Friday, January 7, 2011

Health Care and Dementia

Have you ever been with a senior citizen or loved one that has started to exhibit signs of mental failure, such as memory loss, disorientation, or unusual emotional distress? They may be experiencing something known as dementia. Dementia is not a specific disease, according to MedicineNet.com. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain and mental functions. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems such as agitation, delusions, and hallucinations.

While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory, language skills, perception, or cognitive skills including reasoning and judgment - are significantly impaired without loss of consciousness, according to MedicineNet. There are many disorders that can cause dementia. Some, such as Alzheimer's disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment. With Alzheimer's disease and many other types of dementia, disease processes cause many nerve cells to stop functioning, lose connections with other neurons, and die. In contrast, normal aging does not result in the loss of large numbers of neurons in the brain.
According to the Mayo Clinic, dementia symptoms vary depending on the cause, but common signs and symptoms include:
■Memory loss.
■Difficulty communicating.
■Inability to learn or remember new information.
■Difficulty with planning and organizing.
■Difficulty with coordination and motor functions.
■Personality changes.
■Inability to reason.
■Inappropriate behavior.
■Paranoia.
■Agitation.
■Hallucinations.

The Mayo Clinic recommends that if these symptoms occur, see a doctor if you or a loved one experiences memory problems or other dementia symptoms. Some medical conditions can cause symptoms of dementia and are treatable, so it's important that a doctor determine the underlying cause. Early diagnosis is also important so that treatment can begin before symptoms get worse. If the diagnosis is a dementia that will progressively worsen over time, such as Alzheimer's disease, early diagnosis also gives a person time to plan for the future while he or she can still participate in making decisions. If a cause of dementia has already been diagnosed, talk with a doctor if symptoms seem to be getting worse.
 
According to eMedicineHealth.com, dementia is most common in elderly people; it used to be called senility and was considered a normal part of aging. It's now know that dementia is not a normal part of aging but is caused by a number of underlying medical conditions that can occur in both elderly and younger persons. In some cases, dementia can be reversed with proper medical treatment. In others, it is permanent and usually gets worse over time.

Dementing disorders can be classified many different ways, according to MedicineNet. These classification schemes attempt to group disorders that have particular features in common, such as whether they are progressive or what parts of the brain are affected. Some frequently used classifications include the following:

--Cortical dementia: dementia where the brain damage primarily affects the brain's cortex, or outer layer. Cortical dementias tend to cause problems with memory, language, thinking, and social behavior.
--Subcortical dementia: dementia that affects parts of the brain below the cortex. Subcortical dementia tends to cause changes in emotions and movement in addition to problems with memory.
--Progressive dementia: dementia that gets worse over time, gradually interfering with more and more cognitive abilities.
--Primary dementia: dementia such as Alzheimer's disease that does not result from any other disease.
--Secondary dementia: dementia that occurs as a result of a physical disease or injury.

Alzheimer disease is the most common cause of dementia, according to the Journal of the American Medical Association (JAMA). Persons with Alzheimer disease lose functioning neurons (nerve cells) in areas of the brain dealing with cognitive function and memory. They also experience buildup of abnormal proteins in some brain cells. Alzheimer disease affects mostly older adults but can sometimes begin in younger individuals. The cause of Alzheimer disease is not known, but risk factors for Alzheimer disease include family history, a specific gene, and advanced age.
 
Also, according to JAMA, vascular dementia is usually caused by strokes over a period of time that affect blood flow to areas of the brain related to memory and thinking. Some neurological diseases, such as Parkinson disease (a brain disease that causes tremors and muscle stiffness) and Huntington disease (an inherited disease that causes abnormal movements and dementia), can cause dementia because of their effects on brain tissue. Symptoms like those of dementia may be caused by many other factors, including medications and some illnesses. A careful evaluation by a doctor is important to look for treatable causes.
 
Diagnosing dementia can help the person and his or her family members seek help from available resources, according to JAMA. There is no cure for Alzheimer disease or vascular dementia. Some prescription medications may help slow the progression of dementia during treatment. Your doctor can help you decide if medication may be worthwhile. Medical research on Alzheimer disease and the other dementias may someday help in prevention, early recognition, and more effective treatments.
 
