What is Dementia?
Doctors usually define dementia as trouble with brain function or cognition. This means a person with dementia will have trouble in one or more of the following areas.
- Memory (short-term and/or long-term memory)
- Language (understanding others and/or speaking)
- Attention, concentration, or focus
- Spatial orientation (e.g., knowing where you are and how you got there)
- Planning (developing a plan and/or following one)
- Numeracy (using numbers or doing math)
- Visual processing problems (e.g., recognizing common objects or faces)
- Judgment (making safe, logical decisions)
- Mood (may be anxious, depressed, fearful, suspicious, or over-reactive)1
Doctors can often diagnose dementia based on the results of cognitive tests in the office in addition to a patient’s history of worsening brain function over time that affects their lives significantly. All three of those things are important – impaired cognition tests, a decline from what’s normal for the person, and the effect on day-to-day activities. It’s usually helpful for people with dementia to visit doctors with a caregiver or loved one who can help discuss things the patient may forget or not be aware of.2
Dementia can be caused by one or many factors working together. Some of the more common causes include stroke, tumors, Parkinson’s disease, and Alzheimer’s disease.2 Critically, aging does not cause dementia, but it is a risk factor.1 That means that dementia doesn’t affect every older person, only about 7% of people age 65 have Alzheimer’s disease, but 50% of people age 85 do,2 and some people never have dementia at all.
What is Alzheimer’s Disease (AD)?
Alzheimer’s disease is a specific type of dementia. It is usually a slow disease that gradually gets worse over many months and years. It’s both progressive (meaning it gets worse over time) and incurable. Alzheimer’s disease is often considered the most common type of dementia.1
Technically speaking, Alzheimer’s involves a protein in certain parts of the brain misfolding which leads to brain damage.3 Although doctors can’t diagnose Alzheimer’s disease with any single lab test, many patients have a similar set of Alzheimer’s symptoms that do provide a clear diagnosis.1
Typical early Alzheimer’s symptoms include a gradual loss of memory over many months, difficulty learning new things (particularly remembering recent events in one’s own life), forgetting things like taking medication or paying bills, repeating conversations often, and forgetting words.2
What problems do people with Dementia experience?
Regardless of the cause, many types of dementia result in the same sorts of symptoms for patients, especially when the patient has late-stage dementia.2
The types of memory problems mentioned above tend to get worse over time. For example, if a person forgets his grandson’s birthday in early dementia, he might forget how to use the microwave in late dementia. Trouble finding words is also common and gets worse over time.2
Emotionally, many people with dementia also experience depression and apathy (a lack of interest in anything). They may withdraw or self-isolate. In later stages, people may have less self-awareness of their problems and show more aggression (yelling, kicking, agitation, etc.). 2
Some people with dementia are prone to wandering or leaving the house at odd times and becoming lost. Others may fidget or pick at things like scabs for hours at a time if uninterrupted.2 Potentially problematic behaviors may come up, depending on the individual, such as hoarding, resistance to care, or shadowing the caregiver.1
Dementia also causes problems with sleep and the ability to walk steadily. Some people with dementia hallucinate (see or hear things that aren’t really there), or have delusions (persistent false beliefs – like that a person who has been dead for years is alive).2
What is Memory Care?
Although there are medications that may help with some of the symptoms of dementia, often the best and most important treatments for those with dementia are not medical.1,2 People with cognitive problems often benefit from a simplified environment with set routines and calm, consistent care.1
In early stages of dementia, people benefit from activities that can help exercise their brain, like reading or assembling puzzles, as long as these activities remain enjoyable and not overly frustrating.2 These things can be part of memory care.
Because people with dementia often forget what they’ve already done for the day, they may need help or reminders to care for themselves, including things like
- Eating a healthy diet with plenty of leafy, green vegetables4
- Bathing regularly
- Staying physically active
- Going to bed on time
- Doing activities they find fun and meaningful
- Socializing with friends and family2
People with dementia may also need help communicating effectively, such as with pictures, and with other practical matters, such as navigating to doctor’s offices or putting their affairs in order.2
Sometimes, people with dementia have trouble communicating their feelings in an appropriate way and may lash out or yell when they are frustrated. Skilled caregivers can sometimes recognize these behaviors and help the person focus on another, a more enjoyable task that may prevent aggressive behavior such as hitting.2
When dementia becomes severe, the individual may need increasing care, even up to 24 hours a day.
How can Preferred Gold (or home health) help?
Home health services can help those with memory problems stay in their homes independently. Although this isn’t a good option for everyone, for many people experiencing dementia, the extra help can go a long way.
An aide in the home can help with things that the older adult can’t do safely on their own anymore, like bathing, dressing, toileting, shaving, feeding, and other personal care needs. To protect the safety of a dementia patient, an aide can ensure that they do not wander off if left unattended. Lastly, an aide can remind patients to take their medicine, attend their medical appointments, or access a zoom call with their MD.
Many older adults benefit from having someone there to remind them of things, like what day it is or where they are – this is called reorientation. Because people with dementia can sometimes get stuck in unhealthy thought patterns, a home health aide can help recognize these moments and redirect the older adult to a more productive and fun activity – for instance, if an older adult is fixated on pulling a thread in their couch, the aide might suggest that they fold laundry together instead.
At Preferred Gold, our home health aides are exceptionally qualified to do any and all of these tasks for those living in New York.
References:
- Atri A. The Alzheimer’s disease clinical spectrum. Medical Clinics of North America. 2019;103(2):263-293. https://doi.org/10.1016/j.mcna.2018.10.009
- 2. Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and management of dementia: Review. JAMA. 2019;322(16):1589-1599. https://dx.doi.org/10.1001/jama.2019.4782
- What happens to the brain in Alzheimer’s disease? National Institute on Aging. https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease
- What do we know about diet and prevention of Alzheimer’s disease? National Institute on Aging. https://www.nia.nih.gov/health/what-do-we-know-about-diet-and-prevention-alzheimers-disease