What Stage Of Dementia Is Repetition

What Causes Repetition In People With Dementia

Repetition may be because of memory loss. The person might not be able to remember what theyve done or said, or the answer they received to a question. For example, they may keep checking they have their wallet or handbag with them, or keep checking their fridge to make sure they have enough food.

It is very likely the person does not know they keep asking the same question or repeating the same action. Often if someone is repeating the same question, they need an emotional rather than factual response. This may be because the person feels confused or anxious. They need comfort, security or to feel included or reassured rather than the repeated answer to their question. For example, if they keep asking what day it is they may need reassuring they havent forgotten something rather than needing to know that its Monday.

Using The Gds To Measure Dementia Progression

As the disease progresses, different signs and symptoms will become increasingly obvious. While there are several scales to measure the progression of dementia, the most common scale is the Global Deterioration Scale for Assessment of Primary Degenerative Dementia . The scale is also known as the Reisberg Scale. According to the GDS, there are seven different stages of Alzheimers disease correlating with four distinct categories: no Alzheimers, mild Alzheimers , moderate Alzheimers , and severe Alzheimers .

Signs And Symptoms Of Later Stage Dementia

The symptoms of later stage dementia include the following:

• Severe memory loss including forgetting recent memories , thinking they are living in an earlier time period and difficulties recognising themselves and others .
• Problems with concentration, planning and orientation. They may only be able to carry out very simple activities and become increasingly disorientated in time and place.
• Problems with verbal communication. The person may not understand what is being said to them, they may lose speech and use sounds, gestures and body language instead. They may also repeat the same word or phrase.
• Mobility and physical problems. Many people gradually lose their ability to move around, stand or get themselves out of a chair. Not all people in the later stages will have problems with mobility.
• Changes in behaviour. The person may behave in ways that are out of character such as becoming distressed or agitated, repetitive or aggressive. This can be very upsetting for the person themselves, and their family and friends. These behaviours are often the result of the person having needs that arent being met or because they are confused, distressed, or have delirium. Behaviour is often a means of communication.

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Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

• Getting lost easily
• Noticeably poor performance at work
• Forgetting the names of family members and close friends
• Difficulty retaining information read in a book or passage
• Losing or misplacing important objects
• Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

Symptoms Of Dementia Or Early Alzheimers

Has your aging parent been acting a bit âoffâ compared to their normal behavior? Perhaps getting lost on familiar streets in your neighborhood or maybe repeating stories they just told you ten minutes ago? If so, these may or may not be early warning signs of Alzheimerâs disease.

Very often, memory loss can be attributed to getting older however when dementia sets in it can become difficult for loved ones if they do not understand what is going on with their parentâs mind. First, letâs go over the difference between dementia and Alzheimerâs disease, in case you are just discovering this for the first time.

Dementia is a cluster of symptoms that may include: short-term memory loss, unclear thinking or reasoning, hindered problem-solving ability, repeating sentences or phrases over and over again, getting lost easily or misplacing items . Alzheimerâs is not always caused by dementia, or vice versa. It is a progressive disease that attacks the mind, which can be hard to distinguish when other age-related problems occur.

Here are 8 signs your aging relative may need to be checked by a physician for Alzheimerâs or dementia:

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Check For Distress: Identify Whether The Repetitive Question Is Problematic

If your loved one does appear to be distressed in repeating a question or story, try to address the emotion behind what is being said. Answer the question calmly each time it is asked, and be sure to answer as if it is the first time, every time.

If there is no distress, it may be that telling the story is enjoyable for your loved one with dementia. Breathe and try to have fun engaging with them about it. Consider introducing activities which could resolve the repetition for example, if they are asking when dinner is, involve them in preparing the meal.

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When Are We Going To That Doctors Appointment

In this scenario, Snow suggests that you avoid telling your loved one that theyve already been to the doctors appointment. The key is to let them know that the doctor doesnt need to see them again, without contradicting them when their brain is saying that they havent been to the doctor yet, she explains. Join their reality.

