Most families that live together with elder members benefit from the rich experience of wisdom, experience, familiarity and love that has taken generations to accumulate. Our parents or grandparents, the very first guides to our own lives, are a great resource not only for us but also for our children and all of the life’s domestic ups and downs. Moreover, most elderly family members end up becoming our primary support-system during our mid-adulthood as we get busy chasing and perfecting our own career dreams. In most homes, they are also the resident Google & Wikipedia for various things. The list of the goodness that parents and grandparents bring to our lives today is endless.
However, old age also brings changes –to them as well as us and our lives. Our work, our kids, our time, our finances, are all affected by old age and what it holds for the elderly members in our lives.
As the body ages, the organs which kept it going for all these decades, start getting tired. These natural biological changes in the elderly not only affect them but also us. It is common to witness life changes such as restrictions on travel, increased visits to the doctor, a constant requirement of medicines, new adjustments in our social engagements, etc.
Along with the body, the human brain also undergoes degenerative changes, as our parents or grandparents approach old age. Seeing symptoms such as forgetfulness, lack of articulation, impatience, speech difficulties, being mentally disconnected, etc. is very common amongst elderly members living with us.
However, most of us see these as natural age-related issues, and may not always know how to deal with the possibility of a deeper issue. The onset of such changes right here within our own homes at times makes us frustrated and helpless.
As a result, a neurological disorder such as Dementia may go unnoticed in the early stages. Dementia is the term used for a group of symptoms that affect a patient’s memory, thinking, and social ability. In some cases, it can impact a patient so severely that even his or her simple daily tasks are affected. Dementia consists of impairment in language, reasoning, focus, and communication.
As Dementia progresses, there can be challenging behavioral problems. This can lead to physical and verbal aggression in patients. The disorder can cause distress in both the patient and their caregiver, as a result of its symptoms as well as a caregiver’s difficulties in helping an individual. In order to deal with the disorder, a caregiver can look out for behaviors that may suggest that an individual is developing dementia. Identifying the presence of the disorder may help an individual receive better care in the early stages of dementia itself, potentially slowing its progress.
Similarly, one must look out for specific triggers or circumstances that cause a patient to be more aggressive, as their dementia progresses. Caregivers should note if there is a specific time of the day or carrying out certain tasks cause aggressiveness in the patient. Knowing these details could help initiate changes in one’s own approach to an individual with dementia, and as a result, it could alter their challenging behavior. This is because of aggression or acting out may be linked to how a patient feels.
For instance, an individual with dementia may get angry when questioned about an action, or if they are unable to complete a task. This is often because they may be unable to understand your motivations or how to perform a task.
Guidelines for Caregivers
- Is the patient’s behavior harmful to himself or others?
- Has the patient been assessed for any pain or other infection?
- Is the patient is comfortable and cared for?
- Whether the patient is active, happy, and able to carry out daily responsibilities?
- How would a caregiver react to a patient’s aggressive behavior?
- What are the risks, side effects, etc. of the drugs prescribed to a patient?
One of the most difficult aspects of dealing with dementia-related behaviors is the communication difficulty that results in frustration to patients and its caregivers.
Here are some common situations and strategies that can help in managing dementia-related behavior:
Aggressive Speech or action
In such situations, an individual may behave stubbornly, and refuse to comply with a request. This behavior can occur in simple situations, such as hygiene –not taking a bath, brushing etc. It may perhaps even occur with more complex situations- leaving a store or the house. They become mean or verbally or physically aggressive for unrelated situations as well.
Recommended Solution: One thing all caregivers need to accept is the patient does not behave like this on purpose. It is usually a result of physical discomfort, environmental factors, an unfamiliar situation or poor communication that causes such behavior in patients with dementia. They may not be able to perceive a behavior, or request, as it is intended- leading to a different conclusion being formed.
A caregiver should analyze and identify the cause behind a patient’s aggressive behavior. It is also important to make sure that the patients are not placing themselves or others in any kind of harm.
Caregivers can shift the patient’s focus to something else in calm and a reassuring manner.
Patients may also not like to be constantly told to do certain things, in a certain way, by their caregivers. In such cases, it is better for a caregiver to take a step back and give the patient more space.
It is important to remember, to never engage in an argument or force an issue that leads to a patient being aggressive. If they do act out, one should not immediately choose to restrain them through force. This should be a last resort.
Confusion regarding place and time
In such situations, an individual may exhibit confusion regarding their environment. They may be unable to orient themselves to the present which can result in a number of issues. Such confusion may create trouble in situations where an individual may be in a caregiving facility, and constantly choose to go home- not realizing their current situation. They may feel unsafe or anxious as their environment becomes unfamiliar. Similarly, if they are not aware of the time, they may experience confusion in recognizing individuals or remembering events that have occurred.
In such a situation a caregiver should work towards making an individual feel at ease where they are. This can be done by gently diverting their attention to a different activity or perhaps indirectly suggesting that an event may have already passed.
A person who is confused about time and place, should not be constantly reminded that they are experiencing orientation and memory issues. This serves as a constant reminder of their condition and can be overwhelming.
Reasoning, justifications and lengthy explanations usually never work with Dementia patients.
In such situations, an individual may display difficulties in simple calculations, judgment, or comprehension of a situation. It can come across as accusatory statements if they are unable to understand a series of events, or perhaps even as difficulties and mistakes with finances etc.
Recommended caregiving: Here too, a caregiver should work towards being encouraging and gently reassuring. Outright offers to provide help may not be easily accepted and may aggravate the situation. A caregiver can always offer help to a patient in staying organized with smaller tasks, make it appear as assistance and not as though the patient is completely unable.
Never question or argue with a patient in his or her ability to handle a particular task at hand as this may escalate aggression.
