Rush Manual - Contents and Foreward
FOREWARD

Loss of memory and other cognitive abilities have been
recognized since antiquity. However, the modern age of
Alzheimer's disease is less than 100 years old. In 1906, Dr. Alois
Alzheimer described the case of a relatively young woman (in
her 50s) who suffered from a rare form of progressive dementia.
At the time of death, she underwent brain autopsy. Taking
advantage of recent advances in neuropathology, Dr. Alzheimer
described numerous neurofibrillary tangles and neuritic plaques
in the woman's brain, which he presumed to be the cause of her
progressive dementia. We now know that these are the same
lesions found in the brains of older persons with dementia (or
senility) and this too is Alzheimer's disease.

In 1906, when Dr. Alzheimer described his patient, life
expectancy for the average American was less than 50 years.
Remarkable medical advances over the past century have
resulted in a marked increase in life expectancy so that a person
born this year can reasonably expect to live to about age 80.
Thus, greater numbers of persons are living to the age when
Alzheimer's disease becomes common. There are currently an
estimated four to five million Americans with the disease. That
number is expected to triple over the next 50 years, making
Alzheimer's disease among the most common – and most feared
– chronic, age-related neurologic diseases.

The Rush Alzheimer's Disease Center (RADC) is dedicated to
reducing disability due to Alzheimer's disease and other age-
related neurologic conditions through clinical care, education
and research. Since 1987, the RADC has been designated by
the Illinois Department of Public Health as the Regional
Alzheimer's Disease Assistance Center for Northern Illinois. In
addition, the RADC has been designated since 1991 as an
Alzheimer's Disease Core Research Center by the National
Institute on Aging. The RADC's multidisciplinary clinical and
educational staff is dedicated to creating an atmosphere that
promotes the best possible care for people with these conditions.

Managing the care of someone with Alzheimer's disease
requires patience, compassion and skills that go beyond the
sophisticated therapies that characterize much of modern
medical practice. The patient has a disease that frequently
changes one's personality, robs a spouse of one's partner or a
child of one's parent, and costs tens of thousands of dollars for
care. An ongoing relationship between the RADC's staff and the
patient's family is needed to ensure that the patient is kept in a
stimulating and supportive environment if hospitalization, insti-
tutionalization and caregiver distress are to be avoided. While
there are several pharmacologic options for treating the cogni-
tive dysfunction and behavioral disturbances associated with
Alzheimer's disease, there are many areas in which other types of
intervention also can markedly improve the quality of life for
both the patient and the family.

The way to improve the care of persons with Alzheimer's
disease for future generations requires treatment and prevention
strategies that will only come from the conduct of large, carefully
designed longitudinal research studies. The RADC is at the fore-
front of such efforts. The National Institute on Aging has
funded the Religious Orders Study since 1993 and the Memory
and Aging Project since 2001. The RADC is nationally recog-
nized for its clinical and basic-science research efforts that seek
to understand the causes of Alzheimer's disease and other
common neurologic diseases of aging. Our hope is that through
our ongoing research efforts, we will learn how to improve the
lives of people with these conditions and how to prevent these
conditions from affecting our loved ones and future generations.

This sixth edition of The Rush Manual for Caregivers, reflects
the vast experience of the RADC's dedicated team of physicians,
psychologists, gerontologists, nurses and social workers who have
evaluated thousands of patients over the past 20 years. We have
learned much from our patients and caregivers and we will
continue to learn from them in the years to come. This manual
reflects the combined wisdom of both the RADC staff and the
many people who have shared with us the joys and sorrows of
taking care of someone with Alzheimer's disease.

David A. Bennett, M.D.
Director, Rush Alzheimer's Disease Center


CONTENTS

Foreward

1. What is Dementia?

Understanding Dementia
The Stages of Alzheimer's Disease
Treatment of Alzheimer's Disease
Participating in Research

2. Communication

Bridging the Communication Gap
Helping the Person Who Is Aware of Memory Loss
Changes in Marital Intimacy

3. The Family Needs Care Too

Care for the Caregiver
Involving Family and Friends
Helping Children Cope
Acknowledging Spiritual Needs
Taking Charge of Legal Matters

4. Safety Concerns

Tips for Traveling
The Dangers of Driving
Creating a Safe Home

5. Providing Daily Care

Keeping Active
Ensuring Personal Hygiene
Promoting Mobility and Exercise
Dealing with Incontinence
Addressing Nutritional Needs

6. Managing Health and Understanding Behaviors

Understanding Behavior as a Form of Communication
Common Medications
Facts about Basic Medical Problems
Easing a Trip to the Emergency Room
Coping with a Hospitalization

7. Getting Outside Help

Using Community Resources
Understanding Government Benefits
Finding the Best Living Arrangement
Selecting a Nursing Home
Hospice Care

8. Selected Resources

Books
Videos
Internet Sites


Sixth Edition
The Rush Alzheimer's Disease Center
710 South Paulina Street, 8 North
Chicago, IL 60612
312-942-4463