This course is intended to give you an overview of the common types and symptoms of dementia as well as going into how it can affect the brain in different ways. It also covers strategies to use with clients with dementia and dealing with challenging behaviour.
The course is intended for anyone who works with or around people that may be suffering from dementia
Dementia is used to describe the symptoms that occur when the brain is affected by specific diseases and conditions. It is a chronic progressive problem of cognition – which is the failure of the brain’s functions. It affects people at different stages of life, it affects different parts of the brain and it affects it at different speeds.
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What is dementia? For most people, dementia is associated with older people and is brought about by memory loss. This is not far from the truth. However, dementia is never described as any one disease. What this means is that the term dementia refers to a general term that was coined to explain different symptoms that are related to a cognitive decline or dwindling memory like forgetfulness.
There are close to 47.5 million people living with dementia worldwide. Dementia research has also shown that in every four seconds, a new patient is being diagnosed with the disease. Most people who suffer from dementia are elderly people. However, this does not mean that dementia is a normal part of the ageing process.
In the United States alone, for instance, it is estimated that about 4.7 million people above the age of 65 are said to have Alzheimer’s disease. This figure is important given that the Alzheimer’s Association says that Alzheimer’s disease accounts for 60 to 80 percent of all dementia diagnosis. While dementia is caused by different things, the main cause is brain cell death.
The existence of a neurodegenerative disease that results in the death of brain cells over a given period of time is also linked to most dementia cases. Still, doctors haven’t been able to verify whether dementia itself can result in the death of the brain cells. Other known causes of dementia include brain tumour, stroke, head injuries and many more.
Types of Dementia
As mentioned, dementia is a general term that is used to refer to different symptoms that are linked to memory and cognitive decline. As such, there are different types of dementia. It is important for anyone caring for a dementia patient to understand the different types of dementia as well as any dementia information that is available out there.
In addition, there is continuous research on dementia which will come in handy for any dementia caregiver as it will enable them to provide person-centered care for a dementia patient regardless of whether one is in a residential care home or nursing home. It’s also important to mention that care services for people living with dementia vary greatly depending on the different forms of dementia. Below are some types of dementia:
As stated, Alzheimer’s disease accounts for a large percentage when it comes to patients that are diagnosed with dementia. The brain of patients who suffer from the Alzheimer disease tends to have less cells and nerve connections which leads to a shrinkage in the brain size. Protein abnormality in the brain is linked to Alzheimer’s disease.
Lewy Body Dementia
Lewy Body Dementia is another form of dementia. In this case, there are abnormal structures that are found in the brain that lead to a cognitive decrease.
Vascular dementia is caused by conditions that damage the blood vessels in your brain. Once the blood vessels are damaged, their ability to supply the brain with the needed oxygen and nutrients it needs to perform thought processes effectively is greatly reduced. Some common causes that increase your risk of vascular dementia include stroke, heart disease and high blood pressure among others.
As the name suggests, mixed dementia refers to two or more type of dementia that exists together. For example, a patient may have both Alzheimer’s disease and vascular dementia.
Symptoms of Dementia
Symptoms and signs of dementia vary greatly from one patient to the other. However, there are certain symptoms that doctors and other health professionals can rely on in order to diagnose dementia. Some patients may be able to notice their own symptoms of dementia while others will rely on a caregiver or healthcare worker to notice the symptoms. Some of the signs and symptoms include:
Recent memory loss which results in one asking the same question frequently
Communication challenges – tend to forget simple words easily or even use the wrong words as well as difficulty in speaking their language
Struggle to complete familiar tasks such as making a drink or cooking a meal
Easily gets lost when walking or strolling down a street that was once familiar as a result of being confused or disoriented
Unexpected mood changes
Problems with keeping track of where they place their day-to-day items such as keys or wallets
Changes in their personality especially where they become apprehensive of anyone around them
For one to be fully diagnosed with dementia, the Alzheimer’s Association states that at least two of the below core mental functions must be greatly impaired. These include:
Reasoning and judgment
Communication and language
Ability to focus and pay attention
So far, research on dementia has shown that most dementia cases are progressive. This means that while the symptoms of dementia may start out steadily, they gradually increase and become worse. As such, if you notice any of the above symptoms in a friend or family member, it is important to have them see a doctor and have a proper evaluation done.
Early diagnosis can help dementia patients to make the most out of their life or, alternatively, volunteer for a clinical trial programme or study.
Generally, there are four different stages or phases of dementia. The four phases are mild cognitive impairment, mild, moderate and severe dementia. Health professionals are not only able to diagnose dementia, but with further standard tests, they can also ascertain what stage a patient’s dementia is at. So, what happens in each of the four stages?
Mild Cognitive Impairment
The mild cognitive impairment stage is normally categorized by general forgetfulness. Most people suffer from mild cognitive impairment as they age. However, not all people affected by mild cognitive impairment end up suffering from dementia.
