Alzheimer's

Howard Gruetzner

Description

The landmark bestselling guide—now updated with the latest essential information

The third edition of this critically acclaimed guide leads you through the realities of caring for a loved one struggling with Alzheimer’s. The author, a nationally recognized authority, details the latest developments in treatment and care options and offers helpful, hopeful advice for getting through difficult challenges. Now fully revised and updated, this edition includes new chapters designed to help caregivers cope with stress and depression and offers information on the latest breakthrough research developments and treatments. Alzheimer’s speaks directly to your vital concerns, including:

• the symptoms and traits of Alzheimer’s, what to expect at each progressive stage, and how to respond to behavior problems
• the full range of treatments and support services available, including tips on how to locate and finance them
• ways to understand your feelings and the impact of grief
• new information on managing caregiver stress and chronic depression in sufferers
• the latest therapies and medical research

With its sensitive and in-depth examination, Alzheimer’s shows how to make the care you give more rewarding and effective and how to make the life of anyone caught in the grip of Alzheimer’s more loving and comfortable.

Sujets

• Santé et bien-être
• Santé du quotidien
• Vie de famille
• Relations familiales
• Alzheimer's
• Caregiving
• Medical
• Médecine
• Alzheimer's disease
• Caregiver
• General officer
• General

Informations

• Publié par: Turner Publishing Company
• Date de parution: 20 juillet 2001
• Nombre de lectures: 0
• EAN13: 9780471211716
• Langue: English

Extrait

Alzheimer s
A Caregivers Guide and Sourcebook

T HIRD E DITION

Howard Gruetzner, M.Ed .

John Wiley Sons, Inc.
New York Chichester Weinheim Brisbane Singapore Toronto
To Bob Herbert, a dedicated warrior for the welfare of the community and its people.
Copyright 2001 by Howard Gruetzner, copyright 1992 by John Wiley Sons, Inc.
All rights reserved
Published by John Wiley Sons, Inc.
Published simultaneously in Canada
Design and production by Navta Associates, Inc.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone]. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley Sons, Inc., 605 Third Avenue, New York, NY 10158-0012, [phone], fax [phone], email: [e-mail].
This publication is provided to serve the reader as a supplement to professional medical guidance and treatment, and not as a substitute for professional medical care. As new medical research broadens our knowledge, changes in treatment and drug therapy are required. The author and publisher have made every effort to ensure that information regarding medical treatment is accurate and in accordance with the standards accepted at the time of publication. Readers are advised, however, to follow the product information sheet included with any drug administered and to seek professional advice before proceeding with medical treatment.
This book was sponsored by Heart of Texas Region Mental Health Mental Retardation, Waco, Texas and DePaul Center (A division of Providence Hospital, Daughters of Charity of St. Vincent DePaul), Waco, Texas
Library of Congress Cataloging-in-Publication Data
Gruetzner, Howard.
Alzheimer s : a caregiver s guide and sourcebook / Howard Gruetzner.-3rd. ed.
p. cm.
Includes bibliographical references and index.
ISBN: 978-0-471-37967-6
1. Alzheimer s disease. I. Title.
RC523 .G782001 2001026232
362.1 96831-dc21
Printed in the United States of America
10
Contents
Preface
Acknowledgments
Special Acknowledgment
PART I The Caregiver Experience
1 What Is Alzheimer s Disease?
A Case History
Early Detection and Treatment
Causes of Disease-Multiple Factors
The Statistics
2 Symptoms and Phases of Alzheimer s Disease
Symptoms of Alzheimer s Disease
Phases of Alzheimer s Disease
Stage I: Early Confusional Phase
Stage II: Late Confusional Phase
Stage III: Early Dementia
Stage IV: Middle Dementia
Stage V: Late Dementia
3 Depression and the Person with Alzheimer s Disease
Risk Factors for Depression
Signs and Symptoms of Depression
Depressive Symptoms and Disorders
Causes of Depression with Alzheimer s Disease
Treatment for Depression
Grief and Coping
4 Possible Causes of Alzheimer s Disease
What Does Not Cause Alzheimer s
The Genetic Theory
The Viral Theory
The Immune System Theory
The Aluminum Theory
Psychosocial Factors and Dementia
5 Six Common Myths About Alzheimer s
Myth 1: Alzheimer s Symptoms Are a Normal Sign of Old Age
Myth 2: Senility Is the Usual Cause of Problems in Old Age
Myth 3: Nothing Can Be Done for the Person with Alzheimer s
Myth 4: Alzheimer s Is Strictly a Mental Illness
Myth 5: Only the Family Should Care for the Person with Alzheimer s
Myth 6: All Relatives of People with Alzheimer s Are Likely to Inherit the Disease
6 Coping: A Step-by-Step Guide to the Caregiver s Experience
A Hypothetical Case History
1. Noticing Initial Symptoms
2. Confirming Suspicions
3. Seeking Information
4. Taking Action
5. Weighing Findings
6. Identifying Resources
7. Planning Care
8. Managing Caregiver Stress
7 From Family Care to Alzheimer s Care: Preparing for Caregiving
Differences in Alzheimer s Caregiving and Traditional Family Care
Coping with Problems Common to Chronic Disease
Motivations for Helping
8 Understanding Behavioral Changes
Early Threats to Who We Are
The Impact of Losses on Relating
Attempts to Understand Behavior
Revising Your Expectations
Questioning Old Beliefs About Behavior
Emotions and Alzheimer s Behavior
Emotional and Behavioral Communication
Behavior and Stress
Catastrophic Reactions
Excess Disability
Summary
9 Stages of Family Adjustment
Accepting the Disease
1. Denial
2. Overinvolvement
3. Anger
4. Guilt
5. Acceptance
10 Family Responses to Care
Need for Family Support
Compatible vs. Conflictual Families
New Views of Parent
Cohesive vs. Fragmented Families
Productive vs. Nonproductive Families
Fragile vs. Stable Families
Family Roles and Rules
Family Roles During Crisis
Caregivers and Caregiving
11 Values, Beliefs, and the Caregiver Experience
Expectations Influence Our Feelings and Reactions
12 How to Respond Positively to Alzheimer s Behaviors
13 Depression and the Alzheimer s Caregiver
How Common Is Caregiver Depression?
Reasons We Fail to Recognize Depression
Depressive Disorders
Generalized Anxiety Disorder
Risk Factors for Caregiver Depression
14 Coping with Ongoing Caregiver Stress
Learning to Analyze and Manage Change
Stressors, Stress, and Coping
Responding to Thoughts and Stressors
Stress and Self-Talk
Irrational Beliefs Cause Stress
Coping Model
Different Types of Stress
Manifestations of Stress
Coping Examples
Coping Approaches for Different Stressors
Twelve Steps for Caregivers
15 Exploring Community Resources
Drawing upon Community Resources Reduces Strain on the Caregiver
Community Resources for Alzheimer s Care
Considerations for Nursing Home Care
Final Resource Considerations
PART II Research and Treatment
16 Abnormal Changes in the Brain
Physical Changes in the Brain
Anatomy of the Brain
Neurofibrillary Tangles
Senile or Neuritic Plaques
Granulovacuolar Degeneration
Hirano Bodies
Congophilic Angiopathy
Chemical Changes in the Brain
More About Brain Anatomy
The Cholinergic System
The Serotonergic System
The Noradrenergic System
Somatostatin
The Glutaminergic System
Treating Neurotransmitter Deficiencies
Summary
17 Treatment Possibilities
Role of Drugs in Alzheimer s Treatment
Should You Participate in Drug Research Study?
Inconsistencies in Drug Studies
Cholinergic Agents
Available Cholinesterase Inhibitors
Cholinergic Receptor Agonists
Naloxone and Naltrexone
Vasodilators and Nootropic Agents
Neuropeptides
Psychostimulants
Glutaminergic Agents
Combination Drug Studies
Estrogen, Anti-Inflammatory Agents, and Antioxidants
Statins
Neuronal Transplants
18 Psychiatric Medications and Dementia
Side Effects
Major Tranquilizers (Neuroleptics or Antipsychotics)
Minor Tranquilizers
Antidepressants
Summary

