The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
If The Diagnosis Is Dementia
Dementia is one of the health conditions that people are most afraid of.
A study by the Alzheimer’s Society has shown that more than half of people wait for up to a year before getting help for dementia symptoms, because they feel afraid. But an accurate and early diagnosis can have many benefits.
After you’ve had the necessary tests , your doctor should ask if you want to know your diagnosis.
They should explain what having dementia might mean for you and give you time to talk about the condition and ask questions.
Unless you decide otherwise, your doctor, or a member of their team, should talk to you and your family or carer about:
- the type of dementia you have or, if it’s not clear, they should talk to you about being assessed again in the future
- the symptoms and how the condition might develop
- the treatments you might be offered
- the name of a health or social care professional who will co-ordinate the different types of support you need
- care and support services in your area, including support groups and voluntary organisations for people with dementia, their families and carers
- advocacy services
- how dementia will affect your driving or employment, if this applies to you
- where you can get financial and legal advice
You should also be given written information about dementia.
But What About Preventative Stuff
Finally, it depends on what type of appointment. Begin with the end in mind when it comes to specialty appointments and testing. Im not in any way saying people living with dementia deserve anything less in the way of care than anyone else.
What I am saying is theyre typically more medically fragile , and thats something that deserves consideration. Think carefully about routine mammograms, Pap smears, colonoscopies, and the like.
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Making Hospital Care Easier For A Person With Dementia
The philosophy of person-centred dementia care is considered best practice, but has to be adapted for the particular circumstances of the acute hospital. All healthcare team members must contribute.
Try to see the world through the eyes of the person with dementia. Make no assumption about what is understood or remembered. Hearing and visual impairments, and other physical impairments, can make confusion appear worse. Situations may be misinterpreted, often in terms of memories from the past . Responses will vary with personality and life history. Knowing about this from a personal profile can help .
Medical, nursing and interpersonal care must be individualised. Failure to see the whole person is a major source of resentment for family carers . Identify and make use of retained abilities. Occupational profiling can help by finding activities that the person with dementia can do and succeed at.
Providing purposeful activity can help to maintain abilities and represent a diversion to prevent boredom and restlessness. Opportunities to do this are few in acute hospitals, and have become fewer as hospitals become more brutally focused on sole management of acute medical problems. However, unregistered care assistants can deliver activities to those who are well enough. Mundane everyday tasks, including meals, can become an activity. Getting patients up and dressed enhances dignity and a sense of normality.
Your Best Choice May Not Be Your Family Doctor
Although a preliminary diagnosis may begin with your primary care doctor, theyll most likely refer you to a specialist. Some people express a preference to continue seeing their family doctor because its someone they know and trust. Others may feel disheartened by their diagnosis and question the use of seeing a specialist.
Thats an understandable concern, but misinformed. New research is published every month about findings in Alzheimers treatment. Although scientists havent yet found a cure, they have uncovered much that is helpful for people who have been diagnosed.
Dementia is a rapidly developing area of study, and its likely that the family doctor wont be as up to date with the latest information. This may be especially true in the case of early onset Alzheimers, where symptoms and treatment are less well-known among most regular doctors.
Seeing a specialist will ensure your loved one benefits from the most recent therapies and medications.
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Neurologist Or Memory Disorder Specialist
A neurologist is a specialist who is trained in nervous system disorders, especially issues with the brain, spinal cord, and peripheral nerves.2
As with most branches of medicine, neurologists can focus on different aspects of these disorders, or choose to concentrate their care on one disorder. This is something to consider when looking for a neurologist: ask them if they specialize in dementia or the care of Alzheimer’s patients.
In addition to a medical degree, neurologists complete an internship and then a residency in neurology that is at least three years long. If they decide to pursue further specialization like training in sleep medicine or want to focus on one disorder, they might have additional training after their residency.3
You might also see doctors labeled as memory disorder specialists. These can be neurologists, psychiatrists, psychologists, or geriatricians who specialize in diagnosing and treating dementia or other memory disorders.
