What Medications Are Available To Treat Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, are discussed below. These drugs are also used to treat people with some of the other forms of dementia.
- cholinesterase inhibitors
- NMDA receptor antagonist memantine
These two classes of drugs affect different chemical processes in the brain. Both classes have been shown to provide some benefit in improving or stabilizing memory function in some patients. Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, the appropriate drugs used to treat those specific conditions are prescribed.
What Are The Signs And Symptoms Of Late Or Severe Dementia
- Worsening of symptoms seen in early and intermediate dementia
- Complete dependence on others for activities of daily living
- May be unable to walk or move from place to place unassisted
- Impairment of other movements such as swallowing: Increases risk of malnutrition, choking, and aspiration
- Complete loss of short- and long-term memory: May be unable to recognize even close relatives and friends
- Complications: Dehydration, malnutrition, problems with bladder control, infections, aspiration, seizures, pressure sores, injuries from accidents or falls
The person may not be aware of these problems, especially the behavior problems. This is especially true in the later stages of dementia.
Depression in elderly people can cause dementia-like symptoms. About 40% of people with dementia are also depressed. Common symptoms of depression include depressed mood, loss of interest in activities once enjoyed, withdrawal from others, sleep disturbances, weight gain or loss, suicidal thoughts, feelings of worthlessness, and loss of ability to think clearly or concentrate.
People with irreversible or untreated dementia present a slow, gradual decline in mental functions and movements over several years. Total dependence and death, often from infection, are the last stages.
What Are Common Causes Of And Risk Factors For Arrhythmia
Arrhythmia may occur due to various reasons ranging from genetic condition to medication side effects and an unhealthy lifestyle. The most common causes include:
- Extreme fright or stress
- Scarring of the heart as a result of a previous heart attack
- Blocked blood vessels in the aortic region
- High blood pressure and an imbalance in the bodys blood sugar and salt levels
- Thyroid diseases
The most common risk factors include:
- Advancing age: People over the age of 60 years are at risk of arrhythmia.
- Congenital heart defects
- Known family history
- Previous heart attacks or surgeries: Damage to the heart can weaken the muscle and affect its electrical system.
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The Right To Refuse Medical Treatment
The truth is that a person who is of sound mind has the right to refuse medical treatment. If a senior is competent and capable of informed decision-making, they can manage their own health in any way they choose, so long as they do not pose an immediate threat to their community. This means that family caregivers cannot force their loved ones to seek out or receive medical treatments, even if doing so would improve their health and quality of life. Seniors who have their mental faculties have the right to make decisions about their own medical care, even if we’d consider those decisions to be poor ones.
Making Tough Care Decisions For An Older Adult
If you have an aging parent who wont go see a doctor of any kind, period, you have to realize that, when you were a child and you were ill, your parent would have done everything in their power to make you better. If you recall, it didnt matter how much you kicked and yelled. If you needed to see a doctor, get your shots or take some medicine, they made it happen.
Yes, as adults, weve earned the right to make our own decisions, but oftentimes once-competent elders dont think as rationally as they used to, and they can begin making unwise decisions. When you know in your heart that the time has come to step up and ensure your loved one gets the care they need, think creatively about how to make it happen. Look into house calls, telemedicine, or use therapeutic fibs to get them into the doctors office. Theres no shame in guaranteeing your mom or dad gets proper medical treatment.
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What Is The Life Expectancy For Dementia Can It Be Cured
There is no cure for dementia.
- Although Alzheimer’s disease is listed as the 6th most common cause of death in the U.S.. Patients with Alzheimer’s disease most commonly die due to infections caused by lack of mobility.
- Pneumonia, bladder infections, bedsores, and other causes can lead to more wide-spread infection and subsequent death.
- Patients with dementias have widely varying life expectancies, depending on the underlying cause of their dementia. Life expectancy can range from only 1 to 2 years to more than 15 years the average duration of the disease is between 4 and 8 years after diagnosis.
End Of Life Dementia Care And Covid
Older adults and people with serious underlying medical conditions are at higher risk for severe illness from COVID-19. Older adults also have the highest rates of dementia. Given the risks that older adults face from both COVID-19 and dementia, its important to understand how to protect yourself and your loved one. Find more information about dementia and COVID-19 from the CDC.
When a dementia like Alzheimers disease is first diagnosed, if everyone understands that there is no cure, then plans for the end of life can be made before thinking and speaking abilities fail and the person with Alzheimers can no longer legally complete documents like advance directives.
End-of-life care decisions are more complicated for caregivers if the dying person has not expressed the kind of care he or she would prefer. Someone newly diagnosed with Alzheimers disease might not be able to imagine the later stages of the disease.
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What Happens If Arrhythmia Is Left Untreated
It may lead to the inadequate blood supply to multiple organs because the heart may not function properly.
Patients may exhibit symptoms such as dizzy spells, shortness of breath, faintness, or serious heart problems. Recurrent episodes of arrhythmia may lead to multiorgan failure and even death.
Arrhythmia is a disturbed rhythm of heartbeat in other words, it is an irregular heartbeat:
- When the heart beats faster than its natural rhythm of 60 to 100 beats per minute, it is called tachycardia.
- When the heart beats too slowly compared with the average rate, it is called bradycardia.
