Written by Alisa Matsushita-Bomba & Reviewed by Gurnoor Mand
What is Dementia?
Dementia is a broad term used to describe a group of symptoms associated with a decline in cognitive function, including memory loss, difficulty communicating, changes in mood and behaviour, and feeling disoriented. It is a chronic disorder that progresses over time and impacts a large number of people worldwide, both directly and indirectly. Dementia is a collection of symptoms brought on by other illnesses; it is not a disease. For someone to remain healthy and have a good quality of life, it is important to understand what dementia is and what quality care could look like.
Causes of Dementia
Dementia is caused by damage to brain cells. Age, genetics, lifestyle choices, and other health complications are just a few examples of the many variables that can be risk factors. Dementia can take many different forms. The most common form of dementia is Alzheimer’s disease, which accounts for 60-80% of all cases. The abnormal accumulation of two proteins called amyloid and tau is thought to be the underlying cause of Alzheimer's disease. Amyloid plaque deposits form around brain cells. Tau buildups result in "tangles" within brain cells. Research is being done in this area, but there is still much to understand about how amyloid and tau contribute to the death of brain cells. Stroke, Parkinson's disease, Huntington's disease, and Creutzfeldt-Jakob disease are other causes of dementia. These drugs stop acetylcholine, a chemical that aids in nerve cell communication in the brain, from being broken down by an enzyme.
Dementia is Not a Normal Part of Aging
The frequent usage of the phrases "mental decline" or "early onset dementia" to describe dementia reflects the false belief that significant mental decline is a natural part of ageing. Being a medical condition, dementia does not affect all older adults. Although it is less frequent, dementia can occur in younger people as well.
Symptoms of Dementia
Depending on the type of dementia and the stage of the condition, the symptoms of dementia may change. Early signs may include confusion, disorientation, and trouble remembering information. They may have communication and language problems, attitude and behaviour changes, and a decrease in their capability to carry out daily tasks as the dementia progresses. In some cases, they may also experience problems with mobility and coordination.
There is no one test that can determine if someone has dementia or not. Diagnosing dementia can be a complex process and may involve several tests, including cognitive assessments, medical tests, and brain scans. A thorough evaluation by a healthcare professional is necessary to accurately diagnose the condition and rule out any other underlying conditions that may be causing the symptoms. However, it is harder to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap. A doctor may diagnose "dementia" and not specify a type.
It can be split into two groups based on the part of the brain is affected:
- Cortical dementias happen because of problems in the cerebral cortex, the outer layer of the brain. They are essential for language and memory. These varieties of dementia are characterised by significant memory loss, inability to understand language or remember words. The cortical dementias Creutzfeldt-Jakob disease and Alzheimer's are two examples.
- Subcortical dementias happen because of problems in the parts of the brain beneath the cortex. Subcortical dementia patients frequently experience alterations in their ability to initiate tasks and their speed of thought. People with subcortical dementia typically do not have forgetfulness or linguistic difficulties. These forms of dementia can be brought on by Parkinson's disease, Huntington's disease, and HIV.
Some dementias have an effect on both sides of the brain. Lewy Body dementia, for instance, has both cortical and subcortical components.
Treatment for Dementia
Unfortunately, as of now, there is no cure for dementia. There are treatments available that can slow down the progression of the condition and improve quality of life. Medications, such as cholinesterase inhibitors and memantine, can be used to improve symptoms and slow down the progression of the condition. Other treatments may include therapy, such as speech therapy, and natural interventions such as occupational therapy and physical therapy.
There are some medications to treat symptoms of dementia and keep them from progressing faster. In the case of most progressive dementias, including Alzheimer's disease, two treatments; aducanumab (Aduhelm™) and lecanemab (Leqembi™) demonstrate that removing beta-amyloid which is one of the hallmarks of Alzheimer’s disease, from the brain reduces cognitive and functional decline in people living with early Alzheimer’s.
