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Doctor's Thoughts

Alzheimer's Disease & Patient-Centered Care by Dr. Rehan Rahim M.D.

Amina, a 73 year-old from Jordan, was diagnosed with Alzheimer’s disease (AD). She had been living independently in her own home for the last 10 years. Her only daughter, Houda, was living with her family in Dubai. Once aware of her mother’s condition, Houda brought her mother to Dubai.

Following the move, as a result of Alzheimer’s progressions, Amina found it difficult to get comfortable and as an example, had trouble finding specific rooms in this new home environment. She would forget where she kept her belongings and started forgetting the names of basic things such as people, food, etc. She also lost orientation of day and night. This affected her sleep patterns and so she slept less, would walk around at night and sometimes fell. Mood swings became frequent and she would get aggressive and cry sometimes.

Although Houda had a part-time maid to help with housework; in pursuit of the best care, she gave up her job at a bank to provide care for her mother, full-time. Frequently, she would consult Amina’s neurologists for help. The best advice she got would be to continue administering the Alzheimer’s medication to help manage her mother’s condition. Taking care of Amina was a full-time job; Houda started ignoring her family and her own needs. Eventually, she was completely exhausted and had a breakdown.


Alzheimer’s Disease is the most common form of dementia, a serious brain disorder that impacts daily living through memory loss and cognitive changes. Although not all memory loss indicates AD, one out of every ten people aged over 65 has it. This condition affects more than 35 million people worldwide.

AD is progressive and irreversible. The cause is likely the result of various inter-related factors including genetics, environmental influences and “lifestyle factors” – such as dietary habits, high blood pressure and high cholesterol. Chemical and structural changes in the brain slowly destroy the ability to create, learn, remember, reason and relate to others. As critical cells die, drastic personality loss occurs while body systems fail.

This condition will advance in stages. The progression begins with mild forgetfulness and cognitive impairment followed by widespread loss of mental abilities. In advanced Alzheimer’s, people become very dependent on others for every aspect of their care. The speed at which Alzheimer’s progresses varies by individual and ranges from 5 to 20 years.

 

Treatment Guidelines for Alzheimer’s Disease

Medication: Speak to your doctor. A wide range of medication is available to treat memory loss, behavior changes, sleep problems and other symptoms of AD. There is no existing solution to stop Alzheimer’s and force the disease into remission. These medications may help reduce and delay the progression of symptoms in terms of month(s) and/or possibly year(s) but this is unique to every individual case.

Alzheimer’s Rehabilitation: Rehabilitation programs vary greatly depending on symptoms, level of expression and progression of disease.

Keys to Health Maintenance:

  • Social Activity
  • Physical Exercise
  • Proper Nutrition
  • Daily Routines
  • Keep a sense of Structure and Familiarity with home environments and family
  • Involve the person in daily activities as much as they are able
  • Communication
    • Language skills are impacted early in AD
    • Therefore - encourage, listen patiently and speak in a calm, loving and simple manner
    • Non-verbal skills become very important as impact of words fade
    • Care-givers can be taught strategies such as the 3 R’s (Repeat, Reassure, Redirect) to reduce behavioral disturbances
  • Environment
    • Create a safe and memory-rich environment
    • Surround your loved one with reminders of happy, successful moments
    • Share enriching sensory experiences

Patient-Centered Care Guidelines for Care-Givers

  • Caring for someone with AD will impact every aspect of your daily life. Providing care for a patient with AD is sometimes described as the reverse of raising a child.
  • Learn as much as you can
    • Learning all you can about what is happening and what to expect not only helps your loved one but is also the first step towards protecting your own total health
    • Anticipating and learning about AD can reduce your frustration, help maintain reasonable expectations and prepare you to face new challenges
  • Seek Help
    • No matter how dedicated you are, at some point you may be overwhelmed. You will likely need help in care-giving as it is not possible to be awake and available 24 hrs/day
    • Having the support system of a care-giver will help your family member and you to cope, monitor and provide proper nursing care
    • If the level of care required becomes overwhelmingly difficult, seek professional advice on what professional services are available - for your loved one(s) - so they can get the care they need
  • Consider Long-Term Care
    • Geriatric care professionals can provide an initial assessment and assistance with managing and choosing care programs which may include:
      • Home Nursing Care
      • Daytime Care
      • Respite Care
      • In-Stay Care
    • In-Stay care provides assistance with activities of daily living and a high level of medical care
    • Licensed physicians, skilled nursing care providers and rehabilitation professionals (such as physiotherapists, occupational therapists, speech language pathologists) should be available on-site (or for home care) to ensure an appropriate level of care and treatment
       

After carefully reviewing all the available solutions to help best care for her mother’s condition; Houda learnt about Emirates Rehab and Homecare  from a friend.

She considered how much energy it took to ensure proper care for her mother. She also considered the lack of attention towards herself, her children and husband. Most importantly, she thought very hard about her own emotional and mental state. The financial and cultural implications were a concern but certainly not as important as both her own well-being and the care for her mother.

After choosing Emirates Rehab and Homecare  Home Care Nursing and Rehabilitation services, Houda was immensely relieved with her decision because of the professional level of medical care and dedicated personal attention for her mother, Amina.

Now that she is able to pursue her own activities and take better care of herself and family, Houda expressed these thoughts about her mother, Amina

“Sometimes when she looks at me and smiles, I know deep in her heart, she still remembers me. My dear mother has sacrificed so much for me and now it’s my turn to take care of her. Help us dear God and give us strength.” - Houda

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