Dementia is a disease in which mental abilities, such as memory and thinking skills, decrease sharply. As a result, motor problems, orientation disorders, speech disorders and a change in personality also occur. As the disease progresses, those affected can no longer perform their daily tasks and are dependent on the help of others.
What is dementia?
Memory training is usually applied in the early stages of dementia and orientation disorder adapted to the particular disease situation. The term dementia includes several diseases in which mainly the thinking ability and memory are disturbed. Above all, dementia patients suffer from a strong decrease of mental abilities. Especially the short-term memory and the sense of orientation are affected. But also speech disorders and motor skills decrease more and more. One form of dementia is Alzheimer’s disease. This form occurs in 60 to 70 percent of all dementia cases. In addition, there is vascular dementia, i.e. dementia caused by blood vessels. This form is rarer and is represented by about 20 percent. There are also various mixed forms of dementia, in which Alzheimer’s dementia and vascular dementia can merge. The disease of dementia occurs more and more frequently among older people in Germany. This is mainly due to the high life expectancy, as well as the lifestyle of our western civilization. Only rarely are younger people affected by dementia. Above all, the over 80-year-old people have a multiple increased chance of dementia.
Causes
The causes of dementia can have a variety of backgrounds. Most commonly, dementia occurs in the context of Alzheimer’s disease. In vascular dementia, stroke or arteriosclerosis or hardening of the arteries are the main causes. In addition, infections (e.g. Creutzfeldt-Jakob disease), metabolic diseases (e.g. diabetes mellitus) and oxygen deficiency of the brain are usually responsible for dementia. Furthermore, there may also be a connection with Parkinson’s disease, depression and hereditary dementia. There are numerous theories as to why the above dementias occur:
Mental reactivity: passive activities (such as watching television) over a long period of time do not optimally stimulate the growth of new neurons or cause them to die slowly because they are not needed. From this point of view, active mental activities can be preventive against dementia. Above all, reading, learning, making music and puzzling sharpen the human mind in the long term. Nutrition: An unhealthy and monotonous diet over the years is harmful to the brain. In particular, a high proportion of saturated fatty acids in meat and a high sugar consumption are detrimental in the long term. Therefore, a balanced and healthy diet with vitamins C and E makes sense. Likewise, fish with its valuable omega-3 fatty acids have a stimulating effect on the mind and memory. Physical activity: In addition to impoverished mental activity in life, lack of exercise can also be responsible for dementia. The body should be considered as a holistic “being”. It is not said for nothing that “in a healthy body there is a healthy mind.” “Fault” the body and the mind slowly over years due to inactivity and stimulating mood, so diseases should not be uncommon.
Symptoms, complaints and signs
Dementia is a disease that is progressive and involves a variety of symptoms. It most often begins with progressive memory loss. Affected persons initially suffer primarily from a restriction of short-term memory: information that has been absorbed is no longer stored and new things can hardly be learned. This is not necessarily noticeable at the beginning, as a certain forgetfulness is considered normal, especially in old age. In the further course, memories are also lost and the affected person forgets more and more aspects of his life. Accordingly, he also changes habits and appears confused when asked about past events – which are actually known to him. Other cognitive qualities are also lost: Word-finding disorders and orientation problems are added. Things that are actually familiar are no longer recognized or are misclassified, and changes can lead to greater confusion or to anger. The end result is severe fatigue, apathy and the inability to recognize even one’s own relatives. In terms of motor skills, dementia primarily affects walking.The steps become smaller, the affected person altogether more unsteady. Motor reflexes of any kind can be lost. Psychologically, there are also many symptoms. In addition to apathy and irritability, there may be irrational behavior (eating inedibles or wandering around), or hallucinations and euphoria. In either case, major behavioral changes may be observed. Signs of dementia include gradual memory loss and changes in the affected person’s character.
Course
The course of dementia can have different features. As a rule, the intensity of the dementia progresses slowly (over several years) and is not immediately apparent. In addition, episodes of dementia occur later in the course of the disease. In this process, days of relatively clear thinking and consciousness alternate with mentally dull days. In addition, many dementia patients suffer from severe mood swings, such as irascibility and anger, as well as depression.
Complications
Dementia does not necessarily lead to complications. If those affected receive appropriate and comprehensive care, the risk can be kept quite low. However, some complications already result from inadequate treatment. Many dementia patients are placed in district hospitals or nursing homes. Due to shortages in terms of staff, very inadequate treatment sometimes occurs. Due to overworked nursing staff, mistreatment can occur, which can trigger further psychological problems. Inadequate physical care can also lead to skin wounds, sometimes with serious inflammation. Dementia diseases occur in many variants and degrees of severity. The complications are strongly dependent on the cause of the disease. Complications that are generally valid for all dementia diseases are, for example, side effects caused by medication, failure of bodily functions, increased infection rates and, in later stages, losses with regard to the ability to interact. Life expectancy also decreases with the onset of the disease. Dementia disorders can also promote falls, bone fractures, and muscle contractures. Malnutrition and dehydration are also frequently observed. A not uncommon complication is violent behavior toward self and others. Dementia diseases are complex and lead to significant losses in the quality of life of those affected and their relatives. Due to the definitive characteristic of the disease, forgetfulness, affected patients not infrequently put themselves in life-threatening situations.
