Understanding The Causes And Finding Ways To Cope
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.
Study: Many With Dementia Don’t Know They Have It
MONDAY, July 23, 2018 — Many older Americans with dementia don’t know they have the disease, a new study indicates.
A review of data from 585 Medicare recipients with probable dementia found nearly 6 out of 10 were either undiagnosed or unaware of their diagnosis.
Those who had less than a high school education, who went to medical visits alone and who had fewer problems with daily tasks were more likely to be among the unaware ones. Hispanics were also more likely to have undiagnosed dementia, according to the study.
“There is a huge population out there living with dementia who don’t know about it,” said study lead author Dr. Halima Amjad. “The implications are potentially profound for health care planning and delivery, patient-physician communication and much more.”
Amjad is an assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore.
“If dementia is less severe and people are better able to perform day-to-day tasks independently, symptoms of cognitive loss are more likely masked, especially for patients who visit the doctor without a family member or friend who may be more aware of the patient’s symptoms,” she said in a university news release.
About 5.7 million people in the United States have dementia, but only half of them have a formal doctor’s diagnosis, according to the Alzheimer’s Association.
The study was published in the July issue of the Journal of General Internal Medicine.
Bundle Up To Venture Outdoors
Make sure your loved one dresses for the weather when venturing out including gloves, hat, scarf and an appropriate coat.
We use cues that tells us it must be cold, such as looking outside and noticing that its snowing. But the person with Alzheimers might not put all that together, Ms. Nelson says.
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Environmental Causes Of Sleeping Problems In Dementia
The environment of the person with dementia can cause sleeping problems in a number of ways including:
- The bedroom may be too hot or too cold.
- Poor lighting may cause the person to become disoriented.
- The person may not be able to find the bathroom.
- Changes in the environment, such as moving to a new home or having to be hospitalised, can cause disorientation and confusion.
Things you can try include:
- Keep the environment as consistent as possible.
- Check whether the person is too hot or cold when they wake up, because dementia can affect the bodys internal thermostat.
- Provide adequate lighting if shadows, glare or poor lighting are contributing to agitation and hallucinations.
- Move the mirror in the bedroom if the person becomes confused when they do not recognise their own reflection or the reflection of others in the room.
- Install night-lights that might help cut down on confusion at night and may help the person to find the bathroom.
- Place a commode next to the bed if finding the bathroom is a problem.
- Make sure the bed and bedroom are comfortable and familiar, because familiar objects may help to orient the person.
- Avoid having daytime clothing in view at night, because this may make the person think it is time to get up.
- Make sure that the person is getting enough exercise try taking one or two walks each day.
Sundowning And Care At Home
Alzheimers and dementia can be difficult conditions to live with, not just for your loved one but also for the extended family. Thats why more and more people are turning to live-in carers to help with loved ones who are in the late stages of dementia. Employing a highly experienced and compassionate caregiver can be a relief to families who are struggling to cope with the demands of the disease, and the peace and calm that a skilled carer can bring to a household are beneficial for everyone.
Live-in carers can provide a range of dementia care services, from simple companion care to the specific demands of dementia. They remain calm under pressure and can cope with emergency situations, making them a great option for families who are concerned about residential care for their loved ones.
They can provide genuine support throughout the day and night, which can make a significant difference for families who are finding things challenging. The cost of live-in care in the UK with Elder starts at £1095 per week.
Even if you think that you are coping well with your loved one, a period of live-in respite care can be helpful for anyone dealing with the particular demands of sundowning, allowing you to return from a short break or holiday refreshed and ready to face the challenges ahead.
Getting funding from your local authority
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What Causes A Dementia Patient To Stop Eating 4 Factors To Consider
The global statistics for dementia are mind-boggling. As of 2017, the total number of people with dementia was estimated to be 50 million.
This number is expected to rise to 75 million by 2030. Furthermore, in the US alone, one in three elderly people dies from Alzheimers or another form of dementia.
These increasing numbers of cases bring with them increasing challenges.
Feeding such patients is indeed one of the biggest challenges.
