What is Dementia?
Dementia is a term which describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. Changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. A person with dementia may also experience changes in their mood or behaviour.
Dementia is caused when the brain is damaged by diseases, such as Alzheimer’s disease or a series of strokes. Alzheimer’s disease is the most common cause of dementia, but not the only one. In fact, there are over 100 hundred different types of dementia.
The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing the dementia.
Different types of dementia tend to affect people differently, especially in the early stages. Other factors that will affect how well someone can live with dementia include how other people respond to them and the environment around them.
A person with dementia may have cognitive symptoms (to do with thinking or memory). They may often have problems with some of the following:
day-to-day memory – for example, difficulty recalling events that happened recently,
concentrating, planning or organising – for example, difficulties making decisions, solving problems or carrying out a sequence of tasks (such as cooking a meal),
language – for example, difficulties following a conversation or finding the right word for something,
visuospatial skills – for example, problems judging distances (such as on stairs) and seeing objects in three dimensions,
orientation – for example, losing track of the day or date, or becoming confused about where they are.
A person with dementia may also have changes in their mood. They may become frustrated or irritable, apathetic or withdrawn, anxious, easily upset or unusually sad. With some types of dementia, the person may see things that are not there (visual hallucinations) or strongly believe things that are not true (delusions).
Dementia is progressive, which means the symptoms gradually get worse over time. How quickly this happens varies greatly from person to person. As dementia progresses, the person may develop behaviours that seem unusual or out of character such as asking the same question over and over, pacing, restlessness or agitation.
A person with dementia, especially in the later stages, may have physical symptoms such as muscle weakness or weight loss. Changes in sleep pattern and appetite are also common.
When a person with dementia behaves differently, this is often mistakenly seen as a direct result of the dementia or simply as another symptom of the condition. However, this is often not the case. The behaviour may have many causes, including difficulties relating to dementia (such as memory loss, language or orientation problems), but also mental and physical health, habits, personality, interactions with others and the environment.
The possible causes of someone behaving out of character may be divided into biological (eg being in pain), psychological (eg perceiving a threat) or social (eg being bored).
The person with dementia may be influenced by an environment that is unable to support or meet their needs. Disorientation is a common feature of dementia, so an environment that is confusing and difficult to navigate can increase distress.
When supporting a person with dementia, it's important to see beyond the behaviour itself and think about what may be causing it. Sometimes behaviour can be a result of frustration in the way others around the person are behaving, a sense of being out of control, or a feeling of not being listened to or understood.
People with dementia have the same basic needs as everyone else. However, they may be less able to recognise their needs, know how to meet them, or communicate them. Behaviour may be an attempt to meet a need (eg removing clothing because they are too hot or walking around because they are bored or feel they need to be somewhere), or to communicate a need (eg shouting out because they need the toilet).
Dementia can make the world a confusing and frightening place as the person struggles to understand what is going on around them. Though it may confuse the carer, the behaviour will have meaning to the person with dementia. It is likely to be an attempt to enhance and maintain a sense of well-being and ease distress. Any response should involve trying to see things from the person's perspective.
How to communicate with a person who has dementia
Make good eye contact have a friendly facial expression
Introduce yourself. The person may have forgotten who you are
Be a good listener, even if you have heard the story many times before
Don’t patronise or ridicule.
Never assume that the person can’t understand what is being said
Avoid correcting the person
Encourage the person with dementia to join in conversations and activities
Background noise can create difficulty in concentrating for someone who has dementia
Treat the person with dementia truthfully and honestly
Remember to smile.
A person with dementia still has the same feelings and emotions as a person not living with dementia. They may not remember what you have said to them, or where they have been, but they will remember how you made them feel. 70% of communication is in our body language and facial expressions. So remember to smile, use open and friendly body language and be patient.
A person living with dementia may find the world around them confusing and frightening at times. They often respond well to how those around them are responding. If you are calm and relaxed, they are more likely to be calm.