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GERIATRICS Living with dementia
When your loved one no longer recognizes you
BY ERIN FAIRCHILD
Dementia and the vulnerability it imposes on its victims is one of the most profound hardships endured by the fast-growing population of Americans over 65. The condition slowly robs people of their dignity and their life-long memories — memories that make them who they are or at least who they were.
“The impact of dementia is so great; it deeply affects not only the patient but also the patient’s family and loved ones,” said Dr. George Taffet, geriatrician and chief of the Geriatrics Section at The Methodist Hospital and Baylor College of Medicine. “The families feel powerless as they see their father, grandmother or spouse grapple with the frustrations of being aware of their own mental decline. Then, the dementia robs the awareness as the one they love slowly fades away.”
What is it?
Taffet says dementia is a manifestation of a number of progressive neurological disorders with symptoms that include memory loss; loss of the ability to problem solve, perform normal daily activities and control emotions, among other things. Personalities may change. Patients may become agitated, delusional or see things that are not there.
Geriatric patients often are plagued with a myriad of afflictions that can be devastating to their quality of life and their sense of independence. Diseases that are common in the elderly run the gamut of medical specialties— from rheumatology to endocrinology to psychiatry.
At Methodist, geriatric patients have access to world-class physicians, leading-edge technology and research, and an extensive array of patient services to address their health concerns. The Methodist Hospital ranked in geriatrics on U.S.News & World Report’s “America’s Best Hospitals” list because it provides excellent geriatric clinical care and because of its comprehensive centers in areas that most affect older patients such as neurology, heart, cancer and orthopedics; and palliative care, rehabilitation and pain management services.
For patients with dementia, there are medications and treatments available to help reduce the neurological decline for some types of conditions, but oftentimes some of the best medicine is the use of support services to help those with dementia live with it.
Methodist’s Institute for Palliative Medicine encompasses an interdisciplinary team that includes medical professionals, social workers, chaplains and therapists to work in conjunction with medical treatment to provide support, while addressing physical, psychological and quality-of-life issues often faced by patients with dementia. Having a solid support team in place is critical
because dementia patients may not be able to comply with discharge orders such as taking medicine properly.
What causes it?
There are many causes of dementia, including Alzheimer’s disease and stroke. According to the National Institute of Neurological Disorders and Stroke (NINDS), Alzheimer’s disease is the most common cause of dementia in people aged 65 and older. As many as 6 million people in the United States are currently living with dementia: 6 to 8 percent of people over the age of 65 and nearly 30 percent of those over 85 have dementia.
Other diseases that can cause symptoms of dementia include Huntington’s disease, Parkinson’s disease and Creutzfeldt-Jakob disease. Reactions to medications, metabolic and endocrine problems, and nutritional deficiencies are among the numerous conditions that also can cause dementia and dementialike symptoms.
Early detection and understanding the underlying cause of dementia is important in order to effectively treat it. If you or a loved one is experiencing any of the following symptoms, consult a physician: impaired memory, thinking and behavior confusion restlessness personality and behavior changes impaired judgment impaired communication inability to follow directions language deterioration impaired visiospatial skills emotional apathy
Tips for patients and their families who are dealing with loved ones who have dementia.
USE MEMORY AIDS.
Many times long-term memories are intact, but shorter-term memory is compromised. This makes it hard to learn new tasks such as a new process on the computer or how to find a new restaurant. Sometimes it is difficult to recall whether the doors have been locked or the washing machine is turned on. Writing down directions and posting reminders can be very helpful and can relieve stress and anxiety.
PLAN. As early as possible, it is smart to review wills, discuss endof-life issues, and designate medical and financial powers of attorney. Making plans now rather than later ensures that family and loved ones can honor the patient’s wishes. Discuss with loved ones that there may come a time when driving is not a safe option, and make plans on how to deal with that scenario.
DISCOURAGE FRAUD. Memory
loss and other symptoms of dementia leave patients open to vulnerabilities that can be exploited by unscrupulous solicitors. To limit access to potential confrontations, join the national Do Not Call lists and remove addresses from unwanted mailing lists. Invest in a computer security and monitoring program.
BE ACTIVE AND INVOLVED.
Participate in activities that you enjoy. Engage not only your mind but also your body. Exercise, walk, bowl or volunteer your time.
ELIMINATE DAILY TASKS THAT CAUSE STRESS OR ANXIETY DUE TO ILLNESS.
Many banks offer automatic bill paying services. Grocery stores will deliver. Home cleaning services that may have seemed like a luxury earlier in life may now be a very therapeutic and healthy option for people with symptoms of dementia, as well as their care givers.
TALK TO CLOSE FRIENDS ABOUT YOUR MEMORY LOSS.
This may seem difficult. It may seem easier to try to hide it or to avoid people. Friends may not know how to react, but an open discussion leads to understanding and support.
GET SUPPORT. Contact one of the many organizations that provide services for people with dementia and Alzheimer’s. Good places to start include www.alz.org, www.nlm.nih.gov/medlineplus/dementia.
