Dementia is not a specific disease. It is a syndrome leading to a progressive decline in mental abilities of a person. This results in, loss of memory, loss of reasoning and judgment, behavioural changes and decline in physical health. Dementia is not just memory loss. Its implications are much more severe that can affect person’s everyday life markedly.
Dementia is reported in 1% of the adult population aged 60 or above and frequency doubles every five years after the age of 65. It is caused by a damage in the brain cells. Thus the manifestations of dementia depend on different types of brain cell damage in different parts of the brain. For example, in a case of Alzheimer’s, Hippocampus the centre for learning and memory in the brain is the first to get affected, thus memory loss is the most common symptom in such patients.
- It is estimated that Alzheimer’s disease causes around 60-80% of dementia cases.
- Parkinson’s disease, vascular dementia, Lewy body dementia are well-known causes of dementia.
- Medical conditions such as Thyroid problems, alcoholism, severe thiamine deficiency and drug toxicity may result in dementia.
- Infections such as Meningitis and Syphilis and conditions such as Hydrocephalus and brain tumours can cause dementia.
- Head injury, Multiple sclerosis, Pick’s disease and stroke may result in dementia.
Dementia affects a person’s life in several ways other than causing memory loss.
- Cognitive impairment: Dementia affects the person’s ability of judgment and thinking. The person’s ability of understanding, reasoning, evaluation, and planning gets affected which disturbs the person’s ability to execute functions. Due to which the person may take more time and effort to understand and complete a simple everyday task.
- Forgetfulness: Due to short-term memory and poor concentration and attention, daily routine activities of person get disturbed. A person may find difficulty in recollecting a known person’s name or recalling an event. Such individuals can find themselves at loss of words very often.
- Behavioural changes and Mood swings: One can also experience extreme behaviour changes that may lead to withdrawal from social activities and mood swings.
- Depression and anxiety.
- Gradual loss of body functions.
- Visuospatial disturbances can also occur.
During mid-late stage dementia, the patient can experience extreme behaviour changes that may lead to unexplained anger, sadness, confusion, fear, and paranoia. Dealing with dementia requires a lot of patience and perseverance at the caregiver’s end. Due to cognitive impairment and forgetfulness, the patient tends to get confused about time and space quite often and may have trouble with finances. The simplest way is to put reminders. Explanation with a photograph can make them understand the situation in a better way. The purpose is to help them in a most loving and caring manner possible, for that the caregiver’s role is of utmost importance.
It is possible that despite all the efforts of caregiver the patient often comes up with aggressive, oppositional and sometimes violent behaviour. The most common trigger for aggression in such patients is physical discomfort. Sometimes the fear of unknown may also add to aggression. In such situation, the caregiver should not get into an argument or try to reason with them rather should try to identify the cause in the most calming manner to reassure them about the situation.
Dementia’s symptoms progress gradually with time, making it more difficult for the patient and caregiver as well. In such situation, senior dementia care centres can be an option where they have medically trained staff that includes round the clock doctor on call, psychologist, nurses and trained attendants.
One can also opt for senior citizen assisted living services which are home for aged people well equipped with medical facilities, trained staff and are well secured. Besides providing basic support and care for elderly, they take care of their personal needs and engage them in a more meaningful manner by means of recreational and social activities. The patients get a stimulating, conducive and relaxing environment which helps them in coping with the stress and depression related to the disease.
