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How to Identify and Help Manage Dementia

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Dementia

As we age, our bodies and our minds evolve. Sometimes this change results in cognitive decline, including a lessening of mental acuity related to dementia.

Identifying, acknowledging, and managing this season of change can be a challenge for the person affected, their caregiver(s) and their family members and friends.

Alzheimer’s disease and other forms of dementia currently affect more than five million Americans over the age of 65; it also affects younger men and women. Learning the signs of dementia, as well as tips for managing the condition, can help improve the quality of life for all involved.

What is Dementia?

According to MedicineNet, dementia is defined as a "significant loss of intellectual abilities, such as memory capacity, that is severe enough to interfere with social or occupational functioning. ... By definition, dementia is not due to major depression or schizophrenia. Alzheimer's disease is the most common cause of dementia."

Typically associated with the most common symptoms such as memory loss and forgetfulness, Alzheimer’s disease progresses from mild cognitive impairment to serious (severe) cognitive impairment with loss of language and motor skills. Other dementia impacts can vary.

How to identify dementia symptoms

Dementia affects everyone differently. Be aware symptoms can develop slowly and build progressively over time. While it is important to recognize the initial symptoms of dementia, you should contact your physician for more information.

Here are some of the early warning signs of dementia in seniors.

  • Short-term memory loss and difficulty finding the right words or phrasing are probably the most well-known and common symptoms of dementia.
  • Visible changes in mood and attitude, such as unexplained outbursts of anger and aggression, are also common. Flares of aggression and anger directed toward caregivers and other family members are reported in 30% of dementia patients. Aggression can sometimes be severe and is often rooted in their frustration of being unable to complete everyday tasks. 
  • Increased confusion can cause difficulty in completing normal, everyday tasks. Obsessive and repetitive behaviors including hiding, hoarding, and rummaging are often caused by confusion and communicate the need for security, novelty, and control.
  • Changes to spatial relation processing abilities can result in accidents or difficulty with directions, getting lost on the way to the grocery store, or finding the way back home.
  • Difficulty with change or disruptions to normal patterns and routines, which can lead to fear, stress, and anxiety.
  • Sundowning is a heightened sense of restlessness, confusion, and anxiety people living with Alzheimer’s or dementia often experience late in the day and as night approaches.

Signs and symptoms of advanced dementia

As dementia progresses, its symptoms rob the person’s quality of life and well-being. It impacts their ability to perform everyday tasks and activities they once enjoyed. Advanced dementia can cause:

  • Changes in personality
  • Depression and anxiety
  • Inappropriate behavior
  • Paranoia
  • Increased agitation
  • Wandering - A stressful or over-stimulating environment can cause an individual with dementia to leave their home or place of care. As dementia progresses, it can be difficult for the affected person to remember major environmental and life changes, so they may mistakenly engage in old routines, such as leaving the house to go to work at a job they have long since retired from or to visit a store no longer in business. 
  • Hallucinations - These hallucinations may begin as auditory but can manifest themselves in any of the senses: the person may taste, smell, feel, see, and hear things that aren’t real.

Dementia Causes and Risk Factors

According to the Alzheimer's Association, there are a number of factors that can potentially increase the risk of developing Alzheimer's disease and dementia. These include:

  • Age
  • Genetics and heredity
  • Race and ethnicity - Hispanic and African American adults have been found more likely to suffer from dementia and Alzheimer's disease than Caucasian adults.

How to support and manage those with dementia

The severity and intensity of dementia symptoms vary from person to person. Depending on their individual circumstances, many families find it difficult to offer a full range of care necessary to keep those with dementia safe and comfortable.

In-home caregivers and other memory care resources are available to support seniors dealing with dementia to maintain their dignity, sense of purpose, and quality of life. 

There are also memory care programs in both assisted living and skilled nursing centers designed to offer individualized attention to ensure all of your loved one's needs are met now and as their symptoms progress and evolve.

Tips on managing dementia

When providing care for a person living with dementia, there are many challenges caregivers face. Remember the anger or frustration you may feel in this situation is normal and does not mean you are a bad person.

As your loved one’s condition worsens, so does their ability to communicate, act and think clearly, and perform many common daily tasks we take for granted. Take into account that individuals with dementia are not deliberately being difficult. Their brains are undergoing physical changes that kill healthy cells and prevent normal functioning. Their sense of reality becomes different from ours but very real to them. We can’t change the person with dementia but, as caregivers, we can employ strategies to deal with problem behaviors.

It is important, too, to examine the behavior objectively.

  • Can the actions of your loved one result in any harm to them or to others? 
  • Is the behavior embarrassing, disruptive, or uncomfortable, but not harmful?

By keeping patience and love at the top of the emotional toolbox, caregivers can provide a good amount of support needed at this most difficult time. Here are ways to help manage some challenging dementia behaviors

Managing dementia symptoms

Discover more about how to manage difficult dementia behaviors

Aggression and anger

  • Make sure you and your loved one are not in any physical danger and then let the behavior run its course. 
  • Try to distract the person by focusing their attention on a topic of discussion or activity away from the anger and towards a source of joy. 
  • Refrain from hugging or physically comforting your loved one then, as physical contact during such incidents often only increases the severity of the outburst.

