Alma And Silvias Story
Alma had been forgetful for years, but even after her family knew that Alzheimers disease was the cause of her forgetfulness, they never talked about what the future would bring. As time passed and the disease eroded Almas memory and ability to think and speak, she became less and less able to share her concerns and wishes with those close to her.
This made it hard for her daughter Silvia to know what Alma needed or wanted. When the doctors asked about feeding tubes or antibiotics to treat pneumonia, Silvia didnt know how to best reflect her mothers wishes. Her decisions had to be based on what she knew about her moms values, rather than on what Alma actually said she wanted.
Quality of life is an important issue when making healthcare decisions for people with dementia. For example, medicines are available that may delay or keep symptoms from becoming worse for a little while. Medicines also may help control some behavioral symptoms in people with mild-to-moderate Alzheimers disease.
However, some caregivers might not want drugs prescribed for people in the later stages of Alzheimers. They may believe that the persons quality of life is already so poor that the medicine is unlikely to make a difference. If the drug has serious side effects, they may be even more likely to decide against it.
Are There Treatments For Vascular Dementia
There are treatments to help with many of the symptoms of dementia. At the moment we do not have a treatment that cures vascular dementia.
How quickly it progresses is different for everyone. Your symptoms may stay the same for months, or even years, but then they will suddenly get worse. Although your dementia will not get any better, it may be possible to slow down how quickly it progresses.;;
Concerned About Memory Loss Talk To Your Doctor
Despite the decline in dementia rates reported in this study, people should still be concerned about their cognitive health, says Oh. Dementia is age-related, and as the population ages, the sheer number of people with dementia is going to be overwhelming, she notes.;
In addition to an aging population, people are also living longer. So, even though the percentage of the population with dementia may decline, the overall number of individuals with the disease is likely to increase.;
Regardless of declining rates, if youre experiencing any problems with memory, you should contact your doctor right away, she says.
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Lifestyle Changes To Improve Vascular Dementia Symptoms
A diagnosis of dementia is scary. But its important to remember that many people with dementia can lead healthy, fulfilling lives for years after the diagnosis. Dont give up on life! As much as possible, continue to look after your physical and emotional health, do the things you love to do, and spend time with family and friends.
The same strategies used to keep your brain healthy as you age and prevent the onset of dementia can also be used to improve symptoms.
Find new ways to get moving. Research suggests that even a leisurely 30-minute walk every day may reduce the risk of vascular dementia and help slow its progression. Regular exercise can also help control your weight, relieve stress, and boost your overall health and happiness.
Create a network of support. Seeking help and encouragement from friends, family, health care experts, and support groups can improve your outlook and your health. And its never to late to make new friends and expand your network.
Eat for heart health. Heart disease and stroke share many of the same risk factors, such as high LDL cholesterol , low HDL cholesterol , and high blood pressure. Adopting a heart-healthy diet may help to improve or slow down your dementia symptoms.
Make it a point to have more fun.Laughing, playing, and enjoying yourself are great ways to reduce stress and worry. Joy can energize you and inspire lifestyle changes that may prevent further strokes and compensate for memory and cognitive losses.
Can I Buy Medicines For Dementia
No – you cannot buy medicines for dementia. They are only available on prescription.
How to use the Yellow Card Scheme
If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to provide basic information about:
- The side-effect.
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Planning For The Future
- Talk to the person with dementia to make sure that they have a current up-to-date;will;that reflects their wishes.
- Encourage the person with dementia to set up a;Lasting Power of Attorney; so that a responsible person can make decisions on their behalf when they are no longer able to.
- Talk to the person with dementia about making an;advance decision;to refuse certain types of medical treatment in certain situations. It will only be used when the person with dementia has lost the capacity to make or communicate the decision in the future.
- If the person youre caring for has already lost the ability to make or communicate decisions but doesnt have an LPA, you can apply to the Court of Protection who can make decisions on behalf of that person or appoint someone else to do so.
If the person you care for drives, the law requires them to tell DVLA about their diagnosis. A diagnosis of dementia doesn’t automatically mean someone has to stop driving straight away – what matters is that they can drive safely. Talking to the person you care for about stopping driving can be very sensitive.;
Dementia Can Happen To Anybody
The risk of getting dementia increases with age, but it is important to remember that the majority of older people do not get dementia. It is not a normal part of ageing. Dementia can happen to anybody, but it is more common after the age of 65 years.When people between the age of 40 and 60 do develop dementia, it is called younger-onset dementia.
