Hoarding is not unusual for people suffering with Alzheimer’s or dementia.  It is a behaviour that will be exhibited throughout the progression of the disease and occurs for a number of observed reasons.

People suffering from Alzheimer’s have delusions and are often confused.  One of the most common fears expressed by those in early stage Alzheimer’s is the fear of being robbed.

Hoarding in this case is not as some expect an obsessive-compulsive behaviour but one that is rooted in a common delusion shown by almost all Alzheimer’s patients.  They hide things rather than hoard them to protect them from being taken.

As a caregiver you should know where to look when things go missing.  Check under the bed, pillows and bedclothes.  You may also want to check any closets, drawers or boxes that are in areas the Alzheimer’s patient may think are “safe” hiding places.  Other places such as purses, bags and hampers are also great places to “hoard” things and protect them from being stolen.  It is even likely items will end up under the mattress, in sugar bowls, coffee cans or in shoes.

Understanding this “hoarding” behaviour stems from a real fear that Alzheimer’s patients exhibit is the first step.  Locating all the common hiding places is the second and will make your life easier as a caregiver.

When a loved one becomes confused or unable to find something, you can assist by pointing out places they can look.

This hoarding behaviour also stems from the regression memory.  Alzheimer’s patients may associate something with a safe time in their younger life.  Given many people with this disease tend to recall early memories they associate safety with a particular item they have a happy memory about.

It will then not be uncommon to see people suffering from Alzheimer’s collecting one type of food item or having a favourite toy.  Being in possession of these familiar and safe items make them feel safe.  Once they hide or place the item somewhere they are unable to locate it again simply because Alzheimer’s affects short term memory so they must acquire the item again to restore the feeling of safety.

To help you as a caregiver cope with this hoarding behaviour you will have to take measures to keep the environment occupied by the Alzheimer’s patient simple and orderly.  Remove unnecessary clutter and identify items that bestows safe feelings for your patient.

Replace items that commonly go missing with ones made of bright colours.  This will allow you to easily locate hiding places and make the items easier to locate should they go missing.

However you should be careful not to remove items that can add to the agitation of the Alzheimer’s patient.  What may appear as something insignificant for you as a caregiver can cause a major incident when initially discovered by the patient.

Once you have made the decision to remove certain items remove them from their residence immediately.  This will prevent them from discovering these items later as they rummage searching for something “safe” and will also help minimize the overall hoarding that occurs.

Should an episode result from removing certain items, be there to support the patient and help them locate another “safe” item.

Once you as a caregiver accept that hoarding by Alzheimer’s patients is a normal behaviour, you can easily plan for and cope with surprises that you may find as you discover their hiding places.

In speaking with Alzheimer’s caregivers many have notice the person they are responsible does the same thing.  Experts in the brain disease have theories as to why this occurs but there aren’t any hard facts to prove why Alzheimer’s people wander.

Why does an Alzheimer patient wander?

As Alzheimer’s Disease progresses, caregivers generally become more concerned with their safety.  It isn’t as straightforward as the disease causes this behaviour.  Prior to being diagnosed, this behaviour may have been considered normal everyday activity, similar to most people going for a walk for exercise.

Because Alzheimer’s patients become disoriented and lose their sense of reasoning and their cognitive function, this behaviour gets labelled as wandering.  If the patient becomes disoriented while out on a stroll it is easier for them to become lost and unable to return home.  This will make the behaviour appear more like mindless wandering.

There are theories around why Alzheimer’s people wander.  Some believe they become bored with the level of care they are receiving and want to escape being restrained to the same “safe” and “simple” behaviours.  They want to do something more challenging and go looking for different environments to stimulate themselves as a form of self-medicated therapy.

Some have speculated they recall memories of their former lives and are looking for something to remind them of how things used to be.  Why others feel they simply want to be anywhere and to be doing something.

This behaviour has also been seen in people suffering with dementia.

How do you deal with an Alzheimer’s person who is prone to wandering?

As a caregiver, it is important to recognize the behaviour and build a routine around it.  Create a walking program that will have you involved with their “wandering” and use it to your advantage as part of the care provided.  Take them on walks to familiar settings around the garden or a park.  Have them interact with people there and encourage this interaction to stimulate their minds.

Keep in mind the urge to wander can hit an Alzheimer’s person at anytime.  As the disease progresses, you must be prepared for them talking their stroll at anytime of the day or night.  Sundowning or Sundown Syndrome may spark a period of unrest where Alzheimer’s patients will want to wander as well.

Ensure the doors are secured when you are asleep and take some precautions to alert you should they attempt to get out of your care.

Hanging a set of bells on the door-handle or installing a buzzer that activates when the door opens can alert the caregiver that someone has opened the door.