When should you see a doctor?
If the habitual ability to remember drops or changes, a doctor should always be consulted. If there is a loss of memory in everyday life, it is advisable to have examinations initiated in good time. If the affected person finds it increasingly difficult to remember events of the past hours or days in particular, he or she needs to consult a doctor. If the ability to read an analog clock correctly disappears, he should have a comprehensive examination. As soon as relatives notice that existing memory gaps are being filled with made-up stories, a calm and trusting conversation should be sought with the affected person about the changes noticed. In case of disorientation or loss of memory of names as well as persons, help is needed as soon as possible. The disease is then already in an advanced stage and the affected person should no longer be left alone. Medical help is also necessary if, in addition to memory loss, conspicuous behavioral changes occur. An aggressive demeanor or a sharp increase in conflicts with people in the immediate environment are considered worrisome and should be clarified by a doctor. If the affected person forgets to take necessary medication or forgets to eat enough food as well as liquids during the day, he needs medical help. If there is a noticeable weight loss or a change in the need to sleep, further investigation should be initiated.
Treatment and therapy
The therapy or treatment of dementia depends on its form. To date, dementia is not curable. Therefore, depending on its form, the treatment of dementia attempts to slow down the mental deterioration as well as the physical symptoms. If dementia is detected in time, attempts can be made at this early stage to slow down serious consequences. Medication is the main method used here.In addition, good social integration in the family is beneficial in order to give the affected person the feeling that he or she still “belongs”. Furthermore, sociotherapeutic or psychotherapeutic treatment is an important support in addition to drug therapy. In addition to these measures, an examination by a neurologist is also advisable, who can provide further important information about the specific form of dementia and thus offer answers to the caregivers or family about the disease. There are also support groups and memory clinics that can help the dementia sufferer retain his independence and mental faculties for longer.
Outlook and prognosis
The course of dementia varies greatly from individual to individual and depends, among other things, on the particular form of dementia. In the most common form of dementia, Alzheimer’s dementia, but also in most other forms of dementia, the disease progresses gradually. Over many years, there is a gradual loss of cognitive ability. The destruction of the nerve cells in the brain is irreversible. The disease cannot be cured by drug treatment or psychosocial measures. Only the progression of the disease can be slowed down or even temporarily stopped. Over the years, the patients become increasingly forgetful and dependent, up to the complete need for care and finally die from the complications of their disease. The patients are no longer able to care for themselves and are completely dependent on the help of others for things such as food intake and physical hygiene. The Alzheimer’s diagnosis itself is not the actual cause of death of the patients. It is rather the case that bedriddenness can lead to an increased incidence of pneumonia, pulmonary embolisms or other infectious diseases, from which the sufferers ultimately die. In general, the later the onset of dementia, the shorter the course of the disease.
Aftercare
Aftercare for those affected by dementia consists of returning them back to their home environment after an inpatient stay. The challenge is often the reliance on family caregivers, who must first adjust to their new role. Aftercare therefore not only affects the patient, but also their relatives, who need to be informed and supported in order to avoid being overwhelmed. To ease the situation, a partial inpatient stay in a clinic can be useful, because here the patients are gradually released into everyday life. Through therapeutic offers, a certain autonomy can be regained, depending on the stage of dementia. It is important that those affected are not overburdened by the therapists, as this can result in a renewed outbreak of the disease. The needs of each individual must be sensitively considered. If the patient then moves fully into the home environment, it is also helpful here to receive regular visits from the doctor or to hire a professional nurse to provide support during the difficult initial period. Good daily planning plays a major role in ensuring that the patient is challenged and that there is no void in which the disease can break out. Participation in social life, taking up old hobbies and regular training of body and mind are just a few recommendations.
Here’s what you can do yourself
As the dementia disease progresses, there are increasing limitations and problems in the daily lives of those affected. With simple self-help tips, the quality of life of those affected can be significantly improved – in addition to medical care. It is extremely important, especially at the beginning of the course of the disease, to exchange information with other patients. This helps patients to better understand their condition and also to distance themselves emotionally. In order for patients to remain balanced despite their illness, sufficient exercise, a healthy diet and time for personal retreat are recommended. It is extremely important for those affected to find a respectful, loving environment that is supportive. An open approach to one’s own illness usually has a positive effect on those affected and on mastering their everyday lives. In addition to self-help tips that those affected can incorporate into their everyday lives, professional counseling and support are also recommended.With various forms of therapy, such as music therapy or occupational therapy, the affected person can free himself from stressful behavioral problems and thus calm himself down. The affected person should concentrate on promoting existing abilities in order to be able to maintain his or her own independence for a longer period of time. Sudden changes in the environment could have a negative impact on the dementia sufferer and should therefore be avoided.
