Hydration is important for all of us, especially during these hot summer months.  However, for the person with early onset Alzheimer’s disease and other types of dementia, hydration becomes critical. As the disease advances, the brain no longer recognizes the feelings of hunger and thirst.  If you are a care partner to someone with the disease, it can be easy to lose track of their fluid intake with the numerous tasks you encounter each day.  It will be important to build into the person’s daily schedule a consistent offering of fluids throughout the day.

It only takes a 2% loss in body fluid, that isn’t replaced, to cause mild dehydration. Signs of dehydration can include:

• Increased confusion
• Weakness
• Less frequent urination
• Dark-colored urine
• Constipation
• Muscle cramping in arms and legs
• Fatigue
• Dizziness
• Headaches

There are a variety of reasons that lead to a higher risk of dehydration for those with this disease. Causes of dehydration throughout the stages include:

• Early stages: a person may simply forget to drink because they are less sensitive to thirst and/or cannot recall when they last took a drink.
• Moderate stages: a person may struggle with remembering the mechanics of how to get a drink—how to turn on the faucet, where the glasses are kept and how to get the beverage into a glass. It may also be increasingly difficult for them to hold a glass or drink from it without the use of a flexi-straw or modified cup.
• Advanced stages: the risk of dehydration is most severe in this stage as one’s sense of thirst may be lost, or they are unable to express their need for a drink. It can also be difficult for care partners to recognize their loved one is thirsty.

Additional causes may also be attributed to medication side effects. Some prescription medications have a diuretic effect, which means additional fluids are being lost due to the medication.

Ideally, your loved one should be consuming 6-8 cups of fluid each day. Below are some suggestions to promote fluid intake:

• Make fluid intake a “team” effort.  As a care partner, it is important for you to also stay hydrated. Take time throughout the day to sit and have a glass of water or cup of herbal tea together.
• Prompt them to drink often.  Give your loved one a small glass of water every 60-90 minutes. Drinking smaller amounts of liquid at a time can be easier than presenting them with a large glass of water, which may feel overwhelming.
• Eliminate challenges.  If your loved one has difficulty holding or drinking from a glass, take steps to eliminate those challenges. Small no-spill cups with a handle can improve their confidence. There are many cup options for adults, so you don’t have to buy one that is meant for a child. Flexible or one-way straws can also help if drinking from a glass becomes difficult. Clear liquid can be hard for them to see in a clear glass, so adding fruit can make it easier to identify the water.
• Provide them with options.  While water is always the best option for hydration, your loved one may not enjoy the taste of plain water. As the disease progresses, adding flavors can help with fluid intake.  Adding fruit to the water, such as strawberries, lemon, oranges, pineapple, and blueberries, can increase flavor. Fruit juices can also be diluted by adding a small amount of water. Sports drinks and Pedialyte have a stronger flavor and also contain salts, minerals, and electrolytes.
• Review medications with your physician.  If your loved one is taking medications that increase the risk of dehydration, we recommend talking with your physician. They may be able to provide additional suggestions for promoting hydration.
• Add foods throughout the day with high water content.  As you prepare meals, consider adding food items with a high water content. Below is a list of ten (10) foods and their corresponding water percentage. The percentage is based upon a one-cup serving:
  • Lettuce – 96%
  • Cucumber – 95%
  • Tomatoes – 94%
  • Watermelon – 92%
  • Bell peppers – 92%
  • Strawberries – 91%
  • Cantaloupe – 90%
  • Peaches – 89%
  • Oranges – 88%
  • Cottage cheese – 80%

Broth-based soups are also a good option. It’s also nice to provide items as special treats, such as popsicles, hot chocolate, lemonade, applesauce, and Jell-O.

If your loved one is living in a memory care community, please ask the staff what steps are taken to ensure residents stay hydrated. If they tell you that beverages are available in the refrigerator for residents when they get thirsty, please ask them to give your loved one something to drink every 60-90 minutes. It is within your right to advocate for your loved one to get the proper amount of hydration they need each day.