Other hi-tech solutions such as ankle bracelets and GPS units may be available through your local Alzheimer’s Society to assist you in finding them if they do get out unnoticed.  Provide the local police departments with a picture of the Alzheimer’s patient with their home address and emergency contact numbers.  This way they can contact the caregiver immediately should the Alzheimer’s wanderer be found.

While in your care, if you are noticing they are attempting to leave and wander, call out to them by their name.  If they are your mother or father, “mom” and “dad” will not work because this brain disease often places the people back in their mind to a time when they were much younger when they were not mom or dad.

Ultimately you can look to having the person fixed with a non-removable ID such as a bracelet, anklet or dog tag.  You can include their name, contact number and their condition on these tags.  Having them affixed to their person and not on a piece of clothing is crucial because Alzheimer’s people tend to lose their wallets, purses and jackets rather easily.

Planning for the safe care of an Alzheimer’s person will allow the caregiver to cope with the wandering and provide a much healthier living environment for the patient.

As part of the research, scientists injected mice with a drug named Gleevec which is generally used to treat leukemia and gastrointestinal tumors.  Researchers found lower levels of three genes in the livers of mice correlated with less brain brain substance and an increase in amyloid brain plaques.

Brain plaques have long been associated with Alzheimer’s disease and research have speculated the formation of such plaques may mean an increased risk of the degenerative brain disease.  This discovery of linking brain plaques origin to the liver provides researchers with opportunity to look elsewhere in their fight against Alzheimer’s.

Family members and patients are often lead to believe that Alzheimer’s Disease and dementia are not related.  When a person is diagnosed with dementia there is often a relief in the patient and in family members because the diagnosis is not Alzheimer’s Disease.

Then one must ask what exactly is the difference between Alzheimer’s disease and dementia?

Dementia is often used to describe a reduction in cognitive ability associated with advanced age.  Dementia is not a disease but rather a group of symptoms used to describe difficulties being experienced with memory, language, attention, problem solving, reasoning, planning, organization and judgement.

The most prominent symptom and most noticeable symptom described as dementia is memory difficulty.

Doctors use the term dementia when referring to the cognitive problems being experienced by a person.  It means there is something wrong with the persons brain but provides no information on the exact cause of the problem.

Dementia is not a disease but a clinical representation of a disease.  Dementia is used to describe symptoms and does not necessarily have to be symptoms of Alzheimer’s Disease.

It should be noted that most causes of dementia are not reversible and the most common cause of dementia is Alzheimer’s Disease.

Dementia is not a diagnosis.  People will hear the term “Alzheimer’s related Dementia” or “Probable Alzheimer’s Disease” and consider it a diagnosis.

There is no definitive diagnosis of Alzheimer’s Disease and such a diagnosis can only be confirmed after death and upon an autopsy.  However, when a person shows symptoms such as dementia, it is very likely they are showing signs of Alzheimer’s Disease.

Thus, the difference between Alzheimer’s Disease and dementia lay within describing the symptom or when referring to the disease.

While the exact cause of sundown syndrome is not known, many speculate people suffering from Alzheimer’s disease and dementia have somehow had their biological clock altered because of a reduction in brain function.  With an altered internal clock, people with Alzheimer’s and dementia are suspected to have difficulty regulating behaviour and activity associated with different times of the day.

Several researchers have also theorized that sundown syndrome may be associated with a drop in blood pressure after a meal, hunger or changes in blood glucose levels may trigger periods of confusion and agitation.

In dealing with sundown syndrome, Alzheimer’s disease caregivers are often left determining what causes the periods of agitation and confusion.  Sundown syndrome triggers can vary greatly from Alzheimer’s patient to Alzheimer’s patient, leaving caregivers often at a loss at how to calm the patient.

When dealing with an Alzheimer’s disease patient prone to sundown syndrome, using full spectrum lighting to simulate sunlight may alleviate sundown symptoms.  Regulating snacks and diet may help if sundown syndrome is triggered by diet.

Some Alzheimer’s caregivers have indicated they have success with sundown syndrome if they play a person’s favourite music or move them to a quiet room.  Others have indicated using relaxation techniques and a gentle touch helps calm Alzheimer’s patients dealing with sundown syndrome.

It is important to recognize that Alzheimer’s patients experiencing sundown syndrome need reassurance and understanding of the Alzheimer’s caregiver.  Recognizing triggers and alleviating triggers known to cause sundown syndrome will make both the Alzheimer’s caregiver and Alzheimer’s patient cope with the situation at hand.

