Dealing with Dementia. The Essential Guide for Caregivers
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1 Dealing with Dementia The Essential Guide for Caregivers
2 If you have any questions regarding the information you find enclosed or would like to discuss your senior living options, please feel free to reach out to Five Star Senior Living today. us at or call us at
3 Inside This Guide Thank you for downloading Dealing with Dementia: The Essential Guide for Caregivers. In this ebook, we ll cover the essentials for any caregiver tending to the needs of a loved one with dementia. Topics include the types of dementia, a behavior comparison chart, and common afflictions that masquerade as dementia. Many seniors rely on support from friends and family. Seniors thrive because of the community around them, and attentive caregivers like you make their lives comfortable and fulfilling. At Five Star Senior Living, we understand the responsibility assumed by caregivers. We trust that the education and insight in this ebook will enable you to provide the best comfort and care imaginable. This guide is not intended to replace any medical advice, treatment, diagnosis, or opinion. It is for educational purposes only. If at any time you have questions or comments, we want to hear from you. Please reach out to us at info@5ssl.com. Or give us a call at Sincerely, Roxy Mast Director of Sales Training 3
4 Table of Contents 5 About the Author 6 A Community of Supporters 7 Types of Dementia 11 Behavior Chart Comparison 12 5 Conditions Masquerading as Dementia 15 Finding the Right Professional Help 17 Beyond the Physician 18 About Five Star Senior Living 4
5 About the Author Meet Roxy Roxy Mast, Director of Sales Training at Five Star Senior Living, spent the first four years of her life in a hotel in New Orleans with her grandparents. Her grandparents owned the hotel, located on St. Charles Avenue in the Garden District. She believes this time in her life played a role in shaping her love for caring for older generations. Roxy has an undergraduate degree in political science from the University of Texas at Austin and a Master s of Arts in Education with a concentration in Counseling-Psychology from the University of Texas at San Antonio. Roxy was a stay-at-home mom for many years. After returning to school to obtain a Master s degree, she found her calling in senior living. She believes that her career in senior living is a way to help make a difference in the world. After spending some time in Geriatric Care Management, Roxy transitioned to senior living and has been proud to be a Five Star Senior Living team member for many years. A resident of San Antonio, Texas, Roxy has a son, daughter-inlaw, and two grandchildren in Austin. A life-long animal lover, she showed Arabian horses for many years and has a dog named Buddy. This ebook comes from her enjoyment of teaching others. Helping seniors and their families find answers is the intention of this ebook. Roxy and her colleagues at Five Star Senior Living hope you find meaningful solutions in this ebook. 5
6 A Community of Supporters THE ROLE OF a caregiver for someone with dementia is both stressful and rewarding. Your loved one s health and happiness are always on your mind and in your heart. While caregiving can consume time and resources, it is an undertaking that also creates a special bond. Caring for someone with dementia can be a challenge. Alzheimer s disease is known as the long goodbye. With dementia, your loved one may experience personality changes, which are often more troubling to loved ones than the associated physical and cognitive declines. Whether you ve recently assumed the role of caregiver or have carried the badge for many years, we want you to know that you are never alone. You have a community of supporters, friends, and family by your side and ready to provide assistance, support, and words of wisdom at any time. We are about Families This ebook comes from our desire to be part of that community of supporters. We at Five Star Senior Living are dedicated to providing the assistance and guidance you need. We are about families both the families of our Five Star residents and the universal family of caregivers. We invite you to rely on us as a resource. We would be honored to be one of your trusted advisors. We hope you find this ebook both informative and enriching. 6
7 Types of Dementia Affecting more than 47.5 million people worldwide, dementia is a syndrome in which the deterioration of cognitive functions interferes with a person s everyday life. Those with dementia suffer from memory loss, behavior changes, and the inability to perform daily activities. While some types of dementia are more common than others, the ways and means in which dementia affects people especially as our loved ones grow older are varied.
