Advance directives
Written documents, completed and signed when a person is
legally competent, that explain a person's medical wishes
in advance, allowing someone else to make treatment decisions
on his or her behalf later in the disease process.
Aggression
Hitting, pushing or threatening behavior that commonly occurs
when a caregiver attempts to help an individual with Alzheimer's
with daily activities, such as dressing. It is important
to control such behavior because aggressive people can cause
injury to themselves and others.
Agitation
Vocal or motor behavior (screaming, shouting, complaining,
moaning, cursing, pacing, fidgeting, wandering, etc.) that
is disruptive, unsafe or interferes with the delivery of
care in a particular environment. An abnormal behavior is
considered agitation only if it poses risk or discomfort
to the individual with Alzheimer's or his or her caregiver.
Agitation can be a nonspecific symptom of one or more physical
or psychological problems (e.g., headache, depression).
Alzheimer's disease
A progressive, neurodegenerative disease characterized by
loss of function and death of nerve cells in several areas
of the brain, leading to loss of mental functions such as
memory and learning. Alzheimer's disease is the most common
cause of dementia.
Amyloid plaque
Abnormal cluster of dead and dying nerve cells, other brain
cells and amyloid protein fragments. Amyloid plaques are
one of the characteristic structural abnormalities found
in the brains of individuals with Alzheimer's. Upon autopsy,
the presence of amyloid plaques and neurofibrillary tangles
is used to positively diagnose Alzheimer's.
Anxiety
A feeling of apprehension, fear, nervousness or dread accompanied
by restlessness or tension.
Apathy
Lack of interest, concern or emotion.
Aphasia
Difficulty understanding the speech of others and/or expressing
oneself verbally.
Assessment
An evaluation, usually performed by a physician, of a person's
mental, emotional and social capabilities.
Assisted living facility
A residential care setting that combines housing, support
services and health care for people typically in the early
or middle stages of Alzheimer's disease.
Behavioral symptoms
In Alzheimer's disease, symptoms that relate to action or
emotion, such as wandering, depression, anxiety, hostility
and sleep disturbances.
Caregiver
The primary person in charge of caring for an individual
with Alzheimer's disease, usually a family member or a designated
health care professional.
Care planning
A written action plan containing strategies for delivering
care that address an individual's specific needs or problems.
Central nervous system (CNS)
One of the two major divisions of the nervous system. Composed
of the brain and spinal cord, the CNS is the control network
for the entire body.
Coexisting illness
A medical condition that exists simultaneously with another,
such as arthritis and dementia.
Cognitive abilities
Mental abilities such as judgment, memory, learning, comprehension
and reasoning. Cognitive symptoms In Alzheimer's disease,
the symptoms that relate to loss of thought processes, such
as learning, comprehension, memory, reasoning and judgment.
Continuum of care
Care services available to assist individuals throughout
the course of the disease.
Creutzfeldt-Jakob disease (CJD)
A rare, ultimately fatal disorder of infectious or genetic
origin that typically causes memory failure and behavioral
changes. A recently identified form called variant Creutzfeldt-Jakob
disease (vCJD) is the human disorder thought to be caused
by eating meat from cattle affected by "mad cow disease"
(bovine spongiform encephalopathy). VCJD tends to appear
in much younger individuals than those affected by sporadic
or inherited Creutzfeldt-Jakob.
Cueing
The process of providing cues, prompts, hints and other
meaningful information, direction or instruction to aid
a person who is experiencing memory difficulties.
Deficits
Physical and/or cognitive skills or abilities that a person
has lost, has difficulty with or can no longer perform due
to his or her dementia.
Dementia
The loss of intellectual functions (such as thinking, remembering
and reasoning) of sufficient severity to interfere with
a person's daily functioning. Dementia is not a disease
itself but rather a group of symptoms that may accompany
certain diseases or conditions. Symptoms may also include
changes in personality, mood and behavior. Dementia is irreversible
when caused by disease or injury but may be reversible when
caused by drugs, alcohol, hormone or vitamin imbalances
or depression.
Disorientation
A cognitive disability in which the senses of time, direction
and recognition become difficult to distinguish.
Early-onset Alzheimer's disease
An unusual form of Alzheimer's in which individuals are
diagnosed with Alzheimer's before the age of 65. Less than
10 percent of all Alzheimer's patients have early-onset.
Early-onset Alzheimer's is associated with mutations in
genes located on chromosomes 1, 14 and 21.
Early stage
The beginning stages of Alzheimer's disease when an individual
experiences very mild to moderate cognitive impairments.
Familial Alzheimer's disease
A form of Alzheimer's disease that runs in families.
Gait
A person's manner of walking. People in the later stages
of Alzheimer's often have "reduced gait," meaning
their ability to lift their feet as they walk has diminished.
Genetic susceptibility
The state of being more likely than the average person to
develop a disease as a result of genetics.
Hallucination
A sensory experience in which a person can see, hear, smell,
taste or feel something that isn't there.
