4 Tips to Enhance Daily Life for a Loved One with Alzheimers

Maximize the therapeutic power of the caregiving relationship

Posted Oct 19, 2018

Kasia Bialasiewicz/BigStockPhoto
Source: Kasia Bialasiewicz/BigStockPhoto

Enhancing daily life for a loved one with Alzheimer’s often starts by empowering caregivers to cope with the increasing memory loss and behavioral changes that characterize the disease. Caregiver support is especially important given that an unprecedented number of new caregivers will be called upon to assist an increasing number of Americans with Alzheimer’s. Currently, 5.7 million Americans are diagnosed with Alzheimer’s, and this number will grow to approximately 14 million by 2050. A simultaneous exponential increase in the 18.4 billion caregiving hours provided by 16.1 million unpaid caregivers in 2017 is also predicted. 

The following tips can help caregivers cope with Alzheimer’s-related memory problems and behavioral changes, and improve quality of life for themselves and their loved one with Alzheimer’s:

1.  Seek ongoing support and education about Alzheimer’s. It is common for caregivers to feel reluctant to take time away from their loved one to attend a support group. However, reluctance often shifts to commitment after experiencing the benefits of support. Support groups provide education about Alzheimer’s, practical tips to cope with challenging behaviors, kindred spirits to discuss the range of changing emotions on the caregiving journey, and connections to community agencies that can assist with household tasks, transportation, day programs, and respite care. Caregivers often also serve as a touchstone and guide for family members who are seeking information and support. 

A first step in seeking support is to contact the Alzheimer’s Association (800-272-3900), which provides a 24-hour hotline and connections to community support groups. Many caregivers come to describe their support groups as a “lifeline” on the caregiving journey. Many are also often surprised to realize that caregiver support can decrease behavioral problems and improve mood and daily life for their loved one with Alzheimer’s.  

2. Minimize corrections of misremembered information. Although our daily lives often condition us to provide corrective information if something is misremembered or misstated, it can be unintentionally counter-therapeutic to correct a loved one with Alzheimer’s. Not only does a correction draw attention to the misremembered information (which can be embarrassing, and may lead a loved one to minimize talking for fear of misremembering again), the corrected information may not be recalled. Instead, the following strategies can be helpful:

a.    Continue the conversation. Rather than stopping to correct a misremembered fact, continue discussing the topic at hand.

b.    Ask an opinion-related question, rather than a factual one. By asking your loved one their opinion, they cannot be wrong in their response (and the information they share may be unexpectedly enlightening).

c.    Prioritize the harmony of the interaction. If the information being discussed is distressing to your loved one, consider changing the subject to discuss something they enjoy. Alternatively, you could discuss your opinion of a situation, or shift their attention to an activity they enjoy.

For example, if your loved one says “I loved the dinner we had last night,” it may be counter-therapeutic to correct them by stating “I loved the dinner too…but I think it was last Thursday that we had dinner." Instead, you could ask, “What did you like about the dinner?” This question keeps the conversation going, asks an opinion-related question that cannot be answered incorrectly, and increases the likelihood that they will engage in future conversations. Of course, if a situation involves a safety issue, corrective information may need to be provided (e.g. such as if someone misremembers where they live), but in most daily conversations, prioritizing the harmony of the interaction can be therapeutic and empowering.

3. Follow a daily routine. Although most individuals with Alzheimer’s have difficulty recalling facts, events, and conversations (“declarative memory”), muscle memory (“procedural memory") is often much stronger. In other words, a person with Alzheimer’s may forget how to navigate to the store, but they may have no difficulty with motoric tasks such as using utensils to eat, shuffling a deck of cards, or walking. Since most routines involve switching between different motorically-based activities (e.g. eating breakfast, reading the paper, going for a walk), following a routine can help etch motor sequences into procedural memory. Since procedural memory is less likely to be forgotten, a greater sense of independence and engagement can typically be experienced for a longer period of time. 

4. Prioritize cardiovascular exercise. Exercise is the only therapeutic tool that grows new neurons, and it can improve memory and other cognitive functions even for individuals with Alzheimer’s or at risk for Alzheimer’s. There is no medication, supplement, or other therapy or activity that has been shown to improve cognitive functioning. (In contrast, memory medications aim to slow down the rate of memory loss, but do not enhance memory). 

A 2018 meta-analysis that examined 19 studies found that exercisers with Alzheimer’s or at risk of Alzheimer’s (average age 77) outperformed non-exercisers by 69% on cognitive tests. Importantly, the cognitive improvement occurred for exercisers who had the same initial level of cognitive impairment as non-exercisers. Other important findings included:

a.    Across studies, aerobic/cardiovascular exercise—in which heart rate is increased—was three times more powerful in enhancing cognitive functioning than a combined exercise program that included aerobics and weight training.

b.    To obtain the cognition-enhancing benefits of exercise, it is recommended that aerobic activity occur 3-4 days per week for 30-60 minutes a day, at a moderate level of intensity. 

c.    Non-exercisers with or at risk of Alzheimer’s had a decline in cognitive functioning. 

Exercise has been shown to enhance not only cognitive functioning, but also cardiovascular health, sleep, mood, and motor functioning (including balance, which is important in minimizing falls for older adults). Adding a social component—such as an exercise class, or exercising with your loved one—can further boost mood and quality of life.

What tips have you found to be most helpful on your caregiving journey? Please share your thoughts in the "Comment" section below!  

References

Alzheimer’s Association (2018). Facts and Figures. Retrieved from https://www.alz.org/alzheimers-dementia/facts-figures

Family Caregiver Alliance. (2016). Depression and caregiving. San Francisco, CA. Retrieved from https://www.caregiver.org/depression-and-caregiving.

Nichols, L., Martindale-Adams, J., Burns, R., Zuber, J., & Graney, M. (2014). REACH VA: Moving from translation to system implementation. Gerontologist, 56(1), 135-144.

Panza, G.A.,  Taylor, B.A., MacDonald, H.V., Johnson, B.T., Zaleski, A.L., Livingston, J., Thompson P.D., & Pescatell, L.S. (2018). Can Exercise Improve Cognitive Symptoms of Alzheimer's Disease? A Meta-Analysis. Journal of the American Geriatrics Society, 2018; DOI: 10.1111/jgs.15241

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