COVID-19 Brings New Challenges to Alzheimer's Caregiving
Caring for someone with Alzheimer's disease comes with daily challenges and disruptions, and those have only increased during the COVID-19 pandemic.
Due to the risk of infection, contact with your loved one may now be off-limits or severely restricted. Caregivers probably need to wear masks, which may be confusing to someone with Alzheimer's. And, if your loved one gets sick, how do you deal with a doctor's office visit?
These were just some of the topics covered Tuesday at the Alzheimer's Foundation of America's "Educating America Tour" in New York City, where TV's Dr. Mehmet Oz talked about his mother's Alzheimer's disease.
"Her name is Suna. She came from a respected family in Turkey. She was married to my dad for 60 years. We would joke that my mom would run the world from her living room," Oz recalled fondly.
After his mother had a small stroke, he noticed that her behavior changed a bit. What Oz didn't realize at the time was how much his father had done to compensate for his mother's shortcomings.
"My dad was there, finishing her sentences, covering for her. Then my dad developed a problem, and we lost him last year. The crutch my mother leaned on wasn't there anymore," he said.
Suddenly, Oz said, her problems became more obvious. The family noticed unusual moods and behaviors.
"She was arguing about everything. She wasn't dressing right. Her makeup wasn't right. We finally put the pieces together," he said.
Oz then acknowledged the harsh reality that so many Alzheimer's caregivers face.
"I will lose my mom twice. She is no longer the same person I grew up with," he said. "Alzheimer's is not just losing memory, you lose your identity. It is a stunning challenge."
It's a challenge many families face. About 6 million people in the United States have Alzheimer's disease, said Charles Fuschillo, president of the Alzheimer's Foundation of America. The foundation is teaming up with several major pharmaceutical companies to sponsor caregiver training sessions across the country.
The effort is timely: Dr. Allison Reiss, head of the inflammation lab at NYU Winthrop Hospital in Mineola, N.Y., noted that the challenge of Alzheimer's is being complicated by coronavirus concerns.
Reiss said that it's important for caregivers to realize that the vast majority -- 85% -- of people over 80 will survive a bout of COVID-19. While it's important to take steps to prevent it, Reiss said people need to know an infection won't always lead to serious complications or death, even for the elderly.
If you suspect your loved one with Alzheimer's might have COVID-19, Reiss recommended trying to get help from a distance, through telemedicine. Most primary care offices offer appointments via phone or internet, and addressing health concerns remotely, while your loved one is in their everyday environment will help head off anxiety, confusion and agitation.
Telemedicine can also be used for non-COVID-19 concerns, too -- both for physical and mental health.
There are also online virtual support groups and activities for people with Alzheimer's and their caregivers, Reiss added.
If your loved one has caregivers who come into the home, be sure they check their temperature before coming inside. "If it's over 99.5 Fahrenheit, they're excluded from providing care," Reiss said.
Those with a normal temperature should wash their hands thoroughly upon entering the home and wear a mask. If possible, care should take place outdoors, she said.
Nancy Lorince is owner and managing director of ComForCare Home Care in Somerset County, N.J.
She said masks can be hard for people with dementia, because they can't see their caregiver's expressions, and miss the emotional cues they provide. Still, Lorince said, it's important for caregivers to wear masks. "Dementia suppresses the immune system," she explained.
It's also important to discourage your loved one from touching their face, Reiss said.
As states reopen businesses and some activities, she recommended trying to maintain your routine and keep your loved one's environment calm.
Oz said it's important to take care of yourself, too. To try to prevent Alzheimer's disease himself, he eats a Mediterranean diet full of vegetables, fruits, nuts and olive oil, and he limits his intake of red meat. He told the audience that sleeping seven to eight hours a night is "the single most overlooked opportunity for health. During REM sleep the brains clears amyloid [a substance that builds up in the brains of people with dementia] and short-term memories are consolidated into long-term."
Maintaining a healthy weight and controlling cholesterol and blood pressure are other key steps to lower your risk.
"What you do right now matters," Oz said.
Staying social and avoiding loneliness play a role in preventing Alzheimer's disease, he added, and are beneficial for those who already have the condition.
One of Oz's biggest regrets is not recognizing his mother's mental decline sooner.
He said signs to watch out for include difficulty in creating plans, confusing time and place, trouble finding the right words. A person with Alzheimer's may use a word that's close in meaning, but it's not how they would normally have expressed themselves, he pointed out.
Learn more about how the COVID-19 pandemic is affecting Alzheimer's disease caregiving from the Alzheimer's Foundation of America.
SOURCES: Mehmet Oz, MD, host, "The Dr. Oz Show"; Charles Fuschillo Jr., president and chief executive officer, Alzheimer's Foundation of America; Allison Reiss, MD, head, inflammation laboratory, NYU Winthrop Hospital, Mineola, N.Y.; Nancy Lorince, owner/managing director, ComForCare Home Care, Somerset County, N.J.; Alzheimer's Foundation of America "Educating America Tour," June 16, 2020