Guide to Caring For Someone With Dementia
When a Person Develops Dementia
Dementia is a broad term that is used to describe a condition where there is an ongoing and generally irreversible decline of the brain and its abilities. At the present time, dementia is not curable. Although medication is available to slow the symptoms of the disease, these are not suitable for everyone.
Regardless of which type of dementia is diagnosed, each person will experience their dementia differently. This will depend on many factors including where the damage in the brain is, and the character and individuality of the person.
The Two Most Common Types of Dementia
Although there are over 100 different types of dementia, residents with a diagnosis of dementia who are living in an Avery care home are most likely to have one of the more familiar forms of the disease:
This is the most common type of dementia. In Alzheimer’s Disease, proteins build up in the brain to form structures called plaques and tangles which lead to connections between nerve cells being lost, and consequently dying.
The progression of Alzheimer’s Disease is relatively steady, with initial symptoms commonly involving memory lapses; for example, misplacing items or a person getting lost in previously familiar places.
Vascular Dementia is the second most common type of dementia affecting people in the UK. This type of dementia occurs when damage to brain cells is caused by a reduced blood supply to the brain, for example due to a stroke.
The progression of Vascular Dementia will vary from person to person depending on whereabouts in the brain damage has occurred, whether the stroke was a single episode, or whether there have been a series of strokes. Underlying medical conditions, for example high blood pressure will also have an impact on the progression of this type of dementia.
How Damage to the Brain Can Impact on Day to Day Living
The areas of the brain that are affected, and the difficulties that a person will experience as a result are dependent on the type of dementia, as well as on other factors, including the person’s previous skills and abilities. For example, a person who has always had a very poor sense of direction, is still likely to have a poor sense of direction regardless of where the damage caused by dementia occurs.
Visual Blind Spots
Sometimes a person’s actions will indicate that they cannot ‘see’ objects or items that are in front of them, regardless of how good (or poor) their eye sight is. This can be due to the brain no longer being able to process the images that are being observed. For example, a person may be unable to locate a cup of tea in front of them without help.
Identifying Colour or Tones
A person may have difficulties identifying colours or distinguishing objects that are a similar colour. Activities or conversations that do not require the person to correctly identify or match colours may be more helpful to avoid additional frustration or distress.
A person with dementia may struggle in distinguishing left from right. Care should be taken not to use left/right directional instructions to avoid further confusion. Similarly, general co-ordination may be affected, for example, a person may have difficulty in managing to use cutlery at meal times and may manage more successfully with finger-friendly buffet style foods.
Orientating Within the Environment
A person with dementia can become disorientated within their environment regardless of the length of time they have lived there. For example, the person may be unable to locate the toilet, or their bedroom and may need guidance and direction to avoid getting lost. Similarly, a person may be unable to make sense of their surroundings and may frequently ask where they are.
Although this can be frustrating for family members, it can be even more distressing for the person themselves.
Reading, Writing and Numbers
A person with dementia may appear to be having problems reading or making sense of written words or numbers. Care should be taken when considering the type of activities that the person may want to engage with. For example, word-based puzzles may cause further frustration or distress, despite the person previously enjoying completing a daily crossword.
A person with dementia may struggle to understand what is being said, and may appear to ignore others, particularly if there is a lot of background noise. Speaking slowly, choosing different words to describe objects or items, making sentences shorter and using gestures and objects. For example, holding a cup when asking a person if they would like a drink of tea are all approaches that may be helpful, as well as making sure that spectacles and hearing aids are worn.
Concentration and Decision Making
A person with dementia may struggle to remain focused for more than a few minutes at a time. Giving too many choices, for example when asking if a person would like tea, coffee, juice or water can cause a person to be overwhelmed. Offering just one or two options is usually much more helpful.
Care for Others
Sometimes the personality of a person with dementia will appear to change radically and they may display behaviour that is very unfamiliar, for example swearing, or being unpleasant to others. When a person is cognitively well, the brain is usually able to regulate behaviour by filtering which thoughts are said out loud and which are not, and which actions are carried out, and which are ‘held back’.
When dementia causes damage in certain areas of the brain, the ability to ‘screen’ behaviour is lost and a person’s capability of judging the right things to say and do in a particular situation may change. The care team can provide support in such situations which can be very upsetting for families.
Life Story Work
Life Story work is used in memory care settings as a useful way of helping others to understand more about a person. Take a look at some of the life story work in our archive.
Knowing something of the life story of a resident can help members of the team to engage with an individual in a meaningful and interesting way. It can also help the care team and family members to make sense of the way a person acts and reacts in situations, allowing the right level of support to be given. The care team can provide more detailed information on how life story work is used and how it helps with planning care for a person with dementia, as well as helping others to connect with the person.