Confronting a dementia patient and challenging their perception of reality will only increase their anxiety and can even trigger outbursts and agitation. When seniors with dementia are constantly corrected, they often begin to feel as though they cannot trust themselves. This loss of control can be frustrating and even frightening for seniors with memory loss. Perpetual confusion causes them to be even more likely to ask you things repeatedly in the future, and it can even breed suspicion of those around them.

Sample Response:I just spoke with the doctor on the phone and she says that she doesnt need to see you again anytime soon.

Stage : Very Severe Cognitive Decline

In this last stage of dementia, symptoms are severe and 24/7 care will be needed, with a focus on providing comfort and quality of life.

Your loved one may have major issues communicating and eventually may not be able to communicate verbally at all. Memory loss worsens and they may lose the sense of where they are in time and revert to their childhood. Theyll require extensive assistance with all activities of daily living, and may lose their ability to walk and become bedridden. Theyll also become vulnerable to infections, including pneumonia.

Severe cognitive decline can last up to 3 years and symptoms include:

• A loss of the ability to communicate
• Disorientation, combativeness and physical outbursts
• Help with walking and ambulation
• The need for full-time help with activities of daily living, including dressing, eating and personal care
• A loss of physical capabilities, such as walking, sitting, and holding ones head up
• The loss of bladder and bowel control
• Increased vulnerability to infections
• Considerable weight gain or weight loss

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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.

Dementia And Repetitive Speech

As dementia progresses, it increasingly hinders the ability to express ideas and formulate questions. In the early stages of dementia, patients commonly repeat things like questions or phrases. Sentence structure and word recall also diminish as the disease deteriorates the area of the brain responsible for language, according to a study from the National Institutes of Health . When a loved one continually says the same thing, it can be difficult for caregivers to maintain patience.

Here are some common ways dementia patients repeat themselves through language:

These behaviors can be brought on by a whole host of causes, making it necessary for caregivers to listen keenly for what the patient is trying to tell them. Confusion, physical discomfort, anxiety, boredom, and desire for comfort are some of the many reasons a patient may repeat themselves as they wrestle with what theyre trying to say, according to Alzheimers Society. If these expressions fall flat with their audience, needs could go unmet and the patients quality of life may suffer.

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Reaching For A Response

It can be hard to keep on listening to the same story, but we need to recognise that the person who is repeating themselves is doing so because they need some kind of response. It may be, for instance, that the person just needs to communicate and feel close to someone in which case, we could try changing the subject to one that we will find more interesting, so that we find it easier to stay talking with the person.

Are There Any Treatments For Dementia

There are treatments that can help with the symptoms of some forms of dementia for a period of time, but there are currently no treatments that slow, halt or reverse the changes in the brain caused by the diseases. There are currently no treatments specifically for vascular dementia or frontotemporal dementia.

In the case of vascular dementia, a doctor may prescribe medication to treat underlying cardiovascular risk factors like high blood pressure or diabetes. Physiotherapy, speech therapy or occupational therapy may be offered to help with speech or movement problems. Non-drug treatments such as cognitive therapies may be available and can help some people with dementia to manage their symptoms.

Alzheimer’s Society has more information on treatments for dementia.

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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:

• 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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Support Feelings Of Safety Security And Reassurance

Identify and remove any possible triggers for the repetition. For example, if there is a reminder card for a doctors appointment on the counter and your loved one is asking about it repeatedly, remove the card and introduce a structured activity.

It is also possible that the person is repeating the first thing that comes to their mind because they cant think of anything else to say. Initiate interactive activities or change the subject to another topic that you know they enjoy talking about.

