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What To Do When Someone Has Dementia

When To See A Doctor

How to respond when someone with dementia constantly asks to go home.

Forgetfulness and memory problems dont automatically point to dementia. These are normal parts of aging and can also occur due to other factors, such as fatigue. Still, you shouldnt ignore the symptoms. If you or someone you know is experiencing a number of dementia symptoms that arent improving, talk with a doctor.

They can refer you to a neurologist who can examine you or your loved ones physical and mental health and determine whether the symptoms result from dementia or another cognitive problem. The doctor may order:

  • a complete series of memory and mental tests
  • a neurological exam
  • brain imaging tests

If youre concerned about your forgetfulness and dont already have a neurologist, you can view doctors in your area through the Healthline FindCare tool.

Dementia is more common in people over the age of 65, but it can also affect younger people. Early onset of the disease can begin when people are in their 30s, 40s, or 50s. With treatment and early diagnosis, you can slow the progression of the disease and maintain mental function. The treatments may include medications, cognitive training, and therapy.

Possible causes of dementia include:

Do Not Try And Alter Undesirable Behavior

Lack of understanding may push one to try and change or stop any undesirable behavior from patients who have dementia. Keep in mind that it is almost impossible to teach new skills or even reason with the patient. Try instead to decrease frequency or intensity of the behavior. For instance, respond to emotion and not the changes in behavior. If a patient insists on always asking about a particular family member reassure them that he or she is safe and healthy as a way of keeping them calm and happy.

Dementia Behavior: Sleep Problems

While quality sleep tends to decrease as you age, people who have dementia experience more sleep disturbances than other seniors. In fact, sleep problems affect as many as a third of seniors with dementia.

Common sleep issues may include:

  • Difficulty getting and staying asleep
  • Agitation and restlessness when trying to sleep
  • Thinking its daytime when its night, going as far as getting up, getting dressed and wanting to start the day, Hashmi says

Sleep disturbances are hard on patients and caregivers alike, Hashmi says. Its physically and mentally exhausting to be up night after night.

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The Alzheimers And Dementia Care Journey

Caring for someone with Alzheimers disease or another type of dementia can be a long, stressful, and intensely emotional journey. But youre not alone. In the United States, there are more than 16 million people caring for someone with dementia, and many millions more around the world. As there is currently no cure for Alzheimers or dementia, it is often your caregiving and support that makes the biggest difference to your loved ones quality of life. That is a remarkable gift.

However, caregiving can also become all-consuming. As your loved ones cognitive, physical, and functional abilities gradually diminish over time, its easy to become overwhelmed, disheartened, and neglect your own health and well-being. The burden of caregiving can put you at increased risk for significant health problems and many dementia caregivers experience depression, high levels of stress, or even burnout. And nearly all Alzheimers or dementia caregivers at some time experience sadness, anxiety, loneliness, and exhaustion. Seeking help and support along the way is not a luxury its a necessity.

Just as each individual with Alzheimers disease or dementia progresses differently, so too can the caregiving experience vary widely from person to person. However, there are strategies that can aid you as a caregiver and help make your caregiving journey as rewarding as it is challenging.

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When Is The Right Time

What Activities Can You Do With Someone Who Has Dementia ...

At first, you might be able to manage some of the risks associated with dementia, but as the condition worsens, things usually change.

For example, the persons dementia may start causing more problems than before, you or their carer find that you are no longer able to meet their care needs, or they might have an accident that requires hospital admission as part of the condition.

If you are unsure whether your loved one needs to go into a home, it can be helpful to write a list of your loved ones needs and whether you are able to adequately meet them if you find that there are a lot of items on the list where you dont feel you can provide proper care and support, its probably the right time to start looking at your options.

Sadly, as dementia can only get worse, the persons condition declines, their care needs increase and there will ultimately come a time when you have to make a decision about their future, which may be moving them into a care home.

In the beginning they may only require help with daily living tasks or personal care but dementia can progress quickly so it is important to choose a care home or nursing home that can provide the required level of care. This may include having a qualified nurse available to look after your loved one or even a full time carer as the dementia progresses.

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Early Symptoms Of Dementia

Although the early signs vary, common early symptoms of dementia include:

  • memory problems, particularly remembering recent events
  • increasing confusion
  • apathy and withdrawal or depression
  • loss of ability to do everyday tasks.

