Dementia is primarily caused by the dead brain cells, but it may also be caused due to head injury, a stroke, prion diseases, HIV infection (virus damages the brain cells), reversible factors like depression, thyroid abnormalities, medication side effects, excess use of alcohol, and vitamin deficiencies
Types of dementias that progress and aren’t reversible include:
- Alzheimer’s Disease: The most common cause of dementia may be due to mutations genes. Alzheimer’s disease patients have plaques and tangles in their brains.
- Vascular Dementia: This second most common type of dementia is caused by damage to the vessels that supply blood to your brain. The most common symptoms of vascular dementia include difficulties with problem-solving, slowed thinking, focus, and organization.
- Lewy Body Dementia: The Lewy bodies are abnormal balloon-like clumps of protein found in the brains. Common signs and symptoms include acting out one’s dreams in sleep, seeing things that aren’t there (visual hallucinations), problems with focus and attention, uncoordinated or slow movement, tremors, and rigidity (parkinsonism).
- Fronttotemporal dementia: This is characterized by the breakdown (degeneration) of nerve cells and their connections in the frontal and temporal lobes of the brain. Common symptoms affect behavior, personality, thinking, judgment, and language, and movement.
- Mixed dementia:This is a combination of several causes, such as Alzheimer’s disease, vascular dementia, and Lewy body dementia.
- Parkinson’s Disease: The person faces issue with the problems like reasoning and judgement. It also increases the irritability, paranoia and depression in the person.
- Huntington’s Disease: The person has a specific type uncontrolled movement along with the dementia.
Dementia-like conditions that can be reversed
Some causes of dementia or dementia-like symptoms can be reversed with treatment & care. They include Infections and immune disorders, metabolic problems, and endocrine abnormalities, nutritional deficiencies, medication side effects. subdural hematomas, poisoning, brain tumors, anoxia, and normal-pressure hydrocephalus.
Dementia can affect many body systems and, therefore, the ability to function. Dementia can lead to
- Poor Nutrition: Many people with dementia eventually reduce or stop eating, affecting their nutrient intake. Ultimately, they may be unable to chew and swallow.
- Pneumonia: Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia.
- Inability to perform self-care tasks As dementia progresses, it can interfere with bathing, dressing, brushing hair or teeth, using the toilet independently, and taking medications accurately.
- Personal safety challenges: Some day-to-day situations can present safety issues for people with dementia, including driving, cooking, and walking alone.
- DeathLate-stage dementia results in coma and death, often from an infection.
To avoid these serious complications, dementia patients need to be in good Care. This could be provided by well-trained spouse or relatives, home caregivers. If not possible, they need to shift to care-home such as PARADISE which have 24X7 caregivers & nurses trained to take care. Care homes are modified to minimize risks.
Dementia’s treatment depends upon its type and what causes it. It cannot be cured, since it is a progressive disease but with proper treatment and care the speed of disease can be put to a halt. There are two types of primary treatments for dementia, these are medications and non-drug therapies.
Medications for Dementia
- Cholinesterase inhibitors:Side effects include nausea, vomiting and diarrhea, slowed heart rate, fainting, and sleep disturbances.
- Memantine A common side effect is a dizziness.
- Other medications:medications to treat others such as depression, sleep disturbances, hallucinations, parkinsonism, or agitation.
As advised by treating doctor, symptoms and behavior problems are treated by PARADISE initially using nondrug approaches, such as:
- Occupational therapy:PARADISE occupational therapist shows caregivers how to make one’s home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior, and prepare one for dementia progression.
- Modifying the environment:Reducing clutter and noise can make it easier for someone with dementia to focus and function. One might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems by PARADISE can alert one if the person with dementia wanders.
- Simplifying tasks:Care attendants break the tasks into easier steps and focus on success, not a failure. Structure and routine also help reduce confusion in people with dementia.
- Enhancing communication:Speaking slowly while maintaining eye contact without rushing for a response, presenting one idea or instruction at a time, using gestures and cues, such as pointing to objects.
- Encouraging exercise: Daily exercise regime by PARADISE team benefits people with dementia in improving strength, balance and cardiovascular health, managing symptoms such as restlessness, protects the brain from dementia, especially when combined with a healthy diet and treatment for risk factors for cardiovascular disease. It slows the progression of impaired thinking in people with Alzheimer’s disease and can lessen symptoms of depression. Exercise during the day eases nighttime restlessness. Napping during the day is discouraged.
- Engage in activities: PARADISE Plans fun activities that the person with dementia enjoys and can do such as dancing, painting, gardening, cooking, singing, etc. that helps one’s loved one focus on what he or she can still do. One on one interactions, outings to a park, mall, for a movie or to a temple/ church, group sessions like Tambola, passing ball games, anthakshari, discussions regarding their favorite movie, actor or a singer, cultural programs by staff or an elderly, arranging special evening like a candle-light dinner, high tea, celebrating festivals and birthdays
- Establish a nighttime ritual:Behavior is often worse at night. PARADISE Care attendants keep a 24X7 watch. They establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup, etc. Night lights are kept on in the bedroom, hall, and bathroom to prevent disorientation.
- Art Therapy:It involves creating art, focusing on the process rather than the outcome
- Music therapy:It involves listening to the soothing music of resident liking.
Respite Care to Caregiver
Providing care for someone with dementia is physically and emotionally demanding. Feelings of anger and guilt, frustration and discouragement, worry, grief, and social isolation are common. PARADISE homes can take dementia patients for short stays providing some relief to caregivers.
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