A look at various treatments at different stages of the disease
Alzheimer's treatment varies significantly at different stages of the disease. The following offers an overview, not only for your education, but to describe some worthwhile resources for caregiving families, especially during early stages of the disease.
Treatments can alleviate some symptoms, empowering you as a caregiver and helping suspend the disease's progress. As you deal with the disorder's progress, medicines are prescribed and there are some natural treatments respected by the health care industry. During middle to later stages of the disease, you will require more professional help, and we also outline treatments available during this stage, with some helpful advice where that is available. As time goes on, families will have to rely on professional help such as that offered by home care services, health care facilities or memory care facilities of local seniors' care homes.
Note: Professional treatment of Alzheimer's focuses on alleviating symptoms caused by the buildup of amyloid plaque on the brain. Apropos of a definition of 'treatment,' none of these is a cure. However, families should rightfully find encouragement in treatments that delay the progress of some symptoms. We present this mainly for your information, assuming of course that you will consult with professional health care every step of the way.
Alzheimer's treatment by caregivers: early stages
Caregivers dealing with the effects of Alzheimer's have a number of different resources they can use. Some of these are available for a cost, but these will offer you reprieve from the progress of symptoms.
The Ashby Memory Method (AMM) is one example of a drug-free Alzheimer's treatment during early stages of the disease. This is a cognitive therapy for dementia, sometimes called Cognitive Retention Therapy (CRT); it was developed by a Canadian, Dr. Mira Ashby. This program has a component specifically tailored to families.
AMM has been shown to be effective as an early intervention and an effective treatment option, and a professional version of the course is in use in many care facilities around the world. Read more about the Ashby Memory Method.
The Montessori Memory Method is another caregiver-focused treatment shown to have benefits. This program adapts Montessori teaching methods focused on engaging the senses, to reawaken learning and reconnect the dementia sufferer to the world. The Method includes physical activities, art activities and music therapy to stimulate the brain and encourage positive emotions. Some caregivers have adapted similar simple methods, providing Alzheimer's sufferers with simple activities like colouring books, puzzles, board games, etc.
The disciplined nature of above programs allows families to manage and understand the progress of the disease. The more disciplined approach that is taken (e.g. AMM), the more likely that caregivers will see positive effects and relief from the symptoms, as the devastating mental deterioration continues. The interactivity of these approaches also facilitates connection to the person still there, underneath the symptoms.
These methods do not necessarily slow pathological progress of the disease but they can provide relief from symptoms. Caregivers during early stages of the disease should be sure to read about validation therapy below.
Medicines used in the treatment of Alzheimer's Disease
Donepezil is the most commonly prescribed medicine, sold under the trade name Aricept.
Rivastigmine (sold under the trade name Exelon) is also approved in Canada, to treat mild to moderate Alzheimer's.
These are both cholinesterase inhibitors that slow down the degeneration of nerve cells in the brain. There are other drugs that work similarly, but have more side effects. In the United States and elsewhere, other drugs meet government approval.
Memantine (or memantine hydrochloride, sold as Namenda) is used later in the progress of the disease to regulate the absorption of glutamate into nerve cells.
Other drug treatments are slow to market, although some are always in trial. Pharmacological treatments like the above are only prescribed by healthcare professionals.
Non-pharmacological and "natural" treatments
The bulk of research money spent on Alzheimer's goes toward pharmacological responses and cures (or attempted cures). Aromatherapy, for example, is used by some patients who feel this has benefits. Beware that some herbal treatments can adversely interact with medicines, though. Some examples of herbal supplements used in the treatment of Alzheimer's are Ginkgo Biloba, vitamin E, and melatonin. Make sure your doctor is aware of alternative methods you are using. Coconut oil is one other product reported to have benefits in the prevention and/or treatment of Alzheimer's, but its efficacy is considered unclear by the medical establishment.
Professional approaches and therapies
in the treatment of Alzheimer's Disease
There is no set manner in which Alzheimer's patients progress through stages or treatments; every sufferer goes through the disease at a different rate, in fact. You will reach a point where you begin to augment personal caregiving with professional help. Some people may be able to avail themselves of home care services; each of these providers has their own training and specialization. Many provinces in Canada support short term respite care, often in a clinical environment like that of a retirement home (also available from home care providers). A growing number of adult day programs are offered publicly or privately, run by professional care workers and offering organized activities with a therapeutic value. In these settings, care workers will be trained in, or able to provide, different professional treatments of Alzheimer's Disease and related dementias.
Here is an overview of non-invasive, drug-free treatments in these settings, and an understanding of the efficacy of each.
Validation Therapy is not so much a treatment as a way of treating Alzheimer's patients. Care workers receive special training in case studies of this approach. However, the basic idea is valuable to any caregiver: treat dementia-related thoughts and feelings as valid, even if you know they don't match reality. The dementia sufferer believes his or her irrational or false thoughts. Correcting them will only create irritation. Treat irrational thoughts as valid, then move on or try to change his or her focus. Read more in our glossary.
The Gentle Persuasive Approach is also more so a way of treating patients, and also worth understanding for any caregiver. This approach is learned through professional training, and focuses on strategies for patience with dementia clients. Course participants learn methods of anticipating negative behaviours and deflecting conflict with agitation-prone Alzheimer's sufferers, before it arises.
Other programs that help professional caregivers in Ontario deal with dementia sufferers are U-First! and a secondary program called Behavioral Support Training Program. Professional care staff may be trained in a variety of other, similar approaches that facilitate the best treatment of seniors with dementia.
Therapies you will find used by caregivers in the above professional environments include:
- Music and/or art and/or storytelling therapy: therapies in creative pursuits help people with memory, exercise the mind, and encourage interaction, creativity and concentration.
- light therapy: use of light has been shown to mitigate symptoms of Alzheimer's.
- brain games like puzzles, word games and other problem solving encourage mental activity and facilitate social interaction.
You can read more about these in our look at Alzheimer care therapies.
Specialized treatments used in clinical settings and memory care facilities are also very helpful. Professionally developed programs described below require a formal setting or a dedicated environment that sometimes also facilitates (or requires) group interaction with fellow Alzheimer's sufferers.
- Java Music Club is a research-based standardized program that encourages peer interaction. It's tailored for use in long-term care and supportive living environments
- Snoezelen therapy rooms are a specialized kind of light therapy that soothes and stimulates. This therapy is also used in swimming pools.
- Professionally oriented memory methods. Both the Ashby Memory Method and Montessori Memory Method (see above) are used by professionals in residential care settings.
- Various proprietary programs are often developed professionally, using a company's expertise and experience. One example is Living in my Today developed by Schlegel Villages. Another is Delmanor's MemoryPlus™ program. There are other examples, also.
Specialized provisions for symptom management are also available in professional care environments. One example is Real-Time Location Systems (RTLS) that help monitor wandering, using wireless technology embedded in pendants or other items worn by dementia clients. Software tracks the location of care patients, with their families' consent, of course. This technology is just one more way that treatment of Alzheimer's Disease is improving through technological development and new research.
Alzheimer's treatments are changing all the time, as our understanding of the disease is growing and deepening. We all look forward to a day when there will be a cure for the disease and no longer any need for treatment. While there is hope that day of resolution is still in the future.
Read more about some subjects covered above:
Final disclaimer: This page is intended to provide basic information and an overview of the treatment of Alzheimer's Disease, for the edification of Canadian consumers and caregivers. Consult with professional health care providers at all times.