Repetitive actions 

  • Focus on the emotional stimuli that drive the behaviors to reduce the frustration you feel as a caregiver. 
  • Remember in these episodes of repetition, your loved one needs assurance and comfort most of all.

Sundowning

  • Monitor your loved one’s diet to limit sugar, non-nutritious foods, and caffeine. 
  • Set up a sleep schedule to encourage a mental wind-down before bedtime. 
  • Encourage physical activity throughout the day. 
  • Keep a commode near their bed to remove confusion in finding the bathroom during the night.

Wandering

  • Reduce noise in the home, including loud TVs, computers, or exhaust fans to prevent increased levels of stress and anxiety. 
  • If they are able, encourage your loved one to engage in physical activity – exercise, dancing, or movement games – to reduce restlessness and promote peaceful sleep. 
  • Offer verbal reassurance that your loved one is secure and in a safe place. 
  • Remove items commonly taken when leaving the home, such as keys, wallets, jewelry, and purses. 
  • Talk to their doctor about pain treatment options as a dementia patient may be wandering in an attempt to escape pain and discomfort.

Hallucinations

  • Talk to the physician immediately if your loved one begins to show signs of experiencing hallucinations. 
  • Create tranquil surroundings with low light and comfortable room temperature. 
  • Remove any potential obstacles or tripping hazards. 
  • Offer reassurance that you are near, the room is safe, and he or she is secure and loved. Direct your loved one’s energy and attention to a favorite song, memory, or game to shift the mind away from feelings of paranoia and toward a calm, relaxed state.

Hiding, hoarding, and rummaging

  • Assess the situation from the standpoint of what may be potentially harmful, and remove only those items.
  • Negotiate the removal of other harmful items to which your loved one may have an emotional attachment, if necessary. 
  • Let your loved one know items can be donated to a church, charitable organization, or a family in need.

A sensory approach to helping manage dementia and Alzheimer's

In addition to the approaches listed above, you may also try a sensory approach to help manage advancing dementia. 

A sensory approach means using everyday objects to stimulate senses to trigger emotions and memories in seniors who have lost their ability to connect with the world around them.

Look around your home — most objects supply us with sensory input. Those family photos represent visual memories and expressions of happiness. That pile of old books has the scent of antiquity and a weight and paper delicacy that triggers our sense of touch.

Impact of this approach

This sensory stimulation can be used strategically to arouse one or more of the five senses to evoke positive feelings. For people with Alzheimer’s disease or dementia, it’s a way to explore a safe, stimulating environment and have the means to express themselves when they can no longer do so with words. 

By drawing attention to a particular item, sensory stimulation encourages memories and responses from those living with dementia. It can help them feel safe and relaxed and may improve their mood, self-esteem, and well-being.

Sensory stimulation works best with familiar objects. Good sensory cues include:

  • Familiar foods and clothing
  • Natural materials, such as flowers
  • Sensory-rich materials, such as wood grains, and grooming and cooking tools

Activities involved in sensory stimulation are often linked to interests the person had prior to dementia and can help build a connection to everyday life. Sensory stimulation activities might include:

  • Bringing in objects the senior does not normally have around, such as sand, seashells, or other items
  • Giving a hand massage
  • Taking a short walk
  • Talking and reading aloud
  • Providing a change of scenery by taking the individual outdoors

Steps to create a sensory experience

Start by learning more about the person with dementia. The most important step is to notice what the person is experiencing. Look for sensory cues and observe how the person with dementia relates to the world through their senses. Make sure to sit close to make sure the person can see and hear you.

Think about the person’s interests and experiences they had earlier in life. This will allow you to create a sensory experience. 

Let’s use the theme of summer vacations on Cape Cod as an example. Here are items that would stimulate the five senses as you create a sensory experience around sunny beachside adventures.

  1. Sight - Present laminated photos of Cape Cod beaches, or familiar landmarks and restaurants.
  2. Sound - Play sounds of the beach through a sound machine, computer, or phone.
  3. Touch - Offer a bowl or bin filled with sand and shells.
  4. Smell - Light a scented candle or scent diffuser with the aroma of suntan oil or give a hand massage with sunscreen.
  5. Taste - Share food the person with dementia may have enjoyed on Cape Cod, such as watermelon, clam chowder, or a glass of cold iced tea.

Allow the person to explore and experience each item. Talk about the theme with a few simple words that will trigger their memories — allow the memories to surface and the smiles to emerge.

SALMON Health and Retirement offers a range of services designed to meet the needs of people living with Alzheimer’s disease or dementia and provides support for the entire family at every stage. In addition to housing, healthcare, and programs for seniors, SALMON Health and Retirement communities offer support groups and resources for caregivers and family members. 

To learn more about the options available to you and your loved ones, contact us today by calling 888-587-8136 for more information.

 

About Us

Organizations such as SALMON Health and Retirement are ready and able to offer assistance so your loved one can have their best life possible, even as their needs increase. SALMON Health and Retirement provides a full spectrum of senior living choices and helps support your caregiving efforts. To learn more about the options available to you and your loved ones, contact us today by calling 888-587-4409 for more information.