We’ve all forgotten a name, where we put our keys, or if we locked the front door. That doesn’t mean we have dementia. It’s normal to forget things once in a while. However, forgetting how to make change, use the telephone, or find your way home are probably signs of a more serious memory problem, such as mild cognitive impairment, dementia or the early stages of Alzheimer’s.

Serious memory problems such as dementia affect your elderly parent’s ability to carry out everyday life activities such as driving a car shopping, or handling money. Signs of dementia or other serious memory problems may include:

• Asking the same questions over and over again.
• Becoming lost in places you know well.
• Not being able to follow directions.
• Getting very confused about time, people and places.
• Not taking care of yourself — eating poorly, not bathing or being unsafe.

What is dementia?
Dementia is not a specific disease. It is a term used to describe a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations.

While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions – such as memory and language skills — are significantly impaired without loss of consciousness.  Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease.

Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems. Although it is common in very elderly individuals, dementia is not a normal part of the aging process.

Is there any treatment for dementia?
Drugs to specifically treat some progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual’s quality of life, ease the burden on caregivers, or delay admission to a nursing home.
Many researchers are also examining whether these drugs may be useful for treating other types of dementia.  Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices or note taking.

What is the prognosis?
There are many disorders that can cause dementia. Some, such as Alzheimer’s disease or Huntington’s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment. People with moderate or advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing and dressing.

What should I do if I’m worried about my parent’s memory?

Caregivers who are worried about their aging parent’s memory problems should make sure he or she sees a doctor. The doctor might conduct or order a thorough physical and mental health evaluation to reach a diagnosis. If your doctor thinks it’s serious, your elderly parent may need to have a complete checkup, including blood and urine tests. Your elderly parent may also need to take tests that check memory, problem solving, counting and language skills. In addition, he or she may need a CAT scan of the brain. These pictures can show normal and problem areas in the brain. Once the doctor finds out what is causing the memory problems, ask about what is the best treatment for your parent.

A complete medical exam for memory loss should review the person’s medical history, including the use of prescription and over-the-counter medicines, diet, past medical problems and general health. A correct diagnosis depends on accurate details, so in addition to talking with the patient, the doctor might ask a family member, caregiver or close friend for information.

Blood and urine tests can help the doctor find the cause of the memory problems or dementia. The doctor also might do tests for memory loss and test the person’s problem-solving and language abilities. A computed tomography (CT) or magnetic resonance imaging (MRI) brain scan may help rule out some causes of the memory problems.

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Dementia

What is dementia?

Dementia is not a single illness. It is a group of symptoms caused by specific brain disorders. The most common cause is Alzheimer’s disease, but dementia can also be the result of a stroke or mini-strokes.

The main symptoms are:

•    loss of memory – such as forgetting the way home from the shops, forgetting names or places, or being unable to remember what happened earlier in the day

•    mood changes – because of damage to parts of the brain that control emotions, people can become frightened, angry  or sad more easily

•    communication problems – a decline in the ability to talk, read and write

Dementia is progressive – the symptoms will get worse over time. Although there is no cure, treatments can slow the progression of the disease, and there are ways of helping to keep it manageable.

 

Understanding dementia

In Ireland, it is estimated that some 38,000 people are likely to have dementia. Because our population is ageing, these figures are likely to reach between 80 000 and 100 000 over the next 30 years. Both men and women are affected.

Becoming forgetful does not necessarily mean that someone has dementia: memory loss can be a normal part of ageing, and it can also be a sign of stress or depression. If you know someone who is worried about their memory, encourage them to visit their GP. A proper diagnosis of dementia is essential. The doctor – either a GP or a specialist – will carry out a number of tests, looking at both memory and the ability to perform daily tasks. The doctor will also aim to rule out any illnesses that might have similar symptoms to dementia, including depression. The right diagnosis, whatever it may be, can help patients and those close to them prepare and plan for the future.

