Trying to understand the world thatAlzheimer patient inhabits

by Joanne Koenig -An edited extract from Learning to Speak Alzheimer's

It is hard for us to understand the world that the Alzheimer's patient inhabits,but we can try to understand how the disease may be affecting him.

IMAGINE gazing into a mirror to find what seems to be someone else looking out at you.

IMAGINE someone telling you to sit down when you cannot find a chair.

Carers can and should alter the environment to help prevent problems.

Consider the following:

LIGHTING

The Goal is to mimic daylight-the most comfortable light for patients. Having several lamps on creates too many shadows, which patients may misinterpret or find threatening.

Leave a light on at night and put reflector tape along the walls between bedroom and bathroom to mark the path. Night-time incontinence may be the result of not being able to find the bathroom quickly enough.

Install dimmer switches and turn up the lights as the sun starts to go down to help prevent 'sundown syndrome'. Often a patient's aberrant behaviour begins to surface at this time of day. Try to replace floor lamps with wall lighting to make the house clutter-free.

COLOUR SCHEMES

Research by Dr. Alice Cronin-Golomb at the psychology department at Boston University has found that the disease affects patient's reactions to colours.

Using specific colours for different areas can help keep them orientated in their home and enable them to go from one room to another without getting lost.

Try to find wall colours that contrast with the functional objects in the room. Put bright cushions on dining chairs and colourful throws on sofas to draw attention to them.

Colour can also be used to camouflage objects to avoid.

Place a black mat inside the front door to suggest a dark chasm that can't be crossed. Many care facilities specialising in Alzheimer's have found this to be a successful way to keep residents from wandering off.

Similarly, painting front and back doors to match surrounding walls makes them harder to see.

Install new locks and doorknobs high up or low down, leaving the useless original ones in place. The patient will often believe the old ones are broken and not see(or look for) the new ones.

FURNITURE

Remove chairs that are difficult to get into or out of.

Mirrors can do more harm than good-the patient may believe that there is someone else in the room-someone who may harm him.If the image seems vaguely familiar, he may perceive this to be an old relative, someone who has passed away, which will cause great distress.