Dementia: Starting the conversation

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Few things are more frustrating than misplacing the car keys – again. It is normal to forget things from time to time, like those keys, a wallet or that extra item on the grocery list. Even though this amounts to a mild inconvenience, it is aggravating and even distressing to have a lapse in memory.

Can you imagine how frightening it would be if you couldn’t remember the week-long vacation you just went on, as if the entire memory was erased? No matter how much you focused or concentrated you couldn’t remember taking that vacation. This is not an inconvenience; this is a symptom of dementia. dementia7

Dementia effects more than memory and can make everyday-life a struggle. Having a basic conversation is exhausting because every time you try to say a particular word, another comes out. You might read the simple instant-coffee directions over and over, but they never make sense. Easy tasks like buttoning your shirt seem impossible – as though your body isn’t doing what your brain is telling it to.

There are many aspects of dementia, and many misunderstandings. TMC is beginning a three-part blog series to discuss the definition, behaviors and treatment of dementia. This is the first blog, defining dementia and outlining its basic affects and characteristics. It might surprise you to learn all that dementia entails.

What is Dementia?
Dementia is a broad term for the diseases (or conditions) that cause nerve cells (neurons) in the brain to stop working or malfunction.

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Symptoms
When the nerve cells in the brain cease, a person will experience a decline in memory and the ability to think clearly and rationally. In addition, many experience changes in behavior, vision and motor function. The most common symptoms of dementia are:

•  Memory loss (affecting daily life)
•  Impaired judgment
•  Inability to reason
•  Problems focusing or paying attention
•  Confusion with time or place
•  Challenges completing familiar tasks
•  Problems finding the correct word(s) in speech and writing
•  Trouble understanding visual images and spatial relationships
•  Frequently misplacing things – inability to retrace steps
•  Changes in mood or personality

What are the causes?
The common causes of dementia are:

How does someone get a dementia-related disease?
Medical science has made significant advancements over the last thirty years, and dementia continues to be a dynamic research field. There are still many mysteries about the brain and it is not yet known, conclusively, what causes many dementia-related diseases.

Age is the greatest risk factor for acquiring dementia. According to the Centers for Disease Control and Prevention, about 10 percent of individuals over the age of 65 experience a form of dementia. Although the risk increases with age, not every senior will experience dementia.

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Family history is another strong risk factor. An individual is at higher risk if a sibling, parent or child has experienced dementia. Certain genes have been identified that indicate an increased risk for specific dementia-related diseases, such as Alzheimer’s.

Sudden or gradual?
Dementia symptoms progress slowly over several years. Many forms progress in stages:

  • Early Stage (Mild)
    • Recent memory loss
    • Difficulty managing money, driving, or handling social situations
  • Middle Stage (Moderate)
    • Difficulty with language
    • Problems keeping track of personal items
    • May need help with grooming
  • Late Stage (Severe)
    • Long- and short-term memory affected

If dementia symptoms are sudden and acute, it could suggest a reversible medical cause such as:

  • Urinary tract infections
  • Metabolic changes (Thyroid)
  • Nutritional deficiencies (Vitamin B12)
  • Tumors

The symptoms of dementia will drastically improve or alleviate when the reversible medical cause is treated. If sudden and severe symptoms arise, contact your doctor right away.

Behavior
Dementia can cause strange and unexpected behavior, which can be one of the most challenging symptoms for individuals and their caretakers. Like most chronic conditions, dementia can affect every person differently. Some of the more common behaviors are:dementia9

  • Repetitive actions, such as hitting, wiping surfaces, making noise (clapping, etc.), rocking
  • Wandering and pacing, not able to sit still
  • Going to the door often, trying to open locked doors, trying to leave when visitors leave
  • Boredom, lack of purpose, looking for something lost
  • Anxiety, stress, fear
  • Hunger, thirst, bathroom needs
  • Wanting to go home (even if at home)

Assisting a friend or family member who has dementia can be exceptionally challenging because symptoms can be severe and persistent. Often, a caretaker will have to repeat things several times – even within the span of a few minutes. The affected individual will usually respond negatively if someone tries to convince them that their thoughts or actions are irrational. The symptoms may become so acute that constant monitoring is needed.

Sound like it would be pretty hard to be the caretaker? It is, however, we must recognize the person’s behavior is beyond their control.

“If you are going to help a person with dementia, you must understand they cannot think, reason or remember,” said Terri Waldman, former director of memory and dementia care at Handmaker/Tucson Medical Center. “You have to let things go, and refrain from challenging their misconceptions.”
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What can we do?
Consult a physician who specializes in dementia-related illness. “It is important to get a diagnosis,” Waldman said. “A diagnosis will determine the most effective medical treatment(s) and will help the individual and their family develop the best care plan.”

 

Medical specialists will perform:
•  Mental status test (memory, reasoning, visual-motor skills)
•  Physical examination (lab tests, brain scan, test for other disorders)
•  Psychiatric evaluation (rule out emotionally related symptoms)
•  Family interviews (get more information about behavior and symptoms)
What treatments are available?
Currently, there is no cure for dementia and all dementia-related conditions are degenerative, meaning they will get worse over time. There are medications that can control or reduce the severity of symptoms, and there are medications that can slow the progression of dementia-related diseases. Medication therapy can help with behavioral and cognitive challenges, and improve the quality of life for some individuals experiencing dementia.

