As an Alzheimer's caregiver, what changes should I look for?

It may be useful to think of caregiving as a kind of job. You have to take it seriously, you have to plan and you have to have a schedule.To start with, you need to be a keen observer. Look for what is changed, and then decide if there is something you need to do about it.

Not all changes you may see will require a specific response. Changes are likely to happen in four areas:Changes in memory: During this phase of the disease you are likely to discover that memory for recent events, recent conversations and updating of events or times, will be the most prominent changes. You may find yourself having to repeat conversations you have had, or you may need to answer the same question more than once.

Keeping track of the day of the week and the date, since these require constant updating, may slip fairly easily. You may want to keep the day of the week and the date displayed somewhere prominently in your home to help with orientation. If your loved one does make mistakes, it is important that you respond to them with equanimity, rather than with annoyance.

Changes in communications: You may observe that your loved one will not finish a sentence, or may get stuck on trying to find a word that simply won’t come out. If you understand enough of the sentence, you don’t need to do anything. If you can guess what word your loved one is trying to say, go ahead and supply the word, so that the conversation can continue.

For example: if your loved is saying: “We have to go to the ... (can’t come up with the name),” go ahead and say “the Williams’s” so that your loved one can complete the sentence. This will be less frustrating than if you are waiting for the right name to emerge. Everyday activities: Let us say your spouse starts to mow the lawn or to wash the dishes, but doesn’t finish the job.

There is no need to make a big deal out of it. Ask your spouse to please start again on the same or finish the job yourself. Changes in mood or behavior: if you notice your loved one becoming blue or irritable, try to initiate a new activity with him or her.

Suggest something that you know they usually really like to do, like: “let’s go for a walk, it is such a beautiful day today,” or “let’s have a picnic out in the back yard today.” Or offer a compliment that you can sincerely make, such as “you’re wearing such a nice outfit today,” or “I sure appreciate your helping me put away the dishes today.

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