Alzheimer's & Dementia For Dummies
Overview
Your sensitive, authoritative guide to Alzheimer's and dementia
If a loved one has recently been diagnosed with dementia or Alzheimer's disease, it's only natural to feel fraught with fear and uncertainty about what lies ahead. Fortunately, you don't have to do it alone. This friendly and authoritative guide is here to help you make smart, informed choices throughout the different scenarios you'll encounter as a person caring for someone diagnosed with dementia or Alzheimer's disease. From making sense of a diagnosis to the best ways to cope with symptoms, Alzheimer's and Dementia For Dummies is the trusted companion you can count on as you navigate your way through this difficult landscape.
Affecting one's memory, thinking, and behavior, dementia and Alzheimer's disease can't be prevented, cured, or slowed—but a diagnosis doesn't mean you have to be left helpless! Inside, you'll find out how to make sense of the symptoms of dementia and Alzheimer's disease, understand the stages of the illnesses, and, most importantly, keep your loved one safe and comfortable—no matter how severe their symptoms are.
- Find out what to expect from Alzheimer's and dementia
- Discover what to keep in mind while caring for someone with Alzheimer's or dementia
- Uncover symptoms, causes, and risk factors of Alzheimer's and dementia
- Learn the critical information needed to help manage these illnesses
Whether you're new to caring for a person affected by Alzheimer's or dementia or just looking for some answers and relief on your journey, this is the trusted resource you'll turn to again and again.
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About The Author
The American Geriatrics Society, (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people.
The Health in Aging Foundation is a national non-profit organization established by AGS.
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alzheimer's & dementia for dummies
CHEAT SHEET
Receiving a diagnosis of Alzheimer’s or dementia is scary. Your loved one’s life and your relationship with him or her will drastically change. As a caregiver, you may become overwhelmed with what to do and how to give your loved one the best care he or she needs. This Cheat Sheet can give you some helpful tips to identify early symptoms of Alzheimer’s and how you can find the care setting your loved one needs.
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Alzheimer's & Dementia
The early symptoms of dementia or Alzheimer’s disease are more varied than simply being a bit forgetful. To be diagnosed with dementia or AD, someone must show at least two, if not more, of these ten warning signs, which can themselves sometimes be fairly subtle when they begin.
Memory problems that affect daily life.
Here is a run-down of the top ten most important early symptoms of dementia to look out for, as voted for by pretty much every dementia charity website or research article you're likely to come across.
Number 1: Memory problems that affect daily life
Forgetting the odd thing every now and again is perfectly normal as you get older; generally, you remember these things later.
Alzheimer's & Dementia
There are many myths about dementia in general and Alzheimer's disease (AD) in particular. These false and misleading beliefs have led many people to try the wrong treatments and avoid seeking appropriate help. Such myths need busting! Here are ten common myths and why they're wrong.
Dementia is a natural part of aging
Dementia isn't a part of normal aging.
Alzheimer's & Dementia
When someone with dementia or Alzheimer’s disease is admitted to the hospital, you need to make sure the staff understands the person they’re looking after.
Doctors, nurses, and everyone else on the unit who comes into contact with patients will try to treat them as individuals and not according to their pathology — “the spleen in room 603.
However you look at it, being given the diagnosis of dementia or Alzheimer's disease (AD) is a difficult blow. And even though you or your close family may have had an inkling that the symptoms you were experiencing were due to this condition, the realization that you were right all along is still tough to take.
Being the partner, friend, or relative of someone with dementia or Alzheimer's disease (AD) often throws you into the role of caregiver. And the closer you are to the person, the more likely you are to be involved.Here are ten tips for the novice caregiver to help make life not only as easy as possible but also fulfilling.
Not every nursing home is a great place. AARP published the following list of warning signs of a bad nursing home. If you encounter one or more of these negative indications, run, don't walk, out of there and definitely do not place your loved one in that facility.
Odors: A strong smell of urine and feces indicates a shortage of staff to help residents to the bathroom or to keep residents and the facility clean.
Alzheimer's & Dementia
In today’s secular society, people may have no faith or religion, and this aspect of palliative care (the holistic care — medically, psychologically, socially, and spiritually — of a patient with an advanced progressive illness) may not be relevant to them. That may also be true of the clinical teams providing end-of-life care for your loved one with dementia or Alzheimer’s disease.
