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Dementia is a result of critical damage being caused to the brain over an extended period of time.
In most cases, this damage is caused by different diseases and have different symptoms that accompany them. These symptoms vary according to the part of the brain that is damaged and each person will experience the condition in a different way.
Because of this, it can be difficult to identify the initial signs that indicate a person may be struggling with the condition.
Therefore, to diagnose as early as possible, it is important to be aware of the signs and symptoms of dementia, some of which are listed below. Click the headers for more detailed information on each sign and symptom of dementia.
If you are worried that somebody you know may have dementia, it is a good idea to consult a General Practitioner (GP).
It is important to seek the help of a professional as the symptoms of dementia can be similar to other health conditions. Without consulting a GP, the condition could be incorrectly diagnosed.
For example, somebody who is experiencing memory problems may assume that they have dementia without seeking a professional opinion. However, memory problems can also be caused by other conditions such as depression, anxiety, delirium, thyroid problems etc. Therefore, it is best to consult a GP in order to avoid lost time and negative future circumstances.
It is a common occurrence that the person who may have dementia does not want to contact the GP at all. There are a variety of reasons why the person may feel this way, which will depend on the personality of the individual and their underlying motivations.
Typically, the person will be feeling frightened of getting a diagnosis and may think that they will lose their independence. In some cases, the person may not even understand the concerns about their condition due to failing memory and changes in their behaviour.
Therefore, it is important to reassure the person and highlight that their symptoms may be due to another potentially treatable condition. This could help them become more willing to visit their GP.
If the person still refuses consult a GP, it may be useful to contact the appropriate surgery directly and explain the situation. The GP may be able to conduct a home visit to speak to the person in question, which can be considered a more comfortable and safe location for diagnosis.
It is important to consider the possibility that the GP may not be able to discuss confidential information with you, depending on the preference of the person in question.
After the person has agreed to consult a GP regarding their condition, there are various steps that need to be undertaken to arrive at the diagnosis.
Initially, the GP will gather as much information regarding the person’s condition as possible. In order to do so, the person may be asked to complete some blood tests, receive a physical examination and answer a range of questions. These questions are designed to give an overview of the person’s wellbeing and may consist of the following:
It may be helpful to have a family member or a close friend present during this process, as they will be able to give an account of the changes that they have noticed and how this affects the person in question.
If deemed necessary, the GP may also ask the person to complete a brain scan or MRI to obtain a more in-depth understanding of their neurological state. The GP may also wish to test the person’s memory and cognitive ability. They will do so by asking the person to answer straightforward questions and to complete simple tasks, such as the following:
Given the nature of these questions and tasks, the person in question may become stressed or upset if they are struggling. Therefore, it is important to remain supportive throughout the examinations and continue to offer reassurance to the person throughout.
Once diagnosed, if the GP feels it necessary to do so, the person in question will be referred to a memory specialist.
This process will be like consulting a GP, in that you will be asked to visit the specialist and they will need to conduct tests and retrieve specific information.
Again, it may be possible to arrange a home visit from the specialist if this would make the person in question feel more comfortable.
Once acquainted, the specialist will take a detailed account of the person’s medical history as well as the medical history of their family members. As previously mentioned, to ensure that the person feels safe and relaxed, it is helpful to have a family member or close friend with them at this appointment.
As well as giving social support, they will also be able to offer any relevant information to the specialist that the person may struggle communicating themselves.
The specialist will also conduct assessments involving the person’s cognitive abilities. It is important to note that these tests may be more difficult than the ones completed with the GP, which may cause the person to become frustrated or upset. It is important to offer support if the person shows signs of distress.
These assessments usually consist of tests of attention, memory, verbal fluency and language, as well as testing their visuospatial abilities by asking the person to copy diagrams or draw a clock.
In addition, they will ask questions about the person’s abilities with everyday tasks such as shopping, housework, driving, and self-care, such as washing and dressing.