Huntington's disease
An inherited, degenerative brain disease affecting the mind
and body, characterized by intellectual decline and involuntary
movement of limbs.
Incontinence
Loss of bladder and/or bowel control.
Late-onset Alzheimer's disease
The most common form of Alzheimer's disease, usually occurring
after age 65. Late-onset Alzheimer's strikes almost half
of all people over the age of 85 and may or may not be hereditary.
Late stage
Designation given when dementia symptoms have progressed
to the extent that a person has little capacity for self-care.
Layering
Behavior that involves inappropriately changing or layering
clothing on top of one another.
Memory
The ability to process information that requires attention,
storage and retrieval.
Multi-infarct dementia (MID)
A form of dementia, also known as vascular dementia, caused
by a number of strokes in the brain. These strokes can affect
some intellectual abilities, impair motor and walking skills
and cause an individual to experience hallucinations, delusions
or depression. The onset of MID is usually abrupt and often
progresses in a stepwise fashion. Individuals with MID are
likely to have risk factors for strokes, such as high blood
pressure, heart disease or diabetes. MID cannot be treated;
once the nerve cells die, they cannot be replaced. However,
risk factors can be treated, which may help prevent further
damage.
Neurodegenerative disease
A type of neurological disorder marked by the loss of nerve
cells. See Alzheimer's disease, Parkinson's disease.
Neurofibrillary tangle
Accumulation of twisted protein fragments inside nerve cells.
Neurofibrillary tangles are one of the characteristic structural
abnormalities found in the brains of Alzheimer patients.
Upon autopsy, the presence of amyloid plaques and neurofibrillary
tangles is used to positively diagnose Alzheimer's.
Neurological disorder
Disturbance in structure or function of the nervous system
resulting from developmental abnormality, disease, injury
or toxin.
Onset
Defines time of life when Alzheimer's disease begins (e.g.,
early-onset, late-onset).
Pacing
Aimless wandering, often triggered by an internal stimulus
(e.g., pain, hunger or boredom) or some distraction in the
environment (e.g., noise, smell, temperature).
Paranoia
Suspicion of others that is not based on fact.
Parkinson's disease
A progressive, neurodegenerative disease characterized by
the death of nerve cells in a specific area of the brain;
the cause of nerve cell death is unknown. Parkinson's patients
lack the neurotransmitter dopamine and have such symptoms
as tremors, speech impediments, movement difficulties and
often dementia later in the course of the disease.
Perseveration
Persistent repetition of an activity, word, phrase or movement,
such as tapping, wiping and picking.
Pick's disease
Type of dementia in which degeneration of nerve cells causes
dramatic alterations in personality and social behavior
but typically does not affect memory until later in the
disease.
Prevalence
The total number of individuals who have a disease at a
given point in time. For example, the estimate that 4.5
million Americans currently have Alzheimer's disease is
a prevalence statistic. Incidence is the number of new cases
expected to occur over the course of a year or some other
limited period.
Psychosis
A general term for a state of mind in which thinking becomes
irrational and/or disturbed. It refers primarily to delusions,
hallucinations and other severe thought disturbances.
Reassurance
Encouragement intended to relieve tension, fear and confusion
that can result from dementing illnesses.
Reinforcement
Employment of praise, repetition and stimulation of the
senses to preserve a person's memory, capabilities and level
of self-assurance.
Reminiscence
Life review activity aimed at surfacing and reviewing positive
memories and experiences.
Repetitive behaviors
Repeated questions, stories and outbursts or specific activities
done over and over again, common in people with dementia.
Respite
A short break or time away.
Respite care
Services that provide people with temporary relief from
tasks associated with caregiving (e.g., in-home assistance,
short nursing home stays, adult day care).
Restraints
Devices used to ensure safety by restricting and controlling
a person's movement. Many facilities are "restraint-free"
or use alternative methods to help modify behavior.
Risk factors
Factors that have been shown to increase one's odds of developing
a disease. In Alzheimer's disease, the only established
risk factors are age, family history and genetics.
Rummaging
Searching through one's own or someone else's belongings
in a way that may seem haphazard and undirected to an observer.
Safe return
The Alzheimer's Association's nationwide identification,
support and registration program that assists in the safe
return of individuals with Alzheimer's or related dementia
who wander and become lost.
Senility
Term meaning "old," once used to describe elderly
diagnosed with dementia. Today, dementia is known to be
caused by various diseases (e.g., Alzheimer's) and is not
a normal part of aging.
Shadowing
Following, mimicking and interrupting behaviors that people
with dementia may experience.
Sundowning
Unsettled behavior evident in the late afternoon or early
evening.
Suspiciousness
A mistrust common in Alzheimer's patients as their memory
becomes progressively worse. A common example is when patients
believe their glasses or other belongings have been stolen
because they forgot where they left them.
Trigger
An environmental or personal stimulus that sets off particular
and sometimes challenging behavior.
Wandering
Common behavior that causes people with dementia to stray
and become lost in familiar surroundings.