Cher Haack: Understanding dementia
For some of us dementia can be a scary word to hear. To families when they hear from a physician their parents have dementia it can be confusing and even overwhelming. Most people do not know what dementia is or how to deal with certain behaviors dementia can cause.
What is dementia?
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. Dementia is not merely a problem of memory. It reduces the ability to learn, reason, retain or recall past experiences and there’s also loss of patterns of thoughts, feelings and activities. Additional mental and behavioral problems often affect people who have dementia, and may influence quality of life, caregivers, and the need for institutionalization. As dementia worsens individuals may neglect themselves and may become disinhibited and may also become incontinent. Some behaviors with dementia may even be inappropriate. People may become restless or wander about during the day and sometimes at night. Unfortunately at times individuals diagnosed with dementia may not recognize their own family members and friends.
Statistics show depression affects 20-30 percent of people who have dementia, and about 20 percent have anxiety as well. Agitation and aggression also often accompany dementia. About 10 percent of people with dementia have what is known as mixed dementia, which may be a combination of Alzheimer’s disease and multi-infarct dementia.
Usually a diagnosis will be determined by a series of cognitive testing the physician will perform, often lasting several hours. Tests of memory, function, processing speed, attention, and language skills are performed. The most commonly used tests are the mini mental examination, the cognitive abilities screening instrument, the trail making test and the clock drawing test. Physicians may also perform blood tests to rule out treatable causes such as infections or other problems that commonly cause confusion or disorientation in the elderly.
How to deal with behaviors
One of the best ways to deal with dementia behaviors is to not argue with them, instead try and determine if there is an underlying cause of any aggression or agitation they may be showing. Since dementia impairs normal communication due to changes in receptive and expressive language, as well as the ability to plan and problem solve, agitation is often a form of communication for the person. Look for signs of the individual having pain, physical illness or possible over stimulation. This may be the reason they are showing aggression or agitation. For some individuals with dementia they may be under stimulated and require more activities and stimulation. It all depends on the individual and their current living environment. It’s of course more difficult to keep an individual active who may live at home and not in a controlled environment. This is where outside caregivers, specialized in dementia training may be of benefit to them and their families. They can participate in activities they enjoy doing and take them out for drives or to the park. Set up an exercise routine that best suits the particular individual. Observe to assure they are eating and drinking enough daily foods and fluids. Due to memory impairment in individuals with dementia at times they may forget to eat and drink. It’s important you be patient with them. They are just as confused as to what is going on and are usually unable to fully express their wishes and concerns.
Books you can read that may give you a better understanding of dementia and how to cope with day to day living: “The 36-Hour Day” by Nancy Mace and Peter Rabins and “Contented Dementia” by Oliver James.
Cher Haack is administrator of The Lodge Assisted Living & Memory Care Community.