This process may take an extended amount of time to complete, as the specialist will want to gather as much information as possible for their evaluation. Once they feel satisfied with the analysis, they will be able to explain the person’s condition in more detail and discuss various possible treatments and future arrangements.
For more information on the diagnosis process please visit:
www.nhs.uk/conditions/dementia/diagnosis/
Although, presently, there is not a cure for dementia, there are a variety of treatments that can be used to help with the symptoms of the disease. Depending on the type of treatment, they can be administered or recommended at specific points in the dementia journey when the treatment is able to have the most positive impact on the person.
As with most diseases, there is a variety of medication available that can temporarily reduce the symptoms of dementia.
Although medication is primarily administered to help to prevent further neurological damage taking place, there are also medicines available that can help with changes in behaviour.
For example, medication may be recommended if the person with dementia is showing persistent aggression or extreme distress.
It can be helpful to talk to your GP to gain a further understanding of the medication available.
In addition to medicine, there are a variety of cognition-based remedies that can engage the community and help the person with dementia to live more comfortably.
One example of this is ‘cognitive stimulation therapy’, which involves group activities and exercises which have been designed to improve the person’s memory, problem-solving skills and language ability.
These improvements can help to make the person feel more confident in their ability and will encourage them to continue to engage.
There is also a practice known as ‘cognitive rehabilitation’, which is completed with a trained professional (i.e. an occupational therapist) and a close friend or family member.
The aim of the sessions is to achieve modest personal goals, such as doing the washing or learning to use a mobile phone. Completing these tasks enables the more functional parts of the person’s brain to help the less functional parts. It has been reported that cognitive rehabilitation can help a person to cope better in the early stages of dementia.
For more information on the different treatments for dementia, please click here.
For more information about coping with behaviour changes, please click here.
For more information about living well with dementia, please click here.
For more information about activities for dementia, please click here.
Dementia is often seen as a disease that impacts the memory, but the word ‘Dementia’ is an umbrella term for a range of progressive conditions that affect the brain.
Symptoms vary according to the part of the brain that is affected and each person will experience the condition differently so whilst common symptoms are memory loss and confusion, dementia can also impact comprehension, mobility, speech and our senses.
Communicating with a loved one with dementia can sometimes be distressing. Their speech is often negatively impacted, worsening over time, and their receptive communication may be affected. Their ability to reason can also decline and their rational ideas might become distorted, resulting in irritation.
Being aware of the unique changes someone with dementia experiences can guide you in altering the way you communicate with them to meet their needs.
Our senses shape how we see, interact with, and understand the world around us. When our senses are affected by dementia it can change how we relate to the world and other people.
Those around the person with dementia will see the signs that they are having issues with memory or mobility, but they may not be aware of the impact that dementia is having on the persons senses.
This can result in the person with dementia appearing confused, reacting in unusual ways or displaying behaviours that may be difficult for other people to understand.
Sight can be affected in many ways by dementia. This includes loss of peripheral vision, motion blindness, depth perception, shape recognition, colour, contrast and tone.
Our brain tries to make sense of the things it sees – like seeing pictures in clouds. Dementia can impact perception and a person’s ability to recognise what is in front of them.
The brain will try to understand what the eyes are seeing and may for instance see a black mat as a hole.
The person will then try to step across or go around the mat or, if it is too big to step over, they may refuse to cross it. To others, who are just seeing a mat, this may appear to be strange behaviour, but if we understand it from the point of view of the person with dementia it becomes very logical behaviour. Who would deliberately step into a hole?
Vision issues with colour, contrast and peripheral vision can also impact mobility and how people walk and behave. As they will find it harder to see where they are going, they are more likely to start shuffling rather than walking normally. They may start looking at the floor more when walking and not be as aware of things around them. They may also be more likely to bump into things or have a fall.
If depth perception is impacted the person may be appear to become clumsier. They may also struggle with stairs. The person may also find it more difficult to identity, for instance, where the actual seat is on a chair or have difficulties getting in and out of a vehicle.
Many of these signs and symptoms of dementia may appear to be mobility issues rather than difficulties with vision.
