Living with Dementia

Dementia is difficult for everyone – for the person diagnosed with it, for the family members who become caregivers and even for healthcare providers who do not always have solutions to the many challenging situations this disease can create for patients and their families.

When confronted with dementia – as a patient or caregiver – the best defense is a good offense. Begin by educating yourself about the disease, treatments and lifestyle practices that can work to slow the disease, behaviors and challenges you can expect as the disease progresses and ways to manage life after a dementia diagnosis with as much joy and dignity as possible.

Dementia is an umbrella term that covers a multitude of disorders that impair memory to the point that daily functions become difficult or impossible. Alzheimer’s disease, cerebrovascular disease, Lewy body disease, mixed pathologies, frontotemporal lobar degeneration and Parkinson’s disease are some of the more common causes of dementia.

Although dementia is not a normal part of aging, the biggest risk factor for the disease is age. For example, the majority of people with Alzheimer’s dementia are age 65 or older and about a third of people age 85 or older have Alzheimer’s dementia. Breakthroughs on causes and treatments continues but currently, dementia is progressive and has no cure.

It is easy to confuse the very early signs of dementia with typical memory issues we all experience as we age, but they are different. For instance, it is normal to misplace your keys or your glasses. It is not normal – and may be an indicator of dementia – to put your keys or glasses in an unusual place, such as the freezer or in the back of a drawer, and then have no recollection of where you put them.

It is normal to walk into a room in your home and forget your purpose for going there. It is not normal – and may be an indicator of dementia – to walk into a room in your home and for a moment not know where you are.

Difficulty performing once routine mathematical tasks such as balancing your checkbook or adding a column of numbers, or feeling excessively challenged when learning new things such as how to work a new appliance, may also indicate a serious memory disorder.

Get Diagnosed – The Sooner, The Better If you suspect dementia, get a diagnosis from a neurologist who specializes in memory loss and do so as soon as possible. Insist that both

the patient and close family members or loved ones are part of the evaluation and are given the opportunity to discuss with the physician what has caused them to suspect dementia. While most patients are well aware that their ability to process information has changed, a loved one is usually in a better position to recall and give details of specific incidents and behavior changes, giving physicians a more complete picture.

While there currently is no cure for dementia, there are medications and lifestyle practices that can slow the progression of the disease especially when a diagnosis is made early. Also, other conditions, such as depression, stress, poor sleep, hearing loss, vision problems, an underlying infection or other illness can worsen symptoms. Simply treating these disorders often can return some memory function. With a diagnosis in hand, a physician is better able to guide the patient and the family as to how to manage symptoms now to maintain the greatest independence and to give all concerned an idea of what to expect for the future.

Although only one member of the family may have dementia, everyone in the family is affected. It makes sense to come together as a family in these early stages and put together a plan of action to care for the patient and manage life as the disease progresses.

As a family, you should decide on roles and responsibilities for everyone who wishes to be part of the care management. Be realistic in your commitments. Dementia is for the long haul. Commit to what you can do and then find resources in the community to help where you and others cannot. continued on next page

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Being there for someone with dementia can pose challenges but there are approaches that can help, many of which involve being supportive, compassionate and understanding of changes caused by the disease. Simplify: Talk about one thing at a time, use fewer words and speak slowly. Sharing too much information – and multitasking – can be confusing and overwhelming. Realize that logic does not apply to an illogical disease. Let your loved one carry out tasks: Offer to help but also be willing to not help so your loved one has the chance to feel good about accomplishing something on his or her own. Use memory aids: Lists, signs, dry-erase boards, alarm clocks and calendars can help as can having designated spots for commonly misplaced items. Be attuned to eyesight and hearing issues: Vision and hearing problems can worsen – and in some cases can mimic – dementia symptoms. Peripheral vision can be lost and perception can change, too, as the disease progresses. Make sure your loved one has his or her eyesight and hearing checked regularly, especially if he or she is having trouble with avoiding obstacles, seeing well even when wearing glasses, struggling to follow a conversation or having problems with balance. Show and tell: Visually communicating with your loved one is as important as talking with him or her so be sure to show and say what you mean. To assist with his or her comprehension, make your loved one’s living space as free as possible of distractions such as visual clutter and noises. Use hand gestures, visual cues and prompts to help convey what you mean. Go down memory lane: Reminisce about the past by looking at old photographs and mementos and telling stories from days gone by. Practice patience and kindness: Reassure your loved one and focus on his or her feelings rather than the facts. Apologize and say “I’m sorry” regularly when he or she is frustrated, sad or angry. Respond with affection through smiles and hugs. Securing the help of a professional at this point such as a geriatric care manager, a social worker or someone from your local council on aging may be a good idea. These professionals are trained to help you know what to plan for. They can inform you of support services and various resources in your area, help you weigh your housing options and help you navigate the system overall.

With dementia, moving to assisted living, using adult day care or needing roundthe-clock care — can become necessary as the disease progresses. With a plan, these transitions become easier financially and emotionally for everyone.

Someone with memory impairment functions better in familiar surroundings. To that end, it is to everyone’s advantage to move the person with dementia into the care situation chosen before rather than after the full force of that care is needed. By making a move before dementia progresses, individuals can make friends, get used to routines and form relationships with staff while they still have the ability to do so.

As you look at living situations, focus on the goal of only moving your loved one only once if possible. Consider places that offer both assisted and skilled care in the same building, or at least on the same campus. If symptoms worsen and skilled nursing becomes necessary, it is healthier for your loved one to be in familiar surroundings with people he or she trusts. Staying put also increases opportunities for independence, reduces your loved one’s fear and makes it easier for friends who live on-site to visit.

