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Responding to behaviors can be intimidating, wrongly executed, and detrimental to the person and the caregiver.  When we don’t understand the underlying reasons for displayed behaviors, we generally become reactive whether the action is right or wrong.  We need to better understand the variety of behaviors that persons with dementia display so we can employ a safe, non-aggressive action that de-escalates what is going on.  Knowledge is power.  How many times have we heard this?  Many times, I am sure; and its true. If we wrap ourselves in understanding why certain behaviors occur, we can avert chaos, disruption, and struggles to keep anxiousness from getting out of hand.

What are some of those underlying causes of dementia related behaviors that we all struggle with whether we are the caregiver or the person with cognitive decline?

1.  Physical issues such as pain, hunger, toileting needs, anxiety, night terrors and/or sundowning, (another blog coming on sundowning and how to cope)
2.  Environmental issues such as room temperature, clothing too tight, breezes thru window screens making noises that are scary.
3.  Personal triggers such as thoughts, emotions or activities that bring on a reaction such as feeling scared about a change in daily routine.

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What are memory cafes? Memory cafes are welcoming spaces designed for people living with dementia, their families, friends, and caregivers. They offer a safe social environment where participants can engage in activities, enjoy refreshments, and connect with others facing similar challenges.
The idea is to provide a break from the routine and isolation that often accompanies dementia creating a sense of community and support.  Memory cafes can vary in their structure, but they typically emphasize relaxation, entertainment, and interaction in a non-judgmental setting, away from the clinical environment associated with healthcare facilities.

The concept of memory cafes originated in the Netherlands and has since spread globally with cafes cropping up in community centers, libraries, churches, and even coffee shops. These cafes are often staffed by volunteers and professionals who help facilitate activities like music sessions, art therapy, games, or memory exercises tailored to the needs of participants. The setting is intentionally casual as the goal is to focus on social engagement rather than cognitive improvement allowing participants to enjoy the moment and foster a sense of connection.

Setting up a memory cafe requires thoughtful planning and consideration of participants needs. First it is essential to choose an accessible, welcoming location that can accommodate group activities and is easy for individuals with dementia and their caregivers to navigate. Next, partnerships with local organizations such as The Alzheimer’s Association, senior centers and healthcare providers can help raise awareness, recruit volunteers, and potentially secure funding and resources. Contact the Alzheimer’s Association to obtain more information.

TELEPHONE:  800.272.3900 alz.org 

Engaging a person with dementia in meaningful activities and teaching new habits or behaviors is a challenging but worthwhile effort. Dementia affects the brain’s ability to store and retrieve short term memories, which makes it difficult for individuals to retain new information or follow through on instructions. However, with patience, consistency, and tailored strategies, it is possible to help someone with dementia stay engaged and even learn new things, though the outcomes will depend on the stage and type of dementia they are experiencing.

While short-term memory loss is the hallmark of dementia, research suggests that individuals with dementia can learn and retain new information under certain conditions. Repetition and consistent reinforcement play critical roles in this process. Tasks such as putting the toilet seat down, washing hands after toileting, or washing hands before eating may require environmental cues like signs or visual aids placed in strategic locations.  Associating these behaviors with routine activities can also strengthen their recall.  For instance, using a brightly colored sticker on the toilet lid as a reminder to close it or placing soap dispensers with engaging scents near sinks may trigger the desired actions.

Learning for individuals with dementia tends to rely heavily on procedural memory-memory for routines and habits-which often remains intact longer than other types of memory. Teaching through demonstration breaking tasks into simple steps and practicing frequently can help embed new behaviors into this procedural memory.  For example, practicing hand washing as a joint activity every time they use the bathroom may reinforce the habit over time.  While they may not consciously remember the rationale behind the action, the routine itself can become automatic with enough repetition.

For individuals with advanced dementia who struggle to retain even procedural routines, alternative strategies may focus more on environmental adjustments than direct teaching. Automated devices such as toilet lids that close automatically or motion-sensor faucets, can minimize the need for learning new habits while still supporting hygiene and safety. Additionally, engaging them in sensory activities, such as aromatherapy or hand massages, before meals can indirectly prompt handwashing by associating pleasant experiences with a necessary task later on.

Gluten is a protein found in wheat, barley and rye, and has gained significant attention due to its potential impact on health, especially in people with dementia.  While most of us tolerate gluten well, research suggests that some individuals, particularly those with dementia, may experience cognitive challenges linked to gluten consumption.  This effect is partly due to gluten’s potential to trigger inflammation which can worsen brain health and contribute to neurodegenerative diseases.

