Living with Dementia: Challenges and Coping Strategies
Dementia is an umbrella term for several diseases affecting memory, other cognitive abilities and behaviour that interfere significantly with a person’s ability to maintain their activities of daily living. Although age is the strongest known risk factor for dementia, it is not a normal part of ageing. The illness gets worse over time. It mainly affects older people but not all people will get it as they age.
Risk Factors
Age (more common in those 65 or older)
High blood pressure (hypertension)
High blood sugar (diabetes)
Being overweight or obese
Smoking
Drinking too much alcohol
Being physically inactive
Being socially isolated
Depression.
Causes, Effects, and Societal Challenges
Dementia is a syndrome that can be caused by a number of diseases which over time destroy nerve cells and damage the brain, typically leading to deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from the usual consequences of biological ageing. Impairment in cognitive function is sometimes preceded by changes in mood, emotional control, behavior, or motivation.
Dementia has physical, psychological, social and economic impacts, not only for people living with dementia but also for their carers, families and society at large. There is often a lack of awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis and care.
Signs and symptoms
Changes in mood and behaviour sometimes happen even before memory problems occur. Symptoms get worse over time. Eventually, most people with dementia will need others to help with daily activities.
Early signs and symptoms are:
Forgetting things or recent events
Losing or misplacing things
Getting lost when walking or driving
Being confused, even in familiar places
Losing track of time
Difficulties solving problems or making decisions
Problems following conversations or trouble finding words
Difficulties performing familiar tasks
Misjudging distances to objects visually.
Common changes in mood and behaviour include:
Feeling anxious, sad, or angry about memory loss
Personality changes
Inappropriate behaviour
Withdrawal from work or social activities
Being less interested in other people’s emotions.
Dementia affects each person in a different way, depending upon the underlying causes, other health conditions and the person’s cognitive functioning before becoming ill.
Most symptoms become worse over time, while others might disappear or only occur in the later stages of dementia. As the disease progresses, the need for help with personal care increases. People with dementia may not be able to recognize family members or friends, develop difficulties moving around, lose control over their bladder and bowels, have trouble eating and drinking and experience behaviour changes such as aggression that are distressing to the person with dementia as well as those around them.
Common forms of dementia
Dementia is caused by many different diseases or injuries that directly and indirectly damage the brain. Alzheimer’s disease is the most common form. Other forms include vascular dementia, dementia with Lewy bodies (abnormal deposits of protein inside nerve cells), and a group of diseases that contribute to frontotemporal dementia (degeneration of the frontal lobe of the brain). Dementia may also develop after a stroke or in the context of certain infections such as HIV, as a result of harmful use of alcohol, repetitive physical injuries to the brain (known as chronic traumatic encephalopathy) or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.
Treatment and care
There is no cure for dementia, but a lot can be done to support both people living with the illness and those who care for them.
People with dementia can take steps to maintain their quality of life and promote their well-being by:
Being physically active
Taking part in activities and social interactions that stimulate the brain and maintain daily function.
In addition, some medications can help manage dementia symptoms:
-Cholinesterase inhibitors like donepezil are used to treat Alzheimer’s disease.
-NMDA receptor antagonists like memantine are used for severe -Alzheimer’s disease and vascular dementia.
-Medicines to control blood pressure and cholesterol can prevent additional damage to the brain due to vascular dementia.
-Selective serotonin reuptake inhibitors (SSRIs) can help with severe symptoms of depression in people living with dementia if lifestyle and social changes don’t work, but these should not be the first option.
If people living with dementia are at risk of hurting themselves or others, medicines like haloperidol and risperidone can help, but these should never be used as the first treatment.
Self-care
For those diagnosed with dementia, there are things that can help manage symptoms:
-Stay physically active.
-Eat healthily.
-Stop smoking and drinking alcohol.
-Get regular check-ups with your doctor.
-Write down everyday tasks and appointments to help you remember important things.
-Keep up your hobbies and do things that you enjoy.
-Try new ways to keep your mind active.
-Spend time with friends and family and engage in community life.
Plan ahead of time. Over time, it may be harder to make important decisions for yourself or your finances:
-Identify people you trust to support you in making decisions and help you communicate your choices.
-Create an advance plan to tell people what your choices and preferences are for care and support.
-Bring your ID with your address and emergency contacts when leaving the house.
-Reach out to family and friends for help.
-Talk to people you know about how they can help you.
-Join a local support group.
It is important to recognize that providing care and support for a person living with dementia can be challenging, impacting the carer’s own health and well-being. As someone supporting a person living with dementia, reach out to family members, friends, and professionals for help. Take regular breaks and look after yourself. Try stress management techniques such as mindfulness-based exercises and seek professional help and guidance if needed.
Risk factors and prevention
While age is a significant risk factor for dementia, it is not an inevitable consequence of biological ageing. Moreover, dementia does not exclusively impact older individuals; there is a phenomenon known as young-onset dementia, which is defined as the onset of symptoms before the age of 65 years. People can reduce their risk of cognitive decline and dementia by engaging in physical activity, refraining from smoking, avoiding harmful alcohol use, maintaining a healthy weight, consuming a nutritious diet, and managing healthy blood pressure, cholesterol, and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity, and exposure to air pollution.