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Paranoia Delusion And Hallucinations
Distortions of reality, such as paranoia, delusions, and hallucinations, can be another result of the disease process in dementia. Not everyone with dementia develops these symptoms, but they can make dementia much more difficult to handle.
Lewy body dementia, in particular, increases the likelihood of delusions and hallucinations, although they can occur in all types of dementia.
How Should I Take These Medicines
It is usual to start with a low dose. This is then increased over a period of weeks to a target treatment dose. The dose is increased slowly because when you first start taking these medicines you may develop some unpleasant side-effects – for example, diarrhoea, feeling sick and being sick .
Most people who develop side-effects find that after a period of time these go away. If you are tolerating a low dose well, your doctor will increase your dose, if needed. How often the dose is increased depends upon which medicine you are taking. For example, if you are taking galantamine, the dose is increased every four weeks. If you are taking rivastigmine tablets, the dose is increased every two weeks.
See the leaflet that came with your medicine for more information.
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What Causes Dementia
More than 100 different diseases can cause dementia. In most cases, dementia isnt inherited from your parents see more on genetics of dementia.
Alzheimers disease, the most well-known cause of dementia, affects nearly 7 out of 10 people with dementia. Alzheimers disease causes certain proteins and other chemicals to build up in the brain and as a result, cells will gradually die and cause the brain to shrink. These changes interfere with a persons thinking and short-term memory, and results in dementia that worsens over time.
Vascular dementia is a broad term to describe dementia caused by problems with blood circulation to the brain. Some people develop dementia after several small strokes . Others develop dementia when high blood pressure and thickened arteries cause poor blood flow.
Lewy body disease causes unusual round clusters of protein to develop inside certain brain cells. These cells eventually break down and die, causing dementia.
Frontotemporal dementia is caused by gradual damage to the front and temporal lobes of the brain. In these cases, the first changes tend to occur in mood, behaviour and personality, rather than memory.
Alcohol-related dementia is a form of dementia caused by excessive alcohol consumption. Its thought that the brain damage is partly caused by a lack of vitamins due to consistent heavy drinking.
Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia ;Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Australian Government Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
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Other Ways To Preserve Cognition And Brain Function In Dementia
Heres the most important thing to keep in mind, when it comes to managing the cognitive decline of Alzheimers and other dementias:
Medications are only a small part of the solution.
In fact, there are many non-drug ways to optimize brain function.;They work for people who dont have dementia too, so Ive listed them in this post: How to Promote Brain Health: The Healthy Aging Checklist Part 1.
If youre concerned about preserving brain function and delaying cognitive decline, youll want to review the ten approaches I cover in the brain health article.
For instance, people often dont realize that many commonly used medications are anticholinergic, meaning they interfere with acetylcholine in the brain and worsen thinking. In other words, these medications essentially have the opposite effect of the cholinesterase inhibitors. Which is not so good for the brain.
In a perfect world, your doctors and pharmacists would notice this problem and stop the anticholinergic medications, or at least discuss the pros and cons with you. But as our healthcare system is still highly imperfect, this may not happen unless you ask for a medication review.
Delirium is another common problem that can worsen dementia and often accelerates cognitive decline. So to manage dementia and delay cognitive decline, it makes sense to learn about delirium prevention.
Getting Help Early Will Make A Difference
The earlier help is found, the better the family and person with the condition will be able to manage and cope. It is important to:
- plan ahead while the person can still legally sign documents, get enduring powers of attorney to manage financial affairs, medical decisions and guardianship
- get information find out about dementia and what lies ahead, so that you will be informed and have more sense of control
- seek support many people find it helpful to talk through what a diagnosis of dementia means and how they can make adjustments
- organise practical help organise help in the home, respite care, day trips and stays at day centres, which can all make a positive difference.
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What Support Is Available For Me If I Care For Someone With Dementia
When youre caring for someone else, its easy to overlook your own needs. But looking after your health and making time for yourself can help you feel better and cope better with your caring role.
Caring for someone with dementia may lead to feelings of guilt, sadness, confusion or anger. Unlike with other conditions, it can be difficult to share these feelings with someone with dementia, leaving you feeling very isolated.
