Dementia vs. Alzheimer’s

Dementia is a broad term, classifying a number of disorders that all impair cognition, thinking skills, behaviors, social skills and relationships in different ways. General signs and symptoms of dementia include trouble remembering things that just happened or happened recently, regularly misplacing everyday items like a wallet or keys, trouble planning meals or remembering to eat, forgetting to pay bills, difficulty remembering how to get to familiar places and missing scheduled appointments to name a few. If you or a loved one are experiencing any of these symptoms or similar, it is important that you notify someone and plan to see your doctor immediately. Dementia tends to progress over time, with symptoms starting as mild and gradually getting worse. Early diagnosis can maximize available treatment options and potentially open the door to inclusion in clinical trials. Considering disorders with dementia symptoms affect memory and cognition, it may be difficult for an individual to recognize these symptoms in themselves. Family members and friends play a crucial role in noticing changes and raising awareness about potential cognitive disorders.

Early detection allows doctors to determine what the cause of an individual’s cognitive deficit is. If diagnosed with dementia, a doctor can classify which type of dementia an individual has, which can help individuals and their loved ones better understand their disease as well as appropriately plan for treatment.

Alzheimer’s Disease

Included within the classification of dementia is Alzheimer’s, which is the most common form of dementia and accounts for 60-80% of all cases. It is important to note that Alzheimer’s is not a normal part of aging, though age is the greatest known risk factor for individuals who develop Alzheimer’s. Most individuals who are diagnosed are 65 years of age and above, with early-onset or younger-onset Alzheimer’s referring to individuals who are diagnosed with Alzheimer’s before the age of 65. Other risk factors include genetics, family history, and risk factors classified as “other”. These include past head injury and the overall health of one’s aging process. While many of these are non-modifiable risk factors, such as aging, genetics and family history, you can facilitate healthy aging by eating a nutritious diet, getting regular exercise, avoiding smoking and alcohol, and visiting your doctor regularly.

What Causes Alzheimer’s?

Alzheimer’s is due to physical changes in the brain. Current research has led scientists to understand that a part of the brain isn’t working properly in individuals with Alzheimer’s, which causes atrophy or shrinkage and death of brain cells. Though it has not yet been identified where the damage begins, research has shown that two types of proteins called plaques and tangles are responsible for much of the brain cell damage and death. Over time, more and more cells shrink and die, leading to irreversible changes in the brain.

Symptoms

The initial changes to the brain begin before any signs and symptoms become present, so it is important to be able to identify early potential symptoms of Alzheimer’s. Early signs and symptoms include forgetting recent conversations and events, misplacing items, forgetting names of common places and objects, repeating questions, poor judgment, difficulty making decisions, isolation from family or friends, and becoming increasingly resistant to change.

Middle-stage symptoms show worsening memory problems. This includes difficulty remembering the names of people they know and struggling to recognize friends and family. Other symptoms at this stage may include getting lost or not knowing what time of day it is, obsessive and repetitive behavior, delusions and paranoia, problems with speech and language, disturbed sleep, and mood changes. Ultimately, in the end stages of Alzheimer’s, symptoms will become so severe that individuals will become totally dependent on their caretaker. While many things may cause memory or cognitive impairment and the early signs of Alzheimer’s may appear unassuming, it is important to contact your doctor if you are experiencing any dementia-like symptoms.

If You’ve Been Diagnosed with Alzheimer’s

While there is currently no cure for Alzheimer’s disease, there are several medications that can slow disease progression and aid in symptom management, such as reducing depression and anxiety. In addition to medication management, facilitating a healthy lifestyle can significantly improve an individual’s lifespan and quality of life with this disease. Consider incorporating regular exercise and eating a diet consisting of less processed foods, while adding in more fresh fruits and vegetables. Reduce or eliminate smoking and alcohol consumption. Spend time with family and friends and take part in social activities and hobbies that inspire joy and encourage engagement with others. If you are taking care of a loved one with Alzheimer’s, try to encourage them to partake in these lifestyle behaviors. In conjunction with current treatments, the quest to better understand Alzheimer’s and ultimately find a cure is at the forefront of biomedical research.

