Understanding Dementia.

Dementia is the common term used to described a group of conditions which affect memory, thinking, behaviour and emotion. Dementia is actually called Neurocognitive Disorder (NCD) in the Diagnostical Statistical Manual 5 (DSM V). It is one of the highest cause of disability in the elderly, although it is also possible to get early onset dementia, this affects people under the age of 65.

Approximately 50 million people worldwide have some form of dementia and it is estimated that someone is diagnosed every 3 seconds. Each person may experience dementia in their own way. But it is progressive and it will eventually mean the person is unable to care for themselves and need help in all aspects of their daily life.

There Are Many Forms Of Dementia.

There are over 100 forms which cause dementia including the most common which is Alzheimer’s. Other forms of dementia include vascular dementia, dementia with Lewy bodies, fronto-temporal dementia, mixed dementia (the person has more than one type of dementia).

Alzheimer’s disease and vascular dementia are responsible for up to 90% of cases of dementia. It is extremely important that more awareness and understanding of dementia is reached so we can challenge the myths and misconceptions that surround it. .

What Are The Symptoms Of Dementia?

Dementia symptoms vary depending on the cause. A person needs to have at least two types of impairment that significantly interfere with everyday life to receive a dementia diagnosis.

Common signs and symptoms include:

Cognitive Changes

1. Memory loss, which is usually noticed by a spouse or someone else
2. A difficulty communicating or finding words
3. Difficulty with visual and spatial abilities, such as getting lost while driving
4. A difficulty with reasoning or problem-solving
5. Difficulty handling complex tasks
6. Difficulty with planning and organizing
7. A difficulty with coordination and motor functions
8. Confusion and disorientation

Psychological Changes

1. Personality changes
2. Depression
3. Anxiety
4. Inappropriate behaviour
5. Paranoia
6. Agitation
7. Hallucination

Most people tend to worry they, or a loved one, will get dementia and although there is no cure, treatment and support is available.

Early symptoms to watch for if you are worried:

1. Memory loss, particularly for recent events. The changes are often subtle and an older person may be able to remember events that took place years ago but not what they had for breakfast.
2. Problems with language. Such as difficulty finding the right word, and conversations might take longer than normal.
3. Changes in mood and behaviour. Depression is a very common early indicator.
4. Along with mood changes, you might also see a shift in personality, i.e. going from being shy to outgoing. This is because dementia often affects a person’s judgment.
5. Becoming confused for a variety of reasons. These can include: forgetting things like keys or wallet, to not knowing whether they met someone before, to getting confused in familiar surroundings or situations.
6. The person can have a difficulty in following conversations, TV programs or reading.
7. Difficulty with their sense of direction. This can mean not recognizing once-familiar landmarks and forgetting regularly used directions. They may also find difficulty in following a series of directions or step-by-step instructions.
8. Difficulty managing money and everyday tasks. This may be subtle to begin with and can be combined with a difficulty in learning something new.
9. Difficulty solving problems or doing puzzles.
10. Loss of interest in hobbies and pastimes. Also apathy, a lack of initiative to start something or go somewhere. They may seem emotionally flat at times.
11. Repeating to themselves or a task. Such as repeating a question or story several times without realizing. Or repeating daily tasks, such as shaving, or they may collect items obsessively. Having a conversation with a loved one with dementia can be very difficult and upsetting at times.
12. Struggling to adapt to change. This may cause fear for the person as suddenly not knowing people they are with, unable to follow conversations, not knowing why or where they are is very frightening. They will crave routine and be very afraid of trying new things so don’t push them.

Early Diagnosis Is Vital.

Most people will experience a number of these signs. It is important to note that they will only increase and more will emerge gradually over time. This will cause stress for the individual and their loved ones.

If you feel you or a loved one has a problem please speak to your GP immediately as there may be another reason why you, or a loved one, are experiencing these symptoms. But an early diagnosis is important as it:

1. It enables carers and people with dementia to be better equipped to cope with the disease progression.
2. It provides people with dementia with an opportunity to make decisions about their financial and legal affairs while they still have the capacity to do so.
3. Plus it gives people with dementia a better chance to benefit from available drug and non-drug therapies. These may improve their cognition and enhance their quality of life.

Types Of Dementia

There are over hundred forms of dementia that cause the symptoms of dementia, and the boundaries between the different types are not necessarily distinct. Remember dementia happens as a result of changes that happen in the brain and the ultimate loss of nerve cells (neurons).

