Know difference between forgetfulness, dementia
Treatment, care often present special challenges as disease
progresses

My mother seems to be very forgetful. Once she left the stove on
and caused a small fire in the kitchen and twice she has forgotten
her way home from the grocery store. Does she have Alzheimer's
disease?

There is a big difference between forgetfulness and dementia.
Dementia is the loss of intellectual functions such as thinking,
remembering and reasoning to the degree that it interferes with
a person's daily functioning.

Dementia is not a disease itself. It is a group of symptoms that
may accompany certain diseases or physical conditions.
The cause and rate of progression of dementias vary.

Alzheimer's is just one type of dementia. Some others are vascular
dementia (multiple strokes in the brain), Huntington's disease,
Pick's disease and Parkinson's disease.

Depression, brain tumors, nutritional deficiencies, head injuries,
infections, drug reactions and thyroid problems are conditions
that may also cause or mimic dementia. Begin by consulting with
your mother's physician to rule out or treat reversible conditions.

My father has been diagnosed with dementia. What do I need to
do to care for him?

Caring for someone with any form of dementia is a challenge.
It helps to have some understanding of the disease and how it
progresses. It also helps to know what the person who has been
diagnosed with dementia needs.

As the disease progresses, persons with dementia have less
understanding of what they are to do and what is appropriate.
They need to be provided with cues or to be told what to do.
Give positive directions. Don't say "don't." Limit the number
of choices. "Would you like strawberry jelly or grape jelly on
your toast?" instead of "What do you want on your toast?"

Provide assistance initiating and stopping tasks. Break down
multi-step activities into smaller tasks. For example, instead
of saying, "Brush your teeth," you might need to say,
"Get your toothbrush, now get the toothpaste."

Monitor the environment on a regular basis and make adaptations
needed to keep it safe. For example, people who wander need
constant supervision or to be provided with secured areas in which
they may move about freely.

Structured time is important. Maintain a regular schedule.
Music may be used as a cue to signal mealtime, bedtime
or time to get up.

As much as possible, allow the same people to provide care
on a regular basis. This allows the caregivers and care receivers
to get to know and get used to each other, lessening the confusion
and agitation of the care receiver.

Provide a low-stress environment. Too much stimulation,
such as a loud radio or television, excessive light or too many people
are not conducive to a good environment for persons with dementia.
A quiet setting is better. Shouting instructions does not improve
the individual's understanding.

Working with people with any form of dementia takes more time.
Plan for it. You cannot rush a person with dementia.

How can I improve the quality of life for the person I care for?
Help them compensate for their losses. If buttons are too difficult
to manage, use Velcro, for example.

Support existing capabilities. If you arrange the person's clothes
in the correct order, they may continue to dress themselves.

Keep them involved. Provide hands-on activities. Provide
containers with items to manipulate.

Provide for comfort.

Protect their dignity. Dignity should be viewed as the flame
of a burning candle - the flame does not change until there
is no more candle.

Help them to feel secure. Pay attention to cues they give about
feelings of security. A person with dementia saying "I want to
go home" may mean "I want to be a part of what's going on here."

Listen to them and make them feel welcome. Always be ready
and willing to talk about absolutely nothing but remember you
are dealing with an adult. Greet them. Call them by name.
Smile at them. Talk to them in warm and caring ways.
Family Information Services reports that one man with Parkinson's
disease whose ability to communicate was declining rapidly said,
"I am still in here. There is still something left."

Educate yourself about dementia and stay up-to-date on the latest
developments in treatment, care and medicine. Contact your local
Cooperative Extension's Family and Consumer Educator
for information about workshops for caregivers.
The more you know, the better off you and the person
for whom you are caring will be.

Glennie Daniels is a family and consumer educator with
N.C. Cooperative Extension in Catawba County.
Address questions about caregiving to her at
NCCE, P.O. Box 389, Newton, NC 28658;
fax (828) 465-8428;
or e-mail [log in to unmask]

SOURCE: The Charlotte Observer
http://www.charlotte.com/observer/local/catawba/docs/extension0713.htm

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