Dealing With Dementia: How To Help Someone You Love
Coping with dementia can fall as heavily on a person’s caregivers as it does on the person living with dementia. There can be many ways to help your loved one cope with dementia, including medications, physical health treatments, specialized assisted living, and home care. Both those with dementia and their loved ones can benefit from working with a licensed therapist as well.
What is dementia?
The first thing you may wish to know about dementia is that it is not necessarily a disease but a condition marked by certain behaviors and difficulty remembering. Dementia can be defined as the name for a group of symptoms that can be caused by various conditions. When most people think about dementia, they may think about memory loss. Memory loss can be one of the symptoms associated with the early stages of dementia, but having memory loss doesn't necessarily mean that a person has dementia. Having dementia can also impact how a person thinks, behaves, and interacts with other people, making it difficult to feel confident in social situations.
In addition to difficulty remembering simple words or familiar objects, other signs of dementia can include trouble choosing words, difficulty planning to-do lists, and personality changes. An affected individual might feel confused more often, ask a question repeatedly, or show changes in posture or facial expressions at inappropriate times. These are tangible examples of how dementia feels for the person, affecting their communication skills and how they process and respond to the world around them.
Similar to memory loss, it can be important not to assume that a loved one has dementia simply because you notice one of these symptoms, as they might react strongly or take things personally. Some symptoms, like motor problems and depression, can occur in advanced age for reasons unrelated to dementia. However, if you notice any of these symptoms independently, it doesn't necessarily mean that you should not take them seriously. It can be best to encourage a loved one to see a professional for a definite diagnosis. Dementia is typically best managed when it is diagnosed early. Even if symptoms aren't indicative of dementia, they can still be treated by a doctor.
Dementia can begin to occur at any age, depending on the cause, although it is more common in older adults. Symptoms are most likely to begin after age 65 and tend to be most common in people with a family history of dementia. It can be important to note that dementia was not always as understood as it is now, so people who are currently at or around this age may not know for sure whether their older relatives had dementia or not.
Possible causes
Dementia can be caused by a wide variety of conditions. The cause of dementia usually impacts the kind of care required. As a result, it may be worth discussing some of the most common conditions that can cause dementia, though the aim of this article is not to include every possible cause.
Alzheimer's disease may be the best-known cause of dementia and is generally the most common cause in people over 65. The exact cause of this disease is currently unknown, and it seems to be incurable, although various treatments can slow its progression.
Vascular dementia, the next most common cause, is typically the result of damaged blood vessels in the brain. This type of dementia can begin earlier in life but tends to be more common in older individuals. Dementia can also be caused by head trauma.
Huntington's Disease can be another example of a condition that may cause dementia at earlier ages, with symptoms usually appearing as early as the person's 30s or 40s. Huntington's Disease normally causes dementia as parts of the nervous system begin to fail.
Finally, dementia can also develop in people with Parkinson's Disease, another nervous system disorder.
Home care and the different stages
Because dementia can cause all-encompassing and pervasive symptoms, people with dementia are often cared for at home by family members or other caregivers. Family members can help manage medications and serve meals with nutritious foods to their loved ones. They can also keep an eye on them while ensuring visual cues or safety features are in place and allowing them to remain in a familiar environment.
Challenges for family members
Eventually, however, many families find that they eventually must admit their loved one to a care facility. This can be because caring for the loved one can impact other obligations, such as work. In addition, because dementia is often caused by conditions that also impact physical health, most families are eventually unable to offer the necessary medical care in a home setting.
While the individual is at home, one of the greatest challenges of dementia can be wandering. This can occur in the mild stage of dementia, when an individual may be having problems with memory, planning, and making decisions, but they may still be in good physical health. Memory problems, issues with planning, and poor decision-making can mean that the individual may also need help with meals to ensure that they are eating well.
In later stages, the underlying cause of dementia may cause physical damage to the nervous system, potentially resulting in problems with coordination. It can become increasingly difficult for individuals with dementia to get around on their own and perform basic tasks. Eventually, they may be unable to do things like go to the bathroom and eat without assistance. In many cases, they might require adaptations like sturdy shower chairs or other safety features around the home.
For even the most dedicated home caregivers, the later stages of dementia may indicate that it is time to consider how to move their loved one into assisted living or nursing care. Assisted living and nursing care facilities can take a great deal of stress and responsibility off the shoulders of home caregivers by taking over meal preparation, medication concerns, and general care. They can help offer reassurance and ensure that the person experiences the best possible quality of life in a supportive environment. They are also more likely to have the ability to provide long-term advanced medical care in a setting that is typically more comfortable and welcoming than a hospital.
