3 – The Challenge of Dementia

Fact sheet no. 3

Dementia is the generic term for illnesses that are accompanied by a loss of mental functions such as thinking, remembering, orientation and making links between the content of different thoughts. It is a disturbance of the brain’s ability to function. Dementia is one of the most common conditions in old age. In addition to memory loss, emotional and social skills are also lost. This can be difficult and challenging if you live with someone who has this condition. There are different types of dementia. The most common form is Alzheimer’s.

The initial signs are often gaps in memory, difficulties in finding the right word or misplacing objects more frequently. In these cases, it is advisable to consult a doctor at an early stage. This is important because different treatments can be used depending on the type of dementia. Alzheimer’s dementia cannot be cured. Its symptoms can be alleviated and the course of the disease delayed. The aim is to enable those affected and their relatives to enjoy the highest quality of life for as long as possible. It is important to differentiate Alzheimer’s from other forms of dementia as other diseases can be cured in some circumstances.

The symptoms experienced by someone who is suffering from dementia can be: limited short-term memory, later also long-term memory, loss of orientation in terms of location and time, loss of the ability to act in a logical way, also delusional or aggressive behaviour, inappropriate behaviour or changes in behaviour. When living with others, certain behavioural patterns usually develop which can be stressful for members of the family.

The following suggestions may help relatives or other caregivers to adapt their forms of communication and how they deal with the situation in a way that maintains the dignity of everyone:

Avoiding criticism: It is often no longer possible to understand criticism. The ability to learn from mistakes and do things differently next time is lost.

Maintain a positive and calm atmosphere: Recognition and a sense of security help the person to maintain their confidence.

Recognizing the person’s point of view: It is important to let those affected see things from their point of view, even if this does not match the real world. Accepting things that are not true is often not easy, but can help to avoid unhelpful discussions and people getting angry.

Making decisions: If it is no longer possible to understand the meaning and consequences of decisions, caregivers must take control and make decisions by themselves. Even asking the person’s opinion can lead to anxiety and fear.

 

Providing patient guidance with everyday life: e.g. showing how to use cutlery, when getting dressed or performing other actions. Helping as needed.

Help with holding conversations: Topics that interest the person affected are good. Short and clear questions encourage people to tell stories. Partial answers can be offered. Too much information or rapid changes of topic should be avoided. Repeated questions should be answered with patience for as long as possible. Leaving enough time to answer is helpful.

Aggression or anger: If people with dementia display angry or aggressive behaviour, this has often been triggered by anxiety. People with dementia live in a world, which is constantly changing for them. They are often apprehensive and don’t know what to expect next. Physical aggression occurs primarily in situations where they feel distressed, which even includes in nursing care situations. Those affected can be reassured and distracted. Physical contact sometimes helps. It’s worth considering what triggered the aggressive behaviour and whether it can be avoided in the future?

Restlessness and wandering about: One of the most frequent changes in behaviour is if the sufferer becomes very restless: running around aimlessly, going up to and shaking door handles. Often this expresses itself in the form of the searching for something they have lost – this can be an object or even a person from the past. Maybe you can find out the reason for their anxiety? Walking around with the sufferer can be helpful and provide a distraction.

Running away: If the sufferer wants to run away, e.g. from their flat or home, he or she can be accompanied and distracted by a conversation. Perhaps a different reason for returning home can be found, such as having to go to work soon. Motion detectors, mobile phones with GPS positioning etc. can help by not restricting this urge to keep moving and still provide reassurance.

The forms of communication and suggestions of how to cope with this situation we have described can be used when dealing with sufferers. People with dementia are adults, feel that they are adults and want to be treated like that. However, caregivers in the family are not able to respond patiently and attentively to the patients every day. That is perfectly normal. So it is good to talk to someone about your own condition and the situation from time to time. Offers of support can also relax the situation at home.

There are a lot of activities available in Berlin for people with dementia and their families. These can be: self-help groups for relatives or people in the early stages of the condition, care services at home or in groups, days out, dementia training courses, dementia-friendly religious services, dance cafés, information events, etc.