Understanding and Managing Dementia

Understanding and Managing Dementia

Dementia is not a normal part of aging. It is a chronic condition affecting brain function that causes a person to act in ways that he/she normally would not. This often leads to an inability to carry out everyday activities. Dementia generally develops slowly over time. 


It is characterized by forgetfulness, difficulty communicating, personality changes and difficulty performing tasks that involve thinking or decision making, such as taking a bus, playing games or managing money. 


The most common types of dementia in older adults are: 

  • Neurodegenerative (slow loss of function), including Alzheimer disease.
  • Vascular (generally caused by tissue damage from a stroke, can worsen with untreated diabetes and is often linked with high blood pressure).
  • A person could have both types of dementia at the same time.


Symptoms most commonly occur after age 65. It is common for a person to live approximately 10 years beyond diagnosis, but this varies. 


How Is Dementia Treated?

 

Once diagnosed, the goals of treating dementia are: 

  • Achieving the best possible physical and mental function.
  • Identifying and managing behavioral symptoms.
  • Identifying and treating any other health conditions that might make the dementia worse (e.g., diabetes, high blood pressure).


Medications and other treatments will not cure or reverse signs of dementia, but they can help maintain quality of life and increase safety for people with dementia and those around them. 

Treatments may include: 

  • Medications to increase function and cognition.
  • Medications to treat any associated depression.
  • Alterations to the physical home and other spaces to increase safety and decrease confusion.
  • Use of memory aids.
  • Avoidance of stressful situations.


If the dementia is not managed well, the following may occur: 

  • Falls.
  • Wandering or getting lost.
  • Depression.
  • Harm to self or others when stressed or confused.
  • Forced movement to a more restrictive environment (e.g., nursing home).
  • Loss of social and family connections.


What Should I Be Alert For?

 

If a person has been diagnosed with dementia, you will particularly want to watch for: 

  • Trouble with daily living skills
  • Tripping/falling hazards in the home and at other locations where he/she spends time
  • New things that can cause anxiety such as different care workers, new persons, etc.
  • Difficulty eating or not finishing meals
  • Bowel or bladder issues (trouble finding the bathroom)
  • Medication side effects: Medications used to manage dementia have a long list of potential side effects. Vomiting, diarrhea and weight loss have been reported. If a person is placed on a medication for dementia, ask the pharmacist or doctor about any potential side effects of this medication and what you should look for and report. There are sometimes other medication options available and each person may react differently to a medication, therefore it is important to communicate problems with a medication to the person’s doctor.


What Are Some Tips To Manage Dementia?

  • Dementia can be a challenging health condition for persons with dementia, their loved ones and caregivers. It is important that everyone surrounding the individual is educated about the condition and is committed to adjusting the environment to achieve a good quality of life and safety for all. 
  • Noisy environments and/or large spaces can cause confusion and stress. If the person goes to a day center for activities, inform staff to find a smaller room with quiet space if the individual starts to become confused or agitated. Recognizing a potentially uncomfortable situation before it escalates is important.
  • Create memory aids for the individual.
  • When transitions in staff or living arrangements occur, try to create a slow transition and make an effort to keep some items/routines familiar.
  • Remove any tripping or falling hazards such as rugs, cords or lightweight furniture.
  • Put signs up to cue the person, such as a photo of themselves on their room door, signs for ‘hot’ and ‘cold’ with colors on the tap and a photo of a toilet on the bathroom door.
  • Use effective communication strategies such as saying the person’s name often while you are talking to them, looking directly at the person when talking, slowing down, and explaining things before you do them (e.g., explain you’ll take a fork and help them cut their food, you’ll help them walk to the bathroom, etc.).
  • Break tasks into easy to manage segments (e.g., ‘One step at a time’).
  • Speak calmly and allow time for response.