Transitioning from home care to assisted living
While some family members may prefer to provide home care for as long as possible, there can be some benefits to making the transition to assisted living earlier in the progression of dementia.
Some of these benefits can have to do with the difficulties of living with dementia. Many assisted living communities are familiar with the many challenges of dementia and have special services to slow the progression of dementia through counseling, activities, and special meals. These treatments usually have the most impact when they are started earlier rather than later. Sometimes, these treatments can be available to people who are not staying in the nursing home, but they may not be in some areas. Dementia assisted living is usually better equipped to provide a comfortable setting for people living with dementia as well.
For example, people with dementia may become easily agitated, and things like the hustle and bustle of living in a family household might result in irritability. While some individuals with dementia may prefer to live with family as long as possible, some might find dementia-assisted living to be more relaxing, as they may have specific activities and outdoor areas to support their physical and emotional needs. These facilities can also be better equipped to handle medical emergencies like falls.
Some of the benefits of moving a loved one with dementia into assisted living, however, may have to do with the potential challenges of caring for a person living with dementia. Many people find that they cannot provide adequate care while working full-time, but working less often results in financial difficulties. Many people also find providing care to a loved one living with dementia to be emotionally challenging. As a result, they might not be able to spend time managing daily life tasks and personal activities.
Many assisted living communities provide "respite care." Respite care can occur when a home caregiver checks their loved one into an assisted living community for a couple of days. This may allow the caregiver to take a vacation, leave town on business, or do whatever they need to do. Knowing that this service is available can be a relief early in the process, but it can also be a good way to introduce all parties involved to the idea of the loved one living with dementia eventually transitioning to one of these communities full-time. Not all assisted living facilities offer respite care, however, so check out their websites or call their management to find out which assisted living communities near you offer it.
Physical and mental health care
Because physical ailments can cause dementia, the primary care provider typically needs to provide medical interventions. Those with dementia may also benefit from talking to a therapist to process their emotions and effectively cope with their diagnosis.
Therapy can be beneficial for family members who have a loved one with dementia. The caregivers can experience "caregiver burnout," which can be a name for the physical and emotional exhaustion that may come from caring for another person around the clock. Because most forms of dementia are progressive, family members can also experience something called "anticipatory grief." Both of these sensations can put the caregiver and family member at risk of serious conditions themselves, such as depression.
Online therapy can be a great option for those with dementia and their loved ones. You can attend online therapy from home or any other location with an internet connection, which can make it a convenient and reachable form of treatment. You can also schedule sessions outside of typical office hours, which can accommodate your other obligations and make it easier to fit therapy into your schedule.
A 2023 study suggested that internet-based cognitive behavioral therapy could be an effective form of treatment for depression symptoms in people living with chronic conditions, such as dementia. In addition, a large body of evidence generally states that online and in-person therapy can be equally effective in addressing a variety of mental health concerns. For example, a therapist may be able to help support other mental health concerns associated with dementia, such as anxiety and depression.
Takeaway
Dealing with someone with dementia requires patience, empathy, and understanding. Here are some tips on how to interact with and support individuals with dementia:
- Be Patient and Calm: Approach interactions with patience and a calm demeanor. Avoid rushing the person or becoming frustrated.
- Use Clear and Simple Language: Communicate using clear and simple language. Break information into smaller, more manageable pieces and allow time for the person to process.
- Maintain Eye Contact and Positive Body Language: Maintain eye contact and use positive body language. Non-verbal cues can enhance communication and convey warmth and reassurance.
- Establish a Routine: Establish a consistent daily routine that includes exercise and eating healthy foods. Predictability can provide a sense of safeness and stability for individuals with dementia.
- Offer Choices: Provide choices when possible to empower the person and promote a sense of control. However, limit options to avoid overwhelming them.
- Provide Gentle Reminders: Use gentle reminders for tasks or activities. Repetition may be necessary, but try to avoid being patronizing.
- Create a Safe Environment: Ensure the physical environment is safe and free of hazards. Minimize clutter and use labels or cues to help navigate spaces.
Coping with dementia, whether you are a person diagnosed with dementia or a caregiver, involves a combination of practical strategies and emotional support. Here are some coping strategies:
- Communicate Openly: According to the Alzheimer’s Association, it may be beneficial to foster open communication between individuals with dementia and their caregivers. Discuss feelings, concerns, and preferences.
