• October 29, 2008 at 2:35 am

    DAY-TO-DAY CARE: The abilities, personality, and moods of a person with Alzheimer’s may change as the disease advances. Some areas that may test family and friends’ skill and creativity are planning activities, improving communication, understanding unusual or unpredictable behavior, recognizing depression, handling safety issues, and providing long-distance or late-stage care.

    HYGIENE AND PERSONAL CARE: People with Alzheimer’s may need help with grooming and hygiene routines, such as bathing, toileting, dental care, and dressing. The need for assistance can be very difficult for them because it signifies a loss of independence and privacy. It is also difficult for caregivers, especially when a person resists help with private routines that he or she is becoming unable to perform.

    CHOOSING HEALTH CARE PROVIDERS AND FACILITIES: The three main categories of services are respite care, residential care, and hospice. The costs differ by service and community. You should carefully interview and compare providers of the service you want before settling on one. Government agencies, insurers, and various Alzheimer’s organizations all publish helpful guidelines and checklists to help you with this research.

    ■ Respite care—provided mainly by community organizations or residential facilities—offers temporary relief for caregivers and gives the person with the disease opportunities to socialize with others and live in the community longer. The most common respite programs are in-home care (companion services, personal care, household assistance, or skilled care to meet specific needs) and adult day services in a community center or facility that provides staff-led programs such as musical entertainment and group discussions.

    ■ Residential care facilities include retirement housing, which generally provides each resident an apartment or room with cooking facilities and may be appropriate for persons in the early stage of Alzheimer’s; assisted living (board and care homes), which typically combine housing, personalized assistance, and health services; and skilled nursing facilities, which may be the best choice when a person with Alzheimer’s needs round-the-clock care or ongoing medical treatment. Certain retirement communities (continuum care retirement communities or CCRCs) provide all three types of living arrangements.

    ■ Hospice programs provide care to persons in the late stages of Alzheimer’s and emphasize comfort and care without heroic lifesaving measures. This type of service is available through local hospice organizations and some home care agencies, hospitals, and nursing homes, and the person with Alzheimer’s may be eligible for benefits through Medicare, Medicaid, and even some private insurance.

    COPING: Caring for someone who has Alzheimer’s disease can be overwhelming, exhausting, and stressful. It’s critical that caregivers watch their physical and mental health. Depression, changes in relationships, a sense of loss, and helping children and teens understand are just a few of the challenges caregivers may face. Some tips for caregivers:

    ■ See your doctor regularly.

    ■ Get screened for stress and depression.

    ■ Get plenty of rest.

    ■ Eat well-balanced meals.

    ■ Exercise regularly.

    ■ Be realistic about what you can do, give yourself credit for what you accomplish, and don’t feel guilty if you lose patience or can’t do everything on your own.

    ■ Accept help from others.