Another common drug is acetylcholinesterase inhibitors. These drugs stop acetylcholine, a chemical that aids in nerve cell communication in the brain, from being broken down by an enzyme.
Care for People with Dementia
Providing care for people with dementia requires a compassionate and understanding approach. Here are some tips for providing the best care possible:
Create a safe and familiar environment. People with dementia may become disoriented and confused, so it’s important to create a safe and familiar environment for them. This may include having familiar objects and items around them, using comforting colours and textures, and providing clear and easy-to-understand signage. You can also use locks on cabinets for anything potentially dangerous, like medicine and dangerous tools, and install handles or grab bars in areas where it may be helpful. Develop a daily routine: Tasks that require the person to be alert and calm, like bathing and going to medical appointments, can be done at a certain time every day to minimise stress. If there are difficult days, allow some flexibility in your schedule.
Use clear communication: People with dementia may have difficulty communicating and understanding language, so it’s important to use clear, concise, and simple language when communicating with them. Avoid using abstract concepts or words that may be confusing. When giving instructions, try to tell them one step at a time to avoid confusion if they need it.
Engage in activities they enjoy: People with dementia may become bored and restless, so it’s important to engage them in activities they enjoy. This may include listening to music, playing games, or engaging in craft activities. Involving the person can be beneficial as well. Try to get them to do as much as possible with the least amount of assistance, like setting the table for dinner or grabbing their socks out of the drawer.
Be patient and understanding: People with dementia may become frustrated and agitated, so it’s important to be patient and understanding. Avoid scolding or criticising them, and instead offer reassurance and encouragement. When the person is having a difficult time, being calm is critical for them to feel safe and eventually get to a relaxed state again. Encourage physical activity: Exercise can be beneficial for people with dementia, as it can improve their mood, increase their energy levels, and slow down the progression of the condition. Encourage them to participate in physical activities, such as walking, swimming, or stretching.
Encourage socialisation with others: People with dementia can become socially isolated, so it’s important to encourage socialisation and engagement in activities. This may include visiting with friends and family, joining a recreational group, or participating in leisure activities such as crafts or gardening.
Make assisted dressing easier with adaptive clothing: People with dementia may need help getting dressed. Using adaptive clothing can make this process easier. June Adaptive has a clothing line specifically for assisted dressing, using features like fully-opening tops to eliminate the need to lift your arms and shoes that unzip open to allow easy slip-on. Find their clothing here, and read more about comfortable and warm adaptive clothing in another one of June Adaptive’s blog posts here.
Each person is unique, and not all people with dementia will require all of these tips. Remember to tailor these practical tips to their needs. Talk to your healthcare provider if you have any questions about how to best support the person.
Caring for Yourself As a Caregiver
Caring for someone with dementia can be physically and emotionally demanding, so it’s important to take care of yourself as well. Here are some tips for self-care:
Seek support from family and friends: Caring for someone with dementia can be a lonely and isolating experience, so it’s important to seek support from loved ones. This may include asking for help with tasks, sharing your feelings and concerns, and seeking advice from others who have gone through similar experiences.
Take breaks and set boundaries: Caring for someone with dementia can be a full-time job, so it’s important to take breaks and set boundaries. This may include scheduling time for yourself, delegating tasks to others, or seeking respite care to give yourself a break.
Seek counselling and support groups: Talking to a counsellor or joining a support group can be beneficial for managing the emotional stress of caring for someone with dementia. These resources can provide you with the support and understanding you need to cope with the demands of caregiving. Exercise and maintain a healthy lifestyle: Exercise and maintaining a healthy lifestyle can help reduce stress and improve your overall well-being. This may include regular exercise, eating a healthy diet, and getting adequate sleep.
Dementia is a progressive condition that affects millions of people worldwide. Understanding the condition and providing care for those who have it is crucial for ensuring their well-being and quality of life. Caregivers play a vital role in providing care, and it’s important to take care of themselves as well. By seeking support, taking breaks, and maintaining a healthy lifestyle, caregivers can manage the demands of caregiving and improve their own well-being.