Its important to acknowledge these feelings, and theres no right or wrong way to feel. If youre feeling anxious, depressed or struggling to cope stressed, talk to your doctor who can let you know about help and support available to you.
Drugs In Dementia Treatment
- There is currently no cure for dementia; however, there are medications that help with dementia symptoms.
- Health Canada has approved 4 drugs to improve cognition in dementia patients: donepezil, rivastigmine, galantamine and memantine. Donepezil, rivastigmine and galantamine are known as cholinesterase inhibitors and are prescribed for mild to moderate dementia. Memantine is one of a group of drugs called NMDA receptor antagonists and is prescribed for moderate to severe dementia.
- These drugs do not cure or slow the progression of the disease. Rather, they improve cognition and function .
- Medications to treat other symptoms or conditions, such as psychosis, depression, sleep disturbances or agitation, may also be prescribed.
- In 20152016, a total of 23,375 seniors living with dementia in Newfoundland and Labrador, Prince Edward Island, Manitoba, Alberta and British Columbia were prescribed the drugs listed above, according to CIHIs National Prescription Drug Utilization Information System. This is about 23.7% of all seniors living with dementia in these provinces, down from 28.0% in 20112012.
Non-pharmacological treatments such as social activity, music and cognitive therapies have also proven to be helpful in managing challenging behaviours and symptoms. These approaches can improve well-being and quality of life for seniors with dementia as well as for their caregivers.
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Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
Comfort Them Should They Wake In The Night
If your parent gets up in the middle of the night, try to establish the cause for waking.;Sit and talk with them for a while quietly in low light. Keep them relaxed and repeat actions they associate with bed time such as soft music until they are ready to return to their bedroom.
A wireless bed exit pad and alarm can help alert you if someone with dementia awakens and is prone to wandering in the night. A motion sensor pad is placed on the mattress. As soon as someone gets out of bed, a wireless signal is sent to the alarm which can be up to 90 metres away. It won’t go off if they just roll over, only when their weight is completely off the sensor. It is a smart way to remotely monitor whether your parent is still in bed, which can even help you to sleep better – safe in the knowledge that you will be alerted should they get up.
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Do These Medications Work For Mild Cognitive Impairment
Not as far as we know. The research evidence so far indicates that dementia medications do not improve outcomes for mild cognitive impairment.
However, it remains very common for patients with mild cognitive impairment to be prescribed donepezil or another cholinesterase inhibitor.
In principle, this should be done as a trial, meaning that the patient and clinician decide to try the medication, see if its helping with memory or other thinking difficulties, and stop if it doesnt appear to be helping.
In practice, many people with mild cognitive impairment end up taking the cholinesterase inhibitor indefinitely. They may be reluctant to stop, but in other cases, it may be that the prescribing doctor doesnt get around to checking on whether the medication is helping or not.
And Finally Do Everything You Can To Promote Relaxation
Create a restful environment in the evening and stick to a night-time routine. During mid-stage to advanced dementia there is advice that suggests someone with dementia shouldn’t watch TV or read a book as they can find this difficult and become frustrated; playing soft music may be a better alternative. You could even try reading to them. The bedroom should be comfortable, not too hot, not too cold and with cosy, breathable bedding.
Find more general tips for elderly parents on how to get a better nights sleep.
If you care for someone with dementia, you may want to consider a system like the CPR Guardian Smartwatch. This light and stylish watch is often preferred by elderly relatives who are used to wearing a watch every day. The CPR Guardian can pair with a carers smartphone, enabling them to find out the wearers GPS location and communicate with the wearer directly through the watch. The watch also comes with an SOS button that alerts the carer directly when pressed. It can even monitor the wearers heart rate! All of these features mean that there is always a way to keep track of your relative with dementia, make sure theyre okay, and be alerted if there is ever a problem.
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Researchers Around The World Are Working To Develop Effective Treatments For Dementia And Eventually To Find A Cure
Much of this work is focussed on Alzheimers disease, the most common form of dementia.
There is currently no cure for Alzheimers disease. Available medications can reduce symptoms and improve quality of life in some people, but they do not stop the progress of the disease.
The potential treatments discussed below are in the early stages of research and are not currently available. However, they are all part of the research effort to find more effective treatments for Alzheimers disease and ultimately a cure.