- Focus on Abilities: Emphasize remaining abilities rather than dwelling on limitations. Adapt activities to align with the person's current capabilities.
- Celebrate Achievements: Acknowledge and celebrate small achievements and moments of joy. Positive reinforcement can enhance the overall well-being of both individuals.
- Plan for Future Changes: As dementia progresses, plan for future changes in care needs and living arrangements. Having a well-thought-out plan can reduce stress during transitions.
Coping with dementia is a journey that requires ongoing adaptation and flexibility. Regular communication, mutual support, and a person-centered approach contribute to a more positive experience for both individuals with dementia and their caregivers.
What is the average age of death for someone with dementia?
The average age of death for someone with dementia can vary widely and is influenced by various factors, including the type of dementia, the individual's overall health, the presence of coexisting medical conditions, and the level of care and support received.
In general, dementia tends to be more common in older age, and the risk of developing dementia increases with age. Alzheimer's disease, the most common cause of dementia, often affects individuals who are 65 years and older, although it can occur earlier.
It may be important to note that dementia itself is not always the direct cause of death. Many individuals with dementia may have other health issues or complications that contribute to their overall decline. Common complications associated with advanced dementia include infections, aspiration pneumonia, and complications related to immobility.
The decision of whether to keep someone with dementia at home or move them to a care facility depends on various factors, including the individual's needs, the level of support available at home, the caregiver's capacity, and the safety and well-being of the person with dementia. Working as a team and forming a strong family-caregiver alliance may be important Here are some considerations:
- Level of Care Needed: Consider the current and future level of care the person with dementia requires. As the condition progresses, caregiving demands and safety concerns may increase.
- Caregiver's Health and Capacity: Assess the physical and emotional well-being of the primary caregiver. It may be important to develop a strong support group to prevent caregiver burnout and ensure they can provide adequate care.
- Financial Considerations: Evaluate the financial aspects, including the costs associated with home modifications, in-home care services, and potential future needs.
- Support Services: Explore available support services in the community, such as home health aides, respite care, and support groups, to augment home-based care.
- Quality of Life: Consider the impact on the quality of life for both the person with dementia and the caregiver. Residential dementia care facilities may provide specialized care and support that can enhance well-being.
Caring for a loved one with dementia requires sensitivity and understanding. Here are three things to avoid when interacting with someone with dementia:
Arguing or correcting:
Avoid arguing with or correcting the person with dementia, especially about facts or memories. Dementia can cause confusion and memory loss, and attempting to correct them may lead to frustration or agitation. Instead, focus on validating their feelings and redirecting the conversation to a more positive or neutral topic.
Rushing or patronizing:
Avoid rushing the person or treating them in a patronizing manner. Speak to them with respect and allow them sufficient time to process information and respond. Rushing can lead to stress and anxiety. Maintain a calm and patient demeanor, offering support and assistance as needed without taking away their sense of independence.
Forget about self-care:
Caregivers should avoid neglecting their own well-being. Providing care for someone with dementia can be emotionally and physically demanding. It's crucial for caregivers to prioritize self-care, seek support when needed, and take breaks to prevent burnout. Neglecting self-care can have negative consequences for both the caregiver and the person with dementia.
The concept of "stages" in dementia is often associated with the progression of cognitive decline. It may be important to note that dementia is a highly individualized condition, and not everyone will experience the stages in the same way or progress through them linearly. However, the Global Deterioration Scale (GDS), commonly used to describe the stages of Alzheimer's disease, provides a general framework. Keep in mind that these stages are applicable primarily to Alzheimer's disease and may not precisely align with other types of dementia. The seven stages are as follows:
Stage 1: No impairment (normal functioning):
At this stage, there is no noticeable cognitive decline. The person functions normally, and there are no memory or thinking problems.
Stage 2: Very mild cognitive decline (age-associated memory impairment):
Some individuals may experience slight memory lapses, such as forgetting names or where they placed everyday objects. These are often attributed to normal aging.
Stage 3: Mild cognitive decline (early-stage Alzheimer's):
At this stage, family and friends may begin to notice cognitive changes. Common symptoms include forgetfulness, difficulty finding words, and challenges in planning or organizing.
Stage 4: Moderate cognitive decline (mild Alzheimer's):
This stage is characterized by noticeable cognitive decline, with difficulties in areas such as concentration, memory, and problem-solving. Individuals may have trouble managing finances or remembering recent events.
