Living With Frontotemporal Dementia
Coping with FTD can be frightening, frustrating, and embarrassing for the patient and family members. Since some symptoms cant be controlled, family members shouldn’t take their loved ones behaviors personally. Families need to maintain their own well-being, while ensuring that their loved one is treated with dignity and respect.
Caregivers should learn all they can about FTD and gather a team of experts to help the family meet the medical, financial, and emotional challenges they are facing.
Its important to find a healthcare provider knowledgeable about FTD. Other healthcare specialists who may play a role on the team are home care nurses, neuropsychologists, genetic counselors, speech and language therapists, as well as physical and occupational therapists. Social workers can help the patient and caregivers find community resources, such as medical supplies and equipment, nursing care, support groups, respite care, and financial assistance.
Attorneys and financial advisors can help families prepare for the later stages of the disease.
Advanced planning will help smooth future transitions for the patient and family members, and may allow all to participate in the decision-making process.
Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
How Can I Support Someone With Dementia Towards The End Of Life
Knowing the person will make it easier to provide person-centred care that is focused on what they need and want. It can help to know about their likes, dislikes and their wishes for how they want to be cared for. If the person isnt able to tell you about themselves, speak to their family, friends or other people who know them well.
Its a good idea to find out if the person has a copy of This is me , a document that records information about themselves. If you cant speak to the person, ask those close to them if they have a copy. They may have these details recorded in their care plan.
There are many ways to support someone with dementia at the end of life.
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Can Dementia Be Inappropriately Diagnosed In A Single Visit
Sadly, yes. Although its common for doctors to never diagnose dementia at all in people who have it, I have also come across several instances of busy doctors rattling off a dementia diagnosis, without adequately documenting how they reached this conclusion.
Now, often these doctors are right. Dementia becomes common as people age, so if a family complains of memory problems and paranoia in an 89 year old, chances are quite high that the older person has dementia.
But sometimes its not. Sometimes its slowly resolving delirium along with a brain-clouding medication. Sometimes its depression.
It is a major thing to diagnose someone with dementia. So although its not possible for an average doctor to evaluate with as much detail as the memory clinic does, its important to document consideration of the five essential features as listed above.
Dementia Stages: How Fast Dementia Progresses Stages Of Dementia And More
Dementia is a progressive impairment of cognitive function caused by damage to the brain. Over time, a person with dementia will have increased difficulty with memory, understanding, communication, and reasoning.
Healthcare providers frequently speak about a persons dementia in terms of stages. This can be helpful for communicating with family or other healthcare providers regarding the persons illness, and it is important for determining an appropriate care plan.
How Fast Does Dementia Progress?
It is important to note that dementia progresses at different speeds for every person, and for different types of dementia. The most well-known form of dementia, Alzheimers disease, is just one specific type of dementia, and tends to have the slowest progression of all types. Some factors that affect the rate of progression include:
- Age
- Repeated infections
What are the Stages of Dementia?
There are a few different systems used to grade dementia — at the most basic there is early, moderate, and end. Many providers use the system developed by Dr. Barry Reisberg of New York University which includes 7 stages. The Reisberg scale is also known as the GDS or Global Deterioration Scale for Assessment of Primary Degenerative Dementia. This scale focuses primarily on cognitive abilities.
Dementia Stages in the Reisberg Scale
Dementia Stages in the FAST Scale
Dementia Stages in the CDR Scale
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Memory Loss And Confusion
My old girl has never been the sharpest tool in the box. She could be trained but she was always a little ditsy. Shes the manic pixie dream girl of the dog park, dazedly floating through life, without a care in the world.
Dementia daze is a slightly more concrete type of confusion that youll be able to tell in the following ways:
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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What Can You Do About It
Unfortunately, there is no cure for Alzheimer’s or other forms of dementia. According to the Alzheimer’s Association, 1 in 10 seniors over the age of 65 has dementia. Though the disease affects each patient differently, most people with Alzheimer’s live only 4 to 8 years after diagnosis.
While you cannot reverse dementia or the damage it causes, there are ways to improve quality of life. Here are some simple tips for management that you can discuss with your doctor:
- Take prescription medications to counteract cognitive and behavioral symptoms such as anxiety, depression, and mood swings.
