Farming with Alzheimer’s Disease

Alzheimer's disease is an irreversible, progressive brain disease that destroys thinking skills and memory, which can reduce the ability to carry out even the simplest task. Alzheimer's disease is the most common form of dementia among older adults. Dementia is commonly known as a loss of cognitive functioning including thinking, reasoning and remembering. This loss of function can have an extreme impact on a person's daily life, and can progress over a long period of time. Therefore, two primary concerns for agricultural workers diagnosed with Alzheimer's are (1) remaining productive and (2) overall safety because of memory loss, language problems and unpredictable behavior.

Progression of Alzheimer's

Early signs and symptoms—Memory problems are typically one of the first warning signs. A decline in other cognitive aspects such as vision, word choice, impaired reasoning or judgment can also be early indicators of the development of Alzheimer's disease.

Mild Alzheimer's disease—As the disease progresses, memory loss worsens and changes in cognitive capabilities are evident. Problems include getting lost, mishandling money, repeating questions, taking longer to complete tasks, and using poor judgment.

Moderate Alzheimer's disease—Damage occurs to the brain that controls language, reasoning, conscious thought and sensory processing. Difficulties include coping with new situations, carrying out tasks with multiple steps, inability to learn new things, or failure to recognize friends and family members.

Severe Alzheimer's disease—Individuals may not be able to communicate and are dependent on others for their care.

Talking About Alzheimer's Disease

The Alzheimer's Association suggests talking is important for helping friends and family members understand Alzheimer's disease and learning about how they can continue to be a part of the individual's life. The following suggestions may help:

• Explain that Alzheimer's disease is not a normal part of aging but a disease of the brain that results in impaired memory, thinking and behavior.
• Share educational information on Alzheimer's disease or invite family and friends to attend Alzheimer's education programs.
• Be honest about being diagnosed with Alzheimer's disease and allow other family members to do the same.
• Assure friends that although the disease will have life changing effects, enjoying their company is still very important.
• Let family and friends know when and how their help and support may be needed.

For an employee, an employer must know about an Alzheimer's diagnosis to ensure that appropriate tasks are assigned throughout the progression of the disease. As an employer diagnosed with Alzheimer's disease, it is important to communicate with employees or family members who assist with the business about how to maintain continuity of day-to-day operations.

Remaining on the Farm

Staying productive and independent:

• Become well informed. Connect with programs that teach families about practical and flexible strategies for dealing the difficulties associated with Alzheimer's.
• Develop a long-term strategy for working and managing the farm.
• Use code words, such as marking a calendar with a.m. after doing morning chores and p.m. after doing evening chores.
• Create work tasks and activities that can be done working together or in a group.
• Stay active. Continue doing activities like gardening, dancing, painting, volunteering, and playing sports or card games because you will benefit from the mental and social stimulation.
• Ask for help with things such as paying bills, doing chores, and doing lawn work.
• Utilize memory aids such as labels on drawers, to-do lists, notebooks and sticky notes.
• Develop large clearly written signs with step-by-step instructions to complete tasks.
• Use photos or pictures to refresh long-term memory.
• Take safety measures by installing safety rails where possible. Lock specific doors to prevent access to hazardous areas.
• Limit access to dangerous areas or items such as pesticide storage areas, flammable liquids, stairwells, and ladders.
• Use simple safety signs like "STOP," "HOT" or "WATCH YOUR STEP" as attention reminders.
• Keep items in familiar locations.
• Take prescribed medication as directed.
• If operating equipment is no longer feasible, hire a farmhand or local co-op to do the work for you.

Wandering can become a safety concern on the farm:

• Six out of ten Alzheimer's sufferers will wander.
• Wandering is especially dangerous for people who live and work in agricultural environments where they can come into contact with large equipment, confined spaces, manure pits, and other bodies of water.
• A program called "MedicAlert^®+ Alzheimer's Association Safe Return^®" is available for families with wandering concerns. It is a national identification program designed to assist in the return of those who wander and become lost.
• Most cell phones have a GPS feature that can be viewed online, so if you think a loved one is lost you may be able to track him or her yourself.
• Wandering generally follows the direction of the dominant hand.
• Keep a list of places where the person may wander to, such as past jobs or daily chores, former homes or a church, restaurant or locations of past daily routines.

Signs of wandering:

1. Returns from a regular walk or drive later than usual.
2. Tries to fulfill former obligations, such as going to work.
3. Tries to "go home" even when at home.
4. Is restless, paces or makes repetitive movements.
5. Has difficulty locating familiar places like the bathroom, bedroom or dining room.
6. Checks the whereabouts of familiar people.
7. Acts as if doing a hobby or chore, but nothing gets done (e.g., moves around gardening pots and dirt without planting anything).
8. Feels lost in a new or changed environment.

Tips to reduce wandering:

1. Control access to vehicle keys, including farm equipment (to prevent a person with dementia access to a vehicle).
2. Move around and exercise to reduce anxiety, agitation and restlessness.
3. Ensure all basic needs are met (toileting, nutrition, thirst).
4. Carry out daily activities, such as folding laundry or preparing dinner, to provide daily structure.
5. Reassure the person if he or she feels lost, abandoned or disoriented.
6. Avoid busy places that are confusing and can cause disorientation, such as shopping malls.
7. Place deadbolts either high or low on exterior doors.
8. Do not leave someone with dementia unsupervised in new surroundings.

Acknowledgments

This fact sheet was reviewed by Karen Mancl, PhD, Professor, Food, Agricultural and Biological Engineering, The Ohio State University; and Pat Luchkowsky, Director of Public Affairs, Easter Seals of Ohio.

References

The Alzheimer's Association. alz.org

Living with Alzheimer's. BrightFocus Foundation. brightfocus.org

About AgrAbility-Based Fact Sheets
These fact sheets were developed to promote success in agriculture for Ohio's farmers and farm families coping with a disability or long-term health condition. AgrAbility offers information and referral materials such as this fact sheet, along with on-site assessment, technical assistance, and awareness in preventing secondary injuries. Fact sheets were developed with funding from NIFA, project number OHON0006.