Mild dementia simply means that the disease hasn’t worsened and can be managed with medication while allowing them to benefit from the treatments that are currently available. At this stage, patients still experience cognitive impairments that affect their day-to-day life. Some of the cognitive handicap experienced include difficulty in planning, memory loss, difficulty carrying out everyday tasks, personality changes, getting lost and disorientation.
Moderate dementia is basically a step-up from mild dementia. At this stage, people with dementia may find their day-to-day life more difficult thus requiring a little help along the way to do simple tasks that they were once familiar with such as dressing. Being a step-up from mild dementia, it means that the symptoms are the same. However, at this stage, the symptoms are hei8ghtened. In addition, they also become more irritable, suspicious and suffer sleep disturbances.
At this stage, patients are forced to live with the adverse effects of the disease. Patients may not only have difficulty communicating, but they also need 24/7 care. Patients at this stage may not have the capacity to recall their family members leave alone be able to sit up or hold their head up. Patients with severe dementia need a lot of support and patience from both their caregivers and family members.
As mentioned, doctors cannot adequately diagnose a patient with dementia unless they use some standard tests. These tests are designed to help doctors test for memory performance and cognitive health. While a doctor may start by asking a patient to do simple tasks and answer standard questions, they have to capture all answers in order to make the right diagnosis. Below are some of the largely used tests in diagnosing dementia.
The cognitive dementia test is one of the most widely used tests by most healthcare professionals. The test is also very reliable in helping doctors diagnose dementia thanks to the changes that have been made to it since it was first created. The test focuses on one’s mental state by asking ten different questions. These questions range from anything such as the patient’s age, date of birth, current year among others. For every question that the patient gives a correct answer, they earn a point. In the case a patient scores six or less points, it indicates cognitive impairment and the doctor can advise on the way forward.
The General Practitioner Assessment of Cognition (GPCOG) test was designed for doctors and is what is formally used in assessing the mental ability of a patient. In this test, doctors don’t just record the answers from the patients only but also includes recorded observations from relatives and caregivers. This assessment of relatives and caregivers is usually the second part and has questions that help the doctor decide whether the patient is struggling to remember recent events or conversations, struggles to find words to use in conversations or has difficulty in managing money among others.
Once the doctor has recorded all observations and feedback from the patient and all seem to indicate memory loss, the next step will be to recommend an investigation that will include a brain CT scan and blood test. These tests are what will be used to establish the cause of memory loss and even the stage of dementia.
The Mini-Mental State Examinations is another test used in diagnosing dementia. This is a cognitive test that is used in measuring attention and calculation, language abilities, word recall, orientation to place and time among others. The MMSE is largely used to establish dementia caused by the Alzheimer’s disease, its severity and whether there is a need to put the patient on any drug treatment.
Although science has come a long way and most diseases have treatments, the case is not the same for dementia. Although research is still being done, there is no known treatment for brain cell death. However, certain types of dementia such as Alzheimer’s disease can be managed with medication and proper care.
Some doctors will investigate the underlying cause and try to treat that to prevent further brain tissue damage. Early stage diagnosis of dementia can be managed by providing other quality of life care such as retraining the brain. While in some patients this may work, in some, it may not hence it’s important for doctors to manage the expectations of the family members and caregivers.
Also, managing dementia means in some cases, providing round the clock care and as such, taking care of people with living with dementia can be exhausting and draining. Besides, primary caregivers also need time off to take care of their own personal needs. It is therefore important to arrange for respite care. This allows them to get away for a few hours a day or for a given period of time.
Why Caregivers Need to Have Up-to-date Training
There are different causes of dementia. And while research on dementia is still widely being done, there is a need for carers to have up-to-date dementia training courses. Why? Because dementia patients are quite vulnerable and rely on their caregivers in order to make sense of what used to be their daily life. With proper care, the quality of life of people with dementia can be greatly improved.
In addition, caregivers who are up-to-date with recent studies, research and best care methods related to dementia are able to provide person-centred care especially if the patient suffers from severe memory loss and remembers little to nothing about themselves and their life. Besides reading books and articles related to dementia, caregivers can also take dementia awareness courses.
These courses are designed to equip people with skills and knowledge on the disease to provide the best possible care while supporting people living with dementia. Memory loss can make one anxious and irritable, and without proper support, they are more than likely to get worse. Besides, a better understanding of the disease among health professionals, caregivers and family can help qualified home nurses meet the set standards by relevant authorities.
A website like the NHS Online also provides a wide range of information on dementia that can also come in handy for caregivers and relatives alike. If you have a relative suffering from dementia or are considering becoming a dementia caregiver, consider taking a dementia awareness course.
Ultimately, the aim for any care home is to provide Dementia Friendly Nurses & Staff with adequate Studies & Research to be able to provide the best aid & care.