Um Isnt That *sneaky*
To any reader aghast I would suggest just making the appointment without first getting buy-in or enduring negotiations akin to Middle East peace talks: I know it feels unnatural that as the partner, youre not treating your spouse as an equal. And that as the adult child, it feels like youre parenting your parent.
Im sorry youre going through this. It isnt fair, and it definitely sucks. Also, its now your responsibility to see to it that this person you love is getting the care he or she needs.
Your parent or partners whole brain is under attack, not just the memory part. Reason, logic, decision-making, insight, and judgment are all affected.
Let kindness be your guide. As my friend, grief therapist Georgena Eggleston, advises, Ask yourself, Whats the kindest, most loving thing I can do in this moment? and then do it!
The kindest thing isnt getting into an argument, or asking a person who can no longer access reason and logic to use it.
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What To Expect When You See A Gp About Dementia
A GP will ask about your symptoms and other aspects of your health.
They’ll also ask if you’re finding it difficult to manage everyday activities such as:
- washing and dressing
- cooking and shopping
- paying bills
If possible, someone who knows you well should be with you at your GP appointment, so they can describe any changes or problems they’ve noticed. They could also help you remember what was said at the appointment, if this is difficult for you.
Memory problems do not necessarily mean you have dementia. These problems can have other causes, such as:
- an underactive thyroid
- side effects of some medicines
To help rule out other causes of memory problems, the GP will do a physical examination and may organise tests, such as a blood test and urine test.
You’ll also be asked to do a memory or cognitive test to check any problems with your memory or ability to think clearly.
Read more about the tests used to diagnose dementia.
Dealing With A Parent Who Denies Dementia Symptoms
Is Dad or Mom having difficulty remembering appointments or names? Or getting lost coming home from the grocery store? You may notice it is becoming more difficult to have a conversation as your parent becomes confused and cant find the words to finish a sentence.
The signs of dementia are obvious to you, but when you mention the possibility to your parent, they deny the dementia symptoms and refuse to get help. What can you do?
Its important to understand the two main reasons why a parent would deny dementia symptoms:
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Speak Clear And Direct
To make sure they can understand what youre saying, even if they are pretty well cognitively, speak slowly and in a clear tone. It can take a few times for them to understand you, and if thats the case, try saying the same thing in a different way. Also, make sure you clearly state names , places, and what you will do.
For example, instead of Your son is here to visit. Why dont you go sit with him for a while, try Your son, Gary, is here to visit with you. Lets sit on the couch next to Gary and chat for a while.
A dementia diagnosis does not automatically mean there is hearing loss. Using loud voices when there isnt a hearing impairment can be condescending and lead to irritation.
What To Do If A Doctor Jumps To A Diagnosis In A Single Visit
Unfortunately, some doctors do jump quickly to a dementia diagnosis in only one visit. Even worse, they dont properly document what led to their decision.
If this happens, you may want to seek a second opinion from a doctor who is willing and able to do more thorough evaluation and testing.
Yes, there is a chance that your older adults symptoms could mean that they have dementia.
Thats why an accurate diagnosis is essential for proper treatment.
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Are Video Visits With A Dementia Doctor Online Covered By My Insurance
Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Dementia doctors who accept your insurance for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.
Various Types Of Demenita
There are various types of dementia. A few of those types include:
- Alzheimer’s disease: A form of dementia that is characterized by a loss of brain function in the areas of memory, thinking, perception, and behavior due to neuron degeneration.
- Amnestic mild cognitive impairment: A brain condition that is a form of cognitive impairment but is specific to memory loss and may be a transitional state between normal brain aging and Alzheimer’s disease.
- Frontotemporal dementia: A rare disorder that damages brain cells in the frontal and temporal lobes of the brain. It also affects a person’s personality significantly in the form of a decline in social skills as well as emotional apathy and memory loss.
