Alzheimer's Disease Patient Caregiver Guide (cont.)

As the disease progresses, many people with Alzheimer's begin to experience incontinence, or the inability to control their bladder and/or bowels. Incontinence can be upsetting to the person and difficult for the caregiver. Sometimes incontinence is due to physical illness, so be sure to discuss it with the person's doctor.

• Have a routine for taking the person to the bathroom and stick to it as closely as possible. For example, take the person to the bathroom every 3 hours or so during the day. Don't wait for the person to ask.
  
  
• Watch for signs that the person may have to go to the bathroom, such as restlessness or pulling at clothes. Respond quickly.
  
  
• Be understanding when accidents occur. Stay calm and reassure the person if he or she is upset. Try to keep track of when accidents happen to help plan ways to avoid them.
  
  
• To help prevent nighttime accidents, limit certain types of fluids—such as those with caffeine—in the evening.
  
  
• If you are going to be out with the person, plan ahead. Know where restrooms are located, and have the person wear simple, easy-to-remove clothing. Take an extra set of clothing along in case of an accident.

For the exhausted caregiver, sleep can't come too soon. For many people with Alzheimer's disease, however, the approach of nighttime may be a difficult time. Many people with Alzheimer's become restless, agitated, and irritable around dinnertime, often referred to as "sundowning" syndrome. Getting the person to go to bed and stay there may require some advance planning.

• Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.
  
  
• Try to schedule physically demanding activities earlier in the day. For example, bathing could be done in the morning, or the largest family meal could be served at midday.
  
  
• Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.
  
  
• Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
  
  
• Limit caffeine.
  
  
• Use night-lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.

Source: MedicineNet.com
http://www.medicinenet.com/alzheimers_disease_patient_caregiver_guide/article.htm