How to Take Care for Your Loved Ones with Cognitive Impairment? 

As we get older, nearly everyone will experience some degree of memory loss. Caused by changes in both the body and brain, mild memory loss is often negligible, resulting in mostly innocuous acts like forgetting to pay a bill or misplacing objects like glasses or television remotes. These usually are signs of mild forgetfulness, not serious memory problems like Alzheimer’s disease or dementia.

That said, it’s important to remember that dementia is a progressive condition, one that cannot be cured – only managed. If you suspect that your loved one is showing early signs of dementia-related cognitive decline, you’ll want to plan an approach to care.

The first step is to understand how dementia works.

Symptoms of Dementia

While the signs of dementia will vary by the person and type of dementia, here are some symptoms to look for:

● Memory loss
○ This might include forgetting the address of a frequently visited store or forgetting the name of an acquaintance.
● Difficulty concentrating
○ In the early stages of dementia, people often have difficulty following a conversation, or even a book or television show.
● Difficulty carrying out familiar daily tasks
○ For example, being unable to calculate the right amount of change at the grocery store
● Struggling to articulate and communicate
○ Many people with dementia have difficulty finding the right words.
● Confusion about times and places
○ Often, a person will be driving their car and forget where they want to go to.
● Mood changes
○ This varies greatly from person to person, but you’ll want to take note of any shifts in emotional states.

Sometimes, people fail to recognize that these symptoms may indicate that something is wrong; mistakenly assuming that they are normal parts of the aging process. In some cases, these symptoms will remain stagnant. In other cases, however, these symptoms are indicative of something more serious.

Difference Between Alzheimer’s and Dementia

While the two terms are often used interchangeably, Alzheimer’s and dementia have some key differences. Dementia is a condition that refers to a group of symptoms associated with a decline in memory, reasoning and thinking skills. Alzheimer’s, on the other hand, is a degenerative brain disease that leads to dementia symptoms.

Types of Dementia

Grouped by common causes, different types of dementia can be caused by brain diseases, medications or even vitamin deficiencies. While they differ slightly in terms of symptoms, dementias are mostly progressive, meaning their symptoms will worsen with time.

● Alzheimer’s Disease: The most common cause of dementia, Alzheimer’s patients have amyloid plaques and tau tangles in their brains. While there is still much to learn about this disease, many think that these clumps of plaque damage both neurons and the tissue that connects them, thus impeding normal brain function. In Alzheimer’s, it is thought that tau proteins suffer from a structural change that causes them to pair with other threads of tau, rendering them unstable.
● Vascular dementia: Vascular dementia is caused by damaged blood vessels or inadequate blood flow to various regions of the brain. Cognitive difficulty may begin with mild symptoms that gradually worsen as a result of several minor strokes or potential other conditions that affect the vessels, leading to more damage. In addition to memory loss––which tends to be less pronounced with vascular dementia––symptoms include difficulties with problem-solving and slowed thinking. Some experts prefer the term “vascular cognitive impairment” to “vascular dementia.”
● Lewy body dementia: One of the more common forms of dementia, Lewy body dementia is caused by balloon-like protein clumps found in the brain. Those with Lewy body dementia often act out in their dreams, experience visual hallucinations, and have difficulty focusing. In some cases, people also experience tremors.
● Frontotemporal dementia: Frontotemporal dementia refers to a group of diseases known for the breakdown of nerve cells in both the frontal and temporal brain lobes. Symptoms include changes in behavior, personality, thinking and language.
● Mixed dementia: While there is still much we don’t know about mixed dementia, autopsy studies have indicated that people who had dementia actually had multiple types of dementia.

Recognizing the Risks of Dementia

In addition to recognizing the early signs of dementia, it’s also important to consider the risk factors that come into play. While age is the most common risk factor, several other variables can help determine the likelihood of developing dementia.

● Family history: Medical researchers have found several genes that correlate with an increased risk of Alzheimer’s disease. That said, while people with a family history of Alzheimer’s disease are generally considered to be at a heightened risk for developing it, many people who have relatives with Alzheimer’s disease never develop it themselves.
● Smoking and alcohol use: Several studies have found that regular smoking and the use of alcohol correlate with an increased risk of several forms of dementia.
● Atherosclerosis: This condition presents a significant risk factor for vascular dementia, as it interferes with the delivery of blood to the brain and can lead to stroke. Several studies have also found a potential link between atherosclerosis and Alzheimer’s disease.
● High cholesterol: High levels of bad cholesterol appear to significantly increase a person’s risk of developing vascular dementia. Some research has also linked high cholesterol to an increased risk of Alzheimer’s disease.
● Diabetes: A risk factor for both vascular dementia and Alzheimer’s disease, diabetes also increases one’s risk of atherosclerosis and strokes.
● Mild cognitive impairment: While not everyone with mild cognitive impairment (MCI) goes on to develop dementia, a recent study found that 10-20% of those over 65 with MCI developed dementia over a one-year period.
Get a Clinical Diagnosis
If you suspect that your loved one has early signs of dementia, your first step should be to contact either your loved one’s doctor or your local cognitive dementia and memory service (CDAMS) clinic. Only a doctor can properly diagnose dementia, and a proper diagnosis is an essential part of planning care for your loved one.

A dementia-related medical assessment might identify an alternate and potentially treatable cause for the symptoms you observe. Alternatively, it may confirm the presence of a specific dementia, allowing you to embrace the proper means of caring for your loved one.

Caring for a Loved One with Dementia

When your loved one is diagnosed with dementia, the first step is to learn all you can about the condition. Unlike the normal issues of aging––which we can all understand––caring for someone with dementia requires specialized knowledge and understanding. By turning to dementia-specific caregiver resources and support groups, you can begin to learn some helpful strategies.

However, it’s important to understand when you might need to call in additional support. If your loved one frequently wanders or presents another risk of injury to themselves, it might be time to consider a community-based solution.

The Role of Memory Care

A type of long-term care tailored to those with Alzheimer’s or a type of dementia, memory care provides the skilled support required by those with progressive cognitive impairments. In many cases, memory care communities are housed within assisted living communities, and the two offer a similar style of living.

As assisted living communities provide support with the regular activities of daily living, so do memory care communities. The primary differences between the two lie in the safety measures at each facility and training of staff. With caregivers and nurses well-versed in the needs of those with dementia, memory care can provide a more tailored, safe and nurturing environment for those with advanced dementias.

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