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Understanding Dementia

What Is Dementia?

Dementia is a progressive and irreversible brain disorder. This condition gradually destroys a person’s cognitive skills and general functioning. At the later stages of dementia, the decline is so severe that a person depends entirely on others for basic everyday activities. 

Dementia is a syndrome that includes a group of symptoms like a loss of cognitive functioning, emotional control, behavior, and social skills. Dementia commonly involves memory loss and decline in attention, visual perception, language skills, and communication. Also, dementia symptoms affect a person’s reasoning and judgment and problem-solving skills.

In the early stages of dementia, people are aware that their health is declining. People with dementia understand that they will come to the point where they won’t be able to carry out day-to-day activities without help. 

What to Do When a Dementia Patient Refuses Help?

Refusing help is the staple of dementia, so providing care to a patient with dementia may be very challenging at times. When a person with dementia refuses help, a caregiver needs to discover why, so this can be addressed. 

A person with dementia has the right to say “no” and refuse help. Whether it is personal care, feeding, or medication, when a dementia patient refuses help try to:

  • Give clear instructions and explanations
  • Be friendly and work on building a closer relationship with the person 
  • Be positive and relaxed
  • Respect the person’s needs and allow them to feel comfortable

What to Do When Dementia Patients Can’t Swallow?

A patient with dementia may not be able to tell you about their difficulties swallowing. If this is the case, pay attention to the following:

  • Choking when drinking and eating
  • Repeated coughing after swallowing food or drinks
  • A reluctance or refusal to eat and drink
  • A person keeps food and drinks in their mouth instead of swallowing

A speech and language therapist should be included in the dementia patient’s care to provide helpful strategies to help the person during meals. 

It is also very important that the person regularly sees a dentist who will make sure that the patient has no dental health complications or difficulties with poorly fitting or missing dentures. 

What to Do When Dementia Patients Refuse to Eat?

For many people with dementia, eating becomes more and more challenging as the disease progresses. A person may experience difficulties chewing and swallowing. They may feel pain while eating or be afraid that they will choke on food. This usually causes dementia patients to refuse the food they are given. Force-feeding is never an option, as it may cause a patient to choke.

If recommended, provide pureed, finely chopped, or minced food. For example, very tender meat can be cut into tiny pieces or minced, while fish must be free of bones and flaked. Also, ripe fruit blended into a smoothie is easier to take and swallow. 

Try varying colors and contrasts to help the patient focus on food. Offer liquid meals like soups and cereal as additional hydration methods and serve small but frequent snacks. Encourage the dementia patient to try small finger foods. Also, ensure that the patient doesn’t have any dental issues and rule out medical causes of their refusal to eat, such as nausea, heartburn, constipation, or diarrhea. 

What to Do When Dementia Patients Sleep All the Time?

It is common for dementia patients, especially in later-stage dementia, to spend a lot of time sleeping, both during the day and night. As dementia advances, the brain impairment becomes bigger and the person progressively becomes weaker over time. This causes dementia patients to become exhausted with day-to-day tasks and sleep more during the day.

Also, medications such as antidepressants, antipsychotics, and sleeping pills may contribute to sleepiness. 

If the excessive sleeping has started suddenly in the earlier stages of the disease, talk to the person’s physician to explore any other conditions that could be having an impact on the patient’s sleepiness. Also, the patient’s GP may want to review the medication the person with dementia is taking, as medication can cause different side effects. 

What to Do When Dementia Patients Stop Talking?

Dementia greatly affects a person’s ability to use language and communicate. As the disease progresses, the loss of the ability to verbally communicate increases and speech problems become greater. Language becomes unclear and extremely limited. This is very frustrating for dementia patients, their families, and caregivers. 

With time, speech problems aggravate to the point where communication is no longer possible whatsoever.

  • Keep Eye Contact

When dementia patients stop talking, establish and keep up eye contact with the person. This will ensure their attention. 

