Coping with Following, Clinging & Other Signs of Dementia

Dementia is a term that is used for a person suffering from a group of diseases or illnesses that affects their thinking, memory, reasoning, personality, behaviour, and mood in such a way that it starts interrupting their daily routine function. It is not a particular disease, but it describes the state of a person’s mental function. It is considered a late-life disease as it is estimated that about 50% of people in the age group 85 or above have Dementia disease.

What is Dementia?

Dementia is a comprehensive term used to describe a group of symptoms affecting a person’s memory,  ability to think and socialise. It is a condition characterised by impairment of at least two main functions: memory loss and judgement.

Signs of Dementia:

Early dementia symptoms include:

• Facing problems remembering even not knowing the season, year, or month.
• Difficulty in recalling names, places, words, etc.
• Asking the same questions again and again.
• Forgetting events or details that have just happened.
• Sudden change in mood and behaviour.

Signs when Dementia is becoming severe include:

• Reduction in rational thinking and ability to solve problems.
• Difficulty remembering even daily tasks such as not remembering whether you have brushed your teeth or not.
• Getting hallucinations or changes in sleeping patterns.
• Increase in anxiety, frustration, agitation, sadness, or depression.
• Difficulty in performing daily activities such as bathing, grooming, and eating.

This list is not conclusive, these are just general symptoms of Dementia. Each person diagnosed with the same may have different symptoms, depending on what brain area is affected.

Types of Dementia:

Dementia is divided into three categories:

1. Primary (a condition in which Dementia is the main cause)
2. Secondary (Dementia caused due to another disease or condition)
3. Reversible causes (Dementia caused by other causes or illness)

Primary Dementia

Types of primary Dementia include:

1. Alzheimer’s Dementia: This is the most common type of Dementia. It is caused by changes in the brain by the abnormal building of proteins, namely amyloid plaques and tau tangles.

Symptoms of Alzheimer’s Dementia:

• There are memory problems, such as regularly forgetting recent events, names, and faces.
• Continuously asking the same thing again and again.
• Difficulties with those tasks and activities that require organisation and planning.
• Often gets confused in unfamiliar environments.
• Difficulty in finding the correct word.
• Problem with numbers or handling money in the shops.
• People with Dementia become more anxious.

Alzheimer’s disease mainly affects older adults-up to 10% of those over age 65, and about 50% of people older than 85 have the disease. Family history is an important risk factor. Approximately 60% to 80% of people suffer from this type of Dementia.

2. Vascular Dementia: This is the second most common type of Dementia. It is caused due to strokes or atherosclerosis, which blocks and damages blood vessels in your brain.

Symptoms of Vascular Dementia:

• Having muscle weakness or temporary paralysis on one side of the body and these symptoms require urgent medical attention.
• Difficulty in walking or there is a change in the way of walking.
• Facing difficulty with those activities that require attention, planning, and reasoning.
• Being depressed and tending to become more emotional.

Risk factors include high blood pressure, diabetes, and high cholesterol level. About 15% to 25% of people with Dementia have vascular Dementia.

3. Lewy bodies Dementia: This is a type of condition in which there is the building of clumps of proteins known as Lewy bodies in your brain nerve cells.

Symptoms of Lewy bodies dementia:

• Fluctuating levels of confusion and drowsiness.
• Seeing things that are not there or even do not exists, i.e., hallucinations.
• Movement and balance problems.
• Feeling of weakness and tenable and often gets worried.
• Changes in sleeping patterns.

About 5% to 10% of dementia cases are of Lewy body dementia.

4. Frontotemporal Dementia: This is caused due to the damaged frontal and temporal lobes of your brain.

Symptoms of Frontotemporal dementia:

• Reduced sensitivity to others’ feelings, making people seem cold and unfeeling.
• Making inappropriate jokes or showing a lack of tact.
• Difficulty in finding the right words or understanding them.
• Becoming obsessive over things or persons, such as developing fads for unusual foods, overeating, and drinking.

Frontotemporal Dementia is a common cause of early Dementia, often occurring in people between the ages of 45 and 64. Approximately 5%-6% of all dementia cases are Frontotemporal Dementia.

5. Mixed Dementia: This type is a combination of two or more types of Dementia. The most common combination is Alzheimer’s and Vascular dementia. The person who possesses both kinds of Dementia symptoms suffers from mixed Dementia. It’s most common in the age group of 80 years or older. It’s often hard to diagnose because symptoms of one Dementia may be more obvious, and many signs of each type overlap. The decline is faster in people who have mixed Dementia compared with those who only have one type.

Secondary Dementia

Types of secondary Dementia:

1. Huntington Dementia
2. Parkinson’s Dementia
3. Creutzfeldt-Jakob Dementia
4. Wernicke-Korsakoff Dementia
5. Traumatic brain injury

Reversible Causes:

• Normal-pressure hydrocephalus
• Vitamin deficiency
• Infection
• Metabolic and endocrine conditions
• Medication side effects

What causes Neediness?

Dementia is scary and gradually removes the ability to think and remember things. People with Dementia often feel depressed, confused, and insecure. Their attention-seeking behaviour is their way of asking for help, especially in older adults.

Dementia patient often feels anxious and afraid on their own, so they look around for someone to be with them and can assure them that they will never leave them alone. In their extreme anxiety, they will come to you, follow you, and may even cling to you for comfort.

