• My husband was diagnosed with early-onset Alzheimer’s disease when he was 59; he is now 65. He had been doing really well and I’ve been able to keep him home. However, in the last month, he has been having problems. From being someone who had a great appetite, he now hardly eats anything. It’s also difficult to give his Alzheimer’s medication. I hardly take him shopping and other places anymore as I'm not sure what he will do. Over the past three years, I have been helping him shower, but now he refuses to do this. What can I do?

    Firstly, if you are struggling with all these challenges alone, you should get help and support from family, friends, a social support agency, the Alzheimer’s Association, as well as a dementia specialist.

    If some of these problems have developed quickly, consider whether a second issue such as depression, a new medical illness, or medication side effects is partly to blame. If swallowing difficulties are contributing to the problem your husband is having in taking medication, ask his doctor whether his medications are available in liquid form or as rapid-dissolving tablets. The bathing problems you describe become common as Alzheimer’s progresses; if no other cause is identified, consider getting help from another person (family or paid aide), decreasing the frequency of the showers, or giving him sponge baths from time to time.

  • My husband was diagnosed with early-onset Alzheimer's disease when he was 59, he is now 65. I have been able to manage him at home, but in the last month he refuses to wash or let me help him, and he has no interest in food. It is hard to get him to take his medications. What can I do?

    An important point is whether he has shown a steady decline in his abilities and behaviour (which is  expected of AD) or whether there has been a sudden deterioration, which would indicate the need to look for another cause. A new medical problem, such as an urinary infection or the onset of depression would be possible explanations of a sudden decline.

  • My 86-year-old mother-in-law has lived with my husband and me ever since she was diagnosed with frontal-lobe dementia eight months ago. In the past, I have taken her with me to go grocery shopping, but lately she has been having outbursts that appear without provocation. She will start to curse a blue streak like an angry dockworker and I can’t get her to stop. I now leave her home, which upsets me, but I don’t have any choice. Is there any way she might lose this profanity aspect of her dementia, or is there a good medication you could recommend for her?

    Emotional outbursts of the kind that you describe can occur in frontotemporal dementia (FTD) and any other disease that causes a brain injury. Sometimes their provocations are quite minor, but sometimes no obvious causes can be found. If this behaviour happens only when you take her to the store, it may well be that being in the supermarket -- with its bright lights, bustle, and noise -- is the stimulus. If that is the case, try to find other places you can go together that don’t elicit the behavior. Keep in mind that this behaviour does not in any way reflect what a person was like before the disease.

  • My husband (82 years old) was diagnosed with Alzheimer’s eight months ago. He has now reached the stage where he asks the same question repeatedly, sometimes for several hours. I try to be patient and give him a real response to the same query, but it has reached to the point where I can say just about anything and it really makes no difference what I say. Is there any "proper" way I should handle this behavior, or is there a medication that may reduce this type of behavior? He currently takes Aricept.

    Question repetition is a very common behavior with Alzheimer’s, and your struggles with it are similar to those of many other caregivers. Unfortunately, since this behavior results from the impaired memory that is an early hallmark of Alzheimer’s disease, the only medical therapy for it is the medication he is now taking.

    Your attempt to answer him each time is both admirable and understandable, since we all would be insulted if our questions were not answered. However, after answering it once or twice, it is sometimes better for all involved to change the subject, to respond that you cannot answer right away but will in a minute (distraction), or to give a very brief response ("no” or "yes”) when a longer one would be more informative. Strategies like writing the answer on a whiteboard and directing his attention to it may help as well.

    It sometimes helps to get the person engaged in activities that keep him or her busy -- adult day programs are one way to do this -- since he is less likely to ask questions if he is otherwise engaged.

  • Re your article in volume 65 regarding the use of commonly used medicines which may prevent Alzheimer's disease. I would be interested to learn the dosage recommended for Famotidine.

    Famotidine has not been proven to prevent Alzheimer's Disease; several medications initially suggested as being of benefit (e.g. oestrogen) have later been shown to be of no benefit. The dose of Famotidine is 40mg at night, usually being used to treat peptic ulcers and oesophageal reflux.

  • Is there a test for Alzheimer's disorder?

    There is no specific test for Alzheimer's Disease. An MR head scan can show atrophy (shrinkage) of part of the temporal lobe of the brain, genetic tests may show an increased predisposition to the disease and special tests on the spinal fluid may show abnormalities, but none of these tests give a yes/no answer.