In people with dementia, the brain is already vulnerable to inflammation and degeneration.  Gluten can aggravate this condition by increasing inflammation throughout the body, including the brain.  When gluten is consumed, it can trigger an immune response that affects brain cells, potentially exacerbating symptoms, such as confusion, memory loss, and cognitive decline. This is especially problematic for people with conditions like Alzheimer’s, who already suffer from chronic inflammation in brain tissues.

What is called “leaky gut” phenomenon, a condition where the intestinal lining becomes more open than normal can worsen gluten’s impact.  In a leaky gut state gluten particles can escape into the bloodstream and activate the immune system.  This can cause widespread inflammation that reaches the brain affecting cognition.  People with dementia may be more susceptible to this as leaky gut and inflammatory responses are recognized in neurodegenerative diseases.

Communication system between the gut and the brain called the gut-brain axis plays a crucial role in how we tolerate gluten.  Disruptions in this connection can lead to increased sensitivity to gluten.  There are also studies suggesting that gluten consumption can lead to decreased blood flow and oxygen delivery to the brain.  This reduced blood flow can contribute to brain fog, poor memory, and diminished cognitive function.  In dementia where brain cells are already struggling to survive, reduced oxygen supply can accelerate cognitive decline and make symptoms more pronounced.  Studies have also found that removing gluten from the diet can lead to improved mental clarity.

In summary, gluten’s impact on dementia and cognitive health may vary, but the evidence supporting its role in inflammation and cognitive decline is compelling.  A gluten free diet rich in whole anti-inflammatory foods is a protective approach enhancing cognitive resilience and supporting overall health.

 

#glutenbraindementia

The progression and symptoms of dementia are influenced by various factors, including the person’s baseline health, cognitive function, social engagement, and support systems.  For example, individuals with higher levels of education and cognitive reserve may experience a slower progression of symptoms.  Physical health conditions like hypertension, diabetes and heart disease can exacerbate cognitive decline.

So, what are the three main crucial focuses we should be engaged in even before symptoms arise?  1. EXERCISE  2. NUTRITION  3. SOCIALIZATION.  

Exercise throughout our lives is very important for healthy aging.  When people hear the word “exercise” they sometimes back off and do not want to get involved.  They believe they must do strenuous exercise that entails getting on the floor and doing sit-ups that they will not be able to accomplish.  So, they give up before they begin.  There are easy moving physical activities that require little to no floor work.  Any type of movement throughout our lives can be beneficial for future healthy brains and hearts.  Learn how to make exercise fun and keep you motivated.

1.  Walking the dog is a good way to get out even for a few minutes.  Besides, you have a partner to walk with and motivation to keep “Fred” healthy too.
2.  Running or jogging is not gentle on your joints and if you have never done this in previous times not a good idea now.  Perhaps an indoor stationary bike at low speed would work for you if outdoors isn’t your idea of fun.
3.  Do the exercise with someone.  A friend may be needing the same type of encouragement and when you team up with someone you won’t want to disappoint each other by not showing up for the activity.
4. Chair routines are excellent for safety.  Sitting on a sturdy chair with feet planted solidly on the floor and raising each leg off the floor and back down one at a time for 5 rotations can help move the blood through your bloodstream.  Do this twice a day and you may feel a difference in energy.  Try this with your arms lifting one at a time into the air and back down.  Talk to your doctor before starting any new routine to be sure it is ok especially if you have had recent surgeries or procedures.
5.  Track your progress to keep yourself motivated.  No fancy watches needed; just write it down on a piece of paper with the date, what you performed and how many repetitions.  You will be surprised at what you can accomplish.

NUTRITION is important but what is more important is the right kind of nutrition.  We can all eat the number calories we need to sustain life but where those calories come from is far more an issue.  For example, consuming most of the calories from fat will not provide the energy we need to live but will clog arteries in the meantime which results in cardiovascular disease.  Starting a wellness diet prior to the age when people can be at greater risk for dementia and Alzheimer’s will place us in a less vulnerable position.  Eating a plant-based diet throughout our lives and leaving the french fries in the freezer will garner a healthier mind and body.  The Mediterranean diet has been touted as being very good for dementia patients as it provides not only the nutrients but the vitamins and minerals to protect the brain from the insults that come from inflammatory foods.

 

SOCIALIZATION plays another crucial role in the life of a person with dementia.  Being alone lends itself to loneliness and depression.  Separation from family either intentionally or by necessity (placed in Assisted Living)  carries a huge burden on the heart of the dementia person who has not perhaps had a choice in the matter.  Imagine a small child taken from the only home they knew whether for a few months or after many years how devastating this would be.  Now imagine your parent, grandparent, or even yourself in the throes of dementia and now you are cast into a home away from family perhaps not even living in the same town anymore.  Just because a person is in a facility with others doesn’t make it any less lonely for them.  Integration is necessary but not everyone clicks with others just because they are in the same age bracket.  Watch for signs of depression and even suicidal ideation in the person with Dementia.

