Coping With Late-Onset Alzheimer's Disease

Alzheimer’s disease is a brain disorder that affects the person’s memory, thinking, and behavior. “This condition affect the person’s ability to perform daily tasks. It tends to start with more complex tasks, but eventually affects more simple ones as well,” says Richard Marottoli, MD, MPH, a geriatrician at Yale Medicine who specializes in treating Alzheimer’s disease.

For approximately 5% of patients, the symptoms first start to appear between the ages of 30 and 60, which is referred to as early-onset Alzheimer’s disease. However, for most people, the symptoms start to appear in the mid-60s or thereafter, which is referred to as late-onset Alzheimer’s disease.

This article explores some strategies that can help you cope with late-onset Alzheimer’s disease, as well as some tips that may be helpful for caregivers.

Coping Physically

Fortunately, physical symptoms are relatively uncommon in Alzheimer’s disease; however, you may start to have difficulty maintaining your balance, and may require increasing assistance with self-care tasks, Dr. Marottoli explains.

Dr. Marottoli suggests some strategies that can help you cope physically:

• Stay active: Stay as physically active as possible. Even mild or moderate amounts of exercise can help slow the progression of the disease, lower your stress levels, improve your balance and coordination, and reduce the risk of falls.
• Follow a healthy diet: Following a healthy, balanced diet such as the Mediterranean diet can help decrease the rate of brain degeneration. The Mediterranean diet focuses on fresh fruits, vegetables, whole grains, seafood, and healthy sources of fat like nuts and olive oil.
• Get help with personal care: Do as much as you can manage, but ask for help with tasks you need assistance with. Over time, you may increasingly need help with personal care tasks such as bathing, getting dressed, brushing your teeth, combing your hair, or rising from a chair. Velcro closures, shoe horns, and other aides can make dressing easier. 
• Manage health issues: Get regular health check-ups and manage healthcare issues such as blood pressure, diabetes, and cholesterol, to reduce the risk of developing complications. Optimizing hearing and vision can help improve brain processing.
• Take your flu shot regularly: It’s important to take your flu shot regularly, as Alzheimer’s disease can make you more prone to catching illnesses like pneumonia and the flu.
• Implement fall-prevention strategies: Difficulties with gait, balance, and coordination can increase your chances of falling. You can help prevent falls by keeping the floor clear of clutter, leaving a light on at night, installing grab bars in the bathroom, avoiding loose clothing, wearing sturdy shoes, and using a cane or walker for support.
• Avoid smoking and drinking: Avoid alcohol or reduce your intake and try to quit smoking. These substances can accelerate cognitive decline.
• Check whether it’s safe to drive: If you drive, ask a loved one to ride with you periodically to ensure you’re still driving safely. Make contingency plans for a time when you may not be able to drive anymore.
• Consult an occupational therapist: It may also be helpful to consult a physical or occupational therapist who can evaluate your symptoms and your home, to determine which assistive devices may be helpful to you and how you can optimize your living situation for better safety and mobility.

Coping Emotionally

Below, Dr. Marottoli suggests some strategies that can help you cope emotionally:

• Come to terms with the diagnosis: Being diagnosed with Alzheimer’s disease can be distressing. You may feel angry or shocked and have trouble accepting the diagnosis. Or, you may feel relieved that there’s finally an explanation for your difficulties. Accepting the diagnosis and coming to terms with it is the first step toward coping with it.
• Educate yourself about the condition: There are many books about Alzheimer’s disease, some from the patient's perspective, others from the caregiver and family members’ perspective.
• Enlist support: Enlist support from family, members, friends, and healthcare providers. Be upfront about your concerns. Designate a trusted person to make decisions on your behalf if a time comes when you are unable to do so. 
• Plan for the future: Talk to your loved ones and your healthcare providers about what's most important to you and try to align your healthcare, finances, and other decisions accordingly. Talk to an attorney specializing in elder law to make sure that estate issues are taken care of and to a financial planner, if you have one, to help understand your options.
• Identify community resources: Many community organizations have resources that can be helpful. Check on resources in your community for activity programs and support groups.

Caregiving & Helping Others

If you are caring for someone with late-onset Alzheimer’s disease, Dr. Marottoli suggests some tips that may be helpful:

• Maintain a routine: Follow a fixed daily routine so the person knows what to expect over the course of the day. They may become confused or disoriented by changes to their daily routine.
• Build enough time into the schedule: It’s helpful to build buffer time into the daily schedule, because everyday tasks can often take longer than anticipated.
• Encourage activities: Encourage the person to be as physically, socially, and mentally active as possible. Find activities they enjoy doing and help them participate in whatever way they can. For instance, if they can no longer play the piano but still enjoy music, play for them or sing to them whenever you can.
• Minimize distractions: Avoid striped or geometric patterned decor and don’t keep the radio or television on in the background, as they can distract the person and make it hard for them to focus.
• Speak simply: Speak slowly and clearly to the person and avoid telling them or asking them multiple things at once. If you’re helping them with personal care tasks, it can be helpful to let them know what you’re doing, so they’re prepared.
• Be patient: The person may be more prone to getting upset or irritable, but avoid arguing with them or showing them your anger, frustration, or stress. Reassure them that you’re there for them and that you can help fix whatever is bothering them. Diffuse tense situations with humor and kindness.
• Keep harmful items out of reach: Keep potentially dangerous items such as matches, knives, scissors, sharp kitchen implements, tools, alcohol, and medications safely out of reach, under lock and key if need be.
• Focus on the moment: While it's helpful to anticipate and plan for the future, try not to obsess too much over your loved one’s condition or worry about certain symptoms or manifestations that may never arise. Focus on the moment and enjoy the time you have with your loved one.
• Take care of your own health: Practice self-care and don’t neglect your physical or emotional needs.
• Seek support: Support is a key factor, so enlist help from other relatives and friends, both for emotional support as well as for more practical aspects and daily tasks. You may also benefit from joining a support group for caregivers, as it can be a helpful source of emotional support and caregiving advice.

A Word From Verywell

Late-onset Alzheimer’s disease can be difficult to cope with because it’s a terminal illness that causes you to slowly lose your mental faculties and physical abilities. Moreover, it also means losing your sense of personal agency and feeling dependent on others.

If you’re having difficulty accepting the diagnosis or adjusting to the changes to your life, it may be helpful to see a mental healthcare provider to help you cope with the frustration, depression, or anxiety you’re experiencing. Friends, family members, and support groups can also be valuable sources of support.