Alzheimer Disease and Dementias: Early Detection and Care Planning _ ______________________________
ALZHEIMER DISEASE STAGE AND FAMILY ISSUES
Disease Stage Issues/Concerns of Family
Steps to Address
Early (Stages 1–3)
Accept and address an uncertain future. Identify potential areas of internal family conflict. Recognize that Alzheimer disease can often unveil past conflict.
Form a cohesive family alliance. Seek professional guidance (elder law attorneys, financial planners, social workers). Identify long-term care needs and desires for the person with Alzheimer disease. Establish an honest, open, and supportive communication method. Acknowledge collective grief and loss as the loved one declines. Family members/caregivers may feel trapped, leading to new or worsened conflicts. There may be a sense of lost freedom due to disease-related limitations. It can be hard to separate the person from the illness, necessitating additional support (e.g., respite care). Managing disease symptoms (wandering, mood swings, sleep changes) can be challenging. Balancing work, caregiving, and personal life may seem impossible as needs increase. Without prior planning, families face tough decisions about living arrangements, finances, and external support. Family members may experience grief, health issues, anger, denial, and exhaustion. Family cohesion may suffer due to concerns about providing safe, proper care (e.g., transferring, feeding, supervision). Long-term planning can ensure the person receives hospice care or allows the family to decide. The person is vulnerable to normal age-related health issues. Family may experience exhaustion and worry about their own well-being and the impact on their children and spouse. Long-term stress and grief can affect family relationships and cohesion, especially without planning. Family members may face physical and mental health challenges requiring additional support and lifestyle changes.
Middle (Stages 4–5)
Caregiving needs become more intense to include financial, home safety, and some life management.
Late (Stages 6–7)
Patient will need full-time support for all activities of daily living. Family members may find themselves dealing with effects of long-term caregiving (e.g., financial and health challenges, inability to work, poor self- care).
Source: [23]
Table 6
healthcare providers should offer opportunities for patients and caregivers to ask questions and voice concerns, fostering a collaborative approach to care management. COMMUNICATION TECHNIQUES Effective communication is crucial when caring for patients who have Alzheimer disease or other dementias. Healthcare providers should use clear, simple language, speak slowly, and maintain eye contact when discussing memory concerns. It is important to approach the topic sensitively, acknowledging the patient’s feelings and concerns [24]. Building trust and rapport involves active listening, showing empathy, and respecting the patient’s dignity. Providers should create a comfortable environment and allow ample time for the patient to process information and respond [22].
Engaging caregivers is equally important. Strategies include educating them about the disease, its progression, and avail- able resources. Caregivers should be encouraged to participate in appointments and care planning discussions. Addressing caregiver concerns involves providing emotional support, offer- ing respite care information, and connecting them with sup- port groups. Healthcare providers should also assess caregiver stress and burnout, offering strategies for self-care and stress management [25]. By fostering open communication with both patients and caregivers, providers can ensure more com- prehensive and effective care for individuals with dementia.
10
MDRI2026
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