Confronting Dementia on Our Terms
For more than 40 years, I have worked with patients experiencing dementia, as well as their families. One of the most common questions I hear from both patients and families is, "What can I do to make this better?" Many also ask, "How did this come about?" "Is it contagious?" "Why me?"
When I began my work with families and those affected by these symptoms of dementia, little was known about the disease, and almost no treatment was available. While known by many names the symptomology was much the same on the surface. The important item to remember is it still does many defining characteristics. There are also those brave practitioners daring to look past the surface and perhaps see the differences. Please know this is not a way to skirt the definition or the ways to treat it, rather it is a good example of the research needed work in this field.
What Is Dementia?
First, what is dementia? Dementia is "a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning." While not often do we expect a disease to be defined when lacking a treatment and cure. Historically, dementia leaves us with more questions than concrete answers. How can we help our loved ones, as they deal with this disease? And for physicians, it is equally as frustrating because they are expected to fix or treat the problem. We have made dramatic progress in our labs and treatments to help those with such a diagnosis. The truth is we still have a very long way to go.
Symptoms and Diagnosis
We can, however, look at any diagnosis with symptoms of dementia and treat the root disease. We are learning more and more each year about how to diagnosis and treat dementia. An example of one common symptom of dementia is the forgetfulness of day-to-day regimens. At first, this forgetfulness can be humorous soon, and we are aware of a problem projected into every aspect of the person's life. An example: coming out of a store and forgetting where the car is. This particular example is easily explained away as the stress of our hectic lifestyles. (Those making available the car alarm system, press a button, and there is a beep, even flashing lights on the car. Is a way to help us deal with this dementia). In truth, we all have had at times a loss for words, forgotten a name, where we put the keys, Kleenex, that article of clothing we just bought. A one-time occurrence may signify the stress in our daily lives. Now, this situation only adds to the mystery and fear of the symptom. Today, people, frequently, make medical appointments to have dementia ruled out. We are all moving forward in our life at a faster speed than ever before. And while speeding along we make mistakes, the keys in the freezer, picking up our children from daycare or leaving the house unlocked. Another part of our problem is not admitting the occurrence of such happenings.
Research and Treatments
We must move forward researching more treatments of dementia. To do this, we must take each action, each symptom of dementia and treat that one action. In other words, if a person is becoming frustrated due to the inability to remember a daughter’s phone number, we need to take this frustration away. (Continuing on the path of being unable to remember the phone number will only serve to make the problem worse.) Give the person in this situation a one number designation for the daughter’s phone number and tie that solution to like situations. Using a picture next to the button for daughter will only work if we re-evaluated on a regular basis. Many living structured living environments for memory care have begun putting a shadow box at the door this memory box made up of items from happy times.
Another example is a symptom of forgetting (more frequently than perhaps we know) when to eat or if they have eaten. Again it is important to tie the solution to a daily item of life. For instance, Uncle Joe cannot remember if he has eaten or not; we can leave a daytime food schedule for him by placing on the counter each snack or meal in a designated spot or order. One solution may be lining up the food along the counter: fresh fruit mid-morning; peanut butter sandwich, and milk or cocoa to drink for lunch; and cookies and milk for the mid-afternoon snack. This arrangement can be organized using the first shelf of the refrigerator.
If we take nothing else away from this article; use the information to relieve stress within the setting a person with dementia must live. As each stressor is eliminated the person will become far less agitated and when calmer they can pick their way through a larger situation. The person with dementia is still the person they were a few years ago when they were a contributing member of our society. A disease should not change the manner we acknowledge a person. Personal issues or requests should be addressed much as if they did not have dementia. They deserve to be treated with autonomy and providing safe choices. We must take the time to slow down and relate to these people. As we do so, we will find many new elements and facets of this person we have called Mom, Dad, sister, brother, neighbor and so on.