- Vascular dementia : An accumulation of cerebrospinal fluid in the brain’s cavities resulting in added pressure on the brain. Individuals with dementia caused by normal pressure hydrocephalus often experience problems with movement, balance, bladder control, speech, problem-solving abilities, and memory.
- Normal pressure hydrocephalus: An accumulation of cerebrospinal fluid in the brain’s cavities resulting in added pressure on the brain. Individuals with dementia caused by normal pressure hydrocephalus often experience problems with movement, balance, bladder control, speech, problem-solving abilities, and memory.
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Key Symptoms Of Dementia
Dr. Kernisan describes the 5 issues that people with dementia typically experience:
- Difficulty with one or more types of mental function, like learning, memory, language, judgement
- Problems that are a change compared to the persons usual abilities
- Problems that make it difficult for them to manage everyday life responsibilities, like work or family
- Problems that arent caused by another mental disorder, like depression
What Are Memory Clinics And Centers
Memory centers are essentially a one-stop shop for everything a patient and their family may need living day to day with Alzheimers disease. These clinics offer a multidisciplinary, comprehensive approach to care.
At these clinics youll find a number of specialists, including behavioral neurologists, neuropsychologists, and geriatricians. These centers provide comprehensive diagnostic and treatment services for Alzheimers disease and other types of dementia. These centers also offer access to physical and occupational therapists and social services.
Your primary care doctor may be able to refer you to a memory clinic in your area. Many large hospitals and medical centers have memory disorder divisions.
You might also find helpful information through the Alzheimers and Related Dementias Education and Referral Center , a service of the National Institute on Aging , which funds Alzheimers Disease Research Centers at major medical institutions across the United States. The ADRCs offer help with obtaining diagnosis and opportunities to volunteer to participate in clinical trials in addition to other services. You can find a list of ADRCs on the NIA website.
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Dealing With Dementia: Tips For Communicating
Dementia is a biological brain disorder that progressively makes simple tasks very difficult for people. With memory and communication being two of the hardest-hit abilities in these patients, its critical to know how to communicate properly with them, making it a little easier for everyone involved. Here are a few things caregivers can do to help facilitate better communication with dementia patients.
What Is Mixed Dementia
It is common for people with dementia to have more than one form of dementia. For example, many people with dementia have both Alzheimer’s disease and vascular dementia.
Researchers who have conducted autopsy studies have looked at the brains of people who had dementia, and have suggested that most people age 80 and older probably have mixed dementia caused by a combination of brain changes related to Alzheimer’s disease,vascular disease-related processes, or another condition that involves the loss of nerve cell function or structure and nerve cell death .
Scientists are investigating how the underlying disease processes in mixed dementia start and influence each other. Further knowledge gains in this area will help researchers better understand these conditions and develop more personalized prevention and treatment strategies.
Other conditions that cause dementia-like symptoms can be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.
In addition, medical conditions such as stress, anxiety, depression, and delirium can cause serious memory problems that resemble dementia, as can side effects of certain medicines.
Researchers have also identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:
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Questions To Ask As You Put Together Your Alzheimers Healthcare Team
Naturally, you and your family will have a lot of questions for your doctors when youve been diagnosed with Alzheimers disease. Youll want to understand all the treatment options that may be available.
Youll also want to learn about all the risks and benefits of each option as your treatment plan evolves.
The following are examples of questions you may want to ask your primary care doctor or any specialists you may see:
- What is the usual course of Alzheimers disease?
- How long can a person with Alzheimers disease expect to function normally?
- What treatment options are available?
- What do you suggest would be the best treatment for me?
- If I take medication for my symptoms, how will you evaluate if it is working?
- What are the side effects of the currently available medications?
- At what stage of the disease might you suggest I stop taking medication?
- What clinical trials are available and how can I find out if I am eligible?
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Disorientation
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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Different Care Professionals You Will Meet
You will see professionals in a range of places, including hospitals and your home. Some will be NHS health professionals, including doctors and nurses. Others will be ‘allied health professionals, such as dentists.
You might also receive help from social care professionals. These are usually arranged through your local council.
Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
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