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DementiaResponding to Older Adults with Substance Use, Mental Health and Gambling Challenges On this page:
People sometimes find it harder to remember certain things as they age, but this is not dementia. Dementia is a brain condition that affects memory and thinking. Its effects depend on its cause, the parts of the brain affected, and the severity or stage of the illness. Dementia makes it harder for people to perform daily tasks, to socialize and to deal with change and uncertainty. It can also cause changes in a person's mood or behaviour. Different forms of dementia include:
Treatments for dementia usually cannot stop or reverse the changes to the brain. They can, however, sometimes slow its progress or treat certain symptoms. One exception is alcohol-related dementia, which may lessen or reverse if drinking is reduced. People with dementia are just as likely to live at home on their own or with family as they are to live in residential care (Canadian Study of Health and Aging, 1994). They do better when they are able to:
When certain daily tasks-such as shopping, cooking, bathing or housework-become too difficult, workers and volunteers can help people with dementia remain at home longer. In the later stages of the disease, many people need to enter long-term care homes. Whether older adults live at home or in long-term care, they need to have a sense of independence and free will. Even if they become less able to take care of themselves, they may still wish to choose what to eat or wear, or what activities they do. Allowing choices can help to maintain their dignity in the face of a difficult disease. When offering choices, remember that some people with dementia have difficulty making decisions-so being pressed to choose could cause them anxiety and stress. If the person seems to be unable to choose, limit the choices offered, or help him or her to make the choice. You could say, for example, "The chicken is very good today; I think you'll like it," or "This blouse looks good on you; let's try this one on." Delirium sometimes looks like dementia, but is very different. Dementia usually develops over a long time, often over many years. Delirium is a severe confusion that comes on quickly and is temporary. Delirium can be life-threatening and requires immediate medical attention. Warning signs of delirium include sudden changes in a person's thinking and behaviour, or changes that seem to come and go over a day. Possible causes of delirium include illness, head injury, lack of fluids, or a reaction to alcohol or certain medications, such as anesthetics used during surgery. How common is dementia in older adults? People are more likely to develop dementia as they age. Dementia is found in:
It's common to forget a name or miss an appointment and then to remember it later. When people have dementia, they don't remember later. They may ask you a question, listen carefully to your answer, and then ask the same question again. Dementia develops at different rates in different people. People with dementia are likely to have at least a few of the following signs:
How to talk with an older adult who has dementia It may be hard for people with dementia to find the right words to say what they want to say and to understand what you are saying to them. But people with dementia need to express themselves and interact with others as much as anyone else. They may become frustrated. Your patience and understanding can sometimes help to ease their frustration. When speaking to people with dementia:
How to deal with behaviour changes Aggression People with dementia may become aggressive when they feel fearful, powerless or threatened. Check with your agency for guidelines on how you should deal with aggressive behaviour. When working with people who are known to be aggressive:
Reduced inhibitions Dementia can affect people's judgment and reduce their inhibition. Although rare, this can sometimes result in awkward sexual behaviours, such as undressing in public, making sexual gestures, or inappropriate touching or language. Again, check with your agency for guidelines to deal with this behaviour. Remember that this behaviour is caused by the disease. Try not to over-react. Gently discourage the activity by redirecting the person's attention. For example, if an older man is rubbing his genitals, try to get him to do something else with his hands, such as playing catch with a large ball or balloon, or looking at a photo album. Another option is to bring the person to a private place. If you've been told in advance that this person may act this way, plan ahead for ways to redirect his or her attention. Communication problems As dementia progresses, it becomes harder for people to communicate. You can help them do the best they can by recognizing and accepting their limitations.
If you believe the person needs a higher level of care for dementia, tell your supervisor. Give examples of how you have seen the person change. Someone may need to visit to re-assess the situation.
In Responding to Older Adults : 2 Substance Use, Mental Health and Gambling Challenges in Older Adults |
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Last updated: Dec 15, 2006 11:29 AM Published: Sep 05, 2008 8:01 PM ID#P18581 |