After going through the process of
diagnosing dementia it is incredibly upsetting to receive confirmation you are a sufferer.
Dementia is a disease which generates great fear, not least because of the fact it is incurable. However, caught early there is a great deal which can be done to slow its progress and preserve quality of life for long into the future.
The Importance of Talking
The starting point after diagnosis must be coming to terms with the situation – an important stage for the sufferer and also their loved ones. The fear surrounding dementia means people are often scared to talk about it – one of the main reasons why so many people in the UK remain undiagnosed. However, keeping these feelings bottled up only does harm. It could mean the proper treatments aren’t taken up and the mental stress of the situation is not going to help.
People should be given time to accept the diagnosis and the situation should be discussed carefully with the relevant medical professionals. Ask plenty of questions to ensure everyone is clear about the facts and start setting out plans for the future.
It might be a good idea to consider exactly who to tell about the diagnosis. The goal should be to make life as normal as possible for the patient and to that end perhaps not everyone needs to know. However, there will also be the question of prudence to keep in mind – friendly neighbours, for instance, could be very useful in terms of keeping an eye on people and helping out where necessary.
Dementia Medication
This has recently become an area for debate. There are a number of drugs which can be prescribed to help slow the advancement of dementia and control its symptoms. However, these vary depending upon the type of dementia you have and the stage of its advancement. Not everybody will benefit from medication and this has to be taken on a case-by-case basis, so this is a question for your own doctor.
Essentially there are two types of medication: drugs to slow the progression of the dementia itself, treating the cognitive effects of the disease, and other medications to deal with the non-cognitive symptoms, such as depression, sleep disorders and anxiety. The latter will not help with the deterioration of brain function but this type of medication makes it easier to get on with life. Day-to-day living can be improved and your confidence boosted, but these drugs are often quite powerful and you should discuss the pros and cons very carefully with both your doctor and family before embarking on such treatments.
Drugs directly treating the cognitive deterioration brought on by dementia are generally administered in the early and middle stages of the condition and can be successful in preventing some symptoms getting worse for a time. They tend to work by stimulating the brain to produce chemicals which help cells communicate. They also block the enzymes which can disrupt this process.
Sadly, at the moment there is no treatment to stop dementia completely, but substantial resources are devoted to finding a cure and new breakthroughs are being made all the time.
The ‘Chemical Cosh’
There has been much discussion in the media lately about the over-use of drugs in dementia care. In particular this has focused on the use of anti-psychotic drugs to control patients whose behaviour has become challenging.
This has created something of a scandal, where dementia patients in some care homes have been described as ‘zombies’ due to the heavily drugged state in which they are kept. Worse still, it has been demonstrated that long-term use of such drugs is actually harmful to patients’ health and can shorten their lifespan.
Clearly such a situation is unacceptable and so the Government has taken action. The Care Services Minister, Paul Burstow, has instructed that such drugs should be prescribed much more carefully and suggests cutting their use by as much as two-thirds. This advice is aimed at GPs and care homes and has been widely greeted by commentators as a welcome move.
A positive side-effect of this new guidance is to draw attention to the other therapies which are available to dementia patients. There are some care homes specialising in dementia which proudly use no anti-psychotic drugs at all, relying instead on such approaches as behavioural therapy to deal with challenging patients.
Non-Drug Therapy
Non-drug therapies are certainly an area to be explored. Clearly there are no problems with side-effects and they have been demonstrated to have considerable success in helping patients.
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Cognitive Therapy. This involves games, puzzles and simple tasks designed to ‘exercise’ the memory. They will be drawn from the activities of day-to-day life, making them practical and easy to relate to. The intention is to improve the patient’s memory, ability to solve problems and their skills with language and numbers.
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Behavioural Therapy. This tends to work in conjunction with cognitive therapy to treat problems such as depression, anxiety, confusion and even aggression. This therapy targets problem-solving skills as a way of uncovering and addressing the reasons for difficult behaviour.
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Psychosocial Therapy. This has similar objectives to cognitive therapy but focuses more on social skills. As such it is best carried out in the home with carers or family and encourages the person with dementia to remain active mentally and physically. Activities such as reminiscence therapy, lifebooks and social interaction are commonly used for this.
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Reality Orientation Therapy. In contrast, this is best undertaken in a group environment and is intended to build awareness of current and local information, such as the time, date and location as well as acquaintances. This helps the memory and improves self-esteem.
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Multi-Sensory Stimulation Therapy. This uses the person’s senses to stimulate the mind, employing such things as music, fragrances and massage to keep the brain active. However, for some patients this can add to the confusion so should be used carefully.
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Exercise Therapy. Physical activity increases blood flow to the brain and can consequently slow the progression of dementia. Gentle exercise classes can help this.
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Dance Therapy. As well as the benefits of exercise, this can help the patient by requiring concentration on the movements of dance. It can also be beneficial in terms of providing an activity involving close contact with a partner and has been shown to help relieve stress and anxiety.
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Horticultural Therapy. Caring for plants provides another means of developing focus, as well as encouraging connections with the past as patients discuss their gardens from earlier in life. Caring for a living thing can build a sense of responsibility and self-esteem, whilst doing so as a group activity can develop the skills of social interaction.
All of these therapies provide a way forward and with the guidance of doctors and carers there is scope to carry out many of them at home, with loved ones.
There are also many alternative therapies on offer which are generally very safe though often without clear medical evidence to back them up. The advice is to look into each very carefully and discuss anything with your doctor.
A recent study has also shown that taking high doses of vitamin B can radically reduce the brain shrinkage which can be a pre-cursor to dementia and Alzheimer’s. As yet there is no proof that this positively affects the memory but it seems another promising stage in the development of treatments.
Specialist Care for Dementia Patients
At Nobilis we understand only too well the distress that dementia can bring and the particular challenges posed by the condition. However, we also understand how to help and bring control, happiness and stability to people affected.
Our in-home dementia carers have all undergone specialist training to ensure they are fully equipped to deal with the particular needs of dementia patients. They are not there to cope, but to care. Their job is to make life safe, happy and fulfilling, taking worry away.
When dementia appears there is so much that can be done, as we hope this article has demonstrated. When the difficulties begin to grow, however, there is so much that we can do. Specialist help is just a phone call away.
If you would like to explore the possibilities for
in-home care to help with dementia, or indeed to ask in general about any aspect of this condition, please get in touch. Our friendly customer care team is ready to help.
Telephone – 0845 680 0225