Part of every plan for dementia care must be to care for the caregivers. This means ensuring caregivers don’t overcommit themselves and that their needs and desires also are considered. They should take time to join a support group online or in person for emotional support as well as to gain insight and strategies for managing the disease. Respite care should be built into the schedule to ensure caregivers have time for rest and for living their own lives.

Remember that the care plan is not written in stone. The person with dementia and the caregivers should feel free to change it as circumstances and abilities change. For instance, a caregiver may commit at first to keeping a loved one at home. As the disease progresses or life circumstances change, this may prove to be too stressful for the caregiver. At that time, the caregiver should feel free to change the plan and find a solution that works better for him or her and the patient.

With increased scientific research now being devoted to Alzheimer’s disease and other forms of dementia, advances in diagnosis and treatment are occurring more rapidly. Medications for memory, treatments for sleep changes, strategies for addressing changing behaviors and a host of alternative therapies are improving the quality of life for dementia patients and their loved ones.

Millions of people in the United States have dementia and that number is expected to rise as the population ages. There is nothing easy about the often long course of dementia. But with early diagnosis and a proactive approach to management, both people with dementia and their caregivers can maintain the highest quality of life possible for as long as possible.

For a list of 10 early signs of dementia, visit ALZ.org/

For updates about advances in treatment and promising clinical research breakthroughs, visit ALZ. org/Research or ALZ.org/Help-

Find a certified Geriatric Care Manager or Aging Life Care professional at the Aging Life Care Association at AgingLifeCare.org.

Determining exactly when loved ones need help at home can be challenging but answers often can be determined by observing personal appearance, home upkeep and driving abilities. Asking these questions can shed light on how loved ones are feeling and managing daily activities:

• Do they stand up straight or are they bent over? Are they leaning to one side or having trouble with balance? • Are they maintaining their normal weight? • Do they appear to be having trouble seeing or hearing? • When walking, is their gait strong?

Or are they shuffling more than stepping? • Are they clean and shaved? Are their nails clean? Is their hair combed? • Are their clothes clean? Are they dressed appropriately for the weather? • Are their buttons buttoned properly?

Are zippers zipped? • Do they seem fatigued, sad, frustrated, upset or confused? • Are there any signs of substance abuse?

• Is the home kept the way it always has been or do you see a change? • Is the kitchen sink clean? Are beds made and floors swept or vacuumed? Are plants alive? • Is the garbage taken care of correctly? • Does the pet have food and water? • Are things that used to be put away now left out? • If they take medications, are they stored neatly in a sensible place? Using dates on the bottles, can you tell if they are being taken as prescribed? • Is mail in an unorganized pile? Are unpaid bills left around? Are checks to pay bills written but never sent? • Does the refrigerator have old, spoiled food or not enough food? • Are the dishes, glasses, and flatware properly put away and clean? • Is their bedroom, bathroom and closet dirty or unorganized?

• Has regular maintenance been carried out on the outside of the house and on other structures? • Are the gutters clean? Porches swept?

Windows washed? • Has the grass been mowed, the shrubs trimmed and the flowerbeds weeded?

• Are there signs the car has been in minor accidents? Any new dents from running into the garage or another bumper? • Is the car well maintained? What does the change-oil sticker say versus the mileage?

Are the fluids full? Is the registration current? • When you drive with them, can they get in and out of the car with ease?

• Do they drive too slowly? How is their reaction time? Do they tailgate? • When they drive, do you observe other drivers on the road being annoyed? • Do you feel afraid when riding with them? • Do they know where they are going? • Do they have trouble parking? • Can they drive safely and confidently at highway speed?

Answers to these questions can serve as indicators of emerging concerns including waning eyesight, hearing problems, issues with movement and walking, depression or other mental health issues, the onset of dementia and more. If you see a pattern of decline, the cause should be determined by a physician to see if any treatments can improve or slow the condition. As with many issues of aging, there are no hard and fast rules as to when to step in to help. However, if what you have observed leaves you feeling uncomfortable, then trust you have the evidence you need to look into finding necessary support services.

If you need in-home, non-medical assistance, we can help. A compassionate caregiver can lend a hand with everyday chores like cooking, cleaning, and running errands so people can stay home and stay independent. 828.348.0988 | GriswoldHomeCare.com

© 2016 Griswold International, LLC

Driving a vehicle is an integral part of American life. But aging can bring changes in vision and response times on the road and health conditions and medications can impact the ability to drive. When it appears that driving is becoming more challenging, it may be time to explore next steps and other transportation options to protect the safety and wellbeing of the driver and others on the road.

Start by having a candid conversation about your concerns about you or your loved one’s driving abilities as well as about alternative transportation options. If someone stops driving, it’s important to figure out ahead of time transportation needs for errands, appointments and recreational activities. Being kind, calm and empathetic during these discussions is beneficial to everyone involved.

A passenger riding along with a driver can assess driving abilities. While such a ridealong is not a test, it is a way to help figure out if someone is having challenges with driving. According to the AARP, signs to look for include: • Being easily distracted. • Having a delayed response to unexpected situations. • Running lights or stop signs. • Clipping the curb. • Exhibiting lane drifting or having trouble changing lanes. • Misjudging distance. • Showing a loss of driving confidence • Getting lost in familiar places. • Driving too fast or too slow. • Having trouble moving the foot from the gas to the brake or confusing the two. • Being pulled over by the police, having dents and scrapes on the vehicle and being involved with accidents – including fender-benders – also indicate that it may be appropriate to evaluate whether or not to drive.

Because driving is often equated with independence, having a conversation about no