M Kaleem Arshad, MD explains best practices for managing Alzheimer’s disease

A condition which is difficult to manage, Alzheimer’s disease patients often suffer from pain, depression, anxiety, medication interactions, and changes in their environment. The source of much agitation, managing these and other complaints and complications calls for a broad spectrum of care.

“The behavioral symptoms are what many individuals with Alzheimer’s and their families find to be the most challenging and distressing effects of the disease,” explains M Kaleem Arshad MD, a board-certified geriatric psychiatrist and former President of Louisiana Psychiatric Medical Association.

Kaleem Arshad MD reveals that, in the U.S., Alzheimer’s disease is the sixth biggest cause of death, as well as a leading cause of disability and poor health in those aged over 65, according to the Alzheimer’s Association.

Alzheimer’s disease typically develops slowly, gradually worsening over a period of several years, according to the doctor. “The rate of progression varies widely and can last more than a decade,” he explains. “On average, an individual will live for four to eight years following diagnosis, although some survive for 20 years or more with the disease.”

During this time, Kaleem Arshad MD explains that managing the disease is key. Monitoring behavioral changes and communicating, as best as possible, are vital according to the doctor.

Often defined in stages, known as a mild or early stage, moderate or middle stage, and severe or late stage, Alzheimer’s disease becomes increasingly difficult to manage as a patient’s health declines, says Kaleem Arshad MD.

Early Stages
“In the early stage, take time to listen to how the person is feeling, what they’re thinking, or what they may need,” he suggests. “Give them time to respond. Don’t interrupt or finish sentences unless they ask for help, for example in finding a word.”

Once symptoms progress and a patient enters middle stage Alzheimer’s disease, things become more difficult according to Kaleem Arshad MD. “This is the longest stage of the disease, often lasting for several years,” he reveals.

“Be patient and supportive,” suggests the doctor. “Offer comfort and reassurance, speak slowly and clearly, maintain eye contact when communicating, and avoid criticizing or correcting.”

Kaleem Arshad MD also advises avoiding arguing during this time, and not overwhelming the patient with lengthy requests. “Offer clear, step-by-step instructions for tasks, and ask yes or no questions, one at a time,” he adds. “For example, ‘would you like some coffee?’ rather than ‘what would you like to drink?’”

Later Stages
As a patient enters late-stage Alzheimer’s disease, Kaleem Arshad MD explains that memory loss becomes more severe and that individuals may lose all ability to communicate, relying heavily on their caregivers.

“During this time, treat the person with dignity and respect,” says Kaleem Arshad MD. “Always approach them from the front and identify yourself. Engage in nonverbal communication — ask the person to point or gesture.”

According to Kaleem Arshad MD, at this stage, the emotions being expressed are often more important than what’s being said.

“Look for the feelings behind words, sounds, or gestures,” he adds, wrapping up, “and use touch, sight, sounds, and smells as forms of communication, especially toward the end.”

M Kaleem Arshad, MD is Distinguished Life Fellow of American Psychiatric Association who Diplomate of American Board of Psychiatry and Neurology. He has practiced geriatric psychiatry over the last 28 years in the New Orleans area and is board certified in the subspecialty.

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