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House Calls: Dealing with dementia

Dementia is a brain disorder that affects memory and thinking. Problems with short term memory can occur as a normal part of aging. Dementia involves symptoms that are severe enough to affect daily activities.

Alzheimer’s dementia is the most common form of dementia, making up about 60 percent of all dementia patients. About 4.7 million people ages 65 and older in the U.S. have Alzheimer’s. This includes over one tenth of people age 65 and older. This proportion increases to one third of people when they reach the age 85 and older.

Dementia is caused by brain cell death that happens over a period of time. Other forms of dementia include dementia due to strokes, Parkinson’s disease, Lewy body disease and dementia related to a head injury or a brain tumor. Stroke related dementia is the second leading cause of dementia. It is caused by the death of brain cells due to lack of blood flow. Alzheimer’s is caused by plaques and tangles between brain cells that kill these cells. These are also known as calcium deposits.

Symptoms of dementia include recent memory loss, such as asking the same question over and over again and forgetting you asked the question. Difficulty completing familiar tasks is another symptom. An example of this is cooking or making a drink and forgetting you did it. Patients who have dementia may have problems with language, such as forgetting simple words or using the wrong words. Disorientation with time and place, poor judgement, problems dealing with money, misplacing things, mood and personality changes and loss of initiative are all signs of dementia.

The first step in determining if you or a loved one has dementia is to see your doctor. A series of standard questions and completion of tasks will help with the diagnosis. An abbreviated mental test score has 10 questions which include the following: what is your age, what is the time to the nearest hour, repeat an address at the end of the test that I will give you now, what is the year, what is the name of the town we are in, can you recognize two people in the room, what is your date of birth, what year did an event occur that the patient should know, name the president and count backwards from 20 down to 1. Each correct answer gives one point, scoring seven or more is normal. If they score less than six points more in depth testing or investigation may be needed.

Death of brain cells cannot be reversed. There is no known cure. Treatment may be possible to prevent further brain damage and stabilize the illness. There are drugs such as Aricept, Exelon and Namenda which may improve quality of life and slow progression of dementia. Ways to reduce the risk factors in stroke related dementia are to stop smoking, stop use of alcohol, reduce cholesterol and control blood pressure and diabetes.

A diagnosis of dementia can be quite overwhelming to caregivers. Frustration and stress are normal responses of someone who is taking care of an elderly person with dementia. Unfortunately you cannot simply change the behavior of someone suffering from dementia. When you feel overwhelmed go to another room to collect your thoughts. Try calling a friend, praying, meditating, singing or listening to music. You must go at their pace. You must find activities they find enjoyable. Sometimes looking at old pictures or talking about when they were younger gives them satisfaction. Find something that gives them their old spark back. Plan activities that make them feel needed and useful. Give them responsibilities toward taking care of themselves and activities that boost their self-esteem. Try giving your loved-one who has dementia something to love such as a doll and let them express emotions freely.

Next week’s article will be on doll therapy with dementia patients. Studies show that a doll or stuffed animal can give these patients a reason to live and to feel needed. It brings them back to a good time in their life such as caring for their children. It gives them responsibilities. Women with dementia especially do well with dolls because they feel the need to nurture or love something. The dolls often help the patient become calmer and can actually help reduce some of the medications they take.

My daughter, Emily, recently founded a charity named Dolls for Dementia, Inc. The purpose of this non-profit organization is to raise money to purchase life-like dolls and stuffed animals for patients with dementia who are in nursing homes or other facilities. For more information visit her web site at www.dollsfordementia.com. I will give more information in my next article about the benefits of doll therapy for patients with dementia.

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