Next week’s post will focus on the causes and implications of urinary tract infections, which can often result from being dehydrated.

Written by: Emily Sutherland

“Dehumanizing always starts with language.”  —Brené Brown

Our words matter. Whether we are nurturing a child’s development or communicating with anyone in our lives, choosing words that clearly communicate respect and compassion benefits every single relationship in our lives. Yet the moment an individual receives an Alzheimer’s diagnosis, foreboding phrases have become normalized – in medical settings, families, and communities – and we may not realize how our words might diminish, stigmatize, or even dehumanize people with the disease.

Families routinely hear their family members being spoken about by medical personnel as if they aren’t there or do not have feelings. Yet, just as any human being deserves to be spoken to and spoken about with dignity and respect, individuals with Alzheimer’s disease and dementia are no exception.

Alzheimer’s is commonly described as “the long goodbye” becaus of the incremental grief that comes with watching someone you love gradually lose their ability to recall the memories you once shared, to communicate effectively, and to maintain their independence. Perhaps this phrase is one best saved for private conversations outside of the presence of the person with the disease.

When talking about “the long goodbye” in the presence of someone still in the early phases of Alzheimer’s or dementia, this understandable expression of a care partner’s sense of loss can unintentionally shift the focus onto the coming deficits and eventual death. It is important for care partners to acknowledge and process the grief that comes with this disease. Of equal importance is honoring the person and treasuring the time still left with them. After all, they still have emotions and long for their remaining days to be about more than simply saying goodbye. The needs and realities of both care partners and individuals with the disease deserve language that honors their emotions and experiences.

We also commonly hear that individuals with Alzheimer’s have “lost their identity” when, in reality, a person’s humanity can never truly be lost. Maybe they no longer remember names, or the job functions they once did, or the roles they fulfilled years earlier, but one’s true identity is never separate from their existence. Let’s always strive to see the person with the disease with the same respect that we would have decades earlier when they were in the prime of their life.

Another phrase often used to describe a person’s difficulty with communication as “word salad.” While Alzheimer’s clearly impacts a person’s ability to transfer their thoughts into words, imagine how much courage it takes for a once-brilliant surgeon, or English teacher, or business owner, to try unsuccessfully to communicate when it used to be so effortless. Rather than “word salad” (which emphasizes the deficiency), let’s consider emphasizing the intense effort they are making and refer to the individual’s speech as an attempt to communicate. After all, difficulty with communication and memory retrieval in no way removes a person’s longing for connection, empathy, and respect.

What many people – even medical professionals – refer to as “behaviors” are, almost without fail, desperate attempts to communicate unmet needs or frustration because the individual feels misunderstood. Relearning how to communicate with someone with Alzheimer’s is arguably a caregiver’s most important challenge as the disease progresses. Yet their humanity is fully intact and, therefore, can still be honored in the terminology we use. Perhaps referring to “behaviors” as “unmet needs” more effectively honors their feelings, contextualizes their actions, and serves as a reminder to everyone that the person with the disease never stops having needs that are difficult for them to communicate appropriately.

The former administrator of a memory care facility in Houston, Texas, shares a powerful example of one daughter who reframed the way she communicated with her mother. On that day, the daughter had become discouraged trying to connect with her mother. Her mother woke up convinced that it was her wedding day. So that day, rather than trying to convince her mother that it wasn’t her wedding day or reminding her that her husband had died years earlier (when the daughter was still a young child), she decided to join her mother in reliving her wedding day by asking questions and celebrating her mother’s joy.

Her mother was an excited bride in those moments and shared all about the events surrounding her big day. She told the story of her groom going out of town to find work during their engagement, and how she kept having to move the wedding date until her husband-to-be was finished with the project he had taken on. Her mother expressed gratitude that he was willing to work so hard to support them financially, yet how hard it was to keep moving their wedding date. She went on to describe the dress she wore, what they were planning to eat, and other details the daughter had never known about her parents’ wedding day.

