In the United States, approximately 200,000 of those under the age of 65 and nearly 5.6 million of those over the age of 65 have some form of Alzheimer’s. That is 5.8 million people estimated to have alzheimers. This includes memory loss as well as other cognitive issues. These people may find it difficult to perform such easy tasks of daily living. Physical therapists often partner with families as well as caregivers in order to assist those people suffering from Alzheimer’s to keep them moving easily and to help delay the severity of the condition.
Alzheimer’s, What Is It?
Alzheimer’s is a condition that progressively changes the cells in the brain and affects how people speak, interacts with others and think. The most common cause of the condition referred to as dementia. This group of disorders of the brain can cause a decline in the person’s memory as well as a decline in their ability to function on a daily level. It’s the fifth leading reason for death amongst those adults who are over the age of 65 in the US alone. It comes in after heart disease, cancers, accidents, respiratory disease and strokes.
As people age, the risk goes up for Alzheimer’s. Rarely is it diagnosed before the age of 60. Those who have a relative who suffered from Alzheimer’s tend to have an increased risk of the disease. However, most who have the condition don’t have any family history of the condition at all.
Confusion is perhaps the most major symptom of the condition. Some of the causes of confusion may be able to be reversed if they are diagnosed early enough.
When confusion comes on suddenly, it’s time to schedule a doctor visit.
If the confusion is worse after a head injury or a fall, it’s time to call 911 or get the person to the emergency room immediately.
Symptoms and Signs
There are 10 vital warning signs of potential Alzheimer’s:
- Memory changes that disrupt normal daily life.
- Difficulty in making decisions such as solving or planning out solutions to problems.
- Challenges in completely normal daily tasks such as dressing or eating.
- Confusion about the time and or the place that a person is at.
- Difficulty understanding visual images or how things should go together such as spatial relationships.
- Finding the correct words when speaking or writing.
- Losing items and not being able to retrace the steps to find them.
- Poor judgment regarding safety.
- Withdrawal from social activities and work.
- Changes in the person’s mood or their personality.
Those suffering from Alzheimer’s may also be lost in places that they know well. During the later stages of the condition, they may become restless and wander off losing their way. This happens most frequently during the late afternoons and early evening hours. It is referred to as sundowning.
Patients may also withdraw from friends and family or see things that aren’t there.
They may accuse others of lying to them, cheating them or trying to hurt them when nothing at all has happened.
In addition to these cognitive symptoms, those suffering from Alzheimer’s may have difficulty in performing easy daily tasks. In time they may require help in eating, bathing as well as using the toilet, getting dressed, and may even need assistance from skilled nursing. They can usually get up and walk around until the final stages of the condition. They will require supervision to protect them from themselves. They may also require a walker or cane to get around.
MRI scans performed by radiologic technologists and radiologists can detect brain abnormalities that can be associated with MCI or mild cognitive impairment. This info can be used to predict those patients with MCI who may develop Alzheimer’s disease eventually. Although, in the beginning stages of Alzheimer’s disease, the brain may appear normal under an MRI scan.
While the precise cause of Alzheimer’s is unknown, it’s likely due to many contributing factors. Researchers are gaining ground on the cause by reviewing brain imaging from Computed Tomography Scans (CAT scans) as well as MRIs, emission scans (PET scans) and ultrasounds.
Such tests show abnormalities and how they are affecting the patient. Spinal taps and biomarkers are also used. Definitive diagnosis is only accurate upon an autopsy.
How A Physical Therapist Can Help
There are many tips for keeping a healthy brain as you age and it is no secret that physical health impacts mental health.
For anyone who is suffering from Alzheimer’s research shows the following:
- Physical activity helps to improve memory.
- Regular exercise can help to delay the onset of dementia as well as Alzheimer’s.
- Regular exercise can help to delay the loss of ability to participate in activities required for daily living in those who are suffering from Alzheimer’s.
- Physical therapists are movement experts. They can create and design an exercise program for those who have such health conditions.
During the early onset of Alzheimer’s, the physical therapist will focus on helping to keep the patient mobile and helping them to continue performing active roles in their home and around their community. During the latter stages of the condition, the physical therapist will assist them in keeping up with their daily activities as long as is possible. This can help to reduce the burden of family and friends as well as caregivers.
Physical therapist assistants can also help the caregivers as well as the family to know how they can improve upon the safety and the specific needs of their family member who is suffering from Alzheimer’s. They can improve the quality of life and in many cases, they can delay the need for the patient to go into a care facility.
Alzheimer’s patients also suffer from other related conditions to aging. They may have arthritis, they may fall frequently and even break bones when they fall. The physical therapist is trained to help treat such conditions in those who are suffering from Alzheimer’s conditions. They can take into account how the disease is affecting the patient and their other health issues. They can determine how well the patient comprehends the condition and make the necessary adjustments to treatment to accommodate the patient and their specific needs.
The physical therapist might use a variety of methods to help the patient. These techniques and methods will help to ease the distress of the patient. They may use any of the following to help the patient:
Visual, tactile and verbal cueing. The therapist will use such cues as pointing to objects or gesturing to help the patient understand. They may give the cue to life with both arms and signal their patient that it’s time to stand by lifting both arms and standing as the patient follows along.
They will learn to use short cues and give them with short easy to follow one or two-step instructions to help the patient understand.
Tactile cues will be to hold the patient’s hand and walk with the patient. Occasionally, the therapist will cue the patient with 2 or 3 different cues at the same time such as saying the direction while acting it out.
The therapist will act as a mirror to the patient and walk them through it by standing in front of the patient and helping them to understand how they need to be moving. This will help the patient to follow the instructions.
The therapist will break the task down in easy to manage parts so that the patient can follow it step by step. Simple easy to follow steps are vital to helping the patient be successful. Teaching the patient to get out of bed and into a sitting position may involve having the patient roll to one side and then ease themselves into a sitting position. The therapist may then teach the patient to carefully stand and move to a nearby chair.
The therapist will chain the information together into easy to follow steps. By chaining these steps the patient can accomplish complicated tasks. It’s an ideal way for the patient to remain mobile and be successful.
The therapist may use hand over hand facilitation. This is when they take the patient’s hand and help them to complete the task until the patient can do it themselves.
While most patients can maintain the ability to walk, some will have balance issues as well as coordination issues. This can lead to challenges in walking. The therapist will help train the muscles to respond to these changes and act accordingly.
Turning it over to the Family
Many allied health professionals such as occupational therapists and physical therapists will help patients with Alzheimer’s disease.
Other caregivers and family members will also be trained to help safely move patients. Lifting and transferring the patient suffering from Alzheimer’s to prevent injury to both caregiver and patient is vital. Additionally, the therapist will provide some hands-on care for the caregiver to help improve safety and lower the risk of injury.
Example: The therapist will walk the caregiver through how to use the equipment like seating systems and long-handed reachers.
Prevention of injury is also taught. While the patients aren’t always able to maintain their movements, the caregiver and therapist will work together to help them remain safe. They will work on fitness and design exercise programs to help the patient maintain mobility.
This is how the physical therapist helps the patient to age in a healthy way and maintain their abilities to be the best that they can be.
For more information on Alzheimer’s you can visit alz.org which is the largest nonprofit funder of Alzheimer’s research.