A beginner’s guide to dementia

Dementia is probably the most difficult problem families face when caring for an older relative

Most dementia cases are caused by Alzheimer’s disease, but there are other causes, including:

• Vascular dementia
• Lewy body dementia (associated with Parkinson’s disease)
• Fronto-temporal dementia.

Many patients have a mixture of Alzheimer’s and vascular pathology

What are the signs of dementia?

The first thing you might notice is memory lapse

• An inability to name objects or people and perhaps the beginning of more difficulty with everyday tasks like cooking and planning
• There may be incidents like losing the car in the car park, or failing to get off the bus at the right stop

Watch this video explaining dementia

What should you do if you think your ageing parent has memory lapses?

• It is important to find out what is wrong and to get the right diagnosis
• Memory problems are sometimes associated with depression, which is easily treated, or they may be worsened, or even caused by physical problems
• It is important to have a set of blood tests, including thyroid function tests and maybe an ECG to check the heart
• These tests can be done by the person’s GP, but then they will also need a referral to the local old age psychiatry service
• They may then be seen at home by a specialist or in a Memory Clinic
• They will probably have some cognitive tests- these have a variety of names, but commonly the Mini Mental State Examination is used and some more detailed tests as well
• They will be offered a CT scan, or even an MRI scan, if it is felt to be necessary
• Dementia is still a diagnosis that is made from the clinical history and talking to the patient and the people who know them best, but the tests may give some clarity

What should you do if your older relative is diagnosed with dementia?

• Dementia is a frightening diagnosis for the patient and for those caring for them, so you will need to learn about the illness and about the help that is available
• The Alzheimer’s Society www.alzheimerssociety.org.uk can be very helpful, but the old age psychiatry service your ageing parent will see will also be able to give you information and point you in the right direction

Caring for someone with dementia is often very stressful

Living with and/or caring for someone with dementia can be very stressful

You can ask for a carer’s assessment for yourself to make sure your needs are properly considered too

You may find it very trying when your elderly relative is very repetitive, or is always asking the same questions

They may have odd ideas, especially if they have lost something and feel that it has been stolen or deliberately moved

There is not much to be gained by arguing with people in this state and it is sometimes easier for both of you to accept some of what they say and only correct them when it is really necessary

As the illness progresses, patients need increasing amounts of help, particularly with personal care and they may become very upset and angry with the people trying to help

It is important always to remember that the person living with dementia is very sensitive to his or her environment and the way in which they are treated, so they should always be offered an explanation of what is happening and be treated with gentleness and consideration

This sometimes can try the patience of a saint and carers almost always need support

Residential care for dementia sufferers

Dementia is the main reason that people have to move into residential, or nursing care

Although this is often very sad, they may find the routine of institutional care reassuring and may benefit from having a larger space to wander around

Carers often feel very guilty as eventually cannot manage and finally have to let their loved one go into care, but sometimes it simply isn’t possible to carry on at home

The children of the person with dementia often live far away and have to try and organise the care from a distance, which is also difficult. These kind of problems can put great pressures on families and can impact on many family relationships

Dementia is increasingly common

Dementia is a very sad illness, which robs the patients of many of the pleasures of life

It is very common and will affect 1 in 5 of us who reach 80 years old

It is less common in people under 80, but some people may start the illness in their 60s, or even earlier

It is very important to get a diagnosis and to find your way through the various caring agencies, including the NHS, social services, the voluntary and private sectors

It can also be very expensive to pay for care, which is only free once the person’s savings are less than £23,000

Early in the illness, people are able to give a Lasting Power of Attorney to ensure someone they trust can look after their money and make decisions about their health and well being when they have lost the capacity to do so

It is important to get this organised and to make sure that they make a will whilst they are able.

In spite of the misery of this illness, there can be moments of joy and even humour for both sufferers and carers

It is often a long and difficult road, but meeting others in the same situation and getting the help you need can make all the difference

Claire Lawton has been a consultant in old age psychiatry for 23 years. 4 years in Tower Hamlets and 19 in Cambridge. She has also worked as an Associate Postgraduate Dean for 7 years and more recently have been involved with the East of England SHA as a Medical Director. Claire was the lead on developing dementia policy in the region and in implementing a number of projects in mental health, long term conditions and dementia. She has now returned to clinical work with a continuing interest in developing services for people with dementia and their carers.

Memory services

www.alzheimersresearchuk.org

www.alzheimerssociety.org.uk