Caring for someone with Alzheimer’s disease often requires daily support, patience and a consistent routine. The person may need help remembering to take prescribed medications and staying involved in activities that keep the brain active.

Having a caregiver or family member nearby can make it easier to manage these needs. Regular support can also help the person maintain daily habits and cope with changes in memory and other abilities.

As the disease progresses, the person may also need help with everyday tasks such as eating, bathing and getting dressed. These activities can become difficult because the person may forget how to do them or no longer understand their purpose.

1. Alzheimer’s medications

A person with Alzheimer’s disease may need to take dementia medications every day, such as donepezil or memantine. These medications can help manage symptoms involving memory, thinking and behavior, including agitation or aggression.

Donepezil is FDA-approved to treat mild, moderate and severe dementia of the Alzheimer’s type. Memantine is FDA-approved to treat moderate to severe dementia of the Alzheimer’s type.

It may be difficult for the person to take medication without help because they may forget to take it. The caregiver should make sure each medication is taken at the dose and time prescribed by the healthcare provider.

It is also common for a person with Alzheimer’s disease to refuse medication. In this situation, the caregiver should ask the person’s doctor or pharmacist whether the medication is available in another form or can be safely given with food.

Medications should not be crushed or mixed with food unless a doctor or pharmacist confirms that the specific product can be given that way. Donepezil 23 mg tablets must be swallowed whole and should not be split, crushed or chewed.

Extended-release memantine capsules must not be crushed, divided or chewed. Certain products may be opened and sprinkled on applesauce, but only when this method is permitted by the product instructions.

2. Brain training

Activities that exercise brain function should be performed every day to stimulate memory, language, orientation and attention. These activities may be completed individually or in a group with the help of a nurse or occupational therapist.

Examples include:

Completing puzzles;
Looking at old photographs;
Reading the newspaper.

The goal is to stimulate the brain and help preserve the person’s abilities for as long as possible. These activities may help the person recall memories, continue speaking, perform simple tasks and recognize themselves and other people.

It is also important to help the person remain oriented. For example, an updated calendar can be placed on a wall at home, and the person can be gently reminded several times a day of their name, the date or the current season.

3. Physical activity

Alzheimer’s disease can gradually reduce mobility and make it more difficult for the person to walk or maintain their balance. As a result, the person may become unable to independently perform everyday activities, such as walking or lying down.

Physical activity can provide several benefits for a person with Alzheimer’s disease, including:

Preventing or reducing muscle and joint pain;
Helping prevent falls and fractures;
Stimulating bowel movements and making it easier to pass stool;
Helping delay prolonged bed rest.

Physical activity should be performed every day when possible and should be appropriate for the person’s abilities. Examples include walking or doing water aerobics for at least 30 minutes a day.

Depending on the severity of the disease, physical therapy sessions may also be needed to help preserve the person’s mobility and quality of life.

4. Social interaction

A person with Alzheimer’s disease should maintain contact with friends and family to help prevent isolation and loneliness, which may contribute to a further loss of cognitive abilities.

Simple activities may include going to a bakery, taking a walk in a garden or attending a family birthday celebration. These activities give the person opportunities to talk and interact with others.

However, calm environments are usually more appropriate. Excessive noise may increase confusion and cause the person to become more agitated or aggressive.

5. Adapting the home

A person with Alzheimer’s disease has a greater risk of falling because of impaired balance and the possible effects of certain medications. The home should therefore have wide, clear walkways without objects blocking the areas where the person walks.

The person should also wear comfortable clothing and well-fitting, closed-toe shoes to reduce the risk of falling.

6. How to communicate with the person

A person with Alzheimer’s disease may have difficulty finding the right words to express themselves. They may also have trouble understanding what other people say or following instructions.

It is important to remain calm while communicating. Caregivers should:

Stay close and look the person in the eyes so they understand they are being addressed;
Hold the person’s hand to show affection and understanding;
Speak calmly and use short sentences;
Use gestures to explain what is being said and demonstrate an action when necessary;
Use simple synonyms or different words to repeat the same message;
Listen to what the person is trying to say, even when they repeat something several times.

In addition to Alzheimer’s disease, the person may have hearing or vision problems. It may therefore be necessary to face the person directly and speak more loudly so they can hear clearly.

Alzheimer’s disease can significantly affect cognitive abilities. Even when these communication strategies are followed, the person may still have difficulty understanding.

7. How to keep the person safe

A person with Alzheimer’s disease may not recognize dangerous situations. This may unintentionally place the person or others at risk.

To reduce these risks, caregivers should:

Place an identification bracelet on the person’s wrist containing their name, address and a family member’s telephone number;
Tell trusted neighbors about the person’s condition so they can provide help if necessary;
Keep doors and windows secured to help prevent the person from wandering away;
Store house and car keys out of sight because the person may try to drive or leave home;
Keep potentially dangerous objects, such as knives and glassware, out of sight.

A person with Alzheimer’s disease should not go out alone. They should always leave home with a trusted companion because the risk of becoming lost is high.

8. How to help with personal hygiene

As the disease progresses, the person may need help with personal hygiene tasks such as bathing, getting dressed or combing their hair. In addition to forgetting to perform these activities, they may no longer recognize the purpose of certain objects or remember the steps involved in each task.

To help keep the person clean and comfortable, the caregiver should calmly demonstrate each step so the person can repeat it when possible.

The person should also be included in the activity as much as they are able. This may help prevent confusion and aggressive behavior during personal care.

9. What the person should eat

A person with Alzheimer’s disease may lose the ability to prepare meals. Over time, they may also lose the ability to eat independently and may have difficulty swallowing.

The caregiver should:

Prepare familiar meals that the person enjoys and avoid offering unfamiliar foods;
Use a large napkin or clothing protector;
Avoid unnecessary conversation during the meal if it distracts the person;
Explain what the person is eating and what objects such as the fork, cup and knife are used for if they refuse food or appear confused;
Avoid arguing if the person does not want to eat or prefers to eat with their hands, as confrontation may trigger aggressive behavior.

A dietitian may need to prepare an individualized eating plan to help prevent malnutrition. If the person has difficulty swallowing, a soft-food diet may be needed.

10. What to do when the person becomes aggressive

Aggressive behavior can occur with Alzheimer’s disease. It may involve verbal threats, physical violence or damage to objects.

Aggression may occur because the person does not understand instructions, does not recognize other people or feels frustrated after noticing a loss of their abilities.

During these situations, the caregiver should remain calm and:

Avoid arguing with or criticizing the person;
Respond calmly and avoid making the situation seem more serious;
Avoid touching the person while they are behaving aggressively;
Avoid showing fear or anxiety;
Avoid giving instructions, even simple ones, until the person becomes calmer;
Remove nearby objects that could be thrown;
Change the subject and encourage the person to do something they enjoy, such as reading or looking at a newspaper.

Episodes of aggressive behavior are usually brief and temporary. The person with Alzheimer’s disease may not remember the incident afterward.