The most common causes are:

1. Alzheimer’s disease
2. Vascular dementia
3. Dementia with Lewy bodies
4. Fronto-temporal dementia (including Pick’s disease)
5. Creutzfeldt-Jakob disease 
6. Wernicke-Korsakoff syndrome
7. Mixed dementia. This refers to a situation where a person has more than one type of dementia.
8. Normal pressure hydrocephalus
9. Huntington’s disease
10. Brain damage due to injury or stroke
11. Other conditions may cause dementia in the later stages. These include multiple sclerosis and HIV.

Diagnosis

Early diagnosis is important. This is because there are a number of other often treatable conditions that may cause memory loss and confusion. Plus an early diagnoses will allow you to access supports, treatment and services, and make plans for the future.

Your doctor can refer you to a neurologist who will determine whether the symptoms result from dementia or another condition. There is, however, no simple test to make a diagnosis. Dementia can only be confirmed with certainty by examining the brain after death, despite significant improvements in brain imaging.

The neurologist will complete a series of memory and mental tests, a neurological exam, blood tests and brain imaging. Although dementia is more common in the over 65’s it may occur in people in the 30’s, 40’s and 50’ this is early onset dementia. With diagnosis and early treatment the disease progression may be slowed.

Treatment may include:

1. Medications
2. Cognitive training
3. Therapy

Complications Of Dementia.

As Dementia can affect many body systems it can lead to some complications. These include:

1. Poor nutrition because of reduced appetite or people may stop eating. They may be unable to chew and swallow either.
2. Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia.
3. Inability to perform self-care tasks. Including: bathing, dressing, brushing hair or teeth, using the toilet independently, and taking medications accurately.
4. Personal safety challenges. These can include driving, cooking and walking alone difficulties.
5. Death, in late-stage dementia.

Cutting Your Risk Factors

Risk factors include age, genetics, lifestyle choices and health conditions. There’s no sure way to prevent dementia, but there are steps you can take that might help. More research is needed, but it might be beneficial to do the following self-help.

Self-Help Tips.

Make sure you have a good basic self-care routine in place. This will include some of the following.

1. Sleep: sleep is extremely important to our mental and physical health. If you are fatigued you will have trouble with memory.
2. Keep active and eat healthy: Exercise and a healthy diet is also very important. Physical activity is thought to delay the symptoms of dementia. Eating a healthy Mediterranean diet is also thought to reduce cardiovascular problems and reduce your rick of dementia. So a diet which is rich in fruits, vegetables, whole grains and omega-3 fatty acids, which are commonly found in certain fish and nuts is best.
3. Most studies show that making sure you are getting enough vitamins will also decrease the likelihood of developing some forms of dementia. Vitamin D deficiency levels has been linked to increased likelihood of developing Alzheimer’s in particular. Vitamin D can be found in supplements and getting 15 minutes of sun exposure daily or in certain foods. Also include a daily B-complex and vitamin C tablet. As I’m not a medical doctor please speak to your GP before changing your diet and if possible get a nutritionist’s advice.
4. Keep your mind active with mentally stimulating activities. These can include: reading, solving puzzles, playing word games such as scrabble, and memory training.
5. Being socially. Social active has also been linked to decreasing and delaying symptoms of dementia in people.
6. Quit smoking. Studies have shown that smoking in middle age and beyond may increase your risk of dementia. This will also improve you health, you can find more help with this here.
7. Cut down on alcohol.
8. Make sure to have regular check-ups and treat any cardiovascular risk factors early. These include high blood pressure, cholesterol, diabetes and weight issues. These may lead to a higher risk of developing dementia if left untreated.
9. Reduce your stress levels.I’ve talked about how you can do this here
10. Treat your mental health as well as you do your physical health. Don’t let depression, anxiety, etc., go. Talk to your doctor sooner rather than later if you are concerned as early treatment means a quicker recovery.

Looking After Someone With Dementia.

It’s not just the person with dementia who’s affected by their illness. Their friends and family are also affected. If you are in this situation please note you too need support.

Partners may find that the relationships changes and becomes strained. Know that at this time you need to talk to someone such as a psychologist and perhaps consider joining a support group too.  It is important to voice your concerns and talk things through in an open manner. A psychologist can help you do this.

Make sure you understand all your rights and entitlements too as this can fall to the partner. Talk to services such as MABS, Citizens Advice or Department of Employment Affairs and Social Protection if you need help, especially financially.

You too need to reduce your stress, exercise, eat healthily and relax. You may need time off away from the family member you are caring for. Never feel guilty about this, as it isn’t unusual to find that you become ill as a result of all the stress.

Further Help

www.alzheimer.ie

www.understandtogether.ie

http://dementia.ie/ 

Work With Me.

Remember you are allowed to ask for support. No one is an island. If you need extra support then you can also work with me. We all struggle with stress and overwhelm from time to time. If you find this has become a problem for you and you’d like some support then schedule an appointment with me.