Some common signs of Alzheimer’s disease typically associated with the onset of the brain disease include:

• Abrupt personality changes;
• A feeling of sadness, agitation, fear and confusion before twilight and sometimes lasting until dawn.  This has been referred to as Sundowner’s Syndrome;
• Inability to cope with change;
• Withdrawal from social activities;
• Loss of interest in family and friends

While these common signs shown to be associated with the onset of Alzheimer’s disease, they may also indicate other conditions.  If a family member or loved one shows these signs it doesn’t necessarily mean Alzheimer’s disease but may be enough to have the individual evaluated by a medical professional.

Even though these are some common signs of Alzheimer’s disease it is important to keep in mind all the symptoms of Alzheimer’s when making an assessment.

It is estimated that these dramatically rising numbers will mean that 1.125 million people or 2.8 percent of Canadians will suffer from a form of dementia or Alzheimer’s disease by 2038.  According to The Impact of Dementia on Canadian Society the impacts of this disease will cost approximately $872 billion in care and result in a tenfold increase in the demand for nursing beds.

According to Mark Burnett of the Hamilton-Halton, Brantford and Haldimand-Norfolk Alzheimer’s societies, they are receiving 150 new referrals of Alzheimer’s disease patients a month.  Burnett attributes this rise to Alzheimer’s awareness campaigns aimed at earlier identification and diagnosis of Alzheimer’s disease and dementia.

These latest number provided in the report by the Alzheimer’s Society of Canada highlights research on ways to reduce the risk associated with developing dementia and to enhance quality of life after diagnosis with dementia and Alzheimer’s.  To help reduce the impact of dementia, the Alzheimer’s Society of Canada recommends taking steps including:

• Prevention programs that promote healthy diets and physical activity that can delay the onset of dementia by two years;
• Skill-building and support programs for family and caregivers responsible for dementia and Alzheimer’s disease patients;
• Assigning case managers to newly diagnosed dementia and Alzheimer’s patients which would facilitate in-home care longer, thus lessening strain on the long-term care system

With no cure for Alzheimer’s disease or dementia, the society wants to see increased funding to deal with the projected increase in Alzheimer’s and dementia patients to help address proejcted shortages in the system.

There is no known cure for Alzheimer’s disease.  In fact, there is no treatment that will top the progression of Alzheimer’s disease.

Without the existence of a cure for Alzheimer’s and treatments to stop its progression, what options are open to Alzheimer’s patients and their families seeking support?

Currently in Canada and the United States, there are several medications that have shown to slow the decline of memory, language and thinking abilities in those people suffering from Alzheimer’s disease.  While not a cure for Alzheimer’s, these drugs do provide patients and families with some relief from the symptoms associated with Alzheimer’s disease.

There are three drugs used to treat patients with mild to moderate Alzheimer’s disease.  These include Aricept, Exelon and Reminyl.  Moderate to advanced Alzheimer’s disease is treated with Ebixa and Aricept.

It is important to remember that these drugs are not a cure for Alzheimer’s disease and merely treat the symptoms associated with Alzheimer’s.

Aricept is not a cure for Alzheimer’s disease but is used as an Alzheimer’s treatment for people with mild, moderate and advanced Alzheimer’s symptoms.

People with Alzheimer’s disease show a progressive degeneration in nerve cells, especially those that make acetylcholine – a chemical thought to be important for both learning and memory.  The Alzheimer’s treatment Aricept works principally by reducing the breakdown of acetylcholine, resulting in more of this chemical being present in the brain of those suffering from Alzheimer’s disease.

With such an Alzheimer’s disease treatment, it has been suggested based on research data that Aricept enhances the action of acetylcholine by making receptors more responsive in the brain.

People treated with the Alzheimer’s disease treatment Aricept may take as long as 12 weeks to show signs of responding to the drug treatment.

In recent developments, the FDA approved a generic version of the Alzheimer’s disease treatment Aricept.

Ebixa is not a cure for Alzheimer’s disease but treats Alzheimer’s symptoms by stabilizing the decline in cognition and daily function.

The Alzheimer’s treatment Ebixa is one of a group of drugs classed as a NMDA receptor antagonists.

Alzheimer’s disease causes nerve cells to leak large quantities of glutamate which leads to excessive interaction with the NMDA receptors resulting in the disease or death of the receiving nerve cells.  With the Alzheimer’s disease treatment Ebixa, the drug interacts with the NMDA receptors and prevent glutamate from interacting with the receiving cells.  This results in the normal transmission of nerve messages between nerve cells.

With such an Alzheimer’s disease treatment, there is a slowing in the decline of memory and cognition in those patients with Alzheimer’s disease.

Ebixa can be used by itself or in conjunction with other Alzheimer’s disease treatments.

People treated with the Alzheimer’s disease treatment Ebixa may take as long as 12 weeks to show signs of responding to the drug treatment.