8 Alzheimer s Disease The most common type of dementia, Alzheimer s disease accounts for an estimated 60% to 80% of all dementia cases. Alzheimer s is a slowly progressive brain disease that begins long before we often detect symptoms. Early signs can include depression, apathy, and difficulty remembering names and events. As the disease progresses, the spread of plaques and tangles throughout the brain causes nerve cell damage. People may experience impaired communication, poor judgment, disorientation, confusion, behavior changes, and difficulty speaking. Vascular Dementia As the name suggests, vascular dementia occurs because of brain injuries such as microscopic bleeding and blood vessel blockage. Vascular dementia is the second most common form of dementia. Those with vascular dementia suffer from impaired judgment and the inability to plan or organize. 8 TYPES OF DEMENTIA
9 Mixed Dementia When a person has more than one type of dementia, we refer to this condition as mixed dementia. With mixed dementia, the abnormalities linked to more than one type of dementia are present commonly Alzheimer s and vascular dementia. The Jersey Alzheimer s Association reports that 45% of patients affected by dementia have mixed dementia but are unaware. Parkinson s Disease with Dementia For some individuals with advanced Parkinson s disease, dementia may occur. A form of subcortical dementia, Parkinson s disease dementia presents problems with comprehending visual information or recollecting everyday tasks. Lewy Bodies Disease When proteins deposit in nerve cells, this interrupts the chemical messages in the brain. The interruption, which causes memory loss and disorientation, is known as Lewy Body disease (LBD). People with Lewy Body disease experience memory loss and thinking problems similar to Alzheimer s. 9 TYPES OF DEMENTIA
10 Fronto-temporal Dementia Fronto-temporal dementia (FTD) refers to several types of dementia that affect the front and side parts of the brain. FTD s symptoms include personality and behavioral changes and difficulty with language. FTD can affect people as early as 45 years old and is hereditary. Creutzfeldt-Jakob Disease One of the most rare forms of dementia, Creutzfeldt-Jakob disease affects people rapidly and impairs memory and coordination. Huntington s Disease Huntington s disease is a progressive, neurodegenerative disease, which is hereditary. For those affected, dementia can occur at any stage of the disease. Symptoms include loss of memory, irritability, depression, and other mood changes. Loss of muscle coordination and behavioral changes are symptoms as well. 10 TYPES OF DEMENTIA
11 Behavior Chart Comparison BECAUSE DEMENTIA S SYMPTOMS can grow gradually over time, we must always keep a watchful eye out for any signs. However, not all signs point to dementia. As we grow older, even the healthiest among us will exhibit a cognitive disruption or lapse in memory or judgment. Use the chart below to better understand the difference in common age-related behavior changes versus dementia-related changes. Typical Behavior Changes More Severe Behavior Changes Temporarily forgetting names or upcoming events. Ongoing memory loss that disrupts his or her everyday life. Vision or hearing changes. Difficulty understanding visual or auditory input and spatial relationships. Temporarily unable to recall a certain word or phrase ( It s on the tip of my tongue! ). New, consistent problems with words in both speech and in writing. Suffering from absent-mindedness, such as misplacing car keys or glasses. Misplacing things without the ability to retrace his or her steps to find them. Finding it difficult to use devices like microwaves or computers. Unable to complete commonplace tasks at home or at work. Facing misattribution issues, such as recalling an event but not the time or place of the event. Confusing or misremembering the current day of the week or his or her location. Making errors with checkbooks, bill payment, etc. Difficulty in planning or solving problems. Every now and then finding family and friends or other social obligations tiresome or overwhelming. Gradually withdrawing from work or social activities. Becoming irritated when set routines are disrupted. Complete changes in mood or personality. Erring or making a bad decision. Changes or a decrease in judgment that causes negative outcomes. 11 BEHAVIOR CHART COMPARISON
12 5 Conditions Masquerading as Dementia Because Alzheimer s disease and other dementias carry such gravitas, we often worry when we see certain episodes or ailments in our aging loved ones. Dementia is not always the culprit for conditions like irritation, mood changes, and forgetfulness. In this next section you ll find five common conditions that can masquerade as dementia.