If your loved one isn't yet ready for an assisted living facility or a nursing home but you don't feel that your situation is conducive to providing 24/7 in-home care, adult daycare is for you.Adult daycare for people with dementia and its newer cousin, adult day healthcare, can be a real godsend for a two-career family that simply can't provide in-home care during work hours and doesn't like the idea of leaving their loved one alone at home all day alone or with an aide.
Indulging in more than the advised levels of society's favorite drug more often than recommended will reveal it to be the poisonous substance it truly is. The effects on the body are wide ranging, and it can damage several of our internal organs, but it's the problems it can cause in the liver and brain that mimic dementia.
Alzheimer's & Dementia
Although AD isn't the most deadly disease (heart disease claims that dubious distinction), it is one of the more expensive ones, mainly because people live with it for so long and require so much supervision and care.AD puts a huge drain on healthcare resources, and the problem is only getting bigger. In 1900, only 3 million Americans were ages 65 and older; currently, the United States has approximately 34 million senior citizens who make up 13 percent of the population.
Alzheimer's & Dementia
Receiving a diagnosis of Alzheimer’s or dementia is scary. Your loved one’s life and your relationship with him or her will drastically change. As a caregiver, you may become overwhelmed with what to do and how to give your loved one the best care he or she needs. This Cheat Sheet can give you some helpful tips to identify early symptoms of Alzheimer’s and how you can find the care setting your loved one needs.
Alzheimer's & Dementia
Many families feel that they don't have any other choice but to care for their loved ones at home without outside assistance. According to the Alzheimer's Association, 28 percent of caregivers have annual incomes less than $20,000. Financial constraints force them to personally shoulder the burden of providing care for their loved ones.
Alzheimer's & Dementia
Many advances in scientists' understanding of Alzheimer's disease (AD) and its effects upon the brain have come from the study of brains donated by the families of deceased Alzheimer's patients. In addition, some families find closure when they choose to donate their loved one's brain, because a post-mortem brain autopsy is still the only way to confirm a diagnosis of AD with absolute certainty.
Alzheimer's & Dementia
Your loved one won't require as much care in the early stages of dementia or AD as he or she will in the later stages. For someone with very mild memory loss, perhaps all you'll need is someone to ensure that medications are taken as prescribed. The care plan you start out with will change and become more comprehensive as your love one's condition progresses.
Alzheimer's & Dementia
You're about to enter a new world. The parent or spouse or sibling you've known all your life has been diagnosed with dementia or Alzheimer's disease (AD) and is changing before your eyes — perhaps even changing into someone you don't understand or feel as close to as you would like.Remember that your loved one has no more control over these changes than you do over the rising and setting of the sun.
Relatives of people with dementia frequently ask if they will develop dementia as well. Unfortunately, no easy answer exists, and even the experts aren't clear about the genetics of each type of dementia. The case is different for each sort of dementia:
Alzheimer's disease: The situation depends on whether someone has early or late-onset Alzheimer's.
Alzheimer's & Dementia
Studies have shown that Omega-3 fatty acids may help dementia by having anti-inflammatory effects and by protecting brain cell membranes. A 2010 study had mixed results, although those patients taking the Omega-3 supplement didn't do better than those patients taking a placebo.Another study showed mild improvement on computerized memory tests in normal older adults taking Omega-3 fatty acids over those taking a placebo.
Alzheimer's & Dementia
So how do you decide whether you need to take your loved one to a doctor for dementia assessment? Any ongoing memory loss requires professional evaluation. Remember that doctors are looking for memory loss and at least one other cognitive deficit or problem in day-to-day functioning in order to make a diagnosis of dementia.
Alzheimer's & Dementia
Talking about end-of-life care options may seem a bit disheartening, especially because the end may still be many years away. But now, as soon as possible after diagnosis, is the time to discuss your loved one's wishes for her end-of-life care. You're going to have to make more decisions than you might think, so you want to start early.
It's very important to make sure you have an accurate diagnosis of your loved one's condition. Assuming that your loved one is suffering from Alzheimer's disease (AD) won't help if a reversible condition like severe vitamin B12 deficiency that can be identified with a simple blood test actually caused his memory loss and cognitive impairment.
Alongside the memory problems and emotional changes that happen to someone with dementia, getting in a pickle carrying out practical tasks is the other noticeable development that goes hand-in-hand with the other problems to lead to a diagnosis.Of course, some people can make even the simplest practical tasks — from changing a light bulb to hanging a picture — seem extraordinarily difficult.