At one point, her mother looked down at her shoes and exclaimed, “Oh these shoes will never do for my wedding day!”

Wisely, the daughter told her mother not to worry, and that they would make sure she had the right shoes for today. Without lying or derailing the conversation with her mother, the daughter went where her mother was. She reassured her, engaged with her, and as a result, helped her mother enjoy her wedding day all over again.

The daughter later stopped by the administrator’s desk, full of mixed emotions, and exclaimed, “I hate this disease! But… I also just learned things about my father and mother that I’ve never known until today.”

The challenges and pain points experienced by individuals with Alzheimer’s disease are undeniable. But this mother-daughter story offers one simple example of the way one family member’s thoughtful response forged new memories. The result was a sense of connection and shared joy rather than frustration and pain.

The way we communicate with people living with Alzheimer’s has a powerful effect on their well-being. It is imperative to never lose sight of a person’s humanity and keep finding thoughtful ways to connect with them where they are. Engaging with the person compassionately with respectful language preserves their dignity. And every human being deserves to be treated with dignity and respect, regardless of their circumstances.

The next time you hear someone comment that a person with Alzheimer’s “isn’t in there” anymore, think again. That human being is absolutely in there. People with Alzheimer’s experience a full range of emotions, yearn for connection and long for affection as much as they ever have. Mindfulness around the language we use can create a powerful shift in the atmosphere for people with Alzheimer’s and dementia who need to feel loved and supported yet perhaps don’t have the language needed to ask for it.

The Gayle Wells Foundation for Early Onset Alzheimer’s has a created a document Language Guidelines – Reframing for Respect . Please share with your communities and use this as a guide to ensure dignity and respect are used in our communications with those who have this disease.

Emily Sutherland is a career writer and founding board member for the Gayle Wells Foundation for Early Onset Alzheimer’s Disease. The Gayle Wells Foundation is actively working to destigmatize early onset Alzheimer’s disease and other dementias, and our team of clinicians is actively serving individuals impacted by the disease and their care partners. For more helpful resources and services, visit http://gaylewells.org.

When a person with early onset Alzheimer’s disease is indifferent to activities they once enjoyed and are not motivated to accomplish simple tasks, this is known as apathy.  When determining if your loved one is experiencing apathy, compare their current level of interest and motivation to their previous levels of function.  Lack of interest and motivation in the following areas are common signs of apathy:

• Activities of daily living (e.g., bathing, dressing, grooming)
• Starting and participating in conversations
• Involvement in family matters
• Showing little or no emotional response to positive or negative events

You may be thinking this sounds a lot like depression. While there are similarities and apathy can be a symptom of depression, there is a difference. If someone is only experiencing apathy, they will not show common signs of depression such as sad mood, hopelessness, guilt, or suicidal thoughts. It is important for care partners to pay close attention to their loved one’s symptoms and accurately share the information with your loved one’s doctor. If apathy is viewed as depression and treated with antidepressants, the medication may be ineffective, and in some cases, can make symptoms worse.

If your loved one with early onset Alzheimer’s disease is experiencing apathy, the following suggestions can enhance your loved one’s environment and involvement in daily activities:

1. Engage them in a variety of activities they previously enjoyed with the understanding their cognitive abilities have changed. Offer encouragement and praise.

2. Daily exercise such as walking, stretching or other physical activities they enjoy. Sometimes having a friend or family member exercise with them is motivating and enjoyable.

3. Take time each day and talk with your loved one. Reminiscing about happy memories, vacations, favorite times together is a good way increase connection and have meaningful conversations.

4. Music and art are powerful tools to engage your loved one. Create a playlist of your loved one’s favorite songs. Many communities offer art classes designed for people with cognitive impairment. Additionally, there may be art instructors who will come to your home. Check with local art programs for recommendations in your area.

Sadness and depression become common threads which weave their way through the lives of those impacted by early onset Alzheimer’s disease. While illness alone can bring about these emotions, the physical, mental, and emotional processes which are impacted by early onset Alzheimer’s disease heighten the experience of these emotions.

