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Contents Foreword Preface Preface to the First Edition 1. Dementia What Is Dementia? The Person with Dementia Where Do You Go from Here? 2. Getting Medical Help for the Person with Dementia The Evaluation of the Person with a Suspected Dementia Finding Someone to Do an Evaluation The Medical Treatment and Management of Dementia The Physician The Nurse The Social Worker The Geriatric Care Manager The Pharmacist 3. Characteristic Behavioral Symptoms of Dementia The Brain, Behavior, and Personality: Why People with Dementia Do the Things They Do Caregiving: Some General Suggestions Memory Problems Overreacting, or Catastrophic Reactions Combativeness Problems with Speech and Communication Problems the Person with Dementia Has in Making Himself Understood Problems the Person with Dementia Has in Understanding Others Loss of Coordination Loss of Sense of Time Symptoms That Are Better Sometimes and Worse at Other Times 4. Problems in Independent Living Mild Cognitive Impairment When a Person Must Give Up a Job When a Person Can No Longer Manage Money When a Person Can No Longer Drive Safely When a Person Can No Longer Live Alone When You Suspect that Someone Living Alone Is Getting Confused What You Can Do Moving to a New Residence 5. Problems Arising in Daily Care Hazards to Watch For In the House Outdoors In the Car Highways and Parking Lots Smoking Hunting Nutrition and Mealtimes Meal Preparation Mealtimes Problem Eating Behaviors Malnutrition Weight Loss Choking When to Consider Tube Feeding Exercise Recreation Meaningful Activity Personal Hygiene Bathing Locating Care Supplies Dressing Grooming Oral Hygiene Incontinence (Wetting or Soiling) Urinary Incontinence Bowel Incontinence Cleaning Up Problems with Walking and Balance; Falling Becoming Chairbound or Bedbound Wheelchairs Changes You Can Make at Home Should Environments Be Cluttered or Bare? 6. Medical Problems Pain Falls and Injuries Pressure Sores Dehydration Pneumonia Constipation Medications Dental Problems Vision Problems Hearing Problems Dizziness Visiting the Doctor If the Ill Person Must Enter the Hospital Seizures, Fits, or Convulsions Jerking Movements (Myoclonus) The Death of the Person with Dementia The Cause of Death Dying at Home Hospice Dying in the Hospital or Nursing Home When Should Treatment End? What Kind of Care Can Be Given at the End of Life? 7. Behavioral Symptoms of Dementia The Six R's of Behavior Management Concealing Memory Loss Wandering Reasons Why People Wander The Management of Wandering Sleep Disturbances and Night Wandering Worsening in the Evening ("Sundowning") Losing, Hoarding, or Hiding Things Rummaging in Drawers and Closets Inappropriate Sexual Behavior Repeating the Question Repetitious Actions Distractibility Clinging or Persistently Following You Around Complaints and Insults Taking Things Forgetting Telephone Calls Demands Stubbornness and Uncooperativeness When the Person with Dementia Insults the Sitter Using Medication to Manage Behavior 8. Symptoms that Appear as Changes in Mood Depression Complaints about Health Suicide Alcohol or Drug Abuse Apathy and Listlessness Remembering Feelings Anger and Irritability Anxiety, Nervousness, and Restlessness False Ideas, Suspiciousness, Paranoia, and Hallucinations Misinterpretation Failure to Recognize People or Things (Agnosia) "You Are Not My Husband" "My Mother Is Coming for Me" Suspiciousness Hiding Things Delusions and Hallucinations Having Nothing to Do 9. Special Arrangements If You Become Ill In the Event of Your Death 10. Getting Outside Help Help from Friends and Neighbors Finding Information and Services Kinds of Services Having Someone Come into Your Home Adult Day Care Short-Stay Residential Care Planning in Advance for Home Care or Day Care When the Person with Dementia Rejects the Care Your Own Feelings about Getting Respite for Yourself Locating Resources Paying for Care Should Respite Programs Mix People Who Have Different Problems? Determining the Quality of Services Research and Demonstration Programs 11. You and the Person with Dementia as Parts of a Family Changes in Roles Understanding Family Conflicts Division of Responsibility Your Marriage Coping with Role Changes and Family Conflict A Family Conference When You Live out of Town When You Are Not the Primary Caregiver, What Can You Do to Help? Caregiving and Your Job Your Children Teenagers 12. How Caring for a Person with Dementia Affects You Emotional Reactions Anger Embarrassment Helplessness Guilt Laughter, Love, and Joy Grief Depression Isolation and Feeling Alone Worry Being Hopeful and Being Realistic Mistreating the Person with Dementia Physical Reactions Fatigue Illness Sexuality If Your Spouse Is Impaired If Your Impaired Parent Lives with You The Future You as a Spouse Alone When the Person You Have Cared for Dies 13. Caring for Yourself Take Time Out Give Yourself a Present Friends Avoid Isolation Find Additional Help If You Need It Recognize the Warning Signs Counseling Joining with Other Families: The Alzheimer's Association Support Groups Excuses Advocacy 14. For Children and Teenagers 15. Financial and Legal Issues Your Financial Assessment Potential Expenses Potential Resources Where to Look for the Forgetful Person's Resources Legal Matters 16. Nursing Homes and Other Living Arrangements General Rules for Evaluating a Care Facility Types of Living Arrangements Moving with a Person with Dementia Nursing Homes and Assisted Living Facilities Paying for Care Finding a Home or Other Facility Convenience of Visiting Meeting Regulations Costs Cleanliness and Safety Staff Care and Services The Physical Plant Policies on Terminal Care Meals Rights Nursing Home and Assisted Living Programs that Specialize in Dementia Care Moving to a Nursing Home Adjusting to a New Life Visiting Your Own Adjustment When Problems Occur in the Nursing Home Sexual Issues in Nursing Homes The Department of Veterans Affairs (VA) State Mental Hospitals 17. Brain Disorders and the Causes of Dementia Dementia Dementia Associated with Alcohol Abuse Alzheimer Disease Vascular (Multi-Infarct) Dementia Lewy Body Dementia The Frontotemporal Dementias, Including Pick Disease Depression Binswanger Disease HIV-AIDS Other Brain Disorders Delirium Senility, Chronic Organic Brain Syndrome, Acute or Reversible Organic Brain Syndromes TIA Localized Brain Injuries Head Injuries (Head Trauma) Anoxia or Hypoxia Mild Cognitive Impairment 18. Research in Dementia Understanding Research Bogus Cures Research in Vascular (Multi-Infarct) Dementia and Stroke Research in Alzheimer Disease Structural Changes in the Brain Brain Cell Structure Neurotransmitters Abnormal Proteins Transplants of Brain Tissue Drug Studies Metals Prions Immunological Defects Head Trauma Epidemiology Down Syndrome Old Age Heredity Gender Promising Clinical and Research Tools Keeping Active The Effect of Acute Illness on Dementia Research into the Delivery of Services Protective Factors Appendix 1. Using the Internet Appendix 2. Organizations Index
Library of Congress Subject Headings for this publication:
Alzheimer's disease -- Patients -- Home care.
Senile dementia -- Patients -- Home care.
Large type books.