In the seven stages of Alzheimers a patient moves from their dementia being barely detectable to an extremely severe, steady, and visible decline .
Its not abnormal for Alzheimers patients to stop eating or drinking in the later stages of their diagnosis.
Approximately 50 percent of diagnosed Alzheimers patients wont eat enough food or drink sufficient fluids . The resulting weight loss develops into a larger problem as their disease progresses.
As per research, following are the four main reasons dementia patients stop eating and drinking as their disease progresses.
Following A Partner Or Carer Around
Dementia makes people feel insecure and anxious. They may “shadow” their partner or carer as they need constant reassurance they’re not alone and they’re safe.
They may also ask for people who died many years ago, or ask to go home without realising they’re in their own home.
- have the person with you if you’re doing chores such as ironing or cooking
- reassure them that they’re safe and secure if they’re asking to go home
- avoid telling them someone died years ago and talk to them about that period in their life instead
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Symptoms Specific To Dementia With Lewy Bodies
Dementia with Lewy bodies has many of the symptoms of Alzheimer’s disease, and people with the condition typically also experience:
- periods of being alert or drowsy, or;fluctuating levels of confusion
- visual hallucinations
- becoming slower in their physical movements
- repeated falls and fainting
Read more about dementia with Lewy bodies.
Recognising When Someone Is Reaching The End Of Their Life
Read about some of the signs that a person with dementia is nearing their death, and how you can support yourself as a carer, friend or relative.
It is important to know when a person with dementia is nearing the end of their life because it can help in giving them the right care. However it can be difficult to know when this time is.
This uncertainty can have a big impact on how the persons family feel, and may also affect how they feel themselves.
There are symptoms in the later stages of dementia that can suggest the person is reaching the final stage of their illness. These include:
- speech limited to single words or phrases that may not make sense,
- needing help with most everyday activities,
- eating less and having difficulties swallowing,
- bowel and bladder incontinence,
- being unable to walk or stand, problems sitting up and controlling the head, and becoming bed-bound.
It is likely that a person with dementia is nearing the end of their life if they have these symptoms, along with other problems such as frailty, infections that keep coming back, and pressure ulcers .;
When Do Dementia Patients Stop Eating
When a patient stops or refuses to eat, things can be very depressing for the caregiver. Drinking and eating are complex and have to do with a control center that is within the brain, which controls the muscles in the throat and neck area.
Dementia affects this part of the brain as it progresses and things like choking, coughing, grimacing as one swallows, clearing the throat, movements that are exaggerated, especially of the tongue and mouth, refusing to swallow, and spitting the food can be seen. This usually happens in the later stages of the disease.
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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How To Keep Someone Living With Dementia Comfortable In Hot Weather
People living with dementia often find it harder to read their bodily cues, for instance knowing when to drink water, have a rest in the shade, or take off a layer or two. This is why its crucial for caregivers to have a plan for when the summer rolls on.;
ONE: KEEP IT COOL It may sound obvious, but when springs on the way out and summer creeps around the corner, make sure you have a fan or air conditioning unit on hand to help stave off uncomfortable heat. It may be a good idea to get yours regularly serviced so that it doesnt conk out at the zenith of summer.;
TWO: EARLY OR LATE If the person youre caring for needs to leave the house during hot spells, try to make sure they do so in cooler times, such as the morning or early evening.;
THREE: STAY HYDRATED Its easy to forget to drink water, but in hotter weather when were more at risk of dehydration, its even more important. If your loved one doesnt enjoy drinking water, fruit teas, fruit-infused waters, or even diluted fruit juices could be a way of encouraging them to drink more fluids.;
FOUR: CHECK AND CHECK AGAIN Hyperthermia symptoms can come on fast, so its always a good idea to check in with your loved one throughout the day. If youre too far away to do this yourself, its wise to ask a friend or neighbour to keep a lookout to make doubly sure theyre faring well in higher temperatures.;
A word on heating costs
Planning For The Future
- Talk to the person with dementia to make sure that they have a current up-to-date;will;that reflects their wishes.
- Encourage the person with dementia to set up a;Lasting Power of Attorney; so that a responsible person can make decisions on their behalf when they are no longer able to.