13 Urinary Tract Infections When bacteria find their way into the urethra and travel into the kidney and bladder, the result is a urinary tract infection (UTI). While symptoms of a UTI include painful urination, for older adults UTIs can cause confusion, agitation, or withdrawal. However, a UTI in older adults does not necessarily equate to a dementia diagnosis. Older adults can experience improper nutrition and/or hydration. Falls are often associated with urinary tract infections. If you believe your loved one has a UTI, please contact your physician for help. 1 2 The Polypharmacy Problem As we age, our physicians often prescribe a number of medications from blood pressure pills to pain relievers for osteoporosis. Many seniors see specialists in addition to their primary care physician and often have prescriptions from a variety of doctors. In addition, they may be taking over-the-counter remedies. The onslaught of medication can make a person feel worse rather than healthier, causing memory problems and other side effects similar to dementia. Ensure your loved one s doctor understands the breadth of medication they re taking, including supplements. Using the same pharmacy for all prescriptions is helpful as the pharmacist can often identify possible adverse outcomes. 13 MASQUERADING AS DEMENTIA
14 3 Depression Depression affects one out of 17 adults over the age of 65. Common symptoms of depression mirror symptoms of dementia, such as mood/behavior, memory, and reasoning. If you believe your loved one suffers from depression, seek assistance from your physician. Be aware that your physician may refer you to a geriatric psychiatrist, neurologist, or geriatrician. Thyroid Disease Around 30 million people, most over the age of 50, have thyroid disease. According to the American Thyroid Association, half of these people don t even know it. Symptoms include sluggishness, feeling depressed, forgetfulness, or anxiety. Your physician or an endocrinologist can help your loved one understand the differences and make a clear diagnosis. 4 5 Hearing Loss Hearing loss often affects older adults. Hearing loss experienced by older adults is called presbycusis. The loss of hearing can cause seniors to have attention deficit, to misunderstand verbal communication, and to withdraw from social situations. As you can imagine, people can associate these symptoms with dementia. Disorders of the ear are frequently associated with balance issues, which can lead to falls, so there are many reasons to be sure that you are seeking professional help. Work with your loved one s physician or seek an otolaryngologist (ear, nose, and throat physician) or audiologist if you notice any signs of hearing loss. 14 MASQUERADING AS DEMENTIA
15 Finding the Right Professional Help If you believe your loved one may suffer from dementia, you should seek professional help from your primary care physician (PCP). Because a PCP has a knowledgeable history of your mother, father, or other loved one, this physician can approach the situation with a medical context and can provide insight to any mental or physical changes occurring. In addition to the primary care physician, we have provided on the next page a number of physicians that have a specialized understanding and training around dementia.
16 Neurologists A neurologist is a physician who specializes in the treatment of nervous system disorders. Your physician may refer you to a neurologist, who can check your loved one s mental and physical history, lab tests, mental status, cranial nerves, motor system, sensory system, deep tendon reflexes, coordination, and gait. Internal Medicine (Internists) An Internist is a specialist who concentrates on the prevention, diagnosis, and treatment of disease in the adult population. According to the American Board of Internal Medicine, the Internist provides long term, comprehensive care. They will frequently refer patients to specialists while overseeing the management of the patient s medical care. Geriatric Psychiatrist A geriatric psychiatrist is a physician who specializes in the mental and emotional needs of his or her older patients. A geriatric psychiatrist will perform evaluations around memory, mood, sleep, depression, and thinking. Geriatrician A geriatrician is a physician who specializes in the treatment of the health issues of elderly patients. Geriatricians are board certified in either Internal Medicine or Family Practice and have completed a fellowship in geriatrics. They are experts in the biological, psychological, cognitive, and sociological aspects of aging.
17 Beyond the Physician WHEN A LOVED one is diagnosed with dementia, the prospect can be overwhelming and stressful. Much will change in both your lives, and it s more important than ever to consider the future. If you haven t already, seek legal counsel to help you prepare for whatever comes next. A few documents you should investigate: 1. Medical Directive or Living Will so that your loved one s wishes are known. 2. Durable power of attorney for healthcare, which should include a HIPAA release. This gives you the ability to make healthcare decisions for your loved one. 3. Durable power of attorney for finances so that you will have the ability to take care of financial matters. 4. A will, which is a legal document that outlines the distribution of property upon death and the person(s) who will manage this process. 17
18 About Five Star Senior Living Five Star Quality Care, Inc., a national healthcare and senior living provider headquartered in Newton, Massachusetts, proudly offers the highest quality service and care with the warmth and hospitality of home. Five Star has two major operating divisions: Five Star Senior Living and Five Star Rehabilitation Services. The Five Star Senior Living division includes more than 260 Independent Living, Assisted Living, Alzheimer s/memory Care, Healthcare Centers with Skilled Nursing & Rehabilitation and Continuing Care Retirement Communities. We also offer outpatient rehabilitation, day programs, and respite/short stay options. Five Star is committed to maximizing your loved one s independence and enhancing her lifestyle. Residents can choose from a full complement of social, educational, wellness, cultural and spiritual programs; as well as a variety of support options. The happiness, comfort and peace of mind of our residents and families are our goals. Learn more about Five Star Senior Living by visiting fivestarseniorliving.com. Follow Five Star on Social Media: 18
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