An Afterword
Appendix A: Worksheets
Appendix B: Self-Help Groups and Organizations That Can Help
Appendix C: Internet and World Wide Web Resources
Bibliography
Index
Preface to the Third Edition
In the United States today, there are five million people with Alzheimer s disease (AD), and the number is growing. The disease eventually renders the brain virtually useless, and it turns lives inside out-both the lives of the people who have Alzheimer s and the lives of those closest to them. It is a slow and irreversible disease that ultimately leads to death.
However, families confronted with Alzheimer s disease no longer must struggle through this difficult illness alone. Tremendous advances are being made in understanding the disease and devising successful care and management techniques-information that is presented in understandable terms in this book. With this information, caring for an Alzheimer s patient can be a far more positive experience than families could have thought possible.
When I began to work with people who had dementia in the early 1970s, the attitudes toward dementia were reflective of the negative social attitudes we had toward our aging citizens. There was no comprehensive, sensitive approach to evaluation and treatment. Fortunately, attitudes toward older people have changed. However, we still have much work to do to help those with Alzheimer s disease. As medications are developed that slow or delay the disease process, these people are going to be able to remain at a more functional level. They will still face many restrictions on activities such as driving. We need to be sure that we are creating opportunities for a lifestyle that is more commensurate with what they can still do and who they will always be.
This book can give both families and professionals a better understanding of the disease, the behavior of the person with the disease, and ways to cope effectively with the demands of caring for Alzheimer s patients. The first 15 chapters, based primarily on the author s 21 years of specialized work with the elderly in central Texas who suffer from Alzheimer s, depression, and other psychiatric disorders, cover symptoms and stages of Alzheimer s and provide an overview of what to expect as the illness progresses, as well as information on the difficult transition to caregiving. There are chapters that cover depression experienced by people with Alzheimer s and family caregivers. Ways that caregivers can cope with the unique and chronic stress of caregiving are provided. A special section explores the full range of resources for Alzheimer s care available in the community-resources that can provide families with much appreciated relief from the burdens of daily care. The book also includes tips on locating diagnostic resou