A Caregiver’s Guide to Alzheimer’s

By National Institute on Aging

Incontinence and Alzheimer’s

As the disease progresses, many people with AD begin to experience incontinence, or the inability to control their bladder and/or bowels. Incontinence can be upsetting to the person and difficult for the caregiver. Sometimes incontinence is due to physical illness, so be sure to discuss it with the person’s doctor. 

  • Have a routine for taking the person to the bathroom and stick to it as closely as possible. For example, take the person to the bathroom every 3 hours or so during the day. Don’t wait for the person to ask.
  • Watch for signs that the person may have to go to the bathroom, such as restlessness or pulling at clothes. Respond quickly.
  • Be understanding when accidents occur. Stay calm and reassure the person if he or she is upset. Try to keep track of when accidents happen to help plan ways to avoid them.
  • To help prevent nighttime accidents, limit certain types of fluids–such as those with caffeine–in the evening.
  • If you are going to be out with the person, plan ahead. Know where restrooms are located, and have the person wear simple, easy-to-remove clothing. Take an extra set of clothing along in case of an accident.

Sleep Problems and Alzheimer’s

For the exhausted caregiver, sleep can’t come too soon. For many people with AD, however, nighttime may be a difficult time. Many people with AD become restless, agitated, and irritable around dinnertime, often referred to as “sundowning” syndrome. Getting the person to go to bed and stay there may require some advance planning. 

  • Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.
  • Try to schedule more physically demanding activities earlier in the day. For example, bathing could be earlier in the morning, or large family meals could be at midday.
  • Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.
  • Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
  • Restrict access to caffeine late in the day.
  • Use night lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.

Hallucinations and Alzheimer’s

As the disease progresses, a person with AD may experience hallucinations and/or delusions. Hallucinations are when the person sees, hears, smells, tastes, or feels something that is not there. Delusions are false beliefs that the person cannot be dissuaded of. 

  • Sometimes hallucinations and delusions are a sign of a physical illness. Keep track of what the person is experiencing and discuss it with the doctor.
  • Avoid arguing with the person about what he or she sees or hears. Try to respond to the feelings he or she is expressing, and provide reassurance and comfort.
  • Try to distract the person to another topic or activity. Sometimes moving to another room or going outside for a walk may help.
  • Turn off the television set when violent or disturbing programs are on. The person with AD may not be able to distinguish television programming from reality.
  • Make sure the person is safe and does not have access to anything he or she could use to harm anyone.

 

APA Reference
on Aging, N. (2006). A Caregiver’s Guide to Alzheimer’s. Psych Central. Retrieved on September 19, 2014, from http://psychcentral.com/lib/a-caregivers-guide-to-alzheimers/000197
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.