Summary Of Results And Comparison With Previous Literature

We used information collected from an online survey to explore how verbal repetition is experienced in the daily lives of community-dwelling individuals with dementia and their informal caregivers. The proportion of individuals in whom verbal repetition was tracked in our online survey is within the range of 31%90% reported in previous studies . This wide range in prevalence estimates may reflect differences in definitions and timeframe/frequency. For example, Hope et al. inquired about repeated requests or demands only, whereas Terri et al. asked about repeated questions at all in the previous week. Other investigations have relied on formal testing done in non-conversational and non-clinical settings to describe verbal repetition , how these studies relate to the patient’s and caregiver’s real-world experience is unclear. In any case, it is worth underscoring that we did not inquire about prevalence per se only whether, when present, it was a target for tracking change, e.g. in response to treatment, or across the course of the dementia, or simply as a way for caregivers to share with others who use their personal account about how the person for whom they were caring was faring.

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The 7 Stages Of Dementia Using The Global Deterioration Scale

The GDS scale, also called the Reisberg scale, is the most common method of measuring the progression of dementia. It is most relevant for people with Alzheimers since it is based on the degree of memory loss. Since 60 to 80 percent of all dementia cases are Alzheimers patients, this makes the GDS a relevant scale for the majority of dementia patients. The GDS also identifies four distinct categories of Alzheimers including:

• No Alzheimers Stages 1 3
• Mild Alzheimers or Early-Stage Stage 4
• Moderate Alzheimers or Middle-Stages 5 6
• Severe Alzheimers or Late-Stage Stage 7

NO ALZHEIMERS

Stage 1

Stage 1 is the starting line. At this point, there arent any signs or symptoms of dementia. The person who will progress over the starting line and move through the 7 stages of dementia is now in the same position as those who wont develop the disease.

Although there are no noticeable signs of dementia present in your loved one during this stage, the changes in the brain that lead to dementia started many years ago.

Stage 2

For those who progress to stage 2, there is very mild cognitive decline. They begin to experience some forgetfulness, but not to the degree that it seems abnormal. They might begin misplacing things, forgetting to take medications, or forgetting appointments or other engagements. These events will likely be far enough apart to prevent loved ones or medical providers from recognizing the signs of dementia.

Stage 3

MILD ALZHEIMERS

Stage 4

Stage 5

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
• 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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Communicate With The Resident Constantly And In A Variety Of Ways

How one communicates is one of the biggest, most noticeable changes that occur when a person develops Alzheimers disease or dementia. He or she may begin to lose his or her ability to communicate, words may become difficult to recall, and he or she may begin to rely more heavily on hand gestures to communicate. At the same time, he or she may begin to lose his or her ability to understand words that are spoken to him or her. Yet, communication is key. Visual and audio cues, other than words, can be used in conjunction with verbal communication to help reinforce what is being communicated to the Alzheimers resident. For instance, opening up curtains in the morning can signify and reinforce that morning activities are to commence, including waking, dressing, and eating breakfast. Similarly, closing the curtains can signify and reinforce that it is time to wind down and get ready for sleep. Alternatively, playing soft, relaxing music could signify time for sleep as well.

Stage : Moderate Cognitive Decline

Stage 4 is often referred to as the mild dementia stage. When an individual enters this period, he or she will clearly demonstrate deficits when given cognitive examinations.

During Stage 4, you can expect your family member or friend to show continued difficulties with concentration as well as trouble recalling recent events. Short-term memory issues may include things like forgetting what they ate for lunch that day. Memories about past events may begin to fade or become increasingly hard to recall.

Additionally, individuals at this stage of dementia find it hard to operate independently. You may notice they cannot manage their finances, or do not pay bills consistently or on time. The person may not be able to travel alone, especially to unfamiliar areas.

Social anxiety is common during this period. If you notice your family member or friend begin to withdraw themselves from social interactions, it may be due to memory difficulties. They may not remember names and begin to forget personal histories.

Lastly, he or she may also feel in denial about the symptoms and wont want to accept medical assistance. At this stage, a diagnosis from a physician is most likely and a care plan would be recommended. A caregiver may need to assist with managing finances and driving duties. The person will also need a lot of emotional support during this difficult time. Although timeframes for this stage will vary, Stage 4 lasts an average of two years.

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