Dementia and Alzheimer’s Disease

Dementia is a disease that is associated with the loss of brain cells. People suffering from dementia have difficulties in their everyday life as their memory, concentration, speech and thought malfunction. Every person who suffers from dementia doesn’t have the same symptoms. That’ why its progression is different.

Alzheimer’s disease is the most common type of dementia among the others (eg Dementia with Lewy bodies which is related with difficulties in walking and balance, visual hallucinations and delusions, changes in mental functions, vascular dementia as a result of small strokes which is related with difficulties in communication, thinking, memory, Pick’s disease which is related with personality changes, speech,thinking difficulties,). One in twenty people over the age of 65 suffers from Alzheimer’s disease.These patients have low levels of acetylcholine, which plays an important role in cognitive functions. The main characteristic of Alzheimer’s disease is a progressive loss of memory functions where the person has difficulties in recalling recent events, in communicating with others, in orientating himself. There are also changes in his mood, behavior and mobility. It should be stressed that Alzheimer’s disease is divided into three stages: initial, intermediate and advanced, where at each stage there are specific changes.

At the initial stage the person can’t recall recent situations, can’t orientate himself, has difficulty in finding the appropriate words in order to express himself properly, in decision making, in managing his money and work. He can’t obtain satisfaction from activities that were previously enjoyable for him. In this stage the patient understands his difficulties and tries to hide them.

In the intermediate stage the person needs the support of his closed ones in order to fulfill his daily obligations such as shopping, arranging the house, cooking. Also difficulties in speech, memory and orientation are worsened. The patient starts walking without a reason, has hallucinations and ideas of persecution. Some patients may experience incontinence. The person in this stage doesn’t recognize these difficulties.

In the advanced stage memory problems are intensified to such an extent that he can’t identify his closed ones. Moreover he is unable to look after himself eg to eat, drink and use the toilet.

Medication slows down the onset of symptoms. Medication has to be combined with other therapies that strengthen cognitive functions and improving mobility. These therapies are provided by the Greek Society of Alzheimer’s Disease and Related Disorders and by psychologists or psychiatrists. In the early stages of the disease the patient should attend counseling sessions in order to deal with personal matters. These sessions focus on managing his changes, for example coping with his emotions.

Recalling past events and emotions in a therapeutic team is helpful as it reinforces levels of alertness, improves the sensitivity of the patient and his interaction with other people. The sense of control and self-confidence is reinforced by skills like orientating the patient in time and space by reminding him the area and day, object recognition by providing him pieces of information about objects, description of the management of a situation. Moreover cognitive functions like memory, the thinking and attention process are strengthened through specialized exercises. The family members of people with dementia can help them, for example by playing games like memory cards that would be pleasant and not too demanding. Additionally relaxation sessions and special music can help them manage their stress and stimulate their mind.

Caregivers of people with dementia need to be supportive because of the changes that these people experience. They should show them love, help them retain their friendships, activate them by taking a walk with them, discuss about daily matters, be calm and patient when they are angry as this behavior is a result of the disease, understand their needs behind a challenging behavior, form spaces that are easily accessible, choose clothes and shoes that can be easily worn. In general caregivers need to be flexible.

Finally I would like to stress the need for early diagnosis so that the person with dementia is treated appropriately and the need for emotional support which is very important in coping with the new conditions.

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