The challenge of being the loved one or family member of someone diagnosed with Alzheimer’s is not overlooked. If you are a caretaker, make sure you are taking your own health and wellness into consideration. Find individuals that can help with care and consider joining a support group of individuals that you can talk to about your situation.

If you need help, contact the Alzheimer’s Association 24/7 Helpline: 800-272-3900

Sources:

Image 1 – https://www.alz.org/alzheimers-dementia/what-is-dementia

Image 2 –

https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s

Image 3 – https://mind.help/topic/alzheimers/

Alzheimer’s Association – https://www.alz.org/alzheimers-dementia/what-is-dementia

American Brain Foundation –

https://www.americanbrainfoundation.org/diseases/alzheimers-disease/?c_src=gg&gclid=CjwKCAjwu5yYBhAjEiwAKXk_eNO81oRWdRUOgzTK2pZaRirgF82ZxNkyLM6HOMnK3gToS-9F7cjmRoCGEoQAvD_BwE

NHS – https://www.nhs.uk/conditions/alzheimers-disease/symptoms/

Mayo Clinic –

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447

How to Know it May be Time for Hospice

Watching someone you love suffer from Alzheimer’s or another memory debilitating illness is incredibly difficult, and it can be even more challenging to decide when it’s time to consider hospice care. Our latest video discusses the following five signs that indicate it may be time for hospice for an Alzheimer’s patient.

1. Physician determines they are at or beyond stage 7 of the Functional Assessment Staging Scale

The Functional Assessment Staging (FAST) Scale is a tool used to determine if changes in a patient’s condition are related to Alzheimer’s disease or another condition. If due to Alzheimer’s, the changes will occur in sequential order. Alzheimer’s disease-related changes do not skip FAST stages.

2. Unable to ambulate independently

This means a person is no longer able to get around on their own. For example, they require assistance getting from room to room.

3. Requires assistance to dress or bathe

Without assistance, you may notice they put their shoes on the wrong feet or their day-time ‘street’ clothes on over their pajamas. They are also unable to bathe without assistance.

4. Becomes incontinent

This includes urinary or fecal incontinence or both.

5. Unable to speak or communicate

This may begin as the patient only saying 5-6 words per day and gradually reduce to only speaking one word clearly until they can no longer speak or communicate at all. This will also include the inability to smile.

Why Choose Hospice

Hospice care is for patients with a life limiting illness and a life expectancy of six months or less. The main focus is to manage pain and symptoms and ultimately keep the patient comfortable. When you choose hospice for your loved one, their care team can help you to understand what to expect in the final stages of Alzheimer’s. They will also provide support to you and the rest of your family throughout the end-of-life process. If you would like more information on hospice care for Alzheimer’s patients, please contact us. We are here to answer any questions you may have.

Changes in Communication

As Alzheimer’s and Brain Awareness Month continues, we want to discuss a very important topic- communication and Alzheimer’s. As the disease progresses, a person’s ability to communicate gradually diminishes. Changes in communication vary from person to person, but there are several common issues you can expect to see, including difficulty finding the right words and organizing words logically.

Effective Communication

If someone you love is living with the disease, you know it can be challenging at times to communicate with them. The video above discusses the following ten tips for effectively communicating with your loved one.

Never argue. Instead, listen.
Never reason. Instead, divert.
Never shame. Instead, distract.
Never lecture. Instead, reassure.
Never say ‘remember.’ Instead, reminisce.
Never say ‘you can’t.’ Instead, remind them what they can do.
Never say ‘I told you.’ Instead, just repeat.
Never demand. Instead, just ask.
Never condescend. Instead, encourage.
Never force. Instead, reinforce.

Help Make Communication Easier

In addition to these tips, there are steps you can take to help make communication easier, including:

Making eye contact and calling the person by name
Being aware of things like your tone, how loud your voice is, how you look at them, and your body language
Encouraging two-way conversation for as long as possible
Using other methods, such as gently touching
Distracting the person if communication creates problems

You also want to encourage the person to communicate with you. You can do this by doing things like holding their hand while you talk and showing a warm, loving manner. It is also important to be patient with angry outbursts and remember that it is just the illness talking.

If The Person is Aware of Memory Loss

Since the disease is being diagnosed at earlier stages, many people are aware of how it is impacting their memory. This can make communication even more sensitive because they may become frustrated when they are aware of the memory loss. Here are some tips for how to help someone who knows they have memory problems.

