AGING AND DEMENTIA
Due to improved healthcare services and better nutrition, people are living longer and leading more active lives than ever before. This is also true of people with developmental disabilities. By understanding the effects of aging, we can better support the people we serve.
The following are changes we may see in the people we support:
– The lungs become less efficient, so there is a higher risk of developing pneumonia and other lung disease.
– The amount of blood pumped by the heart with each beat decreases, and the heart rate slows. The blood vessels may harden, causing increased work for the heart.
– Hearing and vision usually decline, often causing some degree of sight and hearing loss.
– Reflexes can become slower, and arthritis may affect joints, causing movement to become painful.
– The person can become more susceptible to heat and cold. They may be unable to feel temperature extremes because their body may no longer regulate temperature effectively.
– They become more susceptible to falls as a result of slower reflexes, failing eyesight and hearing, arthritis and problems such as unsteady balance and movement. Falls frequently result in fractures because the bones become weaker and more brittle.
– Physical changes occur in all body systems. Graying hair, wrinkles and slower movements are physical reminders of growing older.
– They have an increased risk of altered thinking patterns and confusion.
What is Dementia?
Dementia is a deterioration of intellectual functioning resulting from an organic disease or disorder of the brain and sometimes accompanied by emotional disturbance. This can make it hard for people to remember, learn and communicate. After a while, this can also make it hard for people to take care of themselves. Dementia may also change peoples moods and personalities. At first, memory loss and troubled thinking may clearly bother people who have dementia. Later, disruptive behavior and other problems may start. People who have dementia may not be aware of these problems.
What causes Dementia?
Dementia is a descriptive name for a group of signs and symptoms seen in a number of different diseases. This means that there is a physical reason for the change in the brain’s function. Many diseases can result in dementia, the most common one being Alzheimer’s disease. Dementia is not a normal part of the aging process; however increasing age is a risk factor.
People with signs and symptoms of dementia need to see a doctor. To determine the cause and type of problem, the doctor will order tests. The treatment depends on the cause of the problem.
Some dementias can be reversed or controlled with proper treatment. When the cause is removed, so are the signs and symptoms. Treatable causes of dementia include:
-side effects of medication
-substance abuse: chemical or alcoho
-trauma to the head
-toxic factors: carbon monoxide, methyl alcohol
-heart, lung, and blood vessel problems
-neurological disorders: hydrocephalus, multiple sclerosis
-infection; especially viral or fungal infections of the brain
-vision and hearing problems
-metabolic disorders: thyroid problems, nutritional deficits, anemia
Other organic mental disorders cannot be reversed. These dementias only get progressively worse. Permanent dementias result from physical changes in the brain. These include:
-Multi-infarct-numerous strokes too small to be seen on a CAT scan
Common sings of dementia
-short term memory loss. People sometimes forget names and appointments, but people who have dementia may never remember them. Long-term memories of the past may remain, while recent memories fade.
-difficulty performing familiar tasks. People with dementia might cook a meal but forget to serve it. They might even forget they cooked it.
-language problems. People with dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
-Time and place orientation. People with dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
-poor judgment. Even a person who doesn’t have dementia might get distracted and forget to watch a child closely for a little while. People who have dementia might forget all about the child and just leave the house for the day.
-problems with abstract thinking. Anyone can have trouble balancing a checkbook, but someone with dementia may forget what the numbers are and what has to be done with them.
-misplacing things. The person might put things in the wrong places and then they can’t find things later.
-changes in mood. Everyone is moody sometimes, but people with dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
-loss of initiative. People with dementia may become passive. They might not want to go places or see other people. People who have dementia sometimes lose their zest for work and their interest in hobbies completely.
The following are strategies to use when working with people who have dementia.
– Get people’s attention before attempting to assist them. Approach people from the front and stand or sit at eye level. Make eye contact and tell them who you are and what you want. Make sure people have their glasses, hearing aides, etc., before you communicate with them.
-Use a quiet, calm and friendly tone of voice. Avoid expressing with your voice any irritation or anger you might feel. An irritated, angry, impatient tone of voice will often trigger aggression.
-Avoid any sudden movements that may be startling to people.
-Give short, simple, concrete explanations of the things you are assisting them with.
-Expect that people will not remember what you said. You will need to repeat, repeat and repeat!
-Give step by step directions. Break tasks down into very short, simple steps. Allow people time to complete one step before giving directions for the next step.
-If people refuse medication or treatment, simply leave and return 5 to 10 minutes later if it is safe and feasible. When you return, act as if you are making the request for the first time.
-Expect that people may resist painful or unpleasant medical or dental procedures. Try to keep them as comfortable as possible.
-Do not respond to name-calling, verbal abuse or unrealistic threats. If these are directed toward other individuals, redirect as needed.
-Redirect people who wander by walking with them. After a few minutes, suggest going in the direction you want to go or an alternative activity. Avoid yelling, trying to pull them in the opposite direction, or blocking the way.
-Use positive statements (e.g. “Come with me” instead of “Don’t go there”).
Because people who have dementia have a hard time remembering, learning and communicating, you may see changes in mood and disruptive behavior. A sudden change in surroundings or frustrating situations can cause people who have dementia to become agitated. As a result, people may cry, become irritable or even strike out. One of the most important things you, as support staff, can do is to avoid situations where people might become frustrated.