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Sunnähus Felsenau Switzerland

Question and Answers

 

The Alzheimer illness is the most frequent reduction process of the central nervous system. Its symptoms are caused by the death of nerve cells and nerve cell contacts. Blood circulation disturbances due to a general vascular stenosis are not the cause of the Alzheimer illness.

The gradual loss of nerve cells and nerve cell contacts creates a progressive disturbance of many psychological performances. It affects the memory, the language, the intellectual capacity and the perception of patterns or spatial conditions.

As the failures extend at the same time to several psychological functions, the ability to live an  independent life deteriorates rapidly. The central personality characteristics however, including the basic needs for closeness, safety and appreciation, the repertoire of social behaviour, as well as the perception and the expression of feelings are less gravely damaged .

For many decades the Alzheimer illness was considered as a rare suffering of the middle aged. Today, we know that the disturbances of the brain performance found with old people are caused by the same modifications in the brain. Thus the Alzheimer illness is one of the most frequent psychological disturbances ever.

It can occur already before the age of 50. With age its frequency rises steeply and achieves

20 % with the eighty-year olds. In Switzerland, at least 70,000 people are affected by the Alzheimer illness.

The illness carries the name of the Bavarian neurologist, who described it for the first time in 1906:

Alois Alzheimer

The symptoms of the Alzheimer illness vary during its process. They also differ between individual patients. Nevertheless, there are characteristic symptoms. There are three different stages.

Early stage

Disturbances of the short term memory are most important: Questions are repeated, agreements are forgotten, the stove stays switched on. At the same time the patient has difficulties in thinking. Demanding activities cannot be practised any more. Deteriorating efficiency on a professional level is noticed at an earlier stage than within the domestic environment. Most patients lose precision of their language. The word identification is difficult, the information content of the messages decreases. Disturbances of spatial orientation become apparent through uncertainty when driving a car, getting dressed or with manual work .

Middle stage

The restrictions of the memory and the intellectual capacity gradually achieve a degree, whereby the patients depend on assistance. At first they can no longer cope in strange surroundings, later not even in a familiar environment . They need support in the bath, when going to the toilet, getting dressed and at mealtimes.

The language progressively consists of more and more empty phrases. The memories of earlier events fade increasingly, even those of the own life story. Frequent additional symptoms are illusionary fears, aimless restlessness, disturbances of the day and night rhythm, reduced control of emotional reactions and urinary incontinence.

Late stage

Assistance is now necessary with all activities of daily life. The  verbal expression is limited to a few words. However,the ability to  realise and express feelings is usually still there. Only now do pronounced physical symptoms occur ,such as swallowing disturbances, convulsions, loss of posture control as well as of bladder and intestine function. The patients become more susceptible to infections. Dangerous falls can happen. The most frequent cause of death is pneumonia.

Each of the three stages of the disease lasts an average of 3 years. The average duration of the disease, from the first symptoms, amounts to 9 years. The Alzheimer illness can sometimes progress  more rapidly, sometimes more slowly.

The perception of the own restrictions is very clear at the beginning of the Alzheimer illness. Later it becomes more and more indistinct. The patients feel ashamed and disconcerted. Above all they suffer from the loss of their independence and their ability to act.

In the early stage the patients notice their loss of efficiency very clearly, particularly the disturbances of memory and language. They react with deep disconcertion ,embarassment and the sense of no longer being a full human being.

The use of excuses, avoiding excessive demands and hiding deficits are understandable defense and handling mechanisms.

These reactions can easily be misjudged, however, as direct provocation or indignation. Because of their reduced brain performance the patients are constantly being in a state of uncertainty and embarrassment. The loss of the independence and capacity to act is often more painful than the disturbances of the memory.

The increasing distress contradicts the self-esteem and the pride of adult people. For many patients this causes the belief, to be useless ballast.

With increasing restrictions of memory and intellectual capacity the perception of the own illness fades in the middle stage. In instants of failure it can however suddenly be evoked again.

Some patients have completely lost the reference to the present. They look for their dead parents  or for their home, which does not exist any longer. Thus they enter into a continuous conflict with their reference persons, which they cannot resolve by correcting their own aspect. It increases the feeling of being misunderstood and rejected .

In the late stage of the Alzheimer illness the patients can not longer understand , what is happening around them. However we can reach their emotions : by an affectionate look, a tender contact and the warm sound of a voice.

The difficulties in living together with Alzheimer patients depend on the stage of the illness, the extern circumstances, the life story of the patients, and in addition, on the personality of the reference person. Therefore an individual solution is to be found for each case. The following 10 basic rules have worked in many families.

1 Obtain thorough information about the Alzheimer illness. This knowledge gives you security and  

   prevents you from placing excessive demands on yourself.

2 Don´t try to change the patient. There is nothing you can do about the Alzheimer illness .

3 Keep and support the independence of the patient as long as possible. It is crucial for his self -   

   esteem.  

   That means: secure sources of danger like gas or electrical appliances, stairs, or smooth bath tubs.

4 Maintain if possible the habits of the patient. Familiar people and things of the past are more 

   important for him than the present, where he can no longer cope.

5 Provide a perceptible and continuous daily routine. You can give the patient security and 

   orientation by signs, colourful indications, well readable clocks, a board with the most important

   messages and a sufficient nocturnal lighting.

6 Find out the personality areas and abilities of the patient, which remained spared from the illness

   and evoke them.

7 Use looks, gestures and contacts as means of communication, particularly if verbal communication

  becomes more difficult.

8 Solve conflicts by diversion or attention. Avoid useless battles of words.

9 React calmly to fearfulness and when being followed, as well as to aggressive behaviour. This

   arises from the embarrassment and the disconcertion of the patient. They are not a conscious

   harassment. Generally they are also short-lived.

10 Don´t  forget yourself because of the patients. Save your strength. You are not acting egoistically,

    when you get some rest and care for yourself. Nor it is shameful to get assistance from outside. Join

    discussions with people, who are in the same situation as you. This exchange of experience gives

    you valuable suggestions and strengthens your confidence.

Consultation particularly for relatives of patients with Alzheimer illness and similar suffering.

Telephone consultation on Wednesday morning 08:00 - 11:00  hours, in the afternoon 14:00 - 18:00 hours

Telephone + 41 56 246 26 00

       Email: s.hofer@sunnaehus.ch

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