 

#Mediterranean# Diet plant based# vitamins

 

To recap, Dementia is a broad term that encompasses various cognitive impairments, impacting memory, thinking behaviors, and the ability to perform everyday activities.  The next few posts will explore dementia’s different manifestations, the connection between head injuries and dementia and the age spectrum of diagnosis including the youngest recorded cases.

Dementia is not a single disease; it’s a syndrome that involves a decline in cognitive functions affecting daily life.  The most common type is Alzheimer’s disease, followed by vascular dementia, Lewy body dementia, and frontotemporal dementia.  Each type of dementia presents unique symptoms and progression patterns complicating diagnosis and treatment.

Dementia primarily affects older adults, but it is not a normal part of aging. While age is a significant risk factor other factors such as genetics, lifestyle, and environmental influences play a crucial role.  Early diagnosis is essential for managing symptoms and planning for the future.

Early onset dementia often has a genetic component, with conditions like familial Alzheimer’s disease being inherited. Other potential causes include autoimmune diseases, infections, and other neurological conditions.  Diagnosing dementia in younger individuals can be challenging due to the rarity of the condition and the overlap of symptoms with other disorders.

A person’s overall health can influence the type of dementia manifested.  Common symptoms include memory loss, difficulty in communication, disorientation, changes in mood and behavior and difficulties in performing daily tasks.

Alzheimer’s disease typically begins with subtle memory lapses, progressing to severe cognitive impairment and loss of bodily functions.  Vascular dementia often results from strokes, leading to sudden cognitive changes and fluctuating symptom. Lewy body dementia is characterized by visual hallucinations, motor symptoms and fluctuating cognitive abilities.  Frontotemporal dementia primarily affects personality and behavior due to the degeneration of the frontal and temporal lobes.

TO BE CONTINUED NEXT POST

#Dementia, #VascularDementia, #LewyBody

 

 

 

 

There are many stories to tell of people who are diagnosed with Alzheimer’s/Dementia to the tune of approximately 6.8 million persons in the US alone, mostly women.

Earlier postings have discussed how they obtain the diagnosis but here is a recap. Persons themselves may notice changes in their memory. They don’t want to admit to themselves much less to their doctor or family. Sometimes family who hasn’t seen mom or dad in a while notice changes. Some things that stand out may be that attention to personal hygiene is lacking or unpaid bills are on the table or checks are being written to multiple unknown organizations. You noticed that she was driving in her own neighborhood and became disoriented. These signs may come on slowly or come on like an elephant falling into quicksand. These situations are of concern and when you mention them your parent may become defensive, angry, and upset thinking you believe they have lost their mind.

Here is an interaction (story) between a woman I’ll call Betty and her daughter Muriel.  During a visit Muriel noticed Betty’s hygiene, unpaid bills and donations to charities. “I noticed there are several unpaid bills here such as your electricity and insurance notices.  Would you like me to go over them with you?” Betty with a furrowed frown on her face immediately and in an angry loud tone responds, “I paid those see these are receipts just give me those WHAT!! you think I don’t know how to write a check?”

Clearly many bills have not been paid with 2nd and 3rd notice stamped on a few.  Muriel now gently approaches her about checks being written to various “charities” (possibly scam organizations.) Muriel asks, “did you mean to give your money to the ‘African Elephant Society and the organization that houses skunks?”  To save face Betty says, “of course I did, it’s my money and I can do what I want with it!” They talk while Muriel respectfully suggests she would like to help her manage her bills, checkbook, and credit cards without taking total control. Betty hesitates with some reluctance but agrees. Betty makes her final intention known to Muriel, “It’s still my money you know, it belongs to me!”  Muriel acknowledges.

Remember, they are vulnerable adults who cannot distinguish a scam from legitimate charities, and they get scammed sometimes out of life savings. Agreeing with the person that you understand the value they place on their money, and you are there to make sure it is protected. Perhaps removing credit cards and suggesting she not write any checks until you see her next week would be helpful. This way she has control with supervision that assures no scammers get her money and legitimate necessary checks be sent out in a timely manner.

Her final words to you this day “It’s still my money.” You answer lovingly “yes, it is.”

Having lost her short-term memory means she probably won’t remember this conversation. Your dedication to her safety on all fronts will be necessary.

 

#dementia, #denial, #memory changes