BY DR. JASON BAINS

Fraser Health

DEMENTIA describes a group of diseases affecting mainly older adults that result in memory loss and behaviour changes as well as changes in judgment and decision-making which affect day-to-day function and personal safety. While dementia medications do exist, it is important to understand that dementia is not a “curable” condition, and the role of any medications is to slow the disease down and prevent the symptoms from worsening quickly. It is therefore very advantageous to identify dementia in its early stages. The main goal of treatment is to keep the disease from affecting the patient’s quality of life for as long as possible. This article in this series will explore how best to manage early dementia.

In all types of dementia, part of the treatment involves controlling the underlying risk factors for worsening dementia, through a combination of healthy lifestyle and medications as needed. Regardless of any medications prescribed, it is always recommended to follow a nutritious diet, stay physically and mentally active, manage stress, and avoid smoking, alcohol, or any other illicit substance use.

When someone with dementia starts showing behaviour and mood changes, or becomes forgetful, it is essential to support them appropriately to avoid aggravating their condition. With an incurable disease like dementia, the ongoing support a person receives is just as important as any medication or therapy towards their overall well-being. Below are some guidelines on how to help manage and support a patient with early dementia:

Maintain their respect and dignity: Remember that the person with dementia has not chosen to become forgetful or moody. They’re often aware and upset about what they are going through, especially in the early stages, and if their loved ones start to treat them like children or unimportant individuals, it further affects their self-esteem. Avoid getting angry or laughing at them; instead, keep a positive, respectful tone and reassure them if they are upset. Avoid pointing out their repetitive questions. Think for a minute that if they remembered, why would they ask again or address somebody incorrectly?

Pick your battles: If someone with dementia is showing poor judgment or memory regarding something important, such as a matter of safety or health, then naturally, it is important to correct their actions and intervene. However, if they are misremembering a date, whether they already ate, or whether someone visited, avoid the temptation to correct them or argue with them; just humbly agree with them and give them encouragement. Avoid making them repeat something many times to try to memorize it; they will likely still struggle to recall it, and will suffer further emotional harm and embarrassment.

Keep things simple: People with dementia often start having trouble finding the right words to say, and can take a long time answering questions. Being unable to express themselves fully can be very stressful and frustrating for them. They may also find it difficult to stay focused when conversing. It is best to ask simple questions that can be answered briefly, such as with a yes or no. Use simple and specific language to avoid confusion or misunderstanding. When giving instructions, it is also important to break things down into clear, simple steps rather than one complex request. When talking to them, it is important to have their full attention, without background conversation or other noises whenever possible.

Address safety concerns:

Due to impaired short term memory, three major safety concerns arise in early dementia, and need to be accounted for:

* Burner safety: Supervise any cooking due to the risk of a person with dementia forgetting to turn off the stove.

* Medication safety: It is best to blister pack medications, as a visual reminder of when to take them. If the person with dementia is making mistakes in taking the medications, a family member should monitor this regularly.

* Driving: As dementia advances, it is common for one to start losing their way or forgetting where they were going. This, along with problems in judgment and decision making, can impact their ability to drive. Family members need to watch this closely, and discuss or plan alternative methods of transport.

Reminder notes: Small written signs around the house can help people with dementia remember important details such as turning off the stove, where their keys are kept, or when their doctor’s appointment is. A visible list of important phone numbers may also be useful.

Consistent surroundings: A person with dementia may have difficulty with orientation and get confused if their environment is changed frequently. It is better to have one consistent place of residence instead of moving from one home to another frequently. Keep the house tidy and organized with things in consistent places. Having a visible clock and calendar is helpful for people with dementia to orient themselves.

Education: Educating the person with dementia and their family is extremely important in the management of this disease, through its journey from early to advanced stage. Connect with the support and education coordinator at the Alzheimer’s Society First Link to learn more about dementia and its management.

This article is the last one in our series on dementia. To read the previous articles, please visit our website at voiceonline.com.