Alzheimer's & Dementia
A person who is diagnosed with Alzheimer’s disease or dementia should name someone as her power of attorney as soon as possible, while she still has mental capacity to do so. A power of attorney is a legal document that authorizes a person to make caregiving, financial, and/or medical treatment decisions on behalf of a person who has become incapable of making her own decisions (this person is called the principal).
Alzheimer's & Dementia
The following conditions are generally not as devastating as neurological conditions. Many of the symptoms caused by these conditions are reversible with the correct treatment. Hormonal and nutritional causes of dementia include the following:
Addison's and Cushing's diseases: These conditions both affect the levels of a hormone called cortisol.
The four medicines used to treat Alzheimer's disease (AD) divide into two groups according to the different ways in which they work: Acetylcholinesterase inhibitors — Donepezil, rivastigmine, galantamine; NMDA receptor antagonist — Memantine (a very small and lonely group of one!).Here's a quick guide to their different mechanisms of action.
Alzheimer's & Dementia
Depression is extremely common in society as a whole, and people with dementia frequently suffer from it. Its symptoms include irritability, loss of interest in doing things, low mood, poor concentration and memory, poor sleep and appetite, tearfulness, thoughts of death and perhaps even suicide.Depression can also provoke feelings of anxiety and worry.
Alzheimer's & Dementia
These medicines were initially developed to treat people who suffer with severe mental health conditions like schizophrenia. They were the first pills to help rid patients of disturbing symptoms like delusional ideas, paranoia, and hallucinations. These pills enabled sufferers to live more normal lives in the community rather than be admitted into asylums to be forgotten about.
Alzheimer's & Dementia
There is no definitive, 100 percent sure way to diagnose Alzheimer's disease (AD) other than by dissecting the patient's brain after death to look for the presence of characteristic neurofibrillary tangles and amyloid plaques in the brain. However, by applying nationally recognized diagnostic criteria, doctors can and do make the diagnosis of AD with 90 percent or greater accuracy.
When it comes to complementary therapies famed for their healing properties in dementia — gingko biloba is probably the most lauded. It pops up so often when you search on the Internet that it can almost be considered a mainstream treatment.This plant extract comes from the gingko or maidenhair tree. This tree is commonly called a "living fossil" because it's been a feature of the earth's landscape since the time of the dinosaurs.
Unfortunately, disturbed sleep patterns are a common and serious symptom of dementia. The person with dementia is at risk of falls at night when lighting is less, not to mention daytime exhaustion, and caregivers are at risk of never getting any sleep themselves. The difficulty can be either with nodding off in the first place or waking frequently through the night.
In relation to dementia, vitamin E is supposed to work wonders. The number of people delving into Mother Nature's medicine chest to look for more organic ways to treat disease has resulted in a huge market for vitamin supplements. Never-ending combinations of vitamins are advertised as cure-alls for everything from the common cold to arthritis.
Alzheimer's & Dementia
In order to assess your loved one's ability to care for herself, questions will be asked to determine whether she still is capable of functioning independently. Be sure to state whether you're already assisting your loved one with functional tasks (such as bathing, grooming, cooking, paying bills, and so on) so the doctor can determine how these tasks are being completed.
Alzheimer's & Dementia
Wandering is a common behavior that arises in the later stages of dementia or Alzheimer’s disease. This behavior is fraught with possible danger. It’s one of the most potentially hazardous of all problems generated by dementia because it involves the risk of
Getting lost
Being run over
Becoming a target for muggers
Developing hypothermia or becoming dehydrated as a result of wearing inappropriate clothing
Of course, none of these things may happen, and the wanderer may just have a lovely stroll.
Alzheimer's & Dementia
You can start by checking the bulletin board in your local senior center or community center. People looking for work as aides often post their credentials there. If you can't locate any potential candidates that way, place an ad in the local paper or post a notice at the senior center. If you're a member of a church or synagogue, ask around to see if anyone is interested in the job or has used such a service.
Alzheimer's & Dementia
Many people try to keep their loved one with dementia or Alzheimer’s disease at home, whether at the patient’s or the caregiver’s home, as long as possible. However, as the condition worsens, the person’s care may become more than the caregiver can handle. When that happens, you may be forced to move your loved one into a different care setting.