Caring for an individual with Alzheimer's disease or a related dementia can be challenging and, at times, overwhelming. Frustration is a normal and valid emotional response to many of the difficulties of being a caregiver. While some irritation may be part of everyday life as a caregiver, feeling extreme frustration can have serious consequences for you or the person you care for. Frustration and stress may negatively impact your physical health or cause you to be physically or verbally aggressive towards your loved one. If your caregiving situation is causing you extreme frustration or anger, you may want to explore some new techniques for coping, according to the Family Caregiver Alliance.

When you are frustrated, it is important to distinguish between what is and what is not within your power to change. Frustration often arises out of trying to change an uncontrollable circumstance. As a caregiver of someone with dementia, you face many uncontrollable situations. Normal daily activities—dressing, bathing and eating—may become sources of deep frustration for you. Behaviors often associated with dementia, like wandering or asking questions repeatedly, can be frustrating for caregivers but are uncontrollable behaviors for people with dementia. Unfortunately, you cannot simply change the behavior of a person suffering from dementia. When dealing with an uncontrollable circumstance, you do control one thing: how you respond to that circumstance. In order to respond without extreme frustration, you will need to:
--Learn to recognize the warnings signs of frustration;
--Intervene to calm yourself down physically;
--Modify your thoughts in a way that reduces your stress;
--Learn to communicate assertively;
--Learn to ask for help.
Much more detailed info about this particular topic related to providing care for dementia patients can be found at this site: http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=891.

Patients with irreversible dementia are eventually unable to care for themselves and may require round-the-clock care, according to the Neurology Channel.  An estimated 2 million people in the United States suffer from severe dementia and another 1 to 5 million people experience mild to moderate dementia. Five to eight percent of people over the age of 65 have some form of dementia and the number doubles every 5 years over age 65. The prevalence of dementia has increased over the past few decades, either because of greater awareness and more accurate diagnosis, or because increased longevity has created a larger population of elderly, which is the age group most commonly affected. It's estimated that as many as 35 million people throughout the world have some type of dementia.

Dementia is a very serious condition that results in significant financial and human costs, according to eMedicineHealth. Many people with dementia eventually become totally dependent on others for their care.
Although people with dementia typically remain fully conscious, the loss of short- and long-term memory are universal. People with dementia also experience declines in any or all areas of intellectual functioning, for example, use of language and numbers; awareness of what is going on around him or her; judgment; and the ability to reason, solve problems, and think abstractly. These losses not only impair a person's ability to function independently, but also have a negative impact on quality of life and relationships. Dementia is the leading reason for placing elderly people in institutions such as nursing homes.

Many older people fear that they are developing dementia because they cannot find their glasses or remember someone's name. According to eMedicineHealht, these very common problems are most often due to a much less serious condition involving slowing of mental processes with age. Medical professionals call this "benign senescent forgetfulness," or "age-related memory loss." Although this condition is a nuisance, it does not impair a person's ability to learn new information, solve problems, or carry out everyday activities, as dementia does. Unless the brain is stimulated with ongoing activity, such as learning new things, it is likely that deterioration of brain functions advance with age. But dementia is an actual illness, not just brief forgetfulness.
 
When symptoms of dementia begin to show up, it's time to get checked out by the family doctor. Delaying that medical exam will further augment the problems. But, don't be guilty of avoiding whatever health care precautions can be instituted to save the patient or at least delay the illness advancing in the brain. Taking care of dementia patients or loved ones who have these patterns of behavior is very stressful. Work with your health care professional to get the best medical advice available and assistance to handle the responsibilities associated with dementia patients.
 
Until next time.

3 comments:

The Knitting Dr said...

Very thorough review! Yes, age dementia symptoms are not a normal part of aging. And it is very important to get an evaluation because there are causes of dementia other than Alzheimer's disease in the elderly. And some are treatable, especially when found early. I describe some of the signs and symptoms in this recent post Part 1: When do you suspect your loved one has age dementia symptoms?

agemattersclinic said...

Dementia is treatable up to a certain degree but as the disease advance the symptoms become incurable.

Dementia Clinic

myrtle mayers said...

This is very good information a really nice blog. keep it up!!!
Day Care Dementia