1. Are there any bad side effects from Alzheimer’s drugs?
A person with Alzheimer's disease may be taking medicines to treat their symptoms and other health problems they have. But when they take many medications at once, there’s a higher chance they’ll have a bad reaction to them. The problems can include confusion, agitation, sleepiness or sleeplessness, mood swings, memory problems, and upset stomach.
Some people who have severe symptoms of Alzheimer's disease -- such as aggressive behavior or hallucinations (seeing, feeling, or hearing things that aren’t there) – may need stronger medicine to keep their problems under control. But some of these drugs can make their other Alzheimer’s symptoms worse. For example:
- Some drugs such as benzodiazepines (tranquilizers) can cause confusion, memory trouble, and slowed reactions, which can lead to falls.
- Some medicines that treat depression can cause sedation and other side effects.
- These drugs may react with medicines that treat Alzheimer's disease, including donepezil (Aricept), galantamine (Razadyne), memantine (Namenda), and rivastigmine (Exelon).
- Some medicines that treat hallucinations can cause sedation, confusion, and drops in blood pressure.
Ask your doctor about the pros and cons of these options. Also, some over-the-counter drugs, including cough and cold remedies and sleep medicines, can have side effects, too. They may also react with other Alzheimer’s meds. A doctor can let you know which ones are safe to take.
2. I'm thinking about taking a trip with my father, who has Alzheimer's. How can I make it easier for both of us?
Plan ahead. Think about his needs so you'll be ready for any changes or problems. You can try taking a short trip first to see how he reacts to traveling. A few other tips:
- Give him simple, relaxing things to do when you’re traveling. He could read a magazine, play with a deck of cards, or listen to music, for examples.
- Never leave a person with dementia alone in a car. When moving, keep his seat belt buckled and the doors locked.
- Plan regular rest stops.
- If he gets agitated during the trip, stop at the first place you can. Don't try to calm him while you’re driving.
- Think about going on vacation somewhere that’s familiar to him -- like at a lake cabin he’s visited in the past, for example.
- If he gets flustered easily, it may be wise to avoid places that are crowded. You may also want to skip fast-paced sightseeing trips.
- If he’s never been on a plane, it may a good idea to drive instead, if possible.
- Alert the airlines and hotel staff that you’re traveling with a relative who is memory-impaired. Make sure he carries or wears some sort of identification.
- Enjoy your time with your dad, but try to find time to relax, too. It may help to bring someone along who can help you with caregiving tasks.
3. I'm having trouble getting my loved one to eat. What can I do?
Her Alzheimer’s symptoms can make it harder for her to get enough to eat. She might have trouble knowing when she’s hungry or thirsty, have problems eating or swallowing, have a hard time using silverware, or feel depressed. Try some of these tips:
- Talk to your loved one's doctor. He may be able to help if she’s not eating because of a treatable problem, like depression.
- Don't force her to eat. If she’s not interested in food, try to find out why.
- Focus on serving more nutritious choices, like protein, fruits, vegetables, and healthy fats, and less salt and sugar.
- Try giving her shakes with nutrition added to maximize the calories she gets.
- Offer smaller meals more often instead of three large ones.
- Encourage her to walk, garden, or do other things that get her moving to boost her appetite.
- Serve finger foods that are easier for her to handle and eat.
Prepare meals that offer different textures, colors, and temperatures.
- Make eating fun, not a chore. For example, liven up your meals with colorful place settings, or play background music.
- Try not to let your loved one eat alone. If you can’t eat with her, invite a guest.
4. My mother has Alzheimer's disease, and I've noticed she’s getting more confused. How can I help her?
- Keep her surroundings and routine the same. If you have to make changes, do it gradually.
- Make things simple, and avoid situations where she has to make decisions.
- Describe the events for the day to her. Remind her of the date, day, time, place, etc. And repeat the names of the people she sees often.
- Put large labels (with words or pictures) on drawers and shelves so she’ll know what’s in or on them.
- If she doesn't seem to understand something you’ve said, use simpler words or sentences.
- Make sure she takes her medicines on schedule.
- Be patient and supportive.
5. Is there anything I can do to help my mother preserve what memory she has left?
Losing cherished memories is one of the hardest parts of Alzheimer's disease. Some medicines may help slow down symptoms. There are also some ways to help her hold on to the things she does remember.
- Use notes, lists, and memos to remind her of her daily tasks.
- Keep photos of family members and friends where she can see them. Label them with names if you need to. Get her to talk about the people or the hobbies she used to enjoy.
- Make sure she gets enough sleep.
- Encourage her to read, do puzzles, write, or do other things that keep her mind active. But if she gets frustrated, don’t push her to keep going.
6. Can ginkgo biloba cure Alzheimer's?
For many years, people thought this extract from the ginkgo tree might be a memory booster. But there’s no evidence that it works in treating or preventing Alzheimer's. In fact, it may be harmful. One large study showed that taking it every day may cause dangerous side effects, such as too much bleeding, and that ginkgo does not slow the decline of cognition.
7. Is exercise good for someone with Alzheimer's disease?
Yes. Exercise improves strength and endurance and keeps the heart healthy. It can also give your loved one more energy and improve his mood and sleep. Physical activity also helps people with Alzheimer's disease keep up their motor skills and balance, which can help them avoid serious injuries from falls. It can make the brain work better, too.
The type of exercise that’s right for your loved one depends on how much the disease affects him. Someone in the early stages of the disease may enjoy walking, bowling, dancing, golf, and swimming. As the disease gets worse, he may need more supervision. Talk to his doctor before he starts any exercise program.
8. Do the symptoms of Alzheimer’s disease vary by the time of day?
Many people with the disease get confused, anxious, and agitated at dusk and into the evening hours. It’s called sundown syndrome, or sundowning. The problems may last a few hours or throughout the night.
Doctors don’t know exactly what causes sundowning, but they think a lot of different things play a role. Those could include physical and mental exhaustion (after a long day), and a shift in the body’s internal clock that happens with the change from daylight to dark. Some people with Alzheimer's have trouble sleeping at night, which may also make confusion worse. Some medications can add to the problem, too.
Some ways for you and your loved one to handle sundowning:
- Schedule harder tasks early in the day when she’s less likely to get agitated.
- Watch her diet and eating habits. Offer sweets and drinks with caffeine only in the morning hours. Serve her a late afternoon snack or early dinner.
- Offer her decaffeinated herbal tea or warm milk. They might help her relax.
- Keep the house or room well lit. Close the drapes before the sun goes down so she doesn't watch it get dark outside.
- If she falls asleep on the sofa or in a chair, let her stay there. Don't wake her to go to bed.
- Distract her with things she enjoys. Soothing music or a favorite video may help.
- Encourage her to be physically active during the day. It may help her to sleep better at night.
9. Are people in the early stages of the disease still interested in sex?
No one has studied sexuality in Alzheimer's. But many people with disease also have a mood disorder, such as depression, or other medical problem, which can lead to sexual problems. Medications that treat these conditions can also affect someone’s sex life. People with dementia often feel less interested in many areas of their lives, like their appearance, clothes, and friends. That may affect their sex drive, too.
If your partner has Alzheimer’s and you’re concerned about their sexuality, try the following:
- Ask your loved one's doctor if she might have a mood disorder.
- Make sure she’s getting treatment for any medical problems that may make her feel worse, like pain from arthritis.
- Ask her doctor how her medications might affect her sexuality.