Depression may reveal itself in statements like these for both the person with the disease and their care partner:

“Why are you bothering me with this?”

“I don’t care.”

“I can’t take this.”

Depression can be the result of endless changes the person is constantly adapting to in their life. Imagine losing your job, friends and family members may no longer interact with you, and daily activities that were once easy and enjoyable, now become difficult to complete.  While sadness and depression are valid emotions to experience with this disease, it is important to watch for signs of prolonged depression. These signs apply to both the person with the disease and the care partner:

• Boredom or indifference to people and activities
• Loss of interest in activities and hobbies
• Social withdrawal
• Isolation
• Difficulty concentrating
• Impaired thinking
• Increased agitation or confusion
• Changes in sleeping patterns

In addition, the person with early onset Alzheimer’s disease may also refuse help with personal care, such as bathing, getting dressed, or taking medications.  Due to changes in the person’s cognitive process, they may not be able to verbalize sadness, loneliness, fear, anxiety, or other feelings they may be experiencing. Below are some non-medication approaches to lessen the symptoms of depression:

• Let them be involved in tasks and activities they once enjoyed and implement safety measures, if needed. It is okay if they do not complete the task or if they do it differently than before. The important aspect is they are participating in their life. Ensure safety measure are in place if needed. Offer them thanks and praise on a job well done.

• Create a pleasant environment. Include people and things they are familiar with. This can brighten their spirit and help soothe any fear or anxiety.

• Avoid loud noises, crowded places, or overstimulation. Overstimulation can occur in public as well as in the home. If the television is on, music is playing in another room or the neighbor’s yard is being mowed, the “noise” becomes sensory overload. This may cause them to withdraw or become agitated.

• Look for ways to increase the level of physical activity. Research has shown that 30 minutes of physical activity can help reduce depression.

• Become involved in a support group for early onset Alzheimer’s disease (65 years of age and younger). Being able to talk with others who are also living with this disease can be powerful.

As the care partner, you too are experiencing significant changes in your life and relationships, which can lead to feelings of sadness and depression. As we stated in our blog post on loneliness, having family and friends who can help and provide emotional support makes a tremendous difference.

• Connect with people. Joining a support group, in-person or online, can be a wonderful outlet to meet new people who understand your experiences with the disease.

• When people offer to help with something, let them. Whether it is spending time with the person who has early onset Alzheimer’s disease, or running errands for you, it is important to let people help.

• Have at least one person who you can talk to on a deep and honest level. Every care partner needs someone who they can be honest with and talk through all they are feeling and experiencing.

If the feelings of depression continue to become harder to overcome for either the person with early onset Alzheimer’s disease or the care partner, please contact your physician or healthcare professional to that a medical evaluation can be performed.

Personal Note from Laura Sutherland, Founder & Executive Director
If you do not have someone in your support system who you are comfortable talking to about your experiences, I invite you to contact me directly. I was Gayle’s sole care partner and I have experienced all the good, bad, and ugly of this disease. Building a community of support and awareness about this disease is why I started the Gayle Wells Foundation. We can set up a regular schedule of phone calls, Zoom calls or face-to-face meetings. I do not want anyone to keep things bottled up inside. Our services are free of charge, and I would love to talk with you and help you through this experience. I can be reached at 832-470-9526 or laura@gaylewells.org.

The isolation and loneliness experienced over the past 15 months due to the pandemic, offers a glimpse into the isolation and loneliness felt every day by those living with early onset Alzheimer’s disease and their care partners. The diagnosis of a medical disease often expands one’s social network of family and friends who offer comfort, support, and companionship. However, a diagnosis of early onset Alzheimer’s disease may shrink the person’s support system enhancing the stigma associated with this diagnosis.

Early onset Alzheimer’s disease does not cause someone to stop living their life nor does it render them unrecognizable to others. While it is a progressive brain disease, the need for connection to others is greater and more important than ever. The person diagnosed remains a unique individual with their own personality, history, relationships, memories, thoughts, talents, ideas, roles within families and communities, cultures, beliefs, and occupations.