- Find support in the form of therapy, support groups, friends, or family to help develop coping mechanisms for cognitive and behavioral changes.
- Address safety issues in the home by installing safety bars in the bathroom and shower, automatic shut-off switches on appliances, and reminders to lock the door.
- Stay on top of co-existing conditions, working with your doctor to manage medical problems with the proper form of treatment.
- Follow a healthy diet that supports brain health and function. Focus on antioxidant-rich fruits and vegetables, natural sources of omega fatty acids, and foods high in fiber and protein.
- Talk to your doctor about taking supplements to support memory and cognitive function. Options you might consider include caprylic acid, coenzyme Q10, ginkgo biloba, phosphatidylserine, and omega-3 fatty acids.
Poor Judgment And Difficulty Making Decisions
Another important side effect of dementia occurs when a person experiences changes in his or her judgment. This can lead to serious issues with the way one handles money. For example, a person who was usually on-time with payments may forget to handle monthly utilities, or give large sums of money to telemarketers when he or she typically avoided such activities in the past. If a person develops dementia or Alzheimers they may eventually be unable to manage the household bills.
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What Happens In Vascular Dementia
Vascular dementia can cause different symptoms depending on where the blood vessels are damaged in the brain. For example, a person who had a stroke may have sudden problems with memory, balance, or speech. However, a person can have several strokes that may be unnoticeably small, but the damage can add up over time.
Many people with vascular dementia have trouble with memory. Others may have difficulty with organization and solving complex problems, slowed thinking, or being easily distracted. People with vascular dementia may also have changes in mood or behavior, such as irritability, loss of interest, or depression.
Sometimes, people with vascular dementia have trouble with balance and movement. This might include weakness on one side of the body, and the symptoms may get worse over time.
How To Prevent Infections
Preventing infection for a person with any cognitive impairment may prove difficult. They may lack the ability to practice proper hygiene.
You can help by:
- making sure they stay vaccinated against the flu each year
- vaccinating yourself as well
- having everybody wash hands and sanitize upon entering the home
- washing and sanitizing your loved ones hands regularly
- offer them fluids frequently to encourage proper hydration
Even in the early stages of dementia, little tasks like hand washing might slip their mind. If you cannot always be around during the earlier stages, keeping reminder signs near sinks can help.
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What Are The Symptoms Of Vascular Dementia
The symptoms of vascular dementia can vary from person to person and from type to type. If youve had a stroke, you may find that your symptoms develop suddenly. Symptoms typically develop more gradually when vascular dementia is the result of another condition, such as small vessel disease.
Early cognitive symptoms of vascular dementia include:
They may also order tests to rule out other possible causes of memory loss and confusion, including thyroid disorders or vitamin deficiencies.
Brain imaging tests, such as a CT scan or MRI, may also be necessary. These can help your doctor identify any visual abnormalities.
Because vascular dementia is a complex condition that gets progressively worse as time goes by, your doctor may recommend seeing additional specialists.
Although there arent any medications specifically for vascular dementia, treatment plans often include medication recommended for people with Alzheimers disease. Alzheimers disease is the most common type of dementia.
There are two types of drugs used for managing Alzheimers disease, cholinesterase inhibitors and memantine .
Cholinesterase inhibitors boost the levels of a chemical messenger in your brain thats involved with memory and judgment. Side effects of cholinesterase inhibitors may include:
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Are There Medicines To Treat Vascular Dementia
Though there is no cure for vascular dementia yet, there are medications that can help manage the symptoms. Sometimes medications used to treat memory problems in Alzheimers disease may be helpful for vascular dementia. Sometimes, people with vascular dementia can have mood changes, such as depression or irritability. These can be managed by medications like the ones used for depression or anxiety.
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What Are The Signs That Someone With Dementia Is Dying
It is difficult to know when a person with dementia is coming to the end of their life. However, there are some symptoms that may indicate the person is at the end of their life including:
- limited speech
- needing help with everyday activities
- eating less and swallowing difficulties
- incontinence and becoming bed bound.
When these are combined with frailty, recurrent infections and/or pressure ulcers, the person is likely to be nearing the end of their life. If the person has another life limiting condition , their condition is likely to worsen in a more predictable way.
When a person gets to within a few days or hours of dying, further changes are common. These include:
- deteriorating more quickly
- irregular breathing
- cold hands and feet.
