As medical director of the Geriatric and Neuropsychiatry Treatment Unit at MetroWest Medical Center in Natick, Massachusetts, Dr. Antonio Bullon focuses on coordinating the treatment of patients with dementia. Dr. Antonio Bullon also has shared his expertise on television presentations about Alzheimer’s disease and related disorders.
An individual in the advanced stage of Alzheimer’s disease needs around-the-clock care. The person is unable to attend to his or her own daily tasks, including eating, bathing, and dressing. Because the ability to speak also disappears as the disease advances, the person typically cannot communicate needs.
It is thus important for the caregiver to anticipate needs, such as hunger and elimination, whenever possible. A predictable schedule can help both patient and caregiver. The caregiver may also find it beneficial to reduce sensory input, such as the number of foods on a plate, in order to reduce the patient’s resistance to daily tasks of living.
The caregiver must also be attentive to the patient’s struggles and help him or her to adapt whenever possible. Finger foods can make eating more pleasant for a patient who has difficulty manipulating a fork, while protein drinks can be beneficial to someone with difficulty chewing. The patient’s physician also can help the caregiver to ensure that the person gets enough calories.
Finally, the caregiver must be aware that although the patient at this stage may not be able to communicate in the normal way, he or she is still present inside the body. A person with Alzheimer’s disease still experiences sadness, joy, loneliness, and connection, and many experts believe that his or her core self is still present and aware. Shared sensory-based experiences, such as brushing the patient’s hair or listening to music together, can dramatically improve quality of life and deepen connection beyond attention to basic physical needs.