Friends and family may withdraw because they fear doing or saying something that may be upsetting. However, the withdrawal by those who were part of the person’s life is extremely hurtful. This hurt can lead to feelings of being unworthy, valueless, and a failure. Research has shown that those living with any type of dementia can still make new memories. As the disease progresses, cognitive memories are not as important as the emotional and “heart” memories. People with early onset Alzheimer’s disease never lose their heart and soul during the disease process.

“The ability to receive emotional love endures far longer
than the ability to express it.”  –Gary Chapman

The person with early onset Alzheimer’s disease needs to have a sense they are still part of the society they lived in prior to their diagnosis. All of us need connection and to feel that we are doing something that matters—that we are making a difference in someone else’s life. Those with a diagnosis of early onset Alzheimer’s disease are no different.

This connection extends to the care partner as well. As the disease progresses, the amount of time spent caring for the person with the disease increases. Conversations and connections begin to change with the person diagnosed, so having family and friends who can help and provide emotional support makes a tremendous difference.

Below are suggestions for care partners as well as family and friends to stay engaged through the disease process. We recommend that care partners put COVID safety measures in place to protect themselves and the person early onset Alzheimer’s disease.

Family & Friends

• Ask the care partner how you can be supportive. Find out when is the best time of day to visit and what topics are good to discuss.
• If you do not live in close proximity to the person with the disease, connect with them through Zoom or Facetime. Ask the care partner to let you know when it is a good time to call. Keep the calls short and talk about happy times. Do not quiz the person with the disease, but instead talk about happy memories and tell them how glad you are to see them and hear their voice.
• Engage in meaningful activities the person enjoys. This can include walks, listening to music, watching a favorite movie, and getting ice cream.
• Reminisce about good and happy times. Share your memories and let them share what they remember. It is okay if some of the memories are not accurate. The important thing is they are engaging in conversation.
• If the person with early onset Alzheimer’s disease no longer recognizes you, you still know them. Research has shown that people can recognize a person’s voice well into the late stages of the disease. Talk to them. Tell them you love them and how grateful you are that they are in your life. Please keep in mind that just because you may not see any outward signs of recognition, does not mean that recognition is gone. They might not be able to express the recognition.

Care Partners

• Connect with people. Joining a support group, in-person or online, can be a wonderful outlet to meet new people who understand your experiences with the disease.
• When people offer to help with something, let them. Whether it is spending time with the person who has early onset Alzheimer’s disease, or running errands for you, it is important to let people help.
• Have at least one person who you can talk to on a deep and honest level. Every care partner needs someone who they can be honest with and talk through all they are feeling and experiencing.

Personal Note from Laura Sutherland, Founder & Executive Director
If you do not have someone in your support system who you are comfortable talking to about your experiences, I invite you to contact me directly. I was Gayle’s sole care partner and I have experienced the good, bad, and ugly of this disease. Building a community of support and awareness about this disease is why I started the Gayle Wells Foundation. We can set up a regular schedule of phone calls, Zoom calls or face-to-face meetings. I do not want anyone to keep things bottled up inside. Our services are free of charge, and I would love to talk with you and help you through this experience. I can be reached at 832-470-9526 or laura@gaylewells.org.

This month we will share fascinating information on the role the heart plays in making and storing memories.  Heart memories become critically important for those with early onset Alzheimer’s disease. In order to lay the foundation of understanding, below are facts highlighting the physical power of the heart.

Did you know…

• An adult heart is the size of a fist.
• The heart weights between 9 and 12 ounces.
• Your heart beats 115,000 times a day.
• The heart pumps approximately 2,000 gallons of blood per day.
• Neurotransmitters found in the brain have also been identified in the heart.
• When the muscular walls of the heart’s upper chambers contract, the heart produces a hormone that profoundly affects every major organ in the body, including the brain.
• When we experience heart-felt emotions like love, care, appreciation and compassion, the heart produces a different rhythm. A visual printout of this rhythm looks like gently rolling hills.
• Your heart produces enough energy to fly to the moon.
• The brain is programmed for success and the heart is programmed for connection.
• A study conducted by the University of California, Davis revealed that when two people are in love their heartbeats are synchronized.
• The Mayo Clinic reported that broken-heart syndrome, while rare, is a real thing.
• Laughing is good for your heart as it reduces stress and gives a boost to your immune system.

