Understanding Dementia and How to Help

What is dementia?

Dementia is an umbrella term that encompasses other cognitive declining disorders. These include Alzheimer’s Disease, Vascular Dementia, Lewy Body Dementia, Frontotemporal dementia, and mixed dementia. These different cognitive declines exhibit multiple overlapping symptoms and progression, but there are some variations.

According to Webster, dementia is “usually a progressive condition marked by the development of multiple cognitive deficits (as memory impairment, aphasia, and inability to plan and initiate complex behavior).”

The Early Signs

It is easy to dismiss it as stress or age-related. It is critical to begin addressing it when you see the signs. Your loved one may say things like “I think I am losing it.” Or “Why can’t I remember things like I used to?” You can start the conversation by discussing their concerns and what you’ve observed, and then get a professional evaluation.

It could be stress, physiological causes, or purely age-related, but you won’t know until there is an official evaluation by a professional. Whether the person with signs realizes it consciously or not, a natural tendency to cover up occurs when others are around, so it can take some time for others to notice it. It requires spending more time with them and watching their behavior.

Research shows that untreated hearing loss is connected to dementia and other cognitive decline. It includes cognitive overload, neural atrophy, and social isolation. As we age, hearing decreases, which in turn affects what our brain processes and how it is stimulated. When our brain is not being used in a certain way, it loses the capacity to function in that way.

AARP lists fifteen warning signs of dementia.

1. Short-term memory loss
2. Word loss
3. Difficulty multitasking
4. Repetition
5. Personality Changes
6. New Sleep Behaviors
7. Worsening Sense of Direction
8. Depression
9. Confusion about time and place
10. Difficulty with visual perceptual tasks
11. Financial Missteps
12. Changes in judgement
13. Misplacing things
14. Misusing items
15. Hallucinations”

Dementia can be assessed by primary care physicians, neurologists, geriatric psychiatrists, or neuropsychologists. The evaluation includes blood tests to rule out other medical conditions, brain imaging, cognitive functioning tests, and interviews with family or caregivers.

What do we do now?

Multiple factors go into caring for someone with dementia. These include, but are not limited to, factors such as time available, family availability, geographical closeness to the loved one, relationship closeness, and financial funds, among others. Finding the best care plan for your loved one is a significant stressor for the caregivers and the family.

Here are some of the caregiving options:

• Home health
• Hospice
• Palliative care
• Private in-home care
• Assisted living
• Nursing home
• Memory care

In addition to the above, families and patients have the option to choose their caregiver, who is then paid to provide care, rather than hiring a company with someone they don’t know.

Other great resources include podcasts and online videos that educate caregivers about dementia patients and their needs, such as “Be Light Care Consulting,” “Dementia Success Path,” and “Creative Connections Dementia.”

Things to be aware of in caring for and communicating with a loved one with dementia:

• Take out the word “remember.” We sometimes use this word to begin a conversation with someone, but there are ways to replace it in your conversations with those with memory loss. Instead of “Remember when we took the grandkids to Disney?” Instead, say “The grandkids are still talking about when we took them to Disney a few years ago.” “That was so fun.”
• Focus on what they can do instead of what they can’t.
• Instead of “You have to drink more water.” Say, “Here is a cup of water.” Or I just found a new flavor to put in our water, let’s see if it is any good.”
• Find something they can feel productive with. In earlier stages, they can assist with laundry, dishes, and other small tasks that may or may not need some supervision without micromanaging. During the later stages, it might be folding napkins multiple times a day or sorting colored cards.
• Keep medications locked up so that they do not accidentally take something when they are not supposed to. Even when someone lives with them, medication accidents can still occur. There are automatic pill dispensers that can help with this.

Therapeutic Lying

As Christians, we may struggle with this term. It is used in dementia care to provide emotional support. If your loved one wants to know when their Mom will be home, it is not always best to remind them that their Mom died twenty years ago. They can grieve and not remember being told of the death or attending the funeral, and then begin getting upset that they were not allowed to participate in the service.

Instead, say “Well, where do you think she might be this afternoon?” They might reply, “At work,” and you can say, “I bet she is.” During the mid to later stages, those with dementia will ask to go home. You can reply, “Well, I’ll go with you, but I need to make supper first.”

Or “I am enjoying your company here, will you stay for a few more days?” Most of the time, telling them they are home or they live with you now leads to more confusion and frustration that can then lead to defensiveness and escalation.

How can the church minister?

Just like parents need someone to step in and be a relief, the same is true for those caring for family members with dementia. It takes some time to become more comfortable doing this. The caregiver needs thirty minutes to shower without worrying about what their loved one is doing. They might want to run to the store or take a walk without their loved one.

They need a break. Offering someone this simple assistance encourages them to prioritize self-care, enabling them to better take care of their loved ones. It doesn’t take long for the caregiver to be refueled when others extend care. It is Scriptural for Christians to care for widows and widowers, and this applies to this area of life.

Caregiving is draining – mentally, emotionally, and physically. You need to take care of yourself so you can better take care of those with dementia. Caregivers feel that they can’t get away, even for a few minutes. When they do have time, they feel guilty. I encourage you to seek out help from friends, family, or professional caregivers sooner rather than later.

You are not less of a spouse, child, or family member by enlisting more assistance. Allowing your loved one to share their stories with several people, receive encouragement, and experience the impact of the disease on both them and you.

Counseling is one way to take care of yourself. It is a safe place to release the thoughts and feelings associated with caregiving. Grief can begin way before the person passes away. It is a loss of a relationship, meaning that the relationship you had with that person is no longer the same.

The spouse you could do all of life together with can no longer remember who you are or anything you have done together. The Mom or Dad you used to take care of you and be your biggest supporter is now relying on you for all of their needs. Counseling can provide resources and walk you through the process of choosing the best option for you and your loved one.