Dementia

Dementia is a group of symptoms--not a specific disease.  Depending on the type and the underlying cause, dementia can affect the way a person thinks, functions, and the way he or she interacts with others.

CORTICAL DEMENTIAS

• Alzheimer’s disease, Pick’s disease and Creutzfeldt-Jakob disease all affect the cortical region (or outer layer) of the brain.  They cause the characteristic problems with memory and aphasia.
• Alzheimer’s disease is, by far, the most common cause of dementia.  It is an irreversible disorder of the brain.
• Pick’s disease usually develops before age 70.
• Creutzfeldt-Jakob disease is very rare, affecting about 200 Americans each year.

SUB-CORTICAL DEMENTIAS

Dementias that arise from a deeper area in the brain, called the sub-cortical region, include Parkinson’s disease, Huntington’s disease and AIDS dementia complex.

COMBINED CORTICAL AND SUB-CORTICAL DEMENTIAS

Vascular dementia, also known as multi-infarct dementia is mental deterioration caused by a series of strokes in the brain.  These strokes are more common among men and usually begin after age 70.

THE THREE STAGES OF DEMENTIA

EARLY STAGE: People in the early stage of dementia may show signs of a gradual decline, such as:

• Becoming more forgetful of details or recent events.
• Repeating themselves during conversations.
• Showing poor judgment and making poor decisions.

MODERATE STAGE:  During the moderate stage of dementia, the problems become more obvious:

• Becoming very forgetful of recent events.
• Becoming confused about time and place.
• Getting lost in familiar surroundings.

SEVERE STAGE:  People who have severe dementia are in the third stage and need total care.  They:

• Are unable to remember things, even for a few minutes.
• Lose the ability to understand or use speech.
• Have difficulty walking.

TIPS FOR HELPING CLIENTS WHO HAVE DEMENTIA

• Always speak in short uncomplicated sentences to avoid confusing or overwhelming people with dementia.
• Keep distractions that aggravate your client to a minimum—such as televisions or radios, loud telephones and/or certain people.
• Try to use the same location each day for dressing and a different spot for undressing.
• Avoid mirrors if your client no longer recognizes him or herself.
• Keep afternoon and evening hours calm, filled with quiet activities only.
• Close the drapes and turn on the lights well before sunset.  This cuts down on shadows which can add to the client’s confusion.
• Keep daytime clothing hidden at night.  Your client may see the clothes and think that it’s time to get up and get dressed.
• Simplify mealtime by using just one plate, one piece of silverware and just a few food choices.
• Avoid using foam cups—dementia clients may try to eat them.
• Demonstrate how to chew and say “chew now” in a friendly tone of voice.
• Encourage your clients to finish one food completely before moving on to another.  (Some people get confused by a change in texture.)
• Be sure to report any sudden changes in appetite or other eating difficulties.  There may be a medical or treatable cause for the problem.
• For most people with dementia, the things they learned most recently are the most easily forgotten.  Allow your clients to focus on what they DO remember.
• There is a fine line between providing stimulation to people with dementia and overwhelming them.  Get to know each client as an individual so you know what their limits are.
• As with all clients, try to imagine how you would like to be treated and talked to if you were suffering from the confusing symptoms associated with dementia.