Join us next week as we share ideas for connecting to memories of the heart.

While holiday celebrations may be different this year, safety concerns remain of utmost importance for those living with early onset Alzheimer’s disease. During the holiday season, special decorations may be displayed throughout the home that could pose a hazard to those with the disease. Additionally, care should be taken with special food and beverage items that may be delivered to the home from friends and family. Below are suggested steps to take to keep your holiday season safe for everyone.

Holiday Decorations

• Christmas trees, lights, menorahs, or other decorations should be secured so they do not fall or catch on fire.
• Trade out wick candles for LED candles. LED candles are beautiful and provide a beautiful candlelight glow without creating a fire hazard.
• Remove clutter (stacks of boxes, newspapers, magazines, wrapping paper, etc.) from hallways and walking pathways. Also make sure electric outlets or extension cords are placed away from these potentially flammable items.
• Avoid plugging multiple extension cords into each other.
• Ensure there are no electrical or extension cords running across walking areas  or underneath carpets or rugs, as this can create tripping and fire hazards.

General Safety

• Ensure there are working smoke detectors located throughout the home.
• Keep flashlights easily accessible in each room of the home in case of a power outage.
• Keep a list of emergency telephone numbers in the kitchen (display on refrigerator) and also on the bedside table in the bedroom of your loved one.
• Keep areas free of clutter to decrease the risk of falling.
• Keep power tools and other dangerous equipment in a place that is not accessible to the person with early onset Alzheimer’s disease.
• Remove or lock up all poisonous household items. Colorful cleaning products may be mistaken for food.
• Use the brightest bulbs possible in lamps. This helps decrease shadows, which can be unsettling to the person with early onset Alzheimer’s disease.
• Remove throw rugs as they can be a trip-and-fall hazard.
• Use automatic night-lights in bedrooms, hallways and bathrooms to illuminate the pathway from the bed to the bathroom.

Kitchen

• Make sure there is a working fire extinguisher located in the kitchen.
• Clean out the refrigerator on a weekly basis and discard food items that have expired or are inedible.
• As the disease progresses, you may need to place knives and sharp objects out of reach or utilize safety devices, such as child-proof locks, to limit access to these items.
• Put all garbage out of sight.
• Keep cleaning supplies in a locked place.
• Remove spices or medicines from the counter.
• If alcoholic beverages are in the home, place them out of site or lock them in a cabinet.
• As the disease progresses, it may be necessary to remove the knobs from the stove or cover them so that the person in your care will not notice them.

We invite additional suggestions and ideas in the comments below, if you have found other helpful ways to avoid danger for individuals with early onset Alzheimer’s disease and other forms of dementia. We wish you and your loved ones a safe and happy holiday season.

Providing care to someone with early onset Alzheimer’s disease or other form of dementia is one of the hardest and most stressful roles a person undertakes. During this holiday season, it’s important to remember the sacrifices care partners make, whether they are family, a friend, or a trained healthcare professional.

Below are some gift ideas for care partners. As you consider gift options, keep in mind the personality of the care partner. When they receive the gift, you want them to know you chose it just for them.

Single-Item Gifts

• Sleep mask
• Super-soft throw blanket
• Comfy pajamas
• Dark chocolate
• Nice journal
• Tote bag
• A gift card to their favorite grocery store or drug store
• A massage gift card (most caregivers would NEVER buy one for themselves!)
• Meal delivery – meals can be prepared by friend/family or you can provide the care partner with gift cards for meal delivery. Uber Eats, Grub Hub, and Door Dash all provide gift cards for their services.
• Willow Tree “Just for You” angel (holding ‘Thank You’ sign). Click here to view at Amazon.com.

