Dementia

What is dementia' Dementia is the loss of cognitive functioning: thinking, remembering, reasoning, and behavioral changes. These impairments interfere with a person’s daily life, his or her ability to function, and his or her ability to communicate. Caring for a person with dementia at home, or in a facility, can be a difficult task that presents many challenges. General Principles to Remember: * One of the greatest human needs is to be understood * People with dementia retain the capacity to feel emotion * Communication skills deteriorate progressively in dementing illness * When a person no longer has the ability to function “rationally”, they may no longer be able to change his or her behavior * Family, friends, and other caregivers must adapt their behaviors, and the environment, to meet the needs of the person with dementia Challenges in Caring For Individual With Dementia * Changes in communication * Expression: * Trouble finding the right word when speaking * Problems understanding what words mean * Loss of train-of-thought when talking * Using familiar words repeatedly * Inventing new words * Difficulty organizing words * Using curse words * Speaking less often * Relying on nonverbal gestures more * Frustration if communication isn’t working * Being very sensitive to touch and to the tone and loudness of voices * Understanding: * Difficulty comprehending instructions * Following multi-step instructions * Remembering instructions/conversations * May be able to read words but not make sense of them * Trouble remembering the steps in common activities, such as cooking a meal, * paying bills, getting dressed, or doing laundry * Changes in Personality and Behavior * Common Personality Changes: * Getting upset, worried, and angry more easily * Acting depressed or not interested in things * Hiding things or believing other people are hiding things * Imagining things that aren’t there * Wandering away from home * Pacing a lot of the time * Hitting you or other people * Misunderstanding what he or she sees or hears * No longer cares about his or her personal appearance Challenges to Communication * Limited attention spans * Often able to focus on one thought or task at a time * Often need more time than average person to respond to question * Communication challenges, and resulting frustrations may cause many of the difficult behaviors that commonly occur * Hearing and visual impairments can further impede communication Strategies in Communication * Make eye contact to get his or her attention, and call the person by name * Be aware of your tone and how loud your voice is, how you look at the person, and your “body language” * Gain knowledge or reflect about the person-their likes and dislikes, interests and hobbies * Encourage a two-way conversation for as long as possible. This helps the person with dementia to feel better about him or herself * Pay attention to verbal and non-verbal cues (yours and theirs) * Try distracting someone with dementia if communication creates problems. For example, offer a fun activity such as a snack or a walk around the neighborhood * Respond to feelings * Be open to the person’s concerns, even if he or she is hard to understand * Let him or her make some decisions and stay involved * Be patient with angry outburst. Remember, it’s the illness “talking” * If you become frustrated, take a “timeout” for yourself * Offer simple, step-by-step instructions * Repeat instructions and allow more time for a response. Try not to interrupt * Don’t talk about the person as if he or she isn’t there * Don’t talk to the person using “baby talk” or a “baby voice” Strategies to Coping With Personality and Behavioral Changes * Keep things simple. Ask or say one thing at a time * Have a daily routine; this allows the person to know when certain things will happen * Reassure the person that he or she is safe and you are there to help them * Focus on his or her feelings rather than words * Don’t argue or try to reason with the person * Try not to show your anger or frustration * Use humor when you can * Give people who pace a safe place to walk * Try using music, singing, or dancing to distract the person * Ask for help. For example “Let’s set the table” or “I really need help folding the clothes”. * Make sure he or she is safe at all times