A large part of my elder law practice consists of advising family caregivers dealing with dementia.
When I saw that a free program was being offered today at the Dorothy Benson Senior Center in Sandy Springs, I signed up right away. The more resources and information regarding dementia that I have in my toolbox, the more I can help my clients and their families.
Dementia expert Teepa Snow presented the program, and it was excellent. In preparation for my next post, which involves planning for dementia and long-term care, I wanted to share some of the tidbits I learned from Teepa today:
On dementia in general:
The term “dementia” does not mean the same thing as “Alzheimer’s” and neither “dementia” nor “Alzheimer’s” mean the same thing as memory loss.
There are 85 – 90 types of dementia. Every type has these things in common:
1. At least two parts of the brain are actively dying.
2. Each dementia will destroy at least 2/3 of the brain.
3. All types of dementia are progressive (i.e. they all get worse over time); however, each is progressive in its own unique way.
4. Nothing can slow, stop or turn around dementia.
5. All forms of dementia are terminal.
Because dementia affects several parts of the brain, it causes more than memory problems. Dementia affects thought, language, behavior, personality, and feeling/affect, among other things.
“Dementia” itself is not a diagnosis. Instead, it describes a collection of symptoms. It is vital that patients receive a good evaluation from a qualified physician, so that the patient and caregivers know what kind of dementia they are dealing with.
Medical issues are often misdiagnosed as dementia because of the resulting cognitive issues. Medical problems causing cognitive impairment can include depression, thyroid imbalance, lack of Vitamin B12, long-term alcoholism, diabetes, hypertension, and infection, just to name a few.
A dementia “diagnosis” is very scary to patients. There is a huge stigma surrounding dementia.
On dealing with dementia and patient resistance:
Patients often act illogically, and caregivers may respond with resistance. This response is entirely natural, but counterproductive.
Resistance in the caregiver is often met with resistance in the patient, and caregivers’ efforts to explain or correct illogical or resistant behaviors are not helpful. Instead, caregivers should try to discover the underlying cause (that is, the unmet need) of the behavior (which is often not what it initially seems).
Key: do not correct. Let it go. Join the journey. If Mother said she saw Aunt Eunice last night, don’t correct her, even though Aunt Eunice has been dead for thirty years. Tell her you think it’s nice Aunt Eunice visited, and ask her whether Aunt Eunice still has that terrible perm.
Be aware that sudden changes in behavior often have underlying medical causes, including lack of sleep, lack of nutrition, dehydration, lack of sunlight… Remember, investigate and try to find the underlying cause.
Most important: I asked Teepa to name some resources for family caregivers, and she provided the following:
1. Alzheimer’s Foundation of America
3. More resources listed on Teepa’s website, including free videos
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Elder Law Update 