1. Aging Well: Alzheimer’s Disease and Developmental Disabilities

2. This training was made possible by generous grants from the New Jersey Council on Developmental Disabilities and from Spectrum for Living’s Endowment Fund.

3. Information gleaned from Mercer, M. (2007), Aging and Developmental Disabilities, (Rev. Ed) Minot, ND, North Dakota Center for Persons with Disabilities, a University Affiliated Program at Minot State University

4. What is Alzheimer’s Disease? A slow progressive disorder of the brain Eventually results in gradual decline in brain function and death. Not a normal part of the aging process. Behavioral and psychological symptoms are complex and differ from person to person.

5. What is Alzheimer’s Disease? Symptoms lead to a form of dementia, which is the loss of mental skills and abilities, including self-care capabilities. As the disease progresses, these losses will result in total dependency for even the simplest activities.

6. Symptoms of Alzheimer’s Disease Language Problems: – Cannot find the right word or name for a familiar person, place or object. – This is more than the occasional slip of a name that everyone experiences. Loss of recent memory: – Forgetting very recent activities (E.g., that they had breakfast an hour ago) – However, remembers things from the distant past.

7. Symptoms of Alzheimer’s Disease Loss of a sense of time and place: – May become more confused about what day it is – Forgetting the way to well-known places like local parks or restaurants. Personality changes: – Slight, at first, and can be difficult to notice. – Some people become quieter or withdrawn, others become more restless. – Some may start to get angry over little things or have sudden changes of mood for no apparent reason.

8. Risk Factors for Alzheimer’s Disease Among People with Developmental Disabilities There is a greater risk if the individual: – Has Down Syndrome and is over 40 years of age; – Has had some form of head injury, especially severe or multiple injuries; or – Has a history of Alzheimer’s disease in their family.

9. Behavioral symptoms of Alzheimer’s Disease for People with Intellectual and Developmental Disabilities Development of seizures in someone who previously did not have them Changes in personality Long periods of inactivity or apathy Hyper-reflexivity

10. Behavioral symptoms of Alzheimer’s Disease for People with Intellectual and Developmental Disabilities Loss of activity of daily living skills Visual retention deficits Loss of speech Disorientation Increase in stereotyped behavior Abnormal neurological signs

11. Changes in Daily Routine Needed Person should feel safe and secure in their environment Emphasis on maintaining abilities, particularly those affecting dignity (toileting, eating) rather than teaching new skills Keep changes in environment and daily routine to an absolute minimum Establish a toileting routine to minimize accidents

12. Changes in Daily Routine Needed Simplify routines and reduce choices to minimize feelings of anxiety and frustration. Keep verbal requests simple Talk about past experiences to remind the person

13. Changes in Daily Routine Needed Help the person to maintain orientation – naming events for the day, – reminding the individual of the day, time, and place – repeating names of people around them. Respond to suspicions and delusions with reassurances

14. Program Practice Provide a safe and familiar environment. Closer supervision to minimize confusion and disorientation. Maintain present level of independence by increasing staff supervision, prompts and hands- on care. Modify the individual’s support plan to anticipate changing ADL and supervision needs.

15. Program Practice Monitor and document increased episodes of confusion, disorientation or memory lapses Identify triggers that result in inappropriate or dangerous behavior and try to minimize their occurrence. Adapt program plan to reflect the behavioral and physical changes the person may experience.

16. Help for a families and caregivers Home Care services Adult Medical Day Care Area Agencies on Aging