According to the Family Caregiver Alliance, it is estimated that 8.9 million Americans care for someone with Alzheimer's disease(or other form of dementia) in a home setting. If you are one of these caregivers, you realize, or soon will, that the level and type of care needed by a person with Alzheimer's disease (AD) is ever changing.  You will experience "good days" and "bad days" and,  as the disease progresses, new symptoms may appear and/or old ones worsen.  Being flexible and patient with a person with AD is a must.
   As the caregiver, it is important that you keep in mind that the disease affects the brain DIRECTLY and the body INDIRECTLY.  A person who suffers from AD may be physically healthy otherwise, but due to the deterioration of certain parts of the brain, the body doesn't respond as it should.  The U.S. Department of Health and Human Services; National Institutes of Health & National Institute on Aging, have compiled some guidelines and safety tips in regards to the degeneration of the five senses and how it will affect the person with AD:

SIGHT-As was mentioned earlier, there may be nothing wrong with the eyes of an AD patient, however the brains ability to interpret the images may be decreased.  This can cause confusion, disorientation and the inability to recognize familiar people or places. A few tips to manage this decline would be to:

• Create color contrast between floors and walls to create visual "depth".
• Mark the edges of steps with brightly colored strips of tape to identify height changes.
• Place brightly colored signs or simple pictures on doors for easier identification. (i.e. bathroom, bedroom, etc.)
• Be aware of small pets that may lie in walkways.

SMELL-It is very common for smell to be the first sense affected by AD.  In most cases, it is noticed before the diagnosis of Alzheimer's has been made.  Though, a loss in smell does not indicate that one has AD, it is advised that one consult a physician for an Alzheimer's screening.
It is important to:

• Install smoke detectors and check them frequently.
• Keep refrigerators clear of spoiled food.

TASTE-If you've ever noticed that when you nose is stopped up due to a cold or infection, your sense of taste is greatly decreased.  The loss of smell plus the added decrease in taste bud sensitivity, can really affect the way a person with AD tastes things.  There is also the danger of confusion, leading them to place hazardous items in their mouths.  Some simple recommendations would be to:

• Keep all condiments hidden and locked away if you notice the AD patient using excess amounts.
• Lock up toiletries and cleaning supplies.
• Learn the Heimlich maneuver.

HEARING-As in the case of the eyes, a person could test as having perfect hearing, but not be able to process sounds.  This can lead to agitation, confusion or over stimulation.  You should:

• Avoid excessive noise in the home. (i.e. Having the stereo and television on at the same time)
• Be aware of noise outside the home.
• Avoid large gatherings of people in the home.

TOUCH-As with all of the others senses, sensitivity in touch decreases.  Depending on how severe the loss is, a person with AD may not be able to recognize being cold or hot or even being in pain.  Many of the steps recommended are similar to childproofing your house.  Things to consider:

• Set water heaters at 120 degrees Fahrenheit.
• Color code water faucet handles. (i.e. Red for hot and blue for cold)
• Place warning signs on the oven and other appliances that get hot.
• Cover corners of furniture with padding.

As a caregiver, you will have the best knowledge as to what the care recipient needs.  It is important that you find a balance of being watchful and yet, still allowing them to be as independent as they can be, without sacrificing safety.  If you have questions or would like more information on making the home safer for someone with AD, call The Alzheimer's Disease Education and Referral Center at 1-800-438-4380 or visit www.nia.nih.gov/Alzheimers

If you are a caregiver, what are some of the tips you can offer our readers? Please leave comments or share your experiences.