Solving a jigsaw puzzle can be confusing as there are many different pieces and the clues are not always obvious. It is often the same with dementia. The condition is puzzling to all those affected – both those diagnosed and their family caregivers. This is because dementia is not just one thing, it is many.
Unknowing family caregivers may quickly define a senior’s memory loss problems as dementia. Doing so can be an easy thing to do; however, pointing here is only partially correct. Family caregivers need to dig deeper, better clarify, and understand what specifically they are dealing with and how best to help. For a better visual, family caregivers could imagine dementia as an umbrella under which various types of dementias exist. Dementia characteristics can overlap which can easily lead to misunderstandings.
Here are some further facts about the various types of dementia:
Alzheimer’s Disease (AD)
Family caregivers will find this to be the most common type of dementia. My father was diagnosed with this condition, so I know it all too well. What began as seemingly innocent absent mindlessness with Dad (that the family liked to refer to as “senior moments”) progressed into a much bigger and more serious problem. While conditions for Alzheimer’s vary, family caregivers can see many similar responses.
Dad began by forgetting small and simple things. In the early stage of Alzheimer’s, he would routinely lose his glasses, rely more on written “to-do” lists, and repeat questions and stories. When moving into the middle stage, Dad forgot more of his shorter-term memories (e.g. his youngest daughter who lived elsewhere and couldn’t visit frequently), became increasingly disoriented, struggled with speaking, and lost much of his balance, flexibility, and body strength. During his advanced Alzheimer’s, Dad became completely reliant on outside help from both his family and supportive long-term care home staff. I was appointed Joint Guardian and Alternate Trustee for him and was called upon to make decisions for him. At that point, Dad couldn’t recognize his own family nor recall his childhood or career.
As a family caregiver for Dad, I learned of the plaques and tangles which can occur in a senior’s brain and lead to Alzheimer’s disease. Plaques resemble a wall as protein molecules bunch together in the brain and block signals/messages from being received. Tangles prevent brain protein strands from remaining straight and can negatively affect nutrient flow. This can be like a maze where the route from start to finish is rarely direct. Another lesson learned was that Alzheimer’s disease can progress slowly or quickly.
My sisters and I cared for Dad for close to 10 years before he passed away. With that said, however, significant losses (e.g. the death of a spouse) or a major move may trigger a faster mental and physical decline in AD patients. In Dad’s case, we had to move him three times with his final home being a secured wing in a long-term care home. The lock on the facility door was necessary as wandering in seniors with Alzheimer’s Disease is common, especially at more advanced stages. Despite being under the watchful eyes of long-term care staff, seniors with Alzheimer’s may escape from the building wearing little more than a pair of pajamas or a nightgown. This can become dangerous in colder weather and family caregivers must rely on good Samaritans and/or the local police to return their loved one home. Long-term care homes can resort to other clever means of keeping their residents inside. With Dad’s home, the elevator doors to the Alzheimer’s wing were painted over to better disguise them.
Family caregivers may hear that AD is contagious; this is untrue. Those with Alzheimer’s can still live a good life, feel a family caregiver’s love, and benefit from the support of care strategies for Alzheimer’s disease.
Vascular Dementia (VD)
This is another common type of dementia with strokes often being the underlying cause. A stroke will limit blood flow to the human brain – think of a clogged water drainage pipe. Restricted water flow often leads to nasty flooding; however, blocked blood flow to the brain becomes far more serious as oxygen and nutrients cannot be delivered. If you miss a meal or go hungry, your body will not function properly; a starved brain will respond in a similar manner. Thus, a senior’s thinking will become fuzzy.
A doctor can explain that heart disease, diabetes, sleep apnea, and/or depression can also be contributing factors for Vascular Dementia. Much like seniors with Alzheimer’s disease, those with Vascular Dementia can be confused, have trouble speaking, misunderstand, and be unsteady on their feet when walking or standing. Two other common signs are abrupt headaches and facial/body paralysis. The side effects of blood clotting, higher cholesterol, and increased blood pressure can be controlled with medications.
Frontotemporal Dementia (FTD)
Family caregivers may also hear this condition referred to as Pick’s disease. Frontotemporal Dementia reduces a senior’s brain functioning abilities. The brain’s nerve cells progressively shrink and become lost. As the condition’s name suggests, the two brain zones hit specifically are the frontal (behind the forehead) and temporal lobes (behind the ears). This is more of a younger senior’s dementia (hitting those aged 45 – 65) while Alzheimer’s often strikes much later. What can make this form of dementia more mysterious and difficult to identify is that affected seniors may appear to be functioning more normally for longer periods of time.
An exact cause for FTD has yet to be pinpointed as well. Doctors can only conduct a series of tests, shortlist the problems, and watch for symptoms including memory loss, behavior changes, speech problems, and hallucinations, all of which may be delayed until the later stages. Additionally, FTD patients are likely to remember more and remain oriented; this can effectively trick a doctor into believing nothing is wrong. Like Alzheimer’s Disease and Vascular Dementia, there are medications that may help to treat various side effects experienced by a senior. It is best for family caregivers to seek advice from a doctor about their concerns.
Other Types of Dementia include Lewy Body Dementia, Mixed Dementia, Parkinson’s Dementia, Wernicke-Korsakoff Syndrome, and Creutzfeldt-Jakob Disease. Please watch for further discussion and clarification of these conditions in future Caregiving Collection blogs.