Other common symptoms of arrhythmia include:
- Persistent palpitations that feel like pounding, galloping, or fluttering
- Vision changes
What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
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Can Dementia Be Prevented
No known way to prevent irreversible dementia or even many types of reversible dementia exists. The following may help prevent certain types of dementia:
- Maintaining a healthy lifestyle that includes a balanced diet, regular exercise, moderate use of alcohol, and no smoking or substance abuse
- Taking precautions to prevent infections
- Using protective equipment such as a seat belt or motorcycle helmet to prevent head injury
The following may allow early treatment and at least partial reversal of dementia:
- Being alert for symptoms and signs that suggest dementia
- Early recognition of underlying medical conditions, such as hypoxia, HIV infection, low glucose levels, or low sodium levels
What Do I Do If My Elderly Parent Refuses To Go To The Doctor
Aging is scary for a multitude of reasons and that fear often manifests as a refusal to participate in doctors appointments and medical treatments. What can a caregiver do if an aging parent refuses to go to the doctor?
Some elders have always been wary of doctors, hospitals and medications, while others become more distrustful over the years. It makes sense that an aging loved one might refuse to go to doctors appointments. After all, by avoiding them, a senior can dodge any new diagnoses and information about the status of their existing health conditions.
While the ignorance is bliss approach to aging is somewhat understandable, it also happens to be a major source of frustration and anxiety for family caregivers. Our job is to ensure our care recipients health and safety, but we cant do that without a clear picture of their current physical and mental health.
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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.
Individual Preferences And Routines
Each one of us tends to live our life according to a set of routines. Some are imposed by necessity, but many reflect preferences and choices when we go to bed, when we get up, whether we get dressed before we have breakfast or vice versa, and so on.
A person with dementia may refuse to fit in with a routine that does not match their own. This is a positive sign! It shows us that the person still has a sense of their own identity and autonomy. Care services need to be flexible enough to fit in with the individuals routines. For example, if someone has always worked nights, it might be most natural for them to be up and about at night and this should not be seen as a problem. In this situation, the main challenge will be to find ways of engaging the person and providing company when there arent many other people around. In accepting a care service or moving into a care home a person hasnt given up their right to live according to their own standards and routines.
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When People With Dementia Refuse Help
When a person with dementia is unwilling to do something that we want them to do, this may be described as refusal or resistance.
As with other areas of a persons behaviour that we may find challenging or distressing, we need to try to find out what the person is telling us through their refusal in other words, the reason why they are refusing. And rather than expecting the person with dementia to follow our wishes, we should be focusing on how we can co-operate with their wishes.
Being forced into things makes us upset or aggressive, even fearful.
Less Common Forms Of Dementia
Picks Disease affects personality, orientation and behavior. It may be more common in women and occurs at an early age.
Creutzfeldt-Jakob Disease progresses rapidly along with mental deterioration and involuntary movements.
Huntingtons Disease is an inherited, degenerative disease. The disease causes involuntary movement and usually begins during mid-life.
Parkinsons Disease Dementia can develop in the later stages of Parkinsons disease, a progressive disorder of the central nervous system.
Lewy Body Dementia causes symptoms similar to Alzheimers disease. People with Lewy Body dementia experience hallucinations and can become fearful.
Mild cognitive impairment
Mild cognitive impairment is a stage between normal aging and dementia and involves problems with memory, language, or other cognitive functions. But unlike those with full-blown dementia, people with MCI are still able to function in their daily lives without relying on others.
Many people with MCI eventually develop Alzheimers disease or another type of dementia. However, others plateau at a relatively mild stage of decline and are able to live independently. Some people with mild cognitive impairment even return to normal.
Symptoms of MCI include:
- Frequently losing or misplacing things.
- Frequently forgetting conversations, appointments, or events.
- Difficulty remembering the names of new acquaintances.
- Difficulty following the flow of a conversation.
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What Is The Life Expectancy For A Person With Dementia
The outlook for most types of dementia is poor unless the cause is an early recognized reversible condition. Irreversible or untreated dementia usually continues to worsen over time. The condition usually progresses over years until the person’s death. Life expectancy after diagnosis averages about 8-10 years with a range from about 3-20 years.
Making decisions about end-of-life care is important.
- The earlier in the disease these issues are discussed, the more likely the person with dementia will be able to express his or her wishes about medical care at the end of life.
- The issues may be presented by your health care professional. If not, ask about them.
- These issues include use of aggressive interventions and hospital care, artificial feeding, and medical treatment for medical illnesses.
- These issues should be discussed by family members and decisions made about how to deal with them when the time comes.
- The decisions should be documented in the person’s medical records.
What Is Hydrocephalus
Hydrocephalus is an abnormal buildup of fluid in the ventricles deep within the brain. This excess fluid causes the ventricles to widen, putting pressure on the brains tissues.
Cerebrospinal fluid is the clear, colorless fluid that protects and cushions the brain and spine. Normally, cerebrospinal fluid flows through the ventricles and bathes the brain and spinal cord before being reabsorbed into the bloodstream. The body typically produces enough CSF each day and absorbs the same amount. However, when the normal flow or absorption of CSF is blocked it can result in a buildup of CSF. The pressure from too much CSF can keep the brain from functioning properly and cause brain damage and even death.
Fortunately, there are treatment options that can restore normal levels of CSF. Though treatment is often helpful, it may take multiple surgeries to treat hydrocephalus. With treatment many people lead normal and productive lives.
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Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
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.
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