Dementia

When people think about dementia they usually (accurately) think about memory loss, forgetfulness and not recognising others, particularly family members. What most people aren’t aware of is that dementia is classified on the DSM. If you remember from our very first post in this focus month on mental health, the Diagnostic and Statistical Manual is a system for classifying different mental illnesses. So, this means that dementia is a mental health issue.

Dementia can be a complex and confusing illness. Most people know of two illnesses, Dementia and Alzheimer’s, and use the two titles interchangeably. However, they are different. The simplest way of thinking about it is that Alzheimer’s is a type of dementia. This website from a Gold Coast Psychologist shows a youtube video on the essential differences.

So what actually is Dementia? According to this site, dementia is:

“a collection of symptoms that are caused by disorders affecting the brain. It is not one specific disease. Dementia affects thinking, behaviour and the ability to perform everyday tasks. Brain function is affected enough to interfere with the person’s normal social or working life.”

That covers a pretty wide scope!

The early warning signs of the disease are:

• Progressive and frequent memory loss
• Confusion
• Personality change
• Apathy and withdrawal
• Loss of ability to perform everyday tasks

But, these symptoms don’t necessarily mean it is dementia. They could be caused by a number of things, including other neurological disorders and brain tumours. So it is very important to get a proper medical assessment from a qualified professional.

Some of the symptoms common to people who are further along in the illness are:

• Wandering
• Random noises
• Irritability
• Verbal and physical abuse
• Incontinence (both with bladder and bowel), sometimes including smearing of faeces
• Depression
• Hoarding (collecting random items or objects, including those that most would consider useless)
• Repetitive behaviours
• Anxiety or aggression
• Agitation
• Hallucinations, paranoia and delusions
• Inappropriate or offensive behaviours
• Sundowning (becoming restless, particularly in the evening)

Each of these may cover a variety of symptoms under one particular category. One of the most important things to remember is that every person with a type of dementia is different. One person with the disease may show a completely different set of behaviours to the next person. There are specific strategies that can be used to manage category and the Alzheimer’s Australia website has fact sheets on them.

To describe specific behavioural disturbances, strategies to deal with them and how best to treat the dementias would not only take forever, but would also be very complex and long. I was sent an article that covers a lot of that information so thought I would share it with you. It is an academic article with an American focus and is quite technical and lengthy, but it gives really good information. If you would like anything in the article clarified, please seek the advice from either a dementia specialist or a doctor skilled in the illness.

If you have a loved one experiencing these kinds of disturbances it can be very tough to cope with. Often, as one of the closest people to the person with the disease, the behaviour can easily be directed toward you. When you face constant aggression or the need to settle anxiety, or even managing frequent wandering, it can send your emotions into turmoil and your energy levels spiraling downwards. You can feel guilty, overwhelmed, like you aren’t coping, and you can blame yourself for being unable to control the behaviour. All of these emotions are a natural response to the situation. I work with family carers on a daily basis and often see the impacts of caring for someone with dementia. It is very important that you seek support. In Australia there is a network of carers organisations around the country that offer free counselling services along with more practical assistance. You can find contact details for them on our resources page. If you are in a different country, you may also find assistance from a similar organisation. I am aware that the UK and USA have carers organisations. You can probably find them using google. If searching in the USA, try using the term “caregiver”. There are also often dementia specific organisations that offer support and information.