These are part of the dying process, and its important to be aware of them so that you can help family and friends understand what is happening.
When a person with dementia is at the end of life its important to support the person to be as comfortable as possible until they die
For more information, see our page, Signs that someone is in their last days or hours.
The Progression And Stages Of Dementia
Dementia is progressive. This means symptoms may be relatively mild at first but they get worse with time. Dementia affects everyone differently, however it can be helpful to think of dementia progressing in ‘three stages’.
The progression and stages of dementia
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Signs Of Vascular Dementia
If you or the people around you notice any of the signs below, you should visit your GP:
- Not being able to understand or respond to things very quickly.
- Not being able to remember things.
- Finding it difficult to concentrate.
- Not being able to find the right word when youre speaking.
- Struggling to plan ahead for everyday tasks.
- Difficulty in learning new tasks
- Seeming down or depressed.
At a later stage, signs may include:
- Becoming confused.
- Behaving differently, especially if youre being aggressive or behaving inappropriately.
- Lacking motivation.
- Not being able to control your emotions.
- Finding it difficult to walk and keep your balance.
- Having problems controlling your bladder.
When To Seek Medical Care If You Think You Or Someone You Know May Have Dementia
A person affected with dementia may not be aware he or she has a problem. Most people with dementia are brought to medical attention by a caring relative or friend. Any of the following warrant a visit to the person’s health care professional.
- Behavior or personality changes
- Persistent or frequent poor judgment
- Persistent or frequent confusion or disorientation, especially in familiar situations
- Inability to manage personal finances
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Dying From Dementia With Late
The death of your loved one can be a hard concept to wrap your head around and accept. But knowing what to expect can help you when your loved one has late-stage dementia. It might help to know what will happen in the future so that you can be prepared emotionally and logistically.
This article discusses how dementia progresses and what to expect during late-stage dementia.
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.
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How Is Vascular Dementia Diagnosed
If youre noticing signs of vascular dementia, then you need to go and see your GP as soon as possible.
Your GP will talk to you and do a number of tests to see what may be causing your symptoms. Its probably a good idea to take a friend or family member with you to help you answer your GPs questions. They may have noticed symptoms that you are not aware of, or may be able to say how long youve had them.
To help them rule out any other causes your GP is likely to:
- Talk to you about your symptoms.
- Go through your medical history to see if you have any conditions that are linked to vascular dementia, like heart problems, high blood pressure or diabetes.
- Perform a brief memory test.
- Ask you some questions about your mood.
- Speak to your friend or relative about any changes they may have noticed.
- Take some blood or ask for a urine sample, so that they can check for other problems that could be causing your symptoms such as an infection, thyroid problems or low levels of vitamins or hormones.
- Look at the medication youre taking to see if that could be causing any of your symptoms. It is a good idea to bring a list of all the medications, vitamins and supplements you take including those prescribed by your doctor and the ones you buy yourself.
Your GP may refer you to a dementia specialist. This could be:
- An old-age psychiatrist .
- A geriatrician .
- A neurologist .
- A psychologist .
- A specialist dementia nurse.
Support Their Cultural And Spiritual Needs
Its good to be aware of the persons cultural and spiritual needs and make sure these are respected and supported. You can make use of any advance care plans or documents, friends and family input and your knowledge of the person. Its important to try and meet these needs as much as possible, they are just as important as medical care.
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Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
If It Isnt Alzheimers What Could It Be
Many of us would be relieved to know our loved one isnt suffering from permanent dementia.
My Grandma Ruth had Alzheimers. She knew my son was born and then slowly over the next few years forgot him, then me, then mom and eventually even herself. It sucks. It is excruciating for loved ones to watch. So, please know that I am not belittling that experience. Alzheimers and dementia are rough, but they are not immediately life threatening.
If the delirium comes on within days there are numerous serious medical conditions that could be causing it. Chances are most of their brain function will come back, but it is urgent to get to the root cause.
When I tell people that a urinary tract infection can cause dementia-like symptoms in the elderly I get two responses
Most people do not know unless they have seen it in a loved one. So, now you know and hopefully arent worried about a loved one as you are reading this.
A few medical conditions that can cause temporary confusion and delirium:
- head injury
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