More than memory loss
Dementia is more than memory loss, and the numerous life-changing symptoms have a detrimental impact on individuals and families. Treatments are available, and it is important to know what symptoms to look for and who to talk with. Medical research continues to move quickly, in hope of finding a conclusive prevention and cure.

 

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Support resources:

World Alzheimer’s Day highlights the need for sufferers to be included

Today is World Alzheimer’s Day–a time to honor both people with dementia and their caregivers. Currently, 38 million people globally are affected by dementia. That number is expected to rise to 115 million by the year 2050.

Today is a good day to take a look at The World Alzheimer Report 2012: Overcoming the stigma of dementia. The report, released today, shares results from a worldwide survey conducted with people with dementia and carers on their personal experiences of stigma. The report provides information on stigma and dementia, highlights best practices in the field of dementia, and makes recommendations which could help reduce stigma.

Nicole Batsch, a former member of the TMC Senior Services team and one of the authors of the report, says,”I want you to take a moment to think about the people you know with dementia – whether in your family, or someone else’s family and think about how you can help them stay connected in everyday life perhaps with a smile, a conversation (being patient to wait for the answer) and activities you can enjoy together like visiting a park.”

According to Batsch, the message in the report is one of social exclusion by society. She insists that it is up to everyone to include people with dementia.

“Don’t be uncomfortable talking to a person with dementia or their carer. They need your help. Ask them how you can help,” she says.

The report and accompanying video can be found at: http://www.alz.co.uk/research/world-report-2012

 

New to Memory Loss? TMC Senior Services Can Help

Make a mental note that the Alzheimer’s Association designates Sept. 21 as World Alzheimer’s Day.  In fact, all of September is officially World Alzheimer’s Month, with a  purple “END ALZ” theme to push for solutions to the problem.

Programs offered year-round by Tucson Medical Center’s Senior Services help those dealing with dementia-related challenges, including an active Alzheimer’s and Related Dementias Project.

A special introductory session – “New to Memory Loss” – is offered periodically for those dealing with new memory-related diagnoses in themselves or their loved ones.  This talk is open to the public and, for those who are eligible, the session leads into a six-week Self Management Course on Memory Loss.

“Thank you so much for having a class on memory loss,” wrote one woman whose husband had been struggling with memory issues. “During the class he kept saying, ‘That’s me, I do that, I say that.’  My husband right away said he would like to take the workshop.  He went through two interviews and was accepted.

“It has helped him tremendously.  He is a different person.  He says he has learned what is happening to him and what is in the future.  I have my old husband back.  He still has memory loss, but he understands.”

The one-hour introductory session on memory loss, open to the public, is Thursday, Sept. 20, at 1 p.m. at the TMC Senior Services Classroom, El Dorado Health Campus, 1400 N. Wilmot.  Then, for those who are eligible, a six-week Self Management Course on Memory Loss starts Thursday, Sept 27.  The full course, with limited enrollment, requires a pre-registration interview and diagnosis of memory impairment.

For more information and registration on this session or other future offerings, contact TMC Senior Services, 324-1960.

Maxine Hale helped those impacted by Alzheimer’s maintain as much independence as possible

TMC Senior Services mourns the recent death of long-time volunteer Maxine Hale who died Aug. 10. L’Don Sawyer, our director of Senior Services, touched base with Jessie Pergrin, RN, PhD, with our Alzheimer’s & Related Dementia Project, and shared her thoughts on this talented and dedicated woman.

Maxine’s commitment to people was exemplified in her work on behalf of those coping with Alzheimer’s disease. Jessie first met Maxine in the mid-90s at a local Alzheimer’s Association support group. Her husband, John, would die of the disease within four years, and Maxine then spent the rest of her life helping others impacted by disease.

For seven years, she greeted callers and visitors at the Alzheimer’s Association, and worked to bring art to people with Alzheimer’s. Maxine then migrated over to TMC Senior Services, where she helped in the Alzheimer’s & Related Dementias Project.

Maxine spent 25 years in banking and retired as vice president from Home Federal Savings & Loan, where she was Southern Arizona’s first woman to serve in such a high-level role. This background contributed to her strong feelings about helping people maintain as much independence as possible. She had great expertise in reverse mortgages and was passionate about end-of-life wishes and advance directives. She led Getting Your Affairs in Order each month at Healthy Living Connections.

Maxine also volunteered with her church, and always was involved in the community, such as her work on the City of Tucson Block Grant Committee. To top it off, she was a wonderful painter. Below is an example of her work, a painting given to TMC Senior Services’ Anne Ciampa at her retirement party. 

Maxine was very smart, but often underestimated because of her small size and quiet nature. Behind the scenes, she had a quick wit and loved laughing. She will be missed by many, many people!

Maxine, on the right, with Anne Ciampa and L’Don Sawyer.

Anne Ciampa shows off the painting Maxine Hale gave her at her retirement party.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461