Insightsthe blog of Porter Hills
Maegan Garlock – Wellness Director
Click here to watch the WZZM13 Senior Wellness segment on this topic.
44 million people are thought to be affected by dementia. By 2030, that number is expected to climb to 76 million. That translates to 1 in 5 people between the ages of 65 and 85 and 1 in 2 people over the age of 85. With those statistics, it is likely that everyone knows someone who is living life with dementia at this moment. Because of this prevalence, it is common to think that when someone is old enough, one will develop dementia. It is important to know that dementia is not a normal part of aging. In fact, not only old people have dementia. It can develop in people as early as thirty years old. Dementia is not one specific disease. It is a term used to describe a collection of symptoms that affect a person’s cognitive, physical and social abilities to the point that it interferes with everyday life.
The most common symptom associated with dementia is memory loss. Other symptoms include:
- The inability to concentrate (following a plot line, focus on tasks)
- A lack of orientation to time and place (knowing what time it is, knowing where one is)
- A decrease in the ability to use expressive and receptive language (finding words and answering questions)
- A decrease in judgement (reasoning and risk assessment)
- A decrease in visual interpretation skills (making sense of the world around you)
- A decrease in sequencing skills (following step-by-step directions)
There are multiple forms of dementia.
Some are irreversible, such as Alzheimer’s Disease, Lewy Bodies Dementia, Vascular Dementia, Parkinson’s Disease, Huntington’s Disease, mixed dementias and others. There are other conditions that look like dementia, but are actually able to be treated. Some examples of this are B-12 deficiency, depression, endocrine problems, urinary tract infections, dehydration, medication side effects and others.
Dementia is a result of physical changes in the brain.
As parts of the brain that handle language, expression, reasoning and emotions begin to deteriorate, symptoms of dementia become more apparent. Rates of deterioration differ from person to person. The actual changes in a person’s abilities will also be different depending on what part of the brain is affected. It is difficult to see these changes in people you love and respect. It is also easy to want to change or correct new behaviors and thoughts of a person with dementia. But, because of the physical changes in the brain, it is important to remember that a person with dementia cannot control their actions.
Help support a person’s remaining abilities by meeting a person with dementia “where they are.”
By understanding how dementia has impacted a person’s life will help us to know what approach to use with that person. A person with dementia may think they are a child again and is looking for their mother. It could be very traumatic to tell that person that their mother died many years ago. To that person, their mother is very real and could be a source of comfort. Instead, try asking that person to describe their mother. Ask what their mother does during the day. Affirm that their mother loves them and they are supported. An emotion experienced by the person with dementia will last much longer than the actual conversation. Promote happiness and comfort rather than facts.
If the part of the brain that controls visual interpretation skills, a person may perceive a dark spot on the floor as a hole. This person may be adamant not to step over this spot, as they do not want to fall. Be reassuring and assist them around this “hole.” Again, it could be traumatic to that person to force them to step over or through this spot.
When talking to a person with dementia, be sure to give ample time for that person to respond. That person will need to receive the information you are giving them, make sense of that information, determine how to respond and then create a way to respond to you. If the language centers of the brain are affected, this process can be impeded. If other distractions, like loud music other people or busy patterns on clothing, that person will also need to process that external information. In a healthy brain, this processing seems to happen automatically. In a person with dementia, each processing step has to happen one by one. Generally, if given short, simple questions and time to process a response, that person can create an answer. To support this, get down to the person’s level in front and just to the side of them. Look at the person and speak clearly. It is also helpful to know that we sometimes can perceive this delay as an inability for that person to hear us. Speaking louder will not necessarily help that person to answer any more quickly.
At times, a person with dementia may not be able to express their needs or wants with words. There are certain behaviors that are sometimes attributed with dementia. These include emotional outbursts, wandering, crying and others. All behavior is a form of communication. The person with dementia may not be able to use other methods of communication to tell you their needs. It is important to put the person first and their condition second. Analyze the situation and make an educated guess as to what the person’s needs may be. If a person is wandering, perhaps they feel the need to be physically active. Perhaps they need to use the bathroom. They may be bored looking for something to do. Try to understand that person’s perspective and react accordingly.
Because there are many forms of dementia, early diagnosis is important.
It is important to have a comprehensive diagnostic work-up to allow for a more specific understanding of what condition is causing the dementia and how this will affect a person. This thorough diagnosis can also rule out other contributing conditions. Life can still be enjoyed if given the tools and resources to support remaining strengths. Early diagnosis can allow for the person with dementia to express how they wish to live and be cared for in the future. This allows that person to be empowered and share their preference while they are able.
As a care partner for a person with dementia, it is helpful to seek support.
There are many community resources available to help support the all stages of dementia.
- Dementia Friendly Grand Rapids
- Alzheimer’s Association
- Area Agency of West Michigan
- Caregiver Resource Network
Porter Hills also offers services to assist those with dementia.
(Graphic courtesy of the Alzheimer’s Association)