Alzheimer's & Dementia
Patients with memory disorders such as dementia and Alzheimer's disease (AD) function best in a calm and well-structured environment. That means eliminating potential sources of trouble as much as you can.
According to the National Center for Injury Prevention, falls are the leading cause of injury deaths in adults aged 65 and older.
Alzheimer's & Dementia
The big question on everyone's lips when they're diagnosed with a life-limiting illness is, of course, "How long have I got, Doc?" And it's a question physicians hate having to answer, not only because their estimates may be a lot shorter than the timescale patients are hoping for, but also because doctors' estimates are invariably wrong.
Alzheimer's & Dementia
Medical foods developed to help fight dementia, and particularly Alzheimer's disease (AD), have received extensive media coverage. Described as "miracle milkshakes," two such products are Souvenaid and caprylidene (Axona). The two drinks contain different combinations of nutrients designed to reduce damage to brain cells and therefore improve cognitive functioning.
Alzheimer's & Dementia
When it comes to Alzheimer's disease drugs, the choice is nowhere near as extensive as remedies available for common ailments at your local pharmacy. These drugs are approved by the U.S. Food and Drug Administration (FDA) to treat AD specifically, and some are also approved to treat other dementias. In fact, just four medicines are available.
A fully functional memory is vital for human existence. That's because without some way of remembering what's happened, every waking moment stands alone as a brand-new experience; you have no past and can't plan for the future. Sadly, memory is one of the main casualties of the different dementia processes.Two main types of memory exist: short-term and long-term memory.
Mild cognitive impairment involves more than the limitations that occur as a result of a normally aging brain, but not enough to constitute dementia. Long-term studies suggest that 10 to 20 percent of people age 65 and older may have mild cognitive impairment.Like dementia, mild cognitive impairment can affect a variety of normal thought processes including memory, planning, and judgment, but it doesn't impact mood or a person's ability to perform day-to-day functions.
Music therapy, uses emotional responses to try to improve a person's sense of wellbeing through both listening to and joining in with voices or instruments.
Music has the power to move people. The melody, words, or context can inspire joy or deep sorrow. Music can provide very personal experiences: Songs can both move people to tears and make them jump around the bedroom, yelling lyrics into a hairbrush or strumming the life out of an air guitar.
Some of the most well-known medical conditions affecting the brain and nerves have symptoms that can mimic dementia features alongside their own, more specific features. So doctors may want to rule out some of these diseases before coming to a final diagnosis:
Parkinson's disease: This condition has a genuine overlap with dementia, because people with Parkinson's disease have a higher-than-average risk of also developing dementia.
Alzheimer's & Dementia
What other conditions could possibly be confused with dementia? Because of the number of possible causes for dementia, your loved one's doctor will want to take a thorough medical history, including what drugs your loved one is taking and the start/stop dates for those drugs.
Because so many different conditions can produce symptoms typically associated with dementia, the doctor must rule out all other potential causes and ensure that your loved one's symptoms fit the criteria for dementia (including Alzheimer's disease) before arriving at a diagnosis:
Depression: Severe clinical depression may be mistaken for dementia, which is why such cognitive problems in depressed patients are referred to as pseudo-dementia.
Unlike memory problems, which are noticeable almost from the onset of Alzheimer's disease (AD), with few exceptions early-stage patients display almost no significant physical disabilities. However, some patients do experience the following physical symptoms.
Identifying extrapyramidal signs
As the disease advances, some patients may display what is known as extrapyramidal signs including tremors, rigidity, and slowness of movement.
Alzheimer's & Dementia
Reality orientation aims to reduce confusion by giving a person with dementia a better sense of people, place, and time. It reinforces people's awareness of who they are, whom they're with, where they are, and the date and time.
You can reinforce someone's sense of reality by
Displaying on a board the day, date, time of next meal, and even weather.
Alzheimer's & Dementia
Dr. Barry Reisberg, a geriatric psychiatrist and leading expert in AD at New York University School of Medicine, identified and defined retrogenesis as the reversal of normal human development illustrated by the progressive cognitive and functional losses seen in Alzheimer's disease (AD) and other dementing disorders.
Alzheimer's & Dementia
To arrive at a diagnosis of dementia in general and specifically AD, doctors must evaluate multiple aspects of daily functioning through screening questions. In addition to an interview of the patient and family members/caregiver, mental status screening tests are conducted. Multiple different mental status examinations are available to screen for dementia/AD.
