Managing Dementia

Dementia is a descriptive term referring to a wide array of brain disorders. It is a  progressive illness that worsens over time and almost a million people in the UK suffer from it.

It is often said that Dementia is one of the most terrifying things that can happen to a person, so it is essential to be sensitive and understanding. This can be difficult due to many expressed symptoms of the various disorders under the Dementia umbrella.

How to spot it, and what to do:

• The most common symptoms are:
• Loss of problem-solving ability
• Lack of emotional control
• Personality changes
• Behavioural issues, such as aggression
• Delusion and hallucinations
• Memory loss

It may be difficult, or impossible for the sufferer to notice these changes, so it is important that you keep a keen eye on this. Many of these symptoms can be caused by something completely different, like an infection, illness or just lack of nutrition, so it is important that you do not jump to conclusions. 

Seek a professional diagnosis from your GP, especially id the change has occurred within a very short timeframe. 

Looking after people with dementia

It is sometimes hard to remember that they are the ones who are really suffering, which makes it important that you remind yourself of this every time you see them.

On bad days, dementia suffers can be incredibly difficult and frustrating to be around. They can be aggressive, rude, dismissive, forgetful anxious and wholly illogical.

On good days, or even just in good moments, they can be the person you know and love, their true selves poking through like a ray of sunshine on a cloudy day.

Whatever the day, they still need to be treated with dignity and respect. It is important to face the challenge with them and try to take on a positive view. Focus on what they are still able to do and try to offer new experiences like arts, music, films, walking and crafts.

When speaking with a sufferer try to ignore this background noise and focus on what you are saying and what needs to get done. If it becomes too much, do not react, either persist or walk away. Many professional carers find it useful to change the subject, maybe get them a cup of tea or a snack, before returning to the issue at hand.

There is a wealth of advice online about how to deal with dementia patients. You can also open up the chat (in the bottom right-hand corner of this screen) and share your problems with a member of the team:

• AgeUK always has fantastic resources
• CareGiver is also very up-to-date on behavious and how to handle it
• Unforgettable has a fantastic article as well
• DementiaUk is also a great resource in this area

Dealing with challenging behaviours

Some forms of dementia can present even more challenging forms of behaviour, that can be quite alarming and scary. In this case, we describe challenging behaviour as behaviour that can cause harm, or the potential to cause harm, to themselves and/or others.

In this case, it is important to leave the situation quickly, before it gets out of hand. THey might be a parent or close relative so you may be slow to realise that you are unsafe, so try to be aware of this bias.

It is important to tell your GP, district nurse or Occupational health therapist about this kind of behaviour, so they can treat it effectively. It may be in their best interest to be referred to the mental health team under the mental health Act 2005 where a specialised team can be brought in to support and protect them. 

Examples of Challenging Behaviour:

• Hitting, kicking, biting
• Aggressive
• Shouting swearing & verbal insults
• Wandering
• Repetitive questioning
• Inappropriate sexual expression and behaviour
• Self- harming
• Hoarding
• Urinating in inappropriate places
• Smearing or collecting faeces
• Non- compliance with care {refusing meds, washing, eating} 

You should also reflect on how this behaviour affects you as this is incredibly distressing and should not be taken lightly. Be sure to proactively manage this by asking your GP about therapy for you, and they may recommend counselling or a course of cognitive behavioural therapy. If they broke your arm, you would seek treatment, your mental health should be treated no differently, especially if your loved one relies on you for support.

Medication

There are medications that may be prescribed to deal with the symptoms but these can have service side effects. All involved must ensure these are prescribed in the best interest of the person and will not complicate the managing of their care further.

These medicines may be:

• Anti-psychotics { e.g haloperidol, risperidone}
• Sedatives/benzodiazepines {e.g diazepam}
• Anti-depressants {e.g citalopram}
• Anti-convulsants {e.g. sodium valproate}
• Anti-dementia drugs {donepezil}

Setting up the home:

A whole new way of communication, an adaption of the home assessing the risks may need to be put in place to assist the wellbeing and independence of the person to stay living safely in their own home. You may find these below useful

• Use picture cards on cupboards and doors
• Write down instructions on cupboards doors fridges
• Get a professional to disconnect the cooker/oven
• Employ experienced carers
• Install a pre-programmed telephone
• Surround them with physical reminders of their past
• Install sensory alarms if they are prone to wandering

We have an in-depth article on this here.