Coping with Dementia: A Guide for Caregivers and Patients

Dementia, which is now officially called major neurocognitive disorder, is characterized by memory loss and a decline in language, problem-solving, and other cognitive skills. It isn’t a disease but rather an over-arching term that affects people with a wide range of diseases and disorders. The most common disease associated with dementia is Alzheimer’s disease.

People with dementia will experience a reduction in their ability to complete everyday tasks that require general thinking skills. It’s a debilitating condition because it not only prevents the sufferer to carry out day-to-day activities, but also affects relationships due to change in behavior.

The symptoms of moderate to severe dementia make living independently unsafe, which results in the need for dementia patients to have full-time care. Coping with dementia can be difficult, but understand the causes can help to make the transition of living with dementia easier.

Dementia Causes and Symptoms

There are many symptoms of dementia, but you don’t have to have all the listed symptoms to be diagnosed. Some of the symptoms include:

  • Memory loss or decline
  • Diminished language comprehension or expression
  • Increasing confusion
  • Personality or behavioral changes
  • Loss of ability to do everyday tasks
  • Difficulty with reasoning or problem-solving

There’s no one specific cause for dementia. It could be the result of an injury, infection, or disease. Although dementia is often associated with old age, it’s not the only cause. It’s often the result of cell damage, which could be localized or spread out over a large area. In turn, this cell damage could be the result of many other factors. Some of the factors that could cause dementia include:

  • Alzheimer’s disease
  • Vascular cognitive impairment
  • Dementia with Lewy bodies
  • Frontotemporal dementia
  • Parkinson’s disease
  • Huntington’s disease
  • HIV
  • Traumatic brain injury

A number of neuropsychological tests can be performed on the patient to see if they have symptoms of dementia. These tests measure cognitive skills, memory, orientation, language skills, as well as reasoning and judgment. However, dementia is still difficult to diagnose. In order to properly diagnose dementia, a doctor must recognize a pattern of the loss of skills and function. Unfortunately, it’s difficult to see a pattern without seeing the patient on an ongoing basis.

Regardless, additional tests can still be run, including CT or MRI scans, which check for evidence of a stroke, bleeding of the brain, a tumor, or hydrocephalus, as well as PET scans, which monitor brain activity and measure whether the amyloid protein has been deposited in the brain, which is an indication of Alzheimer’s disease.

Coping with Dementia: Dementia stages

It’s generally accepted that there are three broad stages and seven stage models of dementia. The three progressive stages of dementia are: mild, moderate, and severe but the rate at which the dementia patient declines varies from person to person and also depends on the type of dementia they have. Understanding the various stages helps caregivers provide the right care to each patient and can help determine the most appropriate treatment plan.

The seven-stage model (Global Deterioration Scale) of dementia is as follows:

No Dementia (Stage 1-3)

Stage 1: During the first stage of dementia, the person functions normally and there is no memory impairment or memory loss. People with no dementia diagnosis are considered to be in stage 1.

Stage 2: At stage 2, the person experiences very mild cognitive decline, as well as normal memory loss associated with aging. At this stage, some level of forgetfulness will start to be noticed but symptoms of dementia are still not apparent to family members or caregivers. During stage 2, a balance of independence and care need to be given. It’s still assumed that the person can perform most tasks, but that help should be on hand if required.

Stage 3: At stage 3 friends and family generally start to notice cognitive problems. The person may start to experience memory loss, decreased performance at work and speech difficulties, as well as problems focusing on everyday tasks. It’s crucial that caregivers start to recognize the symptoms at this stage to provide appropriate support.

Early-Stage Dementia (Stage 4)

Stage 4: Moderate cognitive decline is experienced during stage 4 and neurologists are able to confidently diagnose early-stage dementia or Alzheimer’s. This stage generally lasts an average of 2 years. During stage 4, the person will have difficulty focusing, have poor short-term memory, may forget personal details, and have difficulty with simple arithmetic and finances, as well as have trouble traveling alone.

Mid-Stage Dementia (Stage 5-6)

Stage 5: At stage 5, the person experiences moderately severe cognitive decline and begins to need help with daily activities. They will begin to experience significant confusion and cognitive deterioration and may no longer be able to live alone. This stage lasts an average of 4 years and at this stage, dementia is quite easy to diagnose.

Stage 6: Severe cognitive decline is experienced at stage 6. This stage is characterized by worsened memory loss, difficulty recognizing family members, and some personality changes. The person may wander and routinely get lost, have difficulty with perception and start experiencing delusions or hallucinations. At this stage, a disturbance in sleeping patterns generally starts to begin.

Late-stage Dementia (Stage 7)

Stage 7: Stage 7 is characterized by very severe cognitive decline. This is the final stage of dementia and at this point, communication is limited and physical ability has started to decline. The person will most often experience difficulty eating or swallowing, angry outbursts due to confusion, incontinence, and restlessness. They will also be more vulnerable to infections like pneumonia at this stage.

Treatment for Dementia Patients

Unfortunately, most types of dementia can’t be cured, but if managed correctly, the symptoms of patients can be reduced dramatically. If you are caring for a parent or other loved one with dementia at home, what’s most important is ensuring that they have a safe, comfortable environment to live in that minimizes confusion and the number of outbursts. While coping with dementia isn’t easy, it’s possible for a dementia patient to live a fulfilling life, especially during the earlier stages.

Some therapies to help make dementia patients’ environment more comfortable include:

Occupational Therapy

Since dementia is a progressive condition, which means it continues to get worse with time, it’s important to prepare for the worst and ensure that the dementia patient’s environment is as safe and comfortable as possible. An occupational therapist can help you with this as well as teach you coping mechanisms. The main goal is to prevent accidents and prepare for dementia progression.

Adjusting the Dementia Patient’s Environment

Because people with dementia suffer from memory and cognitive decline, tasks that seemed routine before will now seem momentous and everyday objects will seem unusual and confusing. Because of this, it’s important to modify their environment so that it’s easier for them to navigate this confusing space. Adjustments include safety measures such as removing knives and other sharp objects and minimizing tripping hazards.

Reminiscence Therapy

This type of therapy is especially important for family and close friends of the dementia patient as they will have the most memories to discuss and reminisce about. Talking about memories and reminding them of important facts about their life and milestones such as where they went to school, what they used to do for a living, which neighborhood they grew up in, and what they used to like to spend time doing with their friends and family. You can use various prompts for this exercise like playing some music that is significant or showing the patient photos or objects from their past.

Simplifying Tasks

For the same reason that adjusting the environment is important, simplifying tasks is also useful in helping dementia patients cope with day-to-day tasks so that they don’t get overwhelmed. This could include breaking tasks down into smaller parts or explaining each task in straightforward terms. Lots of structure and routine is also good for dementia patients to minimize confusion.

Home Health Care for Dementia

To cope with dementia during the later stages, sufferers will normally require constant care. Home health care is a great option for dementia patients. Patients get to be in a comfortable, familiar environment while still receiving professional care. Children caring for elderly parents also get to have peace of mind that their parent is in good hands, allowing them to focus on work and other everyday activities, all while being able to have their parent living with them under the same roof.

Rozanne WildsCoping with Dementia: A Guide for Caregivers and Patients

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