Alzheimer's & Dementia
The idea of classifying dementia including Alzheimer's disease (AD) into stages evolved over time, but the various classifications are simply different interpretations of the same information. For example, a group of psychiatrists led by Dr. Reisberg developed the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS) and first published it in The American Journal of Psychiatry in 1982.
Alzheimer's & Dementia
In the United States, most people older than 65 have access to the Medicare program. In other parts of the world, people with dementia who can't afford to pay for their healthcare can become unnecessarily disabled as a result.Making good and sensible use of what is available is thus important. People with a memory disorder obviously need help specifically for whatever disease is producing their symptoms.
Alzheimer's & Dementia
Reminiscence therapy aims to tap into intact fond memories. The sights, sounds, tastes, and even smells of a cherished past can help to improve life for someone whose dementia makes the present day a confusing and scary place.In fact, evidence shows that this type of therapy not only improves the mood of someone with dementia but also has a positive effect on general wellbeing and maintaining relationships with caregivers, friends, and family members.
In a person with mild cognitive impairment (MCI), the symptoms are more significant than those for normal aging. It's not uncommon for people to notice the following:
Forgetfulness
Difficulty following conversations
Declining ability to make sensible decisions
Getting lost easily
Poor concentration and attention span
Those people with MCI that do progress to dementia generally follow the progression charted by the Global Deterioration Scale (GDS) developed by Dr.
Dementia can be broken down into the "big four:" Alzheimer's disease, vascular dementia, Lewy body disease, and frontotemporal dementia. Here is a quick guide to each.
Alzheimer's disease
Alzheimer's disease is the most common cause of dementia worldwide. In the United States, it's the cause of dementia in 62 to 80 percent of cases, accounting for the symptoms of more than 5.
Alzheimer's & Dementia
The Functional Assessment Staging Tool (FAST) was intended to more specifically describe the progressive stages of Alzheimer's disease (AD). FAST divides the disease progression into seven stages but then further divides Stage 6 and 7 into more detailed substages to demonstrate specific losses as follows.The developmental age at which a child gains the listed skill that is being lost at each AD substage is listed, an illustration of retrogenesis.
A clear correlation exists between increasing age and the chances of developing dementia. In fact, less than 1 percent of people are diagnosed under the age of 65. The following table breaks down these figures.
Dementia Diagnosis by Age
Age
Number diagnosed
Younger than 65
1 in 1,500
65–70
1 in 100
71–79
1 in 20
80–89
1 in 4
90+
1 in 3
The obvious question is whether dementia will become more common as people live longer.
It's no secret that as people get older, bits start to wear out and don't work quite as well as they once did. Joints become creakier, backs ache, eyesight isn't quite as clear, hair falls out or goes gray, once excitable parts of the body barely raise a smile, and memory isn't necessarily as sharp as it used to be.
Alzheimer's & Dementia
No medicine comes without its possible side effects, and unfortunately, not all drugs are suitable for everyone who may benefit from them. Take into account the following points about Alzheimer's disease (AD) drug side effects.Every box of pills obtained from the pharmacy comes with a package insert detailing all the possible side effects to look out for when taking the medication.
Alzheimer's & Dementia
The oils used in aromatherapy are extracted from a wide variety of species, each one believed to have its own particular effect on the mind and body. Of the hundreds of oils available, the following are thought to help in dementia:
Basil
Chamomile
Coriander
Lavender
Lemon and lemon balm
Neroli
Applying aromatherapy
Aromatherapists work in a holistic way with their clients.
Alzheimer's disease (AD) is a form of dementia. Although all AD patients have dementia, not all dementia patients have AD. The Alzheimer's Association defines Alzheimer's disease as "an irreversible, progressive brain disease that slowly destroys memory and thinking skills, eventually even the ability to carry out the simplest tasks.
Dementia is a general term for a decline in mental ability (including impaired memory, language, reasoning, judgment, visuospatial skills, and orientation) severe enough to interfere with daily life.Think of dementia as a big general category like the word "building." Just as there are many specific types of buildings (stores, houses, cabins, skyscrapers, factories, and so on), there are many specific forms of dementia.
Dementia interferes with the functioning of brain cells, which stops them communicating between each other and therefore carrying out their normal processes. The process of dementia inflicts two major types of damage on nerve cells, which then produce symptoms:
The cells can be killed off or rendered largely inactive because they receive insufficient oxygen in the bloodstream, as in vascular dementia.
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