Be gentle with them and have patience. Your loved ones need your immense love and affection. These people suffer from fear of strangers, fear of not being able to communicate, and fear of not knowing anything familiar.

How to Deal with Clinginess?

Are you also worried about the attention-seeking behaviour of your loved ones? Do not worry; it’s normal for them to have such feelings. The person with Dementia becomes clingy because they have lost their rational thinking and memory skills and thus become dependent on you. They want to feel secure and loved.

Just imagine how it feels when you get a fracture and can’t even walk, run and sit all by yourself. The same is being felt by dementia patients, to be more precise, even more as their condition is permanent and yours is temporary.

For them, even the simplest of tasks becomes too difficult, and they start questioning themselves for their inability to perform.

Following are some tips you could follow to help your loved ones and take them out of that:

• Develop a consistent routine for them and stick to it no matter what happens.
• Assign them with the easiest tasks throughout the day to divert their mind and achieve a sense of achievement—tasks such as doing dishes, folding clothes, dusting, etc.
• Assure them that you will return whenever you go out somewhere.
• Divert their mind from their fear and anxiety towards such things, which can calm them and make them happy. For example, watching their favourite shows on the television.

How is Dementia Diagnosed?

1. Cognitive and neurological tests: These tests are performed to assess the person’s physical functioning. Some of the tests include assessments of memory, problem-solving, language skills, and math skills and also balance response and reflexes.
2. Brain scans: These tests are performed to identify any strokes, tumours, or other problems that can cause Dementia. These scans are also performed to scan if there are any changes in the brain structure and its functions. The most common scans are:
   • Computed Tomography (CT): This technique uses X-rays to produce images of the brain and other organs.
   • Magnetic Resonance Imaging (MRI) uses magnetic waves and radio waves to produce detailed images of body structures, tissues, organs, bones, and nerves.
   • Positron Emission Tomography (PET) uses radiation to provide pictures of brain activity.
3. Psychiatric evaluation: This test is performed to identify if there’s any depression or other mental problem responsible for Dementia.
4. Genetic tests: Very rare dementias are caused by a person’s genes; in those cases, a genetic test is performed to know if they are at risk for Dementia. Once consulted with the prescribed doctor, this test is done for all family members.
5. Blood tests: These tests are performed by doctors to measure the level of beta-amyloid, a protein that accumulates abnormally in people with Alzheimer’s. With this, Dementia can be figured out at an early stage.

Key Facts:

• Dementia is a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing.
• Although Dementia mainly affects older people, it is not an inevitable consequence of ageing.
• Currently, more than 55 million people live with dementia worldwide, and there are nearly 10 million new cases yearly.
• Dementia can happen due to various diseases and injuries that primarily or secondarily affect the brain. Alzheimer’s disease is the most common form of Dementia and may contribute to 60-70% of cases.
• Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally.
• Dementia has physical, psychological, social, and economic impacts, not only for people living with Dementia but also on their careers, families, and society.

Conclusion:

The person suffering from Dementia requires your immense love, care, and support. They often feel depressed and cornered and thus require your undistracted time. Appreciate their small achievements and motivate them to reach for more. Spend more time with them and understand their needs. You must always remember the quote by Mother Teresa, “We can cure physical disease with medicines, but the only cure for loneliness, despair and hopelessness is pure love.”

FAQs

Do people with Dementia know they have it?

Generally, people who have Dementia don’t know what they are suffering from. This can be caused by anosognosia, which means “not to know a disease,” and is not the same as being in denial.

Do people with dementia sleep a lot?

People in their later stages of Dementia tend to sleep more and more because as Dementia progresses, the more damage it makes to a person’s brain and eventually makes it weaker over time.

What time of day is Dementia worse?

Fading light seems to be a trigger for a person who has Dementia. You will notice a big change in the late afternoon or early evening. Doctors had termed this Sundowning or Sundown syndrome, which worsens as the night goes on.

Why do dementia patients get up at night?

Experts believe that Dementia changes the brain cells, which affects a person’s circadian rhythms. When those rhythms get disrupted, the person often gets confused between morning and evening. This leads Dementia patient to become tired during the day and thus takes many naps and then stays up during the night.

How long can an 80-year-old live with Dementia?

Life expectancy reduces if a person gets diagnosed in their 80s or 90s. The average survival time for people diagnosed with Dementia is about four and a half years.

Does Dementia run in families?

Most people are concerned if they may inherit Dementia or pass on Dementia (hereditary). The majority of Dementia is not genetic, but there are very negligible chances of it being passed on.

When should Dementia patients go into care?

Dementia is progressive in nature, meaning the person suffering from the same will require more affection, care, and support as time progresses. If it has reached its limit, then that’s the time they may need 24-hour care.

Can a brain scan show Dementia?

Brain scans are often used to diagnose Dementia when nothing works. This can help in identifying any severe problems such as stroke or brain tumour but not necessarily can diagnose Dementia.

What is the best medication for Dementia?

No medication can completely cure Dementia. But doctors can recommend medications to treat problems like depression, trouble sleeping, anxiety, and irritation.

Why do Dementia patients fidget with blankets?

The person who has Dementia often show their anxiety or agitation by restlessly pulling at clothes or blankets, rubbing their hands together, and wringing their hands. Fidget blankets are one way to help them restore their calm.