Sometimes, people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of the ageing process. Symptoms may also develop gradually and go unnoticed for a long time. Also, some people may refuse to act, even when they know something is wrong.

Moving To A Care Home

If the persons needs become too great for you to manage at home, you may need to consider other long-term options. If youre becoming exhausted or the person with dementia is becoming harder to care for, a care home might be the best option for you both.

A move to a care home can be a difficult decision, but there are limits to the care you can provide.

If the person you care for is moving into a care home, familiar furniture, belongings or music can help them feel more settled.

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Assessing Depression Risk In Dementia

Awareness of the possibility of depression in people with dementia is important for preventing and coping with suicidal feelings in people with dementia.

In one study, 24.7% of people with vascular dementia, 14.8% of people with Alzheimers disease, and 22.1% of people with mild dementia experienced depression. For example, it is important to assess depression by using the Cornell Dementia Depression Screen and to identify symptoms of depression in dementia because depression increases suicide risk. Treating depression with nonpharmacological methods and antidepressant medication can significantly improve a persons quality of life and reduce their risk of suicide.

Dont Infantilize The Person

How to Talk to Someone With Dementia

Dont talk down to the person or treat them like an infant. This is sometimes called “elderspeak” and it’s got to go.

Have you ever observed how people talk to babies? They might use a high pitched tone and get close to the babys face. While this is appropriate for infants, its not fitting for communicating with adults. Regardless of how much the person with dementia can or cannot understand, treat them with honor and use a respectful tone of voice.

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Remember: Your Needs As A Caregiver Matter Too

Dealing with dementia behaviors can quickly wear out a caregiver or family member, causing caregiver burnout.

If your loved ones dementia behaviors have progressed to the point where you cannot manage them alone, help is available. Senior care options like home care or memory care can help relieve some of the caregiving burden while also helping to keep your loved one safe.

If you are feeling resentment, anxiety, or depression, seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.

Other families, other caregivers, are going through the same thing, Hashmi says. They have a lot of common challenges and common solutions to share. And often those are the most effective, because theyre going through exactly the same process.

Persuade Him To Go To The Doctor

Your loved one needs an assessment by a physician. Sometimes, other reversible conditions might be causing problems with cognition, such as normal pressure hydrocephalus or vitamin B12 deficiency. Thyroid problems or medication interactions can also affect memory and judgment. An evaluation and diagnosis are important so that proper treatment can be provided.

You may find that your loved one is resisting going to the doctor. If this is the case, you can explain that it’s time for an annual check-up.

If you’re not able to get your husband to agree to go the doctor, you could talk to your physician’s office ahead of time about your concerns and ask them to call your family member to schedule a doctor’s visit. Also, in some families, there’s one person who seems to be able to be more persuasive than the others if so, don’t hesitate to ask that person for assistance so that your loved one can get the assessment and care that he needs.

There are also visiting physicians in some communities who will perform house calls to evaluate and treat their patients.

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What Support Is Available For Me If I Care For Someone With Dementia

When youre caring for someone else, it can be easy to overlook your own needs. But looking after your health and making time for yourself can help you feel better and more able to cope with your caring role.

Caring for someone with dementia can 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 to remember that theres no right or wrong way to feel. If youre feeling anxious or depressed, or you’re struggling to cope, talk to your doctor who can let you know about the help and support available to you.

Cope With Changes In Communication

What Not to Say to Someone with Dementia

As your loved ones Alzheimers or dementia progresses, youll notice changes in how they communicate. They may have trouble finding words, substitute one word for another, repeat the same things over and over, or become easily confused. Increased hand gestures, losing their train of thought, and even inappropriate outbursts are all common as well.

Even if your loved one has trouble maintaining a conversationor less interest in starting oneits important to encourage social interaction. Making them feel safe rather than stressed will make communication easier, so try to manage your own frustration levels.

Be patient. If your loved one has difficulty recalling a word, for example, allow them time. Getting anxious or impatient will only inhibit their recall. Gently supply the word or tell the person that you can come back to it later.

Be aware of your body language. Your loved one responds to your facial expression, tone of voice, and nonverbal cues as much as the words you choose. Make eye contact, stay calm, and keep a relaxed, open posture.