It is important to have good lighting in all areas of the house. Warm lights and soft shadows may add to the ambience of a space, but they also make it harder to see and identify shape, contrast, colour and tone.
Having colourful cushions on furniture and a bright coloured on the toilet seat can also help to ensure that they stand out and are easier to identify.
Mirrors can be confusing as they make it look like there are additional rooms and reflections can make it appear that there are others in the room.
Making a home dementia friendly doesn’t have to be difficult – good lighting, cushions, using colour to highlight light switches, and coloured crockery and cutlery can all help.
Smell is one of our very first senses to develop.
Sometimes with dementia one of the early things that people can lose is their ability to recognise: chemical smells, body odours, food that is off or the smell of burning.
This can result in the person not being able to tell that they, or their clothes, need washing, and they may start wearing the same clothes for many days.
Consider laying out clean clothes the night before for the person to wear.
It is also important to check smoke alarms regularly and be aware of chemicals in the house and where they are stored.
Taste can often change with dementia. For many people food starts to taste increasingly bitter. To counteract this, the person may prefer foods that are spicy or sweet.
Consider cooking vegetables in honey or just adding a little sugar to stews. If the person will only eat puddings try encouraging them to have desserts with fruit.
Many people receive physical comfort through contact on the palm of their hands. Holding hands and maximising the amount of palm to palm contact you give to a person living with dementia can enable that person to connect with you and feel safe therefore opening channels of communication.
Unexpected touch will make us all react. Touch and movement are closely connected, for example if we feel something brush against us or a fly lands on our arm we will instinctively move or brush it away.
Touching someone to get their attention, when they don’t know you are there, may mean the person will react suddenly and unexpectedly. Ensure the person is aware of you approaching them; try to approach from the front and use their name to get their attention before touching them.
Sometime dementia can cause hypersensitivity to touch so even the lightest touch can feel painful and clothes may feel itchy or uncomfortable.
Hearing is not just about our physical ability to hear sounds; it is also a vital part of our comprehension and understanding. If hearing is impacted by dementia this can result in:
Listening and communication can take a lot of concentration and focus and therefore as these become more challenging, the person may start to withdraw from conversations and interactions. This can especially be the case in group situations, where several people are speaking, or where there is background noise.
The person with dementia may prefer 1 to 1 conversation. They may also be happier with shorter conversations. Many find family gatherings challenging.
Remember: the person with dementia may not be able to explain that something is wrong or even recognise there is. It is also important make sure people are wearing their glasses and using any hearing aids, and to ensure regular checks on hearing and sight to ensure there is no physical deterioration in vision or hearing.
When an illness can’t be cured, palliative care aims to make a person as comfortable as possible by managing their pain and other distressing symptoms.
Good palliative care focuses on the person, not the disease. It is not just about supporting someone in the last months, days, and hours of life, but about enhancing the quality of life at every stage of the disease process from diagnosis onwards.
Dementia is a progressive disease, so it is important to talk about the future.
Initiating the conversation can be difficult but understanding the person’s wishes will make it easier if decisions have to be made on the person’s behalf.
Additionally, it is important to be aware that there may be legal issues later if certain measures have not been put in place.
There are many devices available to help a person live in their home and as independently as possible for as long as possible.
Some people can be resistant to using aids or having adaptations around the home but not doing so will make it more likely the person will start to find daily tasks more challenging, and more likely that they will be unable to live independently earlier.
There are many devices to help with everyday living. For example, memory aids, assistive tools like calendar clocks, high tech solutions to monitor medication, or satellite navigation systems to find someone that has gone missing.
Much assisted technology can really help carers and can often be linked to computers or smart phones through apps to enable the carers to check the person is okay from a distance.
This includes: trackers, heat sensors, gas and flood sensors, mats to tell if someone is getting up at night or leaving the house, and doorbell cameras.
There are a wide range of social care services available that can help someone stay in their own home and assist the carer.
A cared for and carers assessment will help understand needs and payment options.
Some of the services available include: