Activity and exercise
Being active and getting exercise helps people with AD feel better. Exercise helps keep their muscles, joints, and heart in good shape. It also helps people stay at a healthy weight and have regular toilet and sleep habits. You can exercise together to make it more fun.
You want someone with AD to do as much as possible for himself or herself. At the same time, you also need to make sure that the person is safe when active.
Here are some tips for helping the person with AD stay active:
- Take a walk together each day. Exercise is good for caregivers, too!
- Make sure the person with AD has an ID bracelet with your phone number if he or she walks alone.
- Check your local TV guide to see if there is a program to help older adults exercise.
- Add music to the exercises if it helps the person with AD. Dance to the music if possible.
- Watch exercise videos/DVDs made for older people. Try exercising together.
- Make sure he or she wears comfortable clothes and shoes that fit well and are made for exercise.
- Make sure the person drinks water or juice after exercise.
- For more information on exercise and physical activity, visit www.nia.nih.gov/Go4Life  or call 1-800-222-2225.
Some people with AD may not be able to get around well. This is another problem that becomes more challenging to deal with as the disease gets worse.
Some possible reasons for this include:
- Trouble with endurance
- Poor coordination
- Sore feet or muscles
- Depression or general lack of interest
Even if people have trouble walking, they may be able to:
- Do simple tasks around the home, such as sweeping and dusting.
- Use a stationary bike.
- Use soft rubber exercise balls or balloons for stretching or throwing back and forth.
- Use stretching bands, which you can buy in sporting goods stores. Be sure to follow the instructions.
Eating healthy foods helps us stay well. It's even more important for people with AD. Here are some tips for healthy eating.
When a person with AD lives with you:
- Buy healthy foods such as vegetables, fruits, and whole-grain products. Be sure to buy foods that the person likes and can eat.
- Buy food that is easy to prepare, such as pre-made salads and single food portions.
- Have someone else make meals if possible.
- Use a service such as Meals on Wheels, which will bring meals right to your home. For more information, check your local phone book, or contact the Meals on Wheels organization at 1-888-998-6325 (www.mowaa.org ). See "Meal services"  for more information about this service.
When a person with early-stage AD lives alone:
- Follow the steps above.
- Buy foods that the person doesn't need to cook.
- Call to remind him or her to eat.
In the early stage of AD, the person's eating habits usually don't change. When changes do occur, living alone may not be safe anymore.
Look for these signs to see if living alone is no longer safe for the person with AD:
- The person forgets to eat.
- Food has burned because it was left on the stove.
- The oven isn't turned off.
For tips on helping someone with late-stage AD eat well, see "How to make sure the person eats well" .
At some point, people with AD will need help bathing, combing their hair, brushing their teeth, and getting dressed. Because these are private activities, people may not want help. They may feel embarrassed about being naked in front of caregivers. They also may feel angry about not being able to care for themselves. Below are suggestions that may help with everyday care.
Helping someone with AD take a bath or shower can be one of the hardest things you do. Planning can help make the person's bath time better for both of you.
The person with AD may be afraid. If so, follow the person's lifelong bathing habits, such as doing the bath or shower in the morning or before going to bed. Here are other tips for bathing.
- Never leave a confused or frail person alone in the tub or shower.
- Always check the water temperature before he or she gets in the tub or shower.
- Use plastic containers for shampoo or soap to prevent them from breaking.
- Use a hand-held showerhead.
- Use a rubber bath mat and put safety bars in the tub.
- Use a sturdy shower chair in the tub or shower. This will support a person who is unsteady, and it could prevent falls. You can get shower chairs at drug stores and medical supply stores.
Before a bath or shower:
- Get the soap, washcloth, towels, and shampoo ready.
- Make sure the bathroom is warm and well lighted. Play soft music if it helps to relax the person.
- Be matter-of-fact about bathing. Say, "It's time for a bath now." Don't argue about the need for a bath or shower.
- Be gentle and respectful. Tell the person what you are going to do, step-by-step.
- Make sure the water temperature in the bath or shower is comfortable.
- Don't use bath oil. It can make the tub slippery and may cause urinary tract infections.
During a bath or shower:
- Allow the person with AD to do as much as possible. This protects his or her dignity and helps the person feel more in control.
- Put a towel over the person's shoulders or lap. This helps him or her feel less exposed. Then use a sponge or washcloth to clean under the towel.
- Distract the person by talking about something else if he or she becomes upset.
- Give him or her a washcloth to hold. This makes it less likely that the person will try to hit you.
After a bath or shower:
- Prevent rashes or infections by patting the person's skin with a towel. Make sure the person is completely dry. Be sure to dry between folds of skin.
- If the person has trouble with incontinence, use a protective ointment, such as Vaseline®, around the rectum, vagina, or penis.
- If the person with AD has trouble getting in and out of the bathtub, do a sponge bath instead.
Other bathing tips:
- Give the person a full bath two or three times a week. For most people, a sponge bath to clean the face, hands, feet, underarms, and genital or "private" area is all you need to do every day.
- Washing the person's hair in the sink may be easier than doing it in the shower or bathtub. You can buy a hose attachment for the sink.
- Get professional help with bathing if it becomes too hard for you to do on your own. See "Getting Help with Caregiving"  for information on home health care programs.
For the most part, when people feel good about how they look, they feel better. Helping people with AD brush their teeth, shave, or put on makeup often means they can feel more like themselves. Here are some grooming tips.
Good mouth care helps prevent dental problems such as cavities and gum disease.
- Show the person how to brush his or her teeth. Go step-by-step. For example, pick up the toothpaste, take the top off, put the toothpaste on the toothbrush, and then brush. Remember to let the person do as much as possible.
- Brush your teeth at the same time.
- Help the person clean his or her dentures. Make sure he or she uses the denture cleaning material the right way.
- Ask the person to rinse his or her mouth with water after each meal and use mouthwash once a day.
- Try a long-handled, angled, or electric toothbrush if you need to brush the person's teeth.
- Take the person to see a dentist. Some dentists specialize in treating people with AD. Be sure to follow the dentist's advice about how often to make an appointment.
Other grooming tips:
- Encourage a woman to wear makeup if she has always used it. If needed, help her put on powder and lipstick. Don't use eye makeup.
- Encourage a man to shave, and help him as needed. Use an electric razor for safety.
- Take the person to the barber or beauty shop. Some barbers or hairstylists may come to your home.
- Keep the person's nails clean and trimmed.
People with AD often need more time to dress. It can be hard for them to choose their clothes. They might wear the wrong clothing for the season. They also might wear colors that don't go together or forget to put on a piece of clothing. Allow the person to dress on his or her own for as long as possible.
Other tips include the following:
- Lay out clothes in the order the person should put them on, such as underwear first, then pants, then a shirt, and then a sweater.
- Hand the person one thing at a time or give step-by-step dressing instructions.
- Put away some clothes in another room to reduce the number of choices. Keep only one or two outfits in the closet or dresser.
- Keep the closet locked if needed. This prevents some of the problems people may have while getting dressed.
- Buy three or four sets of the same clothes, if the person wants to wear the same clothing every day.
- Buy loose-fitting, comfortable clothing. Avoid girdles, control-top pantyhose, knee-high nylons, garters, high heels, tight socks, and bras for women. Sports bras are comfortable and provide good support. Short cotton socks and loose cotton underwear are best. Sweat pants and shorts with elastic waistbands are helpful.
- Use Velcro® tape or large zipper pulls for clothing, instead of shoelaces, buttons, or buckles. Try slip-on shoes that won't slide off or shoes with Velcro® straps.