Dementia is a loss of cognitive function that occurs with certain diseases. It affects memory, thinking, and behavior.
While everyone with dementia may have an experience that's unique, knowing the stages of dementia can help a caretaker have a plan and make looking after their loved one easier. It is important to make the necessary lifestyle adaptations and meeting needs as they evolve.
Understanding Dementia and Its Stages
Early Stage - Dementia in its early stage starts with a mild decline in the ability to think and memory lapses that affect daily life. It includes a decreased ability to perform certain tasks which require memorizing. People close to an individual with dementia may also notice subtle changes in personality. Some types of dementia may affect language, while others affect memory or movement. It is easiest to distinguish the types in their early stages.
Middle Stage -As the disease progresses it means a loss of identity and independence. Personality changes may become more noticeable. The person may experience paranoia, confusion, or fear, and memory loss may increase. In this stage, it's normal to forget to eat, lose track of time, have sleep problems. And even commonly forget important information like address or phone numbers.
Late Stage - Dementia can progress and become severe. It often significantly impairs a person's memory. A person with severe dementia may not recognize family members. Symptoms of late-stage dementia may include an inability to communicate, walk, and control bowel, muscle rigidity and abnormal reflexes and susceptibility to infections. They will usually need full-time personal care for basic tasks.
Understanding Behavioural Patterns
Caring for a loved one with dementia comes with the toughest challenge being understanding their troubling behavioural patterns. Major personality changes like aggressiveness, hallucinations, wandering, or eating or sleeping difficulties can be upsetting and make your role as caregiver even more difficult. These changes are sudden but are mostly governed by the environment around them or stress they’re undergoing. It's important to have a lot of patience and have the understanding of this behaviour being non-intentional. However challenging it may be to a caregiver, harsh tone of voice or body language will mostly only make things worse. The first step to resolving the troubling behavior is to establish why your patient is stressed or what’s triggering their discomfort. Assess patterns as to what triggers them and what reduces their anxiety. Simple steps like a smiling face and reassuring words can help control their behaviour.
Ensuring your loved one gets enough nutrition can be a challenge for any caregiver. Expecting them to eat and drink correctly is a bigger challenge than one would realise. To ensure timely and proper eating one may have to monitor their eating and chewing time along with the following tips. Serving simple and delicious meals along with cutting out distraction is the step one to proper feeding. Keeping a playful environment where you could slip in a little food once in a while can ensure better feeding. As the disease progresses, monitoring medicine times becomes more important. In late stages of dementia, your loved one may find it difficult to use simple cutlery and solid food would need to be changed to soft pureed food. Children’s cuppers could also come in handy for drinking. To keep this transition smooth, stick to food items they generally like.
Dementia comes with its own sets of challenges, one of the biggest one being sleep problems. Patients may have wakefulness, disorientation, and confusion beginning at dusk and continuing throughout the night. This is called “sundowning.” to help reduce nighttime restlessness, the caregiver needs to ensure disciplining a sleep routine that helps your loved one fall asleep easier. Provide a comfortable bed, reduce noise and light, and play soothing music to make sleeping easier. Be consistent in keeping the routine same for most days. Monitor napping to asses better if afternoon short naps are helpful or makes sleeping for them tougher at night. Keep a night light on to keep them from imagining things in the dark. By involving them in some sort of physical activity during the day, you will help them feel more tired at bedtime. Limit the patient’s caffeine intake n place a commode near the bed for a comfortable night’s sleep.
A soothing environment and atmosphere created while caregiving can play a large part in helping a dementia patient feel calm and safe. Loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish colors, and patterned wallpaper could act as potential stresses and should be avoided. While you ensure a good environment for them, make sure you give yourself enough room to stay calm and stress free. Easier said than done, the caregiver is allowed time out to reinstall a state of calmness. Other methods include exercising as it is one of the best stress-relievers for both the patient and you, the caregiver. Regular walking, dancing, or seated exercises can help. Simple activities can be a way for your loved one to reconnect with their earlier life. Try to involve your loved one in as many daily activities as possible. Remembering the past may also help calm and soothe your loved one. Use calming music or play your loved one’s favorite type of music as a way to relax them when agitated. Pets can also help the patient relieves stress and anxiety. The company of a domestic trained animal can help give company and happiness both to the patient.
Dealing with wandering
A dementia ridden person is commonly subjected to restlessness and disorientation. The patient may exhibit signs of restlessness when hungry, thirsty, constipated, or in pain. They may feel disoriented, pace, or wander when bored, anxious or stressed due to an uncomfortable environment or lack of exercise. Help manage these issues by redirecting this restless behavior into productive activity or exercise. In case your loved one wanders off uninformed, it’s a good idea to have a plan in place. Prepare a checklist for places to check and people to inform in case they go missing. The general tendency would be to wander off in the dominant hand direction and they can often be found in a distance no longer than 100 feet of road. Ensure to have the address and phone number in their wallet or on them. In case of such an event, notify neighbors and local police about their tendency to wander.
If your loved one develops a habit of hiding things, it wouldn't be something out of the ordinary. Looking out for places where they tend to hide or the kind of things they like to hide to ensure this habit of theirs doesn't cause any harm to them or others. Keep away sharp items that could be used in times of aggression.
Dealing with anger and aggression
An anger outburst is something you would have to deal with more often than you think. First step to dealing with your loved one displaying anger outbursts is understanding as to why. Noticing patterns in and triggers for their aggression like boredom, fatigue, pain, privacy etc can help manage such situations better. There are also things you can do during an angry outburst. Avoid confrontation and any physical contact during such an outburst. Give them enough space to let the aggression play out. Try distracting the person and if needed, don't be afraid to ask for help. Lastly, don't take it personally as this is a part of the dementia.
Hallucinations, suspicion and paranoia
All of these are a result of failing senses, confusion and progressing dementia. One of the most challenging things for a family member would be maintaining calmness during such an event. Reasoning, answering accusations, arguing with a person facing these symptoms wouldn't take you far, instead remaining calm and distracting them would help take away their attention from the hallucinations and suspicions.
Taking care of yourself
Taking care of a loved one with dementia can be extremely demanding and exhausting. With progressing dementia, daily challenges increase and may cause more anxiety and stress. Continuing to take care of them may seem rewardless at times and giving up would seem like an easier path. During such moments it's important to take care of yourself and taking care of yourself and getting help and support is essential for both your well-being and your loved ones. Don't hesitate using any services available to, whether professional or from family members, for one cannot take care of others if they are unable to take care of themselves. Taking time to look after yourself can make all the difference to your success as a caregiver and the well-being of your patient.