 

Five simple ways to help someone living with dementia

1   Respect and dignity : Focus on what the person can do, not what they can’t.

2   Be a good listener and be friendly :  Support and accept the person, be patient.

3   Do one little thing : Cook a meal or run an errand, it all helps.

4    Make time for everyone : Partners, children and grandchildren will be affected.  Could you do something to help one of them?

5   Find out more : Understanding dementia makes living with it easier.

 

Practical tips

Especially in the early stages, there are lots of simple things you can do to help someone with dementia maintain their independence.

•  encourage them to keep a notebook or diary for things such as appointments, To Do lists, thoughts and ideas

•  keep important things like money, glasses and keys in the same place

•  put labels on doors and cupboards

•  place important numbers by  the phone where they can be seen easily

•   put a note on the back of  the door as a reminder to  take keys

•   label family photographs, both on display and in albums

•  pin a weekly timetable to  the wall

•   mark a calendar with the date or get an electronic calendar that changes automatically

•  write reminders to lock the door at night, turn the gas off and put the rubbish out on a certain day

There are products you can buy which are designed to help with memory problems – telephones  where buttons are replaced with photos of people, and pill boxes with compartments for different days. An occupational therapist may be able to advise you on what things could be most useful (you can find an occupational therapist through your GP or social services).

 

Keeping active

People with dementia can continue to enjoy many activities, both individually and with others. Remaining physically and mentally active can help them focus on the positive and fun aspects of life.

Many beneficial activities can be simple everyday tasks, such as taking a walk, polishing a pair of shoes, listening to the radio or looking after a pet. Think about ways of adapting favorite activities (for example, reading magazines and newspapers rather than books), to help the person avoid feeling frustrated that they can’t tackle things they previously took for granted.

Keeping active can help the person feel better about themselves by providing a structure to the day and a sense of achievement.  

 

Showing you understand

A diagnosis of dementia can cause different emotions, many of them difficult to manage both for the person with the illness and those around them. There may also be a sense of relief: now that they know what the problem is, they can begin to deal with it.

A person with dementia will probably be sad or upset at times. In the earlier stages, they may want to talk about their anxieties and the problems they are experiencing. Try to understand how they feel, and don’t brush their worries aside. Listen, let them talk, and show that you are there for them. When someone has dementia, they need:

•  reassurance that they are still valued, and that their feelings matter

•  freedom from as much external stress as possible

•  appropriate activities and stimulation to help them to remain alert and motivated for as long as possible.

Many people who have dementia develop what appears to be unusual or inappropriate behavior. Remember their actions may be perfectly rational to them. You may need to think about how their altered view of the world may lead to different ways of thinking and behaving.

A person with dementia is not being deliberately difficult: often their behavior is an attempt to communicate. If you can establish what this is, you can resolve their concerns more quickly. Try to put yourself in their place and understand what they are trying to express and how they might be feeling.

 

Support services

It is worth thinking ahead about support available, so it  will be easier to organize if needed in the future.

•  Social services have a duty to assess the needs of people with dementia. Help may be in the form of home care assistants, laundry services, meals on wheels or nursing care

•  Day care centres are often run by voluntary organisations such as Alzheimer’s Society, or by social services. They can be a great source of support both to the person with dementia and those who are caring for them

•  Respite care is short-term care used as a temporary alternative to someone’s usual care. It gives the carer an essential break from looking after the person with dementia

Other sources of support include hospital care, sheltered housing and residential care. Your GP or social services will know what is available in your area.

