Struggling with Dementia

Posted By LORRAINE GIBBS , CHRONICLE STAFF WRITER

Posted 19 days ago

Most people can look in a phone book knowing what they are looking for with complete clarity. People with dementia cannot perform some simple daily tasks such as looking up a phone number without confusion and lack of understanding what they are doing or why.

At a recent seminar on communicating with people with dementia at Grandview Lodge, Kathie Savage, Psychogeriatric Resource Consultant, said that dementia is a set of symptoms that includes loss of memory, understanding and judgement, which can be either reversible or non-reversible. It includes Alzheimer's Disease, which is the most common form of irreversible dementia accounting for 60% of all cases.

According to the Ministry Of Transportation, dementia is a brain disorder that causes decline in memory, attention, communication, judgement and behaviour. There are several forms of dementia including Alzheimer's Disease, vascular dementia, frontotemporal dementia, Creutzfeldt-Jacob Disease and Lewy Body Dementia.

Dementia, in its many forms can strike at any age, not just the elderly, and leads to loss of ability to perform daily tasks such as driving, eating and grooming. It also leads to changes in emotions and moods, and confusion; however, not everyone who is confused has dementia.

People who suffer from irreversible dementia have no control over the changes they are happening to them, Savage said.

"Remember to look for the person behind the disease," she said. "They are still there as they once were. A person's abilities will change over time as the disease progresses. It is important to look for the remaining strengths and abilities of the person, and build on them, instead of concentrating on what a person can no longer do. Reinforce remaining strengths, and encourage independence for as long as possible."

The basic function for a person who suffers from dementia is to stay alive.

Everything a person who suffers from dementia does is meaningful to them, she said. People with dementia do not experience they need to be cured.

Alzheimer's, as the most prevalent form of dementia, leads to several changes in the brain. Dense irregular-shaped spots/plaques appear causing surrounding brain cells to shrink and die, Savage said. Thread-like tangles develop within existing brain cells. These tangles eventually destroy healthy brain cells. As the disease progresses the brain shrinks, affecting brain functioning.

Although the onset is gradual, Alzheimer's eventually affects all aspects of a person's life.

Caregivers of Alzheimer's patients, including family and professionals, must remember that it is important not to take any behaviour personally, she said.

The Alzheimer's Society of Canada says on its website that ten of the symptoms of the disease include memory loss that affects day-to-day functioning, difficulty performing familiar tasks, problems with language, disorientation of time and place, poor or decreased judgment, problems with abstract thinking, misplacing things, changes in mood and behaviour, changes in personality, and loss of initiative.

Sometimes the symptoms dementia can be caused by

conditions that are treatable, such as depression, thyroid disease , infections or drug inter-a ctions, " the Alzheimer's Society says. "If the symptoms are not treatable and progress over time, they may be due to damage to the nerve cells in the brain. Sometimes a person may have symptoms such as sudden onset memory loss, early behaviour changes or difficulties with speech and movement. These symptoms may suggest a dementia other than Alzheimer's Disease."

The first defence in responding to symptoms is to seek medical attention, the Society says, so that the person suffering can be assessed and treated.

Savage told the caregivers who were at the seminar that learning to communicating with people with dementia is very important because they may not be able to make themselves understood or may have trouble expressing themselves, they may not understand what others are saying to them, they may not understand humour or sarcasm and they may not understand what is expected of them.

Caregivers shouldn't point out mistakes or correct people with dementia; they shouldn't rush them or talk over them, Savage said. Caregivers should recognise that people who suffer from dementia can have hurt feelings, have a different reality than others and that they are doing the best they can within their abilities. Caregivers should respond to emotions, not words; be patient; avoid arguing or reasoning; and should not talk about the person as though they aren't there.

"Remember that persons with dementia have increasing difficulty understanding verbal messages but non-verbal understanding continues until late in the disease," she said.

People in the middle stages of dementia have limited short-term memory and may ask repetive questions, speak very generally without being specific, and may have difficulty remembering familiar names and objects, Savage said.

"Memory loss will increase as long term memory becomes affected. Focusing on past events may be beneficial to the person if they are happy memories," she said. "Past events can be used for reminiscence, distraction or just to converse."

The middle stages of dementia can lead to the person being embarrassed of their trouble communicating

and withdraw from social activities or become frustrated and anxious with their memory loss and limited abilities. Savage said one on one communication is often easier than group settings because the person with dementia may not be able to remember the names of the people in the group or be able to follow the conversation.

In the late stages of irreversible dementia, people can suffer from aphasia, which the inability communicated. They can lose the ability to read and write, have difficulty making sounds and may only be able to communicate with nonverbal sounds.

"The person with late stage Alzheimer's Disease is still able to read body language and emotional expression of others," Savage said. "Communication is at an emotional level."

Savage said communication also depends on cultural factors.

"It is important when trying to communicate with someone who

has dementia to take into consideration their cultural background in

order to understand what techniques of communication would be helpful or respectful," she said. She stressed that it is important to remember that each person is different.