There is no cure for Alzheimer's. The medications that are available may help to slow down the progress of the disease but nothing has been found to stop the gradual deterioration of the brain.
In the absence of a cure, much emphasis is placed on the care and care planning processes for people with this condition. There is continuing controversy about the availability of actylcholinesterase inhibitors (donezepil, galantamine and rivastigmine)- the National Institute for Clinical Excellence (NICE) has said that these drugs should only be made available (with several coditions) to people with Alzheimer's Disease of moderate severity.
Memantine, which has been used for people with moderately severe to severe Alzheimer's can now only be used as part of "well-designed" clinical studies.
The whole issue of medication for people with Alzheimer's is controversial and NICE's findings have been challenged through the courts. The position as described above is accurate as of September 2007 but this may change. For those wishing to find out more, the NICE site has its latest appraisal of the drugs whereas the Alzheimer's Society has campaigned for these to be more widely available.
With regard to health and social care the NICE guidance makes detailed recommendations as to what should be included in care plans:
The guidance also recommends the use of cognitive stimulation approaches with people with mild to moderate dementia, emphasis is placed on the importance of the carers undertaking this work in an appropriate, respectful and person-centred manner. Cognitive stimulation involves exposure to and involvement with activities and materials requiring some kind of cognitive processing. This can either be carried out in groups or on an individual basis.
Behaviour that challenges is a common feature of Alzheimer's. Challenging behaviours include aggression, wandering, disinhibition and agitation. These can put enormous pressures on carers who often don't know how to respond and often feel completely powerless. The NICE guidance acknowledges that behaviour management techniques have had some success with these problematic behaviours but also emphasises the need for an indivualised, tailored approach. Evidence suggests that its a really good idea to avoid compounding or making worse feelings of failure and humiliation in people with dementia as this has been shown to exacerbate negative behaviours.
Aggressive Behaviours
The Alzheimer's Society has a very useful factsheet that sets out the basics for carers dealing with aggressive behaviour:
