Assisted Living

Dementia is a broad umbrella description used to describe declines in cognitive and intellectual abilities. It includes memory loss, confusion and disorientation.

There are almost 80 different types of dementia.

Alzheimer’s is the most common form of dementia. It is a progressive degenerative disorder that is characterized by an increasing loss of memory and changes in language, personality and the ability to handle activities of daily living.

Increasing age is the most common risk factor for Alzheimer’s. The prevalence among those 65 to 74 years of age is 2% to 4%; among those 75 to 84 years of age, it is 18% to 20%; and among those 85 years of age and older, it is 50%. If you hit 90 years of age, however, the odds of getting Alzheimer’s start going down.

Cognex (tacrine), Aricept (donepezil), Exelon (rivastigmine), Reminyl (galatamine), and Namenda (memantine) are medications currently available for Alzheimer’s. Cognex is one of the very first drugs to be approved for Alzheimer’s and is not being used much anymore. Some of the medications are available by patch.

The purpose of the medications that are currently available to treat Alzheimer’s is to try and slow down the progression of the disease. There isn’t a cure. Patti did note that when Namenda was first released, we put eight residents at Arden Courts on it and four were able to communicate and function better for a period of time. At that time, it was really significant because of the drastic change. Now, however, doctors are prescribing the medication so soon that most families will not see these shifts in ability. She stressed the importance of seeking the counsel of a doctor regard medications.

The signs and symptoms of early stage Alzheimer’s include loss of memory, difficulty following directions, difficulty handling money, difficulty driving a car, changes in mood, poor judgment and poor concentration. People are doing things that are not typical for them. They get lost within a mile of their home. They start drifting when they are driving. They often give away money to anyone and everyone. You’ll see changes in their mood because of the way the disease affects their brain.

For those in the middle stage of Alzheimer’s, memory loss is more severe because there has been more damage to the brain. People will be getting up in the middle of the night thinking they have to go to work. They will not understand what a tool is for, such as a toothbrush being used to brush your teeth. They will get agitated because they can’t make sense of the world around them. People will be wandering possibly because they are in pain, they are looking for something, or they are constipated. They will be rummaging because they no longer have an understanding of mine and yours. If they are hungry but can’t communicate this to anyone, this might trigger inappropriate or harmful behavior.

Late stage Alzheimer’s is probably the hardest stage for families. The person may be unable to communicate or use one word sentences. Immobility is common, and they likely need total assistance with activities of daily living.

Introduce yourself by name, and communicate at eye level. Remind the person that “we used to do such and such.” Speak and move slowly. Hand movement or the waving of hands as you talk can be a problem. Use a calm, non-demanding approach. Maintain good eye contact.

Validate the person’s feelings rather than patronizing them and saying everything will be okay.

If they are hallucinating or having delusions, do not tell them that it is just in your mind. To them, it is real. Patti talked about a resident she found sitting with her trench coat on and in tears. She was reliving her Mom’s death and was waiting for the undertaker to arrive. To her, the situation was real.

Understand that the layering or stripping of clothing is common because executive brain functioning and sense of modesty are gone. Patti talked about a person who wrapped a pair of pants over her head, with the pant legs around her neck. She was cold and used the pants as a hat and scarf.

Limit environmental distractions, and simplify the environment because an environment that is over stimulating can cause harmful behaviors. This includes too many bright and bold things and too many things that sparkle. Blinking lights on a Christmas tree, for instance, can be a problem.

Simplify tasks and routines. Give one step directions.

Be patient for responses. If you need to ask a question again, ask it the same way, using the same language.

If the person is not sleeping well at night, keep them active so they are not napping all day long.

Allow adequate rest between stimulating events. This often can be a problem during the holiday season. Someone with Alzheimer’s needs down time.

Physical Exercise – Physical exercise gets oxygen to your brain. It also helps you keep your muscles strong, which can help reduce your risk of falling and hitting your head. Show up for the exercise classes that are available at Heritage Woods, Patti told the residents who were in attendance at the program she was conducting.

Mental Exercise – The more you work your brain, the better it will function. Be sure to try new things. For instance, Patti told the residents of Heritage Woods, be sure to take advantage of the Dakim computerized brain fitness program that is available at Heritage Woods.

Get adequate sleep. Your brain needs time to rest.

Maintain a low stress level as stress is a factor that can feed into dementia.

Maintain normal blood pressure.

Eat a brain healthy diet. If it is good for your heart, it is good for your brain.

Protect yourself from head injuries. Wear a seat belt when driving or riding in a car and a helmet when riding a bicycle. Take steps necessary to maintain or improve your balance so you do not fall needlessly. If you feel wobbly, don’t ignore it. Seek help.