Learning about Dementia

What is Dementia?

Dementia is an overall term for diseases and conditions characterized by a decline in memory, language, problem-solving and other thinking skills that affect a person’s ability to perform everyday activities.

Alzheimer’s is the most common cause of dementia.

60-70% of dementia cases are Alzheimer’s disease.

Dementia is not a single disease; it’s an overall term — like heart disease — that covers a wide range of specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term “dementia” are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behavior, feelings and relationships.

Signs & Symptoms

Memory loss that disrupts daily life
Challenges in planning or solving problems
Difficulty completing familiar tasks
Confusion with time or place
Trouble understanding visual images and spatial relationships
New problems with words in speaking or writing
Misplacing things and losing the ability to retrace steps
Decreased or poor judgment
Withdrawal from work or social activities
Changes in mood and personality

Types of Dementia

ALZHEIMER'S DISEASE

A type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

VASCULAR DEMENTIA

a decline in thinking skills caused by conditions that block or reduce blood flow to various regions of the brain, depriving them of oxygen and nutrients.

LEWY BODY DEMENTIA (LBD)

a type of progressive dementia that leads to a decline in thinking, reasoning and independent function because of abnormal microscopic deposits that damage brain cells over time.

CREUTZFELDT-JAKOB DISEASE (CJD)

the most common human form of a group of rare, fatal brain disorders known as prion diseases.

HUNTINGTON'S DISEASE (HD)

a progressive brain disorder caused by a defective gene. This disease causes changes in the central area of the brain, which affect movement, mood and thinking skills.

MIXED DEMENTIA

a condition in which abnormalities characteristic of more than one type of dementia occur simultaneously. Physicians may also call mixed dementia "dementia – multifactorial.”

DOWN SYNDROME & ALZHEIMER'S

As they age, those affected by Down syndrome have a greatly increased risk of developing a type of dementia that's either the same as or very similar to Alzheimer's disease.

FRONTOTEMPORAL DEMENTIA (FTD)

or frontotemporal degenerations refers to a group of disorders caused by progressive nerve cell loss in the brain's frontal lobes (the areas behind your forehead) or its temporal lobes (the regions behind your ears).

NORMAL PRESSURE HYDROCEPHALUS (NPH)

a brain disorder in which excess cerebrospinal fluid (CSF) accumulates in the brain's ventricles, causing thinking and reasoning problems, difficulty walking, and loss of bladder control.

POSTERIOR CORTICAL ATROPHY (PCA)

refers to gradual and progressive degeneration of the outer layer of the brain (the cortex) in the part of the brain located in the back of the head (posterior).

PARKINSON'S DISEASE DEMENTIA

a decline in thinking and reasoning that develops in many people living with Parkinson’s at least a year after diagnosis.

Stages of

Alzheimer’s Disease

EARLY STAGE OF AD

The symptoms of the early-stage of Alzheimer’s disease come on slowly and may include:

poor concentration and a short attention span
problems making decisions
short-term memory problems
forgetfulness, such as forgetting names, dates, how things work or how to pay bills
depression
some personality changes such as becoming cranky, silly, frustrated, or very quiet

MIDDLE STAGE OF AD

The symptoms of the middle-stage of Alzheimer’s disease include a worsening of all the signs of the early stage, plus new symptoms, including:

episodes of getting lost, even in familiar places.
problems with speech—not being able to remember words or be part of a conversation
shadowing: tendency to follow people around
behavior problems such as urinating in strange places, cursing, acting silly, or making sexual advances

MID-LATE STAGES OF AD

sundowning: increased confusion, anxiety, agitation, pacing and disorientation beginning at dusk and continuing throughout the night.

LATE STAGE OF AD

The late-stage of Alzheimer’s disease can last for three years or more. It is also known as the terminal period, since these Alzheimer’s patients are nearing death. People with late-stage Alzheimer’s disease are often bedridden and at risk for a number of infections. The symptoms include:

weight loss
loss of balance and ability to walk
loss of short and long-term memory
loss of speech, although Alzheimer’s patients may groan or scream
inability to perform basic skills such as eating or drinking
failure to recognize others or even themselves
respiratory infections (people with Alzheimer’s disease often die from pneumonia)

Communication Tips

Always identify yourself.
Call the person by their name.
Make eye contact & be at their eye level.
Pay attention to body language.
Speak slowly, use visual & verbal cues.
Ask one question at a time.
Speak in short, simple sentences.
Be patient. Be specific.
Give the person enough time.
Give one direction at a time.
Repeat questions or instructions.
Tell the person what you are doing.
Avoid using no, don’t, other negative words, and arguing.
Reassure with words and touch.
Look for the feelings behind the words or actions.

Adaptation Tips

People with dementia can have trouble seeing their food. For example, if there is mashed potatoes on a white plate, they may not be able to see them. It can help to put the food on a dark or brightly colored plate.

Post pictures or signs as clues to help them find their way around.

Prevent complications of immobility: remove rugs to reduce issues.

Adjust lighting in the home to prevent sundowning.

Limit choices: it’s best to limit clothing choices for people with dementia. Asking “what would you like to wear today?” will probably just cause confusion.

Repetitive behavior common to people with dementia. Try to find out if and why your client is upset, adjust repetitive motion into something useful like dusting or folding towels.