Knowledge is the first act of care.

Alzheimer's Disease

The most common form. Caused by abnormal protein deposits (amyloid plaques and tau tangles) that damage brain cells. Typically begins with short-term memory loss and gradually affects language, reasoning, and eventually physical function.

• Early signs: Forgetting recent events, misplacing items, difficulty with familiar tasks
• Progression: Usually 4–8 years after diagnosis, though some live 20 years
• Key fact: Long-term memories (childhood, music, emotions) are preserved far longer than short-term recall

Vascular Dementia

Caused by reduced blood flow to the brain, often after strokes or chronic cardiovascular conditions. Symptoms depend on which brain regions are affected.

• Early signs: Impaired judgment, difficulty planning, slower thinking speed
• Unique trait: May progress in sudden "steps" rather than gradual decline
• Prevention factor: Managing blood pressure, diabetes, and cholesterol can reduce risk

Lewy Body Dementia

Caused by abnormal protein deposits (alpha-synuclein) called Lewy bodies. Shares symptoms with both Alzheimer's and Parkinson's disease.

• Key symptoms: Visual hallucinations, fluctuating alertness, movement difficulties
• Important: People with LBD can be extremely sensitive to antipsychotic medications — always inform doctors
• Unique trait: Vivid, detailed visual hallucinations that the person may recognize as unreal

Frontotemporal Dementia

Affects the frontal and temporal lobes — areas controlling personality, behavior, and language. Often diagnosed in people in their 40s–60s.

• Behavioural variant: Personality changes, impulsivity, loss of empathy, compulsive behaviours
• Language variant: Difficulty finding words, understanding speech, or naming objects
• Misdiagnosis risk: Often mistaken for psychiatric conditions due to behavioural changes

Visiting Tips

• Come with no agenda. You're not there to accomplish anything — you're there to be present
• Bring something sensory: A favourite treat, hand lotion, flowers to smell, a familiar blanket
• Don't quiz them. "Do you remember...?" causes anxiety. Instead, share: "I was just thinking about the time we..."
• Match their energy. If they're calm, be calm. If they're anxious, be gently soothing. Don't try to force cheerfulness
• Short and warm beats long and exhausting. A meaningful 20-minute visit matters more than a draining 2-hour one

Handling Difficult Moments

• They don't recognize you: It's okay. Don't correct. Introduce yourself warmly: "Hi Nan, it's Cody — your grandson. I'm so happy to see you"
• They're agitated: Validate their emotion, not the content. "You seem upset. I'm here. You're safe." Then redirect to something comforting
• They repeat themselves: Respond as if it's the first time. Every time. This is kindness, not dishonesty
• They say something hurtful: It's the disease, not the person. Breathe. Walk away if you need to. Come back when you're ready

Anticipatory Grief

You are grieving someone who is still alive. This is called anticipatory grief, and it is real, valid, and devastating. You may feel:

• Guilt for mourning someone who hasn't died
• Anger at the disease, at God, at the unfairness of it all
• Sadness that visits trigger more than they resolve
• Relief when they have a bad day — and then guilt about the relief

All of these are normal. You are not broken. You are loving someone through the hardest possible circumstance.

General Home

• Remove loose rugs and clutter — fall risk #1
• Install motion-activated night lights in hallways and bathrooms
• Lock away or remove: medications, cleaning products, sharp objects, car keys
• Consider door alarms or smart locks to prevent wandering
• Reduce mirrors if they cause confusion (some people don't recognize their reflection)
• Label cabinets and drawers with words AND pictures

Bathroom

• Install grab bars near toilet and in shower/tub
• Use a shower chair and handheld showerhead
• Set water heater to max 49°C (120°F) to prevent scalding
• Use coloured toilet seats (contrast helps visibility)
• Remove locks from bathroom doors (or reverse them) to prevent being locked in
• Non-slip mats inside and outside the tub

Kitchen

• Install automatic stove shut-off devices
• Remove or lock knife blocks and sharp utensils
• Use contrasting colours for plates/table (white plate on dark placemat helps visibility)
• Simplify the fridge — remove expired items, label leftovers clearly
• Consider removing stove knobs when not in use

Wandering Prevention

• GPS tracking: Apple Watch, AirTags, GPS pendants
• Door sensors: Smart sensors that alert caregivers when exterior doors open
• Visual barriers: Dark mats in front of doors can look like holes and deter exit
• Routine: Wandering often increases with boredom or anxiety — structured activity helps
• ID bracelet: Ensure they carry identification at all times
• Register: Enrol in the Alzheimer Society's MedicAlert Safely Home program

Current State of Treatment

• Cholinesterase inhibitors (donepezil, rivastigmine, galantamine): Can modestly slow symptoms in mild-to-moderate Alzheimer's. Not a cure
• Memantine: Used in moderate-to-severe Alzheimer's. May help with daily function and behaviour
• Lecanemab (Leqembi): First FDA-approved drug to slow Alzheimer's progression by targeting amyloid plaques. Under review in Canada. Requires IV infusions and monitoring for brain swelling
• Non-pharmacological interventions: Music therapy, light therapy, exercise, cognitive stimulation, and validation therapy have strong evidence for improving quality of life

Risk Reduction

Up to 40% of dementia cases may be linked to modifiable risk factors (Lancet Commission, 2020):

• Hearing loss (mid-life) — get hearing aids
• Hypertension — manage blood pressure
• Physical inactivity — 150 minutes/week of exercise
• Social isolation — maintain connections
• Diabetes — manage blood sugar
• Excessive alcohol — limit to moderate consumption
• Air pollution — reduce exposure where possible
• Traumatic brain injury — wear helmets, prevent falls
• Depression — seek treatment early
• Smoking — quit at any age
• Obesity — maintain healthy weight
• Low education — lifelong learning is protective

Ongoing Research Areas

• Blood tests for early detection: Researchers are developing blood-based biomarkers (p-tau217) that may detect Alzheimer's years before symptoms
• Gut-brain axis: Emerging evidence links gut microbiome health to neurodegeneration
• Sleep and dementia: Chronic sleep deprivation increases amyloid accumulation. Sleep may be both a risk factor and intervention target
• AI and ambient monitoring: Systems like reMind represent a new frontier — using environmental intelligence for preventive, non-invasive care
• Clinical trials: Search for trials at clinicaltrials.gov or alzheimer.ca/research