Gift Basket Ideas

• Dark chocolate/assorted chocolates
• Basket of coffees and/or teas with a nice mug
• Spa basket – lotion, bubble bath/shower gel, lavender pillow spray, bath bombs, exfoliating scrub, lip cream/chapstick
• Hands/feet spa basket (Burt’s Bees has nice hand/foot creams and balms)
• Nail care items, including cuticle cream, nail file/buffer, trimmers, hand wash and soothing cream.
• “Movie Night” – favorite snacks (like popcorn, snack mix, chips & salsa), favorite beverage (soda, sparkling water, juice, iced teas), and some uplifting DVDs or a membership to Netflix or Amazon Prime Video.
• Holiday baskets –New Years, Valentine’s Day, St. Patrick’s Day, Mother & Father’s Day, Memorial Day and summer holidays, birthday, Halloween, Thanksgiving, and religious holidays like Easter, Christmas, and Hanukkah are all great themes for caregiver gift baskets.

Long-Term Care Facilities

If your loved one is living in a long-term care facility, it is wise to check with the care facility in advance so you can work within their COVID-19 protocols for sending gifts to the multiple people providing care. Gift ideas for a team of long-term care workers include:

• Breakfast – trays of breakfast sandwiches, danishes, muffins, bagels, or fresh fruit.
• Lunch or dinner – sandwich trays, salads, hot entrees (such as pasta), and desserts.
• Health basket filled with nourishing snacks such as nuts, protein snacks, and fresh or no-sugar-added dried fruit.
• Having a meal delivered to the care team (if permitted) through Door Dash, Grub Hub or other delivery services can be a wonderful way to show your appreciation. (It is a good idea to let them know in advance so they can plan meal breaks accordingly.)
• Basket containing personal care gifts labeled for each person on the care team, such as individual hand creams, bath fizzies, foot soak, or other thoughtful self-care items.
• A beautiful calendar that can be displayed in the care facility that reminds the care team of your gratitude throughout the coming year. You can even personalize a calendar or write messages throughout the calendar’s pages for them to discover during the year.

As you consider gift ideas for your loved one, assess the stage of the disease your loved one is in when shopping for gifts.  Below are some gift ideas by stage of the disease:

Early Stage Gifts

• Activity books, like crossword puzzles or strategy games.
• Classic movies and television shows than can stimulate your loved one.
• CD’s and music that allow your loved one to reminisce.
• A memorable photo album or calendar that features special family occasions and family photos.
• A memory phone that can store photos with the contact information and names of your loved one’s family and friends.

Middle Stage Gifts

• CD’s and music that allow your loved one to reminisce.
• A large type-faced clock that highlights both the date and time.
• Simple craft activities that inspire reminiscing.
• Photo album/scrapbook of past holidays gatherings.

Late Stage Gifts

Sensory stimulating gifts are important in the late stages of the disease.  Gift ideas include:

• A fluffy bathrobe or a soft blanket in a favorite color.
• A stuffed animal or sensory board.
• Music and CD’s that feature songs from your loved one’s childhood or teenage years.
• Hand lotion in a familiar scent like vanilla.

Note:  Vanilla-scented lotion can often stimulate one’s appetite.  If your loved one has a decreased appetite, try massaging their hands with vanilla-scented lotion 30 minutes prior to mealtime.  It could help increase their appetite.

Activity Ideas

Create activities around some of your loved one’s favorite memories or traditions.  Be sensitive to their energy level and any special circumstances.  Stay away from any activities that seem to evoke a negative or upsetting reaction ( e.g. loud noises in a movie).  Let your loved one be the guide.  Activity ideas could include:

• Singing holiday songs familiar to the person with Alzheimer’s disease.
• Watching a favorite holiday movie together.
• Baking/decorating cookies or wrapping gifts.
• Read aloud your loved one’s favorite poem or Christmas story.