Take time to listen. They may want to talk about the changes they are noticing
Be as sensitive as you can and try to understand it is a struggle for them to communicate. Don’t correct them every time they forget something or say something odd
Be patient when they have a difficult time finding the right words
Find a balance between helping them find the right words and putting words in their mouth
Be aware of nonverbal communication. As they lose the ability to speak clearly, they may rely on other ways to communicate their thoughts and feelings

Additional Resources

For more information on Alzheimer’s disease and how it impacts communication, visit the links or reach out to the contacts below:

** NIA Alzheimer’s and Related Dementias Education and Referral (ADEAR) Center

800-438-4380 (toll-free)

adear@nia.nih.gov

** Family Caregiver Alliance

800-445-8106 (toll-free)

info@caregiver.org

** Alzheimer’s Association

Dear Caregiver,

If you are caring for a loved one who is living with Alzheimer’s disease, you do not need us to tell you that it’s not easy. This progressive disease is difficult to cope with – for both the person living with it and their loved ones. People living with Alzheimer’s may become frustrated when they find themselves struggling to do things they used to do without any problem. And it is hard for you, as the caregiver, to watch the person they once were gradually fade away. They may have brief moments of clarity where it feels like they are themselves again; only to break your heart when the moment is gone. While there is nothing anyone can do or say to “fix” what you and your loved one are going through, we want you to know you do not have to face it alone. The Alzheimer’s Association has an abundance of resources for both those living with Alzheimer’s and their caregivers. There are support and educational programs available for both, as well. Take advantage of these resources. They are there to help make things a little easier.

Understanding Alzheimer’s Disease

It all starts with gaining a better understanding of the disease and how it progresses. Alzheimer’s leads to nerve cell death and tissue loss throughout the brain. This results in the brain shrinking dramatically over time which impacts nearly all its functions. Although scientists are not completely certain what causes cell death and tissue loss in a brain affected by Alzheimer’s, plaques and tangles appear to be the culprits. Plaques form when protein pieces called beta-amyloid clump together, and tangles destroy a vital cell transport system made up of proteins. Plaques and tangles tend to spread through the cortex in a predictable pattern as Alzheimer’s disease progresses, but the rate of progression varies greatly.

Early Stage

In the earliest stages, plaques and tangles begin to form in brain areas involved in learning and memory, as well as thinking and planning. In this stage, a person can still function independently but may start to notice they are sometimes forgetting familiar words or where to find everyday objects. Someone in this stage may struggle to:

Think of the right word or name for something
Remember the name of someone they just met
Remember something they just read
Plan or organize things

Middle Stage

In the middle stage, more plaques and tangles develop in the regions of the brain important for memory, thinking, and planning. This leads to the development of problems with memory or thinking that are severe enough to interfere with work or social life. In this stage, someone with Alzheimer’s may have trouble handling money, expressing themselves, and organizing their thoughts. Plaques and tangles also spread to areas involved in speaking and understanding speech and the sense of where your body is in relation to objects around you. It is in this stage that many people are first diagnosed. Symptoms vary from person to person, but may include:

Forgetting events or personal history
Feeling moody or withdrawn
Being unable to recall personal information such as their address
Confusion about what day it is or where they are

Late Stage

Most of the cortex is seriously damaged by the time someone reaches the late stage of Alzheimer’s disease. By this point, the brain shrinks dramatically due to widespread cell death. Individuals often lose their ability to communicate, recognize family and loved ones, and to care for themselves in this stage. In this stage, symptoms are severe and may include:

Need for around-the-clock personal care
Loss of awareness of recent experiences and their surroundings
Changes in physical abilities such as walking and eventually swallowing
Difficulty communicating
Vulnerability to infections, especially pneumonia

Resources for Each Stage

The Alzheimer’s Association provides excellent resources for caregivers for each stage. Visit the links below to learn more. Early-Stage Caregiving MIddle-Stage Caregiving Late-Stage Caregiving Additional Information

Yours truly,

Abode Hospice and Home Health

Speak with our Care Team Now

Abode Hospice & Home Health supports that our patients have the right to determine their own goals of care during the final stages of their illness. We focus on comfort, support, quality of life, and education.

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