.
Education level – Persons with a higher level of education are less likely to develop Alzheimer’s disease. Due to the fact that the more education a person has correlates to the number of neuron connections in the brain. The more connections a person has the more they are able to lose. And highlights the importance of increasing those connections as a person ages by continuing to learn.

When the caregiver of the confused elderly want to know, “How can I help you understand more?”

Caregiver of confused elderly

Helping the confused elderly through cues.

Oxford Dictionary defines cue as” a signal to do something.”
The cue may be a smell, a touch, a sound, an item, or a visual symbol. Using a full complement of cues through out the day can help the confused elderly understand the environment, and what is happening at any given moment.

A smell can be a cue that is time to eat, if the cue you smell is pot roast. A smell can stimulate your appetite such as passing a bakery and smelling the cookies, may make you feel like having a cookie. A fragrance such as baby powder cues you that there is a baby around. The smell of laundry soap cues you that you are wearing clean clothes.

Seeing a symbol works best as a cue when the symbol looks the most like what it represents. So a picture of a lawnmower will be a better cue than a line drawing of the same mower. A picture of a banana will not be as good a cue for “do you want a banana” as holding out a real banana to the confused elder.

Helping the confused elderly through combining cues.

Putting a favorite hand lotion on the elder’s hands and massaging it in is using the cues of touch as well as smell. Hearing running water, holding a bath towel and smelling Dove soap can cue the elder that they are taking a bath.

 

Communicating with the confused elderly using cues, is non-verbal communication. When the elders have lost their “words” and no longer understand what is being said to them. They can still understand what is going on around them, through your cues.

Cues are forms of communication – helping the confused elder do more for themselves, better understand the environment and know what is going on around them, is the reason for offering cues.

Caregiver Tips: Activities for the confused elderly in the home

Activities

Activities start with knowing the person.


I just met a daughter who had put together a “gardening cart” for her elderly father. I could tell by the smile on her face as she described it, the joy she felt in doing this for Dad. He had always enjoyed gardening and now in his wheelchair, sitting at a cart just the right hight for the chair. This elderly man could have all the tools of the trade right at his reach, and continue to enjoy an activity that had been so meaningful to him.

A home traveling activity.


The beauty of the garden cart for that elderly man was it could move. He could garden outside or inside any time of the year. There are many kinds of carts available to turn into activity centers for the home. Small tool carts for men made out of light weight rubber materials available at hardware stores or catalogs. Kitchen carts for women that could be turned into any number of craft centers.

The confused elderly who want to continue to “work.”


I have seen elderly doctors who in the Nursing Home really enjoy being included in staff activities. We have put together patient charts, just to hand to the doctor to give to him the chance to feel involved.
JCPenny catalogue has what they call a “Billpayer’s Desk” on wheels, that could be perfect for the former office worker. It has compartments for pens, paper clips, folders a large file drawer. Many hours of activity could happen at his desk.

Finding that perfect activity for the confused elderly.


Caregiving always comes back to really knowing the person you are caring for. What were their interests?
Puttting together that perfect activity center for they elder can be very rewarding for the caregiver as well as the elder. I know that from the smile on the face of the “gardener’s daughter.”

Alzheimer’s disease, not a part of normal aging memory loss or a “Senior Moment.”

Memory Loss

Distractions prevent forming new memories.

 
You walk into the house, your husband is calling to you “What are we having for dinner?” The phone is ringing and the TV is on at peak volume. You put down your groceries and run to get the phone in the bedroom, where you can hear. You put down your car keys next to the phone. The next morning when you need to run out to a doctor’s appointment, you can’t find your keys.

Distractions, they are all around us. It is so much harder to set down a new memory, when we are surrounded by distractions. But the first thing an older person worries about when they forget, is that this might be the first sign of Alzheimer’s disease.

4 Differences between normal aging memory loss and Alzheimer’s disease.


• When trying to remember a past event, the senior with normal memory loss will often remember parts of the event and often at a later time be able to remember the whole event. The person with Alzheimer’s disease will rarely have better recall at a later time. And it doesn’t really bother them unless someone keeps calling it to their attention that they can’t remember.
• A senior with normal aging memory loss will usually be helped by keeping a detailed calendar, writing themselves notes and reminders. While this will also help the person with Alzheimer’s disease, gradually these aids will no longer help.
• A senior, with normal aging memory loss, will be able to follow written directions, while the person with Alzheimer’s disease will gradually be unable to do this.
• A person with Alzheimer’s disease will eventually be unable to identify money. Will forget how to dress themselves, feed themselves and do all the things we refer to as Activities of Daily Living.

The next time you can’t find your car keys, think about the many young people who loose their keys as well.

Caregiver Tips: When the elder has Alzheimer’s disease, and every task takes time, simplify.

Simplify tasks

I dreaded helping him get dressed in the morning because he couldn’t manage the buttons. He refused my help and ended up tearing his shirt.

I finally bought him shirts without buttons. We turned to loafer-type shoes. I put elastic in his trousers and sewed the zippers shut. I also bought jogging pants. As he loses his dexterity, I search for ways to simplify the task so that he can still do as much for himself as possible.

The other day he simplified the problem of taking his pills. I had been giving them to him one at a time, pausing for him to wash each one down with milk or juice. He dumped all the pills into the glass, drank it down in a single swallow, and laughed when he did it.

I thanked him for helping me solve that one.

Father, thank You that we can enjoy the simple moments together. Help us find joy in those moments and in the in-between.

Book excerpt from:
When Someone You Love Has Alzheimer’s by Cecil Murphey and Beacon Hill Press

Good sources for simplifying the task of dressing are:
Silvert’s Adaptive Clothing & Footwear – www.silverts.com
Buck & Buck Adaptive Clothing – www.buckandbuck.com

Caregiver Tips: Alzheimer’s Disease

Alzheimer's Disease

When the problem is that the person still looks “so good”, it’s not like a broken leg where you see what is wrong.

Many times especially in the very early stage of Alzheimer’s disease people look so good you can’t tell. The person often looks so well physically, which can cause outsiders to question the caregiver’s talk about incompetence. Or family or friends might suggest medical system failure in the diagnosis.
Family members may experience difficulty accepting the diagnosis of Alzheimer’s disease or related dementia. They may maintain an inner hope that the elder does not have dementia as physicians cannot be absolutely positive.

For the hands on caregiver (usually a family member) the swings between good days in contrast with difficult times becomes a challenge. I have seen many people with Alzheimer’s disease who when visited by family, seem to rise to the occasion and visit very normally. I remember a lady who had very severe confusion every afternoon and evening. I explained the situation to her daughter when discussing a proposed trip several thousands of miles away. The daughter chose to take her Mom and then called the first evening she was gone – saying “I don’t know what to do with her, I never saw her like this.”
Many times in life looks can be deceiving and dementia is a case in point. This makes it doubly hard for the caregiver when they are put in the position of constantly explaining.

Families always maintain an inner hope that the diagnosis is wrong, signs that the loved one is getting better or hope that a cure will be found in time.