- Talk to the person with dementia about making an;advance decision;to refuse certain types of medical treatment in certain situations. It will only be used when the person with dementia has lost the capacity to make or communicate the decision in the future.
- If the person youre caring for has already lost the ability to make or communicate decisions but doesnt have an LPA, you can apply to the Court of Protection who can make decisions on behalf of that person or appoint someone else to do so.
If the person you care for drives, the law requires them to tell DVLA about their diagnosis. A diagnosis of dementia doesn’t automatically mean someone has to stop driving straight away – what matters is that they can drive safely. Talking to the person you care for about stopping driving can be very sensitive.;
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Common Changes In Behaviour
In the middle to later stages of most types of dementia, a person may start to behave differently. This can be distressing for both the person with dementia and those who care for them.
Some common changes in behaviour include:
- repeating the same question or activity over and over again
- restlessness, like pacing up and down, wandering and fidgeting
- night-time waking and sleep disturbance
- following a partner or spouse around everywhere
- loss of self-confidence, which may show as apathy or disinterest in their usual activities
If you’re caring for someone who’s showing these behaviours, it’s important to try to understand why they’re behaving like this, which is not always easy.
You may find it reassuring to remember that these behaviours may be how someone is communicating their feelings. It may help to look at different ways of communicating with someone with dementia.
Sometimes these behaviours are not a dementia symptom. They can be a result of frustration with not being understood or with their environment, which they no longer find familiar but confusing.
Are There Any Exceptions
While some dementia patients eat too little, others overeat. Some dementia patients may eat too much food at a time or consume meals too often.
Its also possible for patients to demonstrate excessive eating and other related eating behavioral changes because of changes in their dietary preferences.
They may even be obsessed with certain foods.
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Study Shows Why Some Dementia Patients Lack Empathy
Helen James was constantly explaining her husband to people.
He would stare at people until they squirmed, place his hands on the backs of men he did not know and once pointed and laughed at a paraplegic.
The gentle and intelligent man she married seemed to have lost concept of how his actions affected others.
Gordon James had developed early-onset dementia, a disease characterised by a lack of empathy, confusion, inappropriate behaviour and, in his rare form of the disease, loss of speech.
Helen James with her husband, Gordon, who was diagnosed with early-onset dementia 11 years ago.
“The way that I would normally show affection to him didn’t mean that much to him any more,” Mrs James said. “He would walk away or push your hand away. It’s a very, very cruel disease.”
Patients with Alzheimer’s disease generally remain warm and engaged despite their cognitive decline, but those with the behavioural-variant of frontotemporal dementia undergo a jarring change in personality.
These early-onset dementia patients have blunted emotions and become puzzled by affection, uninterested in socialising and less responsive to the feelings of others.
But a study published in the Journal of Alzheimer’s Disease may give comfort to carers who have borne the brunt of these changes. It indicates that the changes result from fading grey matter in the region of the brain that governs empathy.
For Louise Palmer, the descent into dementia was fast.
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A Person With Dementia Feels Confused More And More Often When They Cant Make Sense Of The World Or Get Something Wrong They May Feel Frustrated And Angry With Themselves They May Become Angry Or Upset With Other People Very Easily They Might Not Be Able To Say Why They May Not Know Why
Everyone feels confused sometimes. Its the feeling you get when things dont make sense, or you dont know what you should be doing.
If someone seems angry with you, it can feel horrible. Remember that its not your fault, and its not their fault. It happens because the persons brain is not well. They may not be able to control their emotions any more. They may not be able to put themselves in your shoes, and realise they are upsetting you.
People with dementia can still feel nice feelings, too. They can feel happy, safe and calm. Some people with dementia may seem like their usual self almost every day and you may only notice small changes every now and then. Some people with dementia may not have as many good days. Those days when they do feel more like their old self can be particularly special.
Everyone with dementia is different. Dont be afraid to ask questions. If the person you know has not been ill for very long, they may be able to tell you what dementia feels like for them.
A person who has had dementia for longer may not be able to tell you how they feel. But you can learn to recognise when they are feeling happy, safe and calm.