  • Use Body Language

Non-verbal communication is a powerful communication tool when talking to someone with dementia. Pay attention to their facial expressions and body posture to determine their feelings and needs.

  • Carry On the Conversation

Even when the person can no longer talk, keep the conversation going. This will show the dementia patient that you care about them and support them.

What to Do When Dementia Patients Wander?

It is common for dementia patients to wander. People with dementia are often disoriented. They don’t remember their names or addresses. If the person wanders, search the immediate area as soon as possible. If you cannot find the person within 15 minutes, call 911. Inform the authorities that the person has dementia and file a missing person’s report. 

However, to prevent wandering, pay attention if the dementia patient:

  • Forgets how to return home or get to familiar places
  • Makes repetitive movements and appears restless
  • Has hard times locating the rooms inside the house
  • Moves around without a purpose
  • Shows anxiety in crowded places like shopping malls or grocery stores

To lower the chances of wandering, avoid taking the person with dementia to busy places and reassure the person if he or she feels lost or disoriented. Provide supervision and make sure that the dementia patient is never left unsupervised. 

What to Do When Dementia Progresses?

People with dementia goo through dementia stages at a different pace and with different symptoms. Once the disease progresses to the point of severe dementia, the person experiences further health decline including:

  • a loss of the ability to communicate 
  • a need for full-time assistance with daily activities
  • an increased risk of infections 
  • a loss of physical abilities 
  • wandering and getting lost 
  • personality changes
  • a decline in social skills
  • withdrawing from social contacts
  • losing awareness of who they are
  • forgetting details about recent events
  • poor judgment
  • hallucinations and delusions
  • aggressive and violent behavior
  • agitation
  • depression
  • incontinence
  • difficulty swallowing

People with late-stage dementia often have problems communicating, so keep a close eye on the patient for signs of discomfort and suffering like restlessness, insomnia, sweating, or moaning. 

As a person with dementia declines, caregivers and family members can help them by providing care and support. This includes spending time with the patient, playing the music they enjoy and showing affection (holding hands, stroking their head, etc.). Also, talk to the patient’s GP about the possibility of palliative care support and hospice care when the person is ready. 

What to Do When Dementia Starts?

The first signs of dementia usually develop gradually, which sometimes causes them to remain unnoticed for a long time. Also, the symptoms of dementia may vary, so people often mistake them for a normal part of the aging process. However, dementia is not a normal part of aging. To spot dementia in its early stage, watch for the following signs:

Cognitive and Language Symptoms

  • Memory loss, especially difficulties remembering recent events
  • Misplacing things
  • Poor judgment and decision-making
  • Problems planning and doing everyday tasks
  • Difficulty solving problems
  • Increasing confusion about time or place
  • Problems speaking or writing
  • A decline in visual perception

Emotional and Behavioral Symptoms

  • Anxiety and depression 
  • Apathy and withdrawal
  • Behavior changes and personality changes

As the disease progresses, the person needs more support from others for meeting basic needs and performing daily activities. Appropriate care ensures that the person keeps their independence as long as possible and maintains dignity. 

Caring for someone with dementia takes a lot of flexibility and patience. People with dementia often experience mood swings and feel confused or disoriented, which can cause anger or aggressive behavior. 

Be flexible and understanding. Create a safe environment at the patient’s home or geriatric care facility. Communicate with the patient gently but keep the communication clear and concise. Avoid criticism and judgment and be patient, reassuring, and supportive. Show empathy and let the person know that you care.

Pay attention to body language and other aspects of non-verbal communication. Look the person in the eye and use a friendly tone and behavior.

There is no known way to prevent dementia. However, studies show that things such as a healthy diet, exercise, socializing, and cognitive training can slow down the progression of the disease.

Seek support. There are many helpful resources available for people with dementia and their caregivers and family that can help understand the disease, manage the symptoms, and help the person handle dementia with dignity.

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