Speak slowly and clearly. Give one direction or ask one question at a time, use short sentences, and give your loved one more time to process whats being said. Find a simpler way to say the same thing if it wasnt understood the first time.

Maintain respect. Dont use patronizing language, baby talk, or sarcasm. It can cause hurt or confusion.

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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.

Recognize Triggers For Difficult Behavior And Stay Calm

If the delusions someone with dementia experiences are severe and may put them or you, the caregiver, at possible risk or harm, it is best to speak to a doctor to see if some medication may be needed.6

A person with dementia can be susceptible to depression, anxiety, agitation, hallucinations, aggression, and loss of inhibition.7 While anxiety and depression issues may need to be dealt with the help of a trained mental health professional, the other behavior may have to be managed by you. You can cope with difficult behavior like aggression by:8

  • Identifying triggers for the behavior to see if they can be fixed. Pain can often be the cause for the unusual behavior.
  • Staying calm.
  • Not taking the behavior personally. It is not directed at you, but just an expression of the emotions or confusion the patient is experiencing. This may be especially hard to do if the dementia has made them suspicious and theyre accusing you of things like theft, infidelity, or inappropriate behavior.
  • Avoiding arguments and confrontation.
  • Accepting this as a symptom of the illness as you would any other symptom of a disease.

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Difficulty Finding The Right Words

Another early symptom of dementia is struggling to communicate thoughts. A person with dementia may have difficulty explaining something or finding the right words to express themselves. Having a conversation with a person who has dementia can be difficult, and it may take longer than usual to conclude.

Understanding The Causes And Finding Ways To Cope

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While some people living with Alzheimer’s disease or other types of dementia remain pleasant and easy-going throughout their lives, others develop intense feelings of anger and aggression.

When someone with dementia lashes out at you for seemingly no reason, it’s normal to feel surprised, discouraged, hurt, irritated, and even angry at them. Learning what causes anger in dementia, and how best to respond, can help you cope.

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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.

The Right And Wrong Words When A Spouse Has Dementia

Experts agree that the willingness to be present and listen is the most effective assistance one can offer to a friend whose spouse has dementia. You want to be a listener more than anything, and a partner, said Kathy Stewart, vice president of nursing and care at Aegis Living, which operates long-term and respite care facilities in California, Washington and Nevada. You have to walk the path with them, and meet them at the place that they are. Still, in the beginning stages, Stewart said its essential to encourage a spouse to take their partner to the doctor and obtain an appropriate diagnosis. That would be the first thing, she said.

Dr. Monica Parker Credit: Emory Medicine Magazine

Logsdon suggests that friends and family members look at this as a gradual process. A child can say, You know, Mom, I think theres something going on with Dad and we should get him to the doctor, she said. Be supportive of just first gathering all the information. Logsdon pointed out that its very hard for people if you hit them with the worst case scenario, and it is instead more appropriate to act as a sounding board for the family caregiver as things change. Listening, helping to do problem solving, thinking through alternatives, but not getting frustrated and upset with the caregiver if they cant follow through on those things right away, she said. The most important thing I think is to keep a good relationship with the person that youre trying to help.

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Coping With Suicidal Thoughts

Assess risk: Your first concern is the current situation. Does the person live alone or in a nursing home? Does he have a history of hurting himself or others? Did his dementia cause his poor judgment? Are his feelings more a reflection of frustration with his diagnosis, or is he actively seeking to take his own life? Some peoples statements about getting ready to go home to heaven do not equate to wanting to end their lives. These and other questions can help you assess how much he is at risk of self-harm.

Determine if a plan has been made: Ask him if he has decided to make a plan to hurt himself, and if so, what the plan is.

Assess the ability to carry out the plan: A person may have a wish and have a plan to die, but if he is incapable either physically or mentally to carry out the plan, the risk is reduced.

Create a safety plan together: Even though people with Alzheimers or other dementias may have poor short-term memory, safety plans can still be useful. A safety plan is your designation in writing that if the person believes he is at risk of harming himself, he will notify someone and take specific steps to prevent self-harm.

Report suicidal thoughts to a doctor: It is important for an individuals doctor to be aware of any suicidal thoughts the person may be experiencing. Doctors can then assess whether medications such as antidepressants will benefit the patient and whether other treatment plans are needed.

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