Care Mountain has home health care leadership experience since 1986 helping families provide care at home for Alzheimer’s disease, and care at home for other types of dementia.  It is from this experience that most of the information in this article is derived from.

Most health conditions we provide home health care for do require a higher level of caregiver skill as the disease or health condition progresses. But, with the home care for Alzheimer’s disease, I believe the earlier stages often require the most skilled and experienced Dallas area caregivers.  While there are several factors impacting this belief, it is acceptance of the disease that I feel is the most predominant factor.

A relevant definition of “acceptance” is “not fighting reality”. One common manifestation of earlier stages of Alzheimer’s disease is a personality change, and/or a reduced ability to easily cope with daily matters.  Without an accepted diagnoses of Alzheimer’s disease, I hear many caregivers, especially spouses, take things as personally directed toward them.  That’s when I hear things like he/she is constantly being rude to me, difficult, selfish or just doesn’t seem to understand or care how I feel.  The person with Alzheimer’s disease will often have the same feelings, since they will experience an agitated or frustrated response to their actions from the caregiver who does not yet know or accept the reality of their Alzheimer’s disease.

When one or both sides do not have a full acceptance of the reality of an Alzheimer’s diagnosis, I often see them “fighting” each other. Husbands and wives, parents and adult children in frequent elevated instances of confrontation.  Often these confrontations involve a legitimate safety issue (i.e.; driving) that drives both sides to dig into their opposing positions, thus further elevating the confrontation.  Alzheimer’s disease is one of the most team intensive home care situations, meaning others in the living environment are more deeply impacted and impact-full.  Team members “fighting” each other will certainly not obtain desired results easy.

A diagnosis of Alzheimer’s disease certainly does not always result in acceptance and as a result diminished confrontation. The person with the diagnosis may never be willing and/or able to accept this diagnoses, and their significant other(s) may take days, months, years or also not be able or willing to accept it either.  I have worked with couples in which the spouse without the disease passed away before their loved one due in a large part to the amount of stress he/she had to deal with as a result of an inadequate lack of acceptance.

As Alzheimer’s disease progresses I feel we have many more easily implementable tactics that a caregiver can use to avoid heightened levels of agitation in the Alzheimer’s inflicted person. These can include simple redirection and music therapy, which will not be too effective in the earlier stages when the person has a much higher level of self awareness and cognition. With the advent of time and increasingly undeniable symptoms of this disease manifesting themselves, more and more caregivers will come to adequate acceptance, which means there coping strategies will have an increasingly favorable outcome for all involved.

When I am visiting Dallas area families to provide a free home health care Alzheimer’s assessment, I hear spouses often say how lucky they are that their spouse doesn’t have the angry form of Alzheimer’s, since things stay relatively calm. I then mention to them that their spouse’s calm behavior has mainly to do with the calmness maintained in the environment.  And in ALL these cases I hear the spouse explain how they came to accept this disease, which made things a lot easier on everybody.

Two client examples come to mind from a few years back.  Karen called Care Mountain for Alzheimer’s home care in Richardson, Texas for her husband. Karen said her husband’s behavior was not a big challenge for her and he was calm most of the time.  She explained how most of the time he thinks she is his sister, but she just goes along with it. There are many times he is wanting to do things that just don’t make sense, but she finds a pleasant way to redirect him to a comfort zone. Around the same time we had the husband (purposely not using his name) of another couple call Care Mountain for Alzheimer’s home care in Coppell, Texas.  When I met the husband for the assessment he explained how stressed out he was because his wife (with diagnosed Alzheimer’s disease) was so uncooperative with him and argumentative.  He explained with determination how he was working so hard at this, but could not understand why things were not working out. He said he felt like his wife had the angry form of Alzheimer’s disease. He told me how hard he tried to convince his wife that he was not her dad, how hard he tried to explain to her that she was repeating the same things over and over again which was causing stress on him to keeping answering the same question etc….I know acceptance of this disease is only easy if you don’t care.

Some local helpful resources in working through an understanding and acceptance of Alzheimer’s disease can found at: Alzheimer’s Association Greater Dallas Chapter, Alzheimer’s Association North Central Texas and the University of North Texas Health Science Center.



The Earlier Stages of Alzheimer’s Disease May Require the Highest Level of Caregiver Skills: An In Home Care For Alzheimer’s Guide For Richardson, TX & Dallas, TX Area Families

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