Dementia is not merely a problem of memory; memory loss alone does not mean you have dementia. Additional mental and behavioral problems often affect people who have dementia, and may greatly affect quality of life.
What is Dementia?
Dementia is not a disease itself, but rather a group of symptoms that are caused by various diseases or conditions. Dementia is the loss of mental functions such as thinking, memory and reasoning that is severe enough to interfere with a person's daily functioning. This loss in brain functioning is beyond what might be expected from normal aging.
Dementia may be the result of a brain injury, or it may be more progressive. More progressive dementia means the person continues to experience worsening symptoms. The two most common forms of dementia are Alzheimer’s disease and vascular dementia. Neither is a “curable” disease.
Alzheimer’s disease is a progressive disease that attacks the brain, slowly killing brain cells. About 60 percent of all dementia cases are Alzheimer’s cases. Generally, it begins with difficulty remembering recent events and doing familiar daily tasks and activities. Symptoms gradually worsen until many patients experience a total loss of function.
Vascular dementia results from small strokes or changes in the brain’s blood supply that kill brain tissue. A doctor may order a CT scan or MRI to help diagnose vascular dementia. The results of these tests will indicate “dead spots” or areas of infarct. A common cause of vascular dementia is high blood pressure. Many symptoms of vascular dementia may be similar to those of Alzheimer’s. However, unlike Alzheimer’s, symptoms of vascular dementia tend to appear quickly. The severity of vascular dementia may worsen as more strokes occur and cause more brain tissue to be destroyed. Specific symptoms depend upon which areas of the brain are damaged. Damage in one area of the brain may cause memory problems, while damage in another area may affect a patient’s behavior or personality.
In some cases, people suffering from the condition may need to eventually reside in a long-term care facility where they can receive 24/7 care.
What are the Symptoms of Dementia?
Dementia symptoms vary depending on the cause, but common signs and symptoms include:
- Confusion, starting with mild confusion then total disorientation
- Asking the same question repeatedly
- Trouble finding the correct term or word
- Impaired judgment
- Becoming lost in familiar places
- Difficulty with anxiety and paranoia
- Not knowing the current month or year
- A change from being mild mannered to irritable or even hostile
- Trouble finishing thoughts
- Trouble following directions or notes
- Trouble staying with a chore or job
- Losing concept of time or confusing night and day
- Neglecting personal safety, hygiene and nutrition
- Loss of ability to dress self correctly, then unable to dress self at all
- Unable to identify loved ones from strangers
- Unable to talk in an understandable manner, then loss of speech altogether
- Unable to toilet self
- Unable to feed self or walk
What Causes Dementia?
- Diseases, such as Alzheimer's, Parkinson's and Huntington's
- Toxic reactions and drug use
- Infections that affect the brain
- Nutritional deficiencies
- Head Injuries
- Certain illnesses that do not occur in the brain, such as kidney or liver disease
A thorough evaluation is important to determine the cause of the dementia. In some cases, dementia is treatable and reversible.
When Should Someone With Dementia See a Doctor?
See a doctor if you or a loved one experiences memory problems or other dementia symptoms. Some treatable medical conditions can cause dementia symptoms, so it's important that a doctor determine the underlying cause.
Alzheimer's disease and several other types of dementia worsen over time. Early diagnosis gives you time to plan for the future while you can participate in making decisions. The diagnosis of Alzheimer’s is usually confirmed with tests that evaluate behavior and thinking abilities, often followed by a brain scan.
Is Dementia Treatable?
Sentara Behavioral Health Services cares for patients with dementia, especially among seniors, with short-term, inpatient treatment and follow-up care. The symptoms and struggles seniors face are often complex. Many patients come to us with a mix of medical of psychiatric issues.
Our experts assess and treat the underlying causes of dementia, as well as the other medical conditions that may coexist. In some cases, dementia can be treated and cured, such as dementia caused by:
- Substance abuse
- Combinations of prescription medications
- Hormone or vitamin imbalances
- Severe depression
In most cases, however, true dementia cannot be cured. Therapy, however, is often useful in helping mildly impaired people adjust to their illness. Other times it helps patients adjust to or become more comfortable with new routines. Treatment and management for dementia may include:
- Behavioral therapy
- General caregiving
Certain steps can be taken in response to the very troubling symptom of memory loss. For example, placing labels or pictures of contents on the doors of closets or cabinet can serve as helpful reminders. Carrying a small pocket notebook with the names of friends and family may also aide memory. Headings, such as “Grandchildren,” can make the notebook even more helpful, along with children’s ages and parents’ names. Other information may also be included, such as the details of specific daily routines or important phone numbers.
As dementia worsens, patients frequently begin to wander. It is a good idea for the patient to wear an ID bracelet at all times and for clothes to be labeled with the patient’s name. During the early stages of dementia, a patient will want his or her wallet, purse, glasses, hearing aids, etc. However, gradually the patient will not remember to use these items. As dementia patients become more and more confused, they frequently will not know where they are. Keeping them busy with easy tasks such as folding clothes can help distract them from confusion. Gradually, the patient may also become more and more resistant to bathing and dressing. Bathing the patient less frequently (about two times a week) is sufficient and may also protect the patient’s skin from becoming too dry. Switching to clothing that can be worn during the day and at night for sleeping (like sweatshirts and pants) decreases the stress of having to change clothes.
Dealing with dementia in a loved one is very difficult. As the dementia progresses, past methods of dealing with your loved one may no longer work. You may need to tell “white lies” to keep peace. It may be easy to lose patience with your loved one, but impatience will only cause the symptoms and behaviors of dementia to worsen. Some tips for care providers include getting help from others, joining a support group, and remembering that you are better able to care for your loved one if you take care of yourself.