Cher Haack: Dementia can be both frightening and mystifying

Dementia can be a frightening word to hear. Hearing it from a doctor about a loved one can be overwhelming and confusing. Most people don’t really understand what dementia is, or how to deal with behaviors it can cause.

What is dementia?

Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. Dementia is not just a problem of memory, it also reduces the ability to learn, reason, retain or recall past experiences. There is often a loss of patterns of thoughts, feelings and activities as well. Additional mental and behavioral problems often affect people who have dementia, and can play a role in how the situation is handled. As dementia worsens, some people might neglect themselves and might behave inappropriately; others may become restless or wander about during the day and sometimes at night. Unfortunately, people diagnosed with dementia might not recognize their family members and friends.

Statistics show that depression affects 20 percent to 30 percent of people who have dementia, and about 20 percent have anxiety as well. Agitation and aggression also often accompany dementia. About 10 percent of people with dementia have what is known as mixed dementia, which may be a combination of Alz­heimer’s disease and multi-infarct dementia caused by strokes.

Getting the right diagnosis is vital. Confusion and disorientation in an elderly person can be caused by treatable problems such as infections. A simple blood test can rule that out. To diagnose dementia, a doctor will perform a series of cognitive testing, often lasting several hours. Tests of memory, function, processing speed, attention and language skills are performed. The most commonly used tests are the mini-mental examination, the cognitive-abilities screening instrument, the trail-making test and the clock-drawing test.

How to deal with behaviors

Dementia can cause a person to become aggressive or agitated. If this is the case, don’t argue or reason, but instead try to find out if there is an underlying cause. Because dementia impairs normal communication due to changes in receptive and expressive language, as well as the ability to plan and problem-solve, agitation is often a form of communication for the person. Look for signs of the individual having pain, physical illness or possible over-stimulation. Others with dementia may be bored and require more activity. It all depends on the person and his or her living environment.

A person who still lives at home might have a difficult time staying active. This is where outside caregivers, specialized in dementia training, may be helpful. They can help them participate in activities they enjoy doing; take them out for drives or to the park and set up an exercise routine that best suits that particular individual. It’s also important to make sure your loved one is eating and drinking enough. Memory impairment may cause them to forget to eat and drink.

Above all, it is important that you be patient with them; they are just as confused as to what is going on and are usually unable to fully express their wishes and concerns.

Resources

Following are books that might give you a better understanding of dementia and how to cope with day-to-day living.

“The 36-Hour Day,” written by Nancy Mace and Peter Rabins

“Contented Dementia,” written by Oliver James

Cher Haack is the executive director of The Lodge Assisted Living Facility in Carson City.