Dementia

Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. Although dementia mainly affects older people, it is not a normal part of ageing and there are many things you can do to reduce the risk of developing dementia.

There are different causes and types of dementia and each person will experience dementia in their own unique way.

Symptoms of dementia may include:

• Memory problems – difficulty retaining new information, become increasingly forgetful, misplacing things regularly
• Difficulties processing information (cognitive ability) – difficulties with time and place, ability to reason and make decisions, movement, a sense of restlessness and difficulties with concentration. 
• Communication – repeating yourself often, having difficulty finding the right words, struggling with reading and writing
• Changes in personality and behaviour, mood swings, anxiety and depression. Losing interest in daily activities and seeing others socially, reduced self-confidence
• Seeing or hearing things that others do not

Reducing your risk of developing dementia

Getting older is undeniably the biggest risk factor for dementia. However, research suggests that you can delay or prevent dementia by making some modifications to your lifestyle. Everything that keeps your heart healthy, can also keep your brain healthy.

• Eat a balanced healthy diet and keep hydrated
• Don’t smoke
• Limit alcohol intake
• Keep your cholesterol and blood pressure under control
• If you have been diagnosed with Type 2 diabetes you will need to follow any advice you have been given to manage this effectively and ensure that your blood sugar levels remain under control
• Try to attend regular check-ups to monitor any conditions and check medication
• Keeping physically fit throughout your life
• Making sure you keep socially active; talk to people in group situations as well as one to one
• Taking part in hobbies like art, woodwork, learning a new language, knitting, puzzles and listening to music will stimulate different areas of the brain and help with attention and concentration

Talk to others about your dementia, this may help you stay independent for longer.

LIVING WITH DEMENTIA

Coping with memory loss and problems with thinking speed can be distressing. But there are things that can help:

• have a regular routine
• put a weekly timetable on the kitchen wall or fridge, and try to schedule activities for when you feel better (for example, in the mornings)
• put your keys in an obvious place, such as a large bowl in the hall
• keep a list of helpful numbers (including who to contact in an emergency) by the phone
• put regular bills on direct debits so you don't forget to pay them
• use a pill organiser box to help you remember which medicines to take when (your pharmacist can help you get one)
• make sure your home is dementia-friendly and safe
• find out more about how technology can help at home e.g. telecare, daily living aids such as clocks showing the day and date as well as the time, smartphones and tablets and the range of apps and functions that these have.

LOOKING AFTER SOMEONE WITH DEMENTIA

Both you and the person with dementia will need support to cope with the symptoms and changes in behaviour. It's a good idea to:

• make sure you're registered as a carer with your GP
• apply for a carer's assessment
• check if you're eligible for benefits
• find out about local support groups

Helping someone with everyday tasks - as symptoms get worse, the person may feel anxious, stressed and scared at not being able to remember things, follow conversations or concentrate. It is important to support the person to maintain skills, abilities and an active social life. This can also help how they feel about themselves. You can help by including the person in everyday tasks such as shopping, laying the table, gardening and walking the dog. Memory aids can be used around the home to help the person remember where things are.

Helping with eating and drinking - Eating a healthy, well-balanced diet is an important part of a healthy lifestyle for everyone. People with dementia may not drink enough because they don't realise they're thirsty. This will put them at risk of urinary tract infections (UTIs), constipation and headaches which will lead to increased confusion and make the symptoms of dementia worse. Common food-related problems can include not recognising foods, forgetting what food and drink they like, refusing or spitting out food and asking for strange food combinations. These behaviours can be due to a range of reasons, such as confusion, pain in the mouth caused by sore gums or ill-fitting dentures, or difficulty swallowing. Try to remember that the person isn't being deliberately awkward. Involve the person in preparing the meal if they're able to. To make mealtimes less stressful make sure you set aside enough time for meals, offer food you know they like in smaller portions, be prepared for changes in food tastes – try stronger flavours or sweeter foods, provide finger foods if the person struggles with cutlery and offer fluids in a clear glass or coloured cup that's easy to hold. Make sure the person you care for has regular dental check-ups to help treat any causes of discomfort or pain in the mouth.

Help with incontinence and using the toilet - People with dementia may often experience problems with going to the toilet. Sometimes the person with dementia may simply forget they need the toilet or where the toilet is. Both urinary incontinence and bowel incontinence can be difficult to deal with. It can also be very upsetting for the person you care for and for you. Although it may be hard, it's important to be understanding about toilet problems. Try to retain a sense of humour, if appropriate, and remember it's not the person's fault. You may also want to put a sign on the toilet door – pictures and words work well, keep the toilet door open and keep a light on at night, or consider sensor lights, look for signs that the person may need the toilet, such as fidgeting or standing up or down, try to keep the person active – a daily walk helps with regular bowel movements and try to make going to the toilet part of a regular daily routine. Items such as waterproof bedding or incontinence pads are available if needed.

Help with washing and bathing - Some people with dementia can become anxious about personal hygiene and may need help with washing. They may worry about the bath water being too deep, a noisy rush of water from an overhead shower, a fear of falling and being embarrassed at getting undressed in front of someone else, even their partner. Washing is a personal, private activity, so try to be sensitive and respect the person's dignity. Ask the person how they'd prefer to be helped, be reassuring, use a bath seat or handheld shower, use toiletries that the person likes and be prepared to stay with the person if they don't want you to leave them alone.

Sleep problems - Sleep disturbance may be a stage of dementia that'll settle over time. Put a dementia-friendly clock by the bed that shows whether it's night or day, make sure the person has plenty of daylight and physical activity during the day, cut out caffeine and alcohol in the evenings, make sure the bedroom is comfortable and either have a night light or blackout blinds and if possible limit the number of daytime naps.

You need to make sure that you look after yourself. Caring for a partner, relative or close friend with dementia is demanding and can be stressful. It is important to remember that your needs as a carer are as important as the person you are caring for.

Family and friends can help in a variety of ways, from giving you a break, even if it's for only an hour, to taking the person with dementia to an activity or memory café. Charities and voluntary organisations provide valuable support and advice on their websites and via their helplines. Sharing your experiences with other carers can be a great support as they understand what you're going through. You can also share tips and advice. If it's difficult for you to be able to attend regular carers groups, join an online forum.

Carers often find it difficult to talk about the stress involved with caring. If you feel like you're not managing, don't feel guilty. There's help and support available. Taking regular breaks can help you to look after yourself and better support you in caring for someone with dementia.