 

Other useful information and organizations

The Alzheimer Society of Ireland
National Office: Temple Road, Blackrock, Co Dublin
Tel (01) 207 3800 // Fax (01) 210 3772 // Email info@alzheimer.ie

 

Dementia Services Information and Development Centre

Top Floor, Hospital 4,

St. James’s Hospital,

James’s Street,

Dublin 8, Ireland  

http://www.dementia.ie/

 dsidc@stjames.ie   +353 1 4162035

The Carers Association
Ireland’s national voluntary organisation for and of family carers in the home. Family carers provide high levels of care to a range of people including frail older people, people with severe disabilities, the terminally ill and children with special needs: www.carersireland.com

Health Service Executive
The Health Service Executive provides thousands of different services in hospitals and communities across the country. These services include public health nurses treating older people in the community. This website also includes published Nursing Home Inspection Reports: www.hse.ie

Preventing falls

Many older people strive to live as active and as independent a life as they can. However a serious fall is all it takes to shake confidence and such a loss can have a negative impact on other areas of an older persons life eg: increasing the likelihood of social isolation.

How can I minimise the chances of a fall?

Falls should not be shrugged off as an inevitable part of ageing. Instead be aware of the factors that might contribute to falls and try to eliminate them. We cannot do anything about the unforeseeable, but we can do something about things we know increase the chances of a fall.

Exercising regularly can help to reduce the risk of falling  as can maintaining a Healthy Body .

Healthy Feet. Consult a chiropodist if your feet are in anyway unhealthy. If you have bunions for example you may wear shoes that are comfortable eg: soft slippers but which have no support in them and can cause trips and falls.

Medication. Some medications can cause dizziness resulting in falls so always explore with your GP or pharmacist any potential side effects of medication you are currently taking or are newly prescribed.

Eyesight. Failing vision can cause falls and therefore it is important that you regularly have your vision assessed by a qualified optician.

Ears. Infections of the ear or build up of wax can cause you to lose balance and therefore any ear problems should be treated as soon as possible.

Environment. Be sensible when undertaking tasks in hard to reach or high places, such as changing a light bulb. Do not stand on chairs instead always using equipment intended for the purpose such as step ladders. Take care on the stairs especially if wearing clothing that trails such as a long dressing gown. Keep lighting bright in areas of increased danger such as stairways and gardens.

What if I do fall?

This will depend on many factors but if you are not hurt then you might want to try and get up by grabbing something sturdy as being on the floor for too long can bring its own problems such as becoming very cold. If you can’t get up, you can’t reach the phone or you don’t have a personal alarm you should try to remain calm but you must attract attention by shouting or banging on the floor / wall.

Whilst waiting for help you should endeavour to keep warm by tensing your arm and leg muscles and if possible cover yourself with a coat or whatever you can reach in order to keep yourself warm

Have your fall assessed

Contact your GP or Primary Health nurse as soon as you can following a fall and they should ask you a series of questions to establish whether you require further medical attention. It would be useful also to ask for a falls risk assessment by a trained healthcare professional with an aim to uncover anything that might make you more likely to fall and to see if there are specific things that can be done to help. In the event that your GP does not offer such a service then contact HOMECARE PLUS and we would be happy to assist in undertaking such an assessment for you.

Home Help

Being a caregiver requires a lot of patience, a lot of time, and a lot of understanding. Most often than not, caregivers become very busy taking care of others and forget about themselves, resulting in frustration, stress, and anxiety or also called “Caregiver Burnout”.

Caregiver Burnout is when a caregiver is tired emotionally, physically, and mentally. This makes caregiving extremely difficult. In order to prevent such a burnout, it is recommended to just sit down and relax! Take a day/week off and spend it with friends, watch a movie, go shopping, stay in bed all day, or whatever it is that helps relieve stress. When doing these stress relieving activities, always remember that you deserve it after all the hard work and dedication you put into taking care of your parent or loved one. No need to feel guilty!

Symptoms of Caregiver Burnout:
•    Sleep Deprivation – sleepless nights
•    Increased Anxiety – not being able to relax
•    Overreacting to minor things – being unable to control patience
•    Hopelessness – being too emotional and feeling helpless
•    Significant Weight Change – unhealthy eating habits

Ways to Prevent Caregiver Burnout:
•    Make time for yourself
•    Ask for help when needed
•    Share your feelings instead of bottling it up
•    Relax
•    Get enough sleep
•    Eat Healthy
•    Get Exercise

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