Stage 5: Moderately severe cognitive decline (moderate Alzheimer's):
Daily functioning becomes significantly impaired at this stage. Individuals may require assistance with activities of daily living (ADLs), and memory gaps become more pronounced. Behavioral changes may also occur.
Stage 6: Severe cognitive decline (moderately severe Alzheimer's):
Individuals at this stage experience a substantial loss of cognitive function. Memory deficits are severe, and there may be a loss of awareness of recent events and surroundings. Assistance is needed with basic self-care tasks.
Stage 7: Very severe cognitive decline (severe Alzheimer's):
In the final stage, individuals lose the ability to communicate coherently and independently perform basic functions. They may lose the ability to walk, sit up, or smile. Total care and support are required and as the disease progresses caregivers may begin to make end-of-life decisions including legal and financial matters.
Signs that dementia may be getting worse can vary depending on the type of dementia and the individual's unique circumstances. However, 10 common indicators of worsening dementia may include:
- Memory Loss Progression: Noticeable and increasing memory loss, including forgetting recent events, names, or familiar faces. Individuals may have difficulty recalling information that was once familiar to them.
- Communication Challenges: Increasing difficulty in expressing thoughts coherently or understanding and following conversations. Individuals may struggle to find the right words or may repeat the same question frequently.
- Impaired Judgment: Progressive decline in judgment and decision-making abilities. Individuals may make poor choices, have difficulty with problem-solving, or become more susceptible to scams and exploitation.
- Increased Confusion: Heightened confusion and disorientation, especially regarding time, place, and people. Individuals may lose a sense of where they are or what day it is.
- Worsening Behavioral Changes: Dementia patients may experience changes in behavior, mood, or personality may become more pronounced. Agitation, aggression, anxiety, or withdrawal may increase. Sundowning, where symptoms worsen in the late afternoon and evening, may become more noticeable.
- Functional Decline: A decline in the ability to perform activities of daily living (ADLs) and everyday tasks, such as dressing, bathing, and eating independently. Assistance may be needed for basic self-care tasks.
- Loss of Motor Skills: Progressive loss of coordination and motor skills, leading to difficulties with balance, walking, and other physical activities.
- Difficulty Recognizing Familiar People: Difficulty recognizing and remembering familiar faces, including those of family members and close friends.
- Hallucinations or Delusions: Increased likelihood of experiencing hallucinations (seeing or hearing things that are not there) or delusions (false beliefs).
- Inability to Recognize or Understand the Environment: Growing difficulty recognizing and understanding the physical environment, which may lead to increased wandering or getting lost.
There isn't a single "number one cause" for dementia behaviors, as behaviors in dementia can be influenced by various factors. Dementia is a complex condition, and behavioral changes can result from a combination of cognitive decline, physical health issues, environmental factors, emotional well-being, and other related dementia symptoms. It's crucial to approach these behaviors with a comprehensive understanding of the individual's unique circumstances.
In dementia, including Alzheimer's and related dementias, expressions of anger or aggression can occur at various stages, and there isn't a specific "anger stage" as a formal designation. Behavioral changes, including anger and physical aggression, can be triggered by a variety of factors and may vary from person to person. Some individuals with dementia may not exhibit anger at all, while others may experience it more frequently.
Dementia is a progressive condition, and its progression can be influenced by various factors. While there is no cure for dementia, certain factors may contribute to the worsening of symptoms or the acceleration of cognitive decline. Some potential triggers for the worsening of dementia include:
- Underlying Health Conditions: The presence of coexisting health conditions, such as cardiovascular disease, diabetes, or infections, can contribute to the acceleration of dementia symptoms.
- Medication Side Effects: Some medications prescribed for other health conditions may have side effects that impact cognitive function. It may be important to monitor medications and consult with healthcare professionals if side effects are suspected.
- Lack of Physical Exercise: Regular physical exercise has been associated with cognitive health. Lack of physical activity may contribute to the progression of dementia symptoms.
- Social Isolation: Lack of social engagement and isolation can negatively impact cognitive function. Maintaining social connections and participating in meaningful activities are important for cognitive health.
- Poor Nutrition: A diet lacking essential nutrients may contribute to the worsening of dementia symptoms. Nutritional factors play a role in overall brain health.
- Chronic Stress: Prolonged exposure to stress can have negative effects on cognitive function. Stress management techniques may be beneficial for individuals with dementia.
- Sleep Disturbances: Sleep disturbances or disorders can impact cognitive function. Ensuring good sleep hygiene is important for overall well-being.
- Previous Article
- Next Article