Dementia causing diseases progressively lead to loss of memory and other cognitive problems linked to language, judgment, and planning. It can lead to trouble with social interactions and result in impairment of their ability to perform daily activities. Depending on the progression of the disease, it can also impact a person’s lifespan.
In India, dementia is a serious and growing problem. It is neglected due to lack of awareness amongst the people. Estimates show that there are above 4 million Indians, above the age of 60 who have this condition. This amounts to 3.7%of the total Indian population. It is said that 1 in every 16 households with an elderly member, has someone with dementia.
There are many families who do not seek diagnoses and treatment for dementia patients. There is also a limited reach for various campaigns regarding dementia awareness. This happens because efforts to spread awareness do not reach less literate, poor people or people in rural areas and small cities.
For forgetfulness, confusion and difficulty in performing daily tasks, patients or their families do not consult a doctor due to lack of awareness. Patients may forget things or get disoriented, and in these instances they may cover up their mistakes out of shame, assuming it is a part of getting older. Although some problems seem to be a part of the normal aging process, they could potentially be due to dementia or other medical conditions. Dementia symptoms are similar to many other medical conditions.
While dementia cannot be cured, it can be managed. In some cases, medication can be sought for relief from symptoms. Treatments for dementia symptoms due to vitamin or hormone deficiencies can help reverse the effects. However, an individual should see a professional in order to obtain an accurate diagnosis and respective treatment plan for a disorder. However, the lack of awareness may also exist at a professional level. People with symptoms of dementia, report instances where they do see a doctor, and the latter do not take their problems seriously. Doctors attempt to pacify them instead, explaining away their problems as a result of their old age Instead of checking for possible medical conditions or referring a particular patient’s case to a professional for further investigation, they assume that some problems do not matter and are a part of growing old.
With dementia, a patient’s dependence on their caregiver is quite high, and they require specialized care. Thus, as a caregiver, it is better to identify the presence of the disease at an early stage and gather information on how to properly care for the patient in all aspects.
At times patients may become forgetful, unable to do their daily tasks or exhibit some unjustified and strange behavior. Family members of these patients may then react to them with irritation and anger instead of accepting that this kind of behavior is on account of dementia or such medical conditions.
There are also cases where family members to seek their doctor’s advice. However, if the physician says everything is normal, most families do not look further for any other medical advice, nor do they consult specialists like psychiatrists, neurologists, geriatricians, counsellors, etc.
In most cases, our biggest challenge is a gap in our own awareness about the elderly. As families, we often fail to notice the symptoms on time and treatment gets delayed. Sometimes stigma and resistance within us also delay us from seeking professional help. For example, we already know the difference between constipation and diarrhea, and we clearly understand that these two conditions require separate treatments and different medication. However, when it comes to mental illness, we often live without even seeking a proper diagnosis for our beloved elderly family members.
There are obvious benefits if dementia is diagnosed early. Some of them are as under:
- Reversible symptoms
Dementias due to degenerative diseases or trauma are irreversible. In cases where dementia is caused by alcohol, drugs, hormone or vitamin imbalances or even depression, most of the symptoms are reversible. Early detection can then help improve brain function.
- Mild Cognitive Impairment Treatment
First signs of Dementia can be a mild cognitive decline. Having a proper diagnosis of this stage can help in reversing or at least reducing its severity in the later stages.
- Diagnoses are more accurate
In early stages of dementia, the diagnoses are more accurate, as a patient may be able to answer most of the questions and report concerns. Dementia patients are able to recall the order in which symptoms occurred in the initial stages. Since once dementia progresses the brain is affected, therefore it would become difficult for an accurate diagnosis to be provided.
Decisions regarding finances, legal decisions, long-term planning, as well as making their wishes known to one’s family, can be carried out more efficiently in the initial stages of dementia- for which an early diagnosis is essential.
- Prioritize goals or activities
Elderly individuals may have wishes or goals such as traveling with their grandchildren, going for a pilgrimage, recording their family history, etc. This list can be vast; hence, if dementia is diagnosed early, patients can review their priorities and focus more on important goals or activities.
- Use resources better
The earlier the better when it comes to diagnosing dementia. One can benefit from going to support groups in the early stages, as we; as learn strategies to manage dementia effectively, cope with the symptoms, create a plan for providing care, etc.
- Better care opportunities
For improved patient care, more research and some clinical trials can also be taken if a diagnosis is done early.
- Helpful to caregivers
Families of the patient can learn about the disease, develop realistic expectations and also plan together for their future if there is an early diagnosis. This also helps in reducing stress, easing the burden, and reducing regret in the later stages of the said disease.
All these advantages summed up together will help a patient and their loved ones to lead a better quality of life. They would have more time to treasure in the present while preparing for the future.
Need for Counselling
Counselling is beneficial for the patient and their family members, in order to help them cope with the stress and trauma that come with dementia. It is highly recommended to consult an expert, so as to get a good hold over the unique patterns of a patient’s adverse behavior.
Counselling cannot reverse dementia, but it help can manage it effectively. Dementia counseling can also help not only the patient but also their family.
These are a few things a counsellor works on:
- Ways to make patients and their caregivers live as normal as possible.
- Coping and managing the changing roles within the family of the patient.
- Working through the emotional turmoil that may be created.
- Overcoming problems like stigma or identity loss can be severe and can be addressed by counselling.
- Help smoothen transition into the new identity.
Therappo’s online counsellors can help families affected with Dementia to face everyday life challenges. This includes developing a structured and systematic routine to make life simpler and normal, assigning duties to family members for better patient care, overcoming emotional issues and difficult behavior, etc.
Dealing with dementia is difficult.
While there may be no observable changes on the outside, an individual is different. Loved ones of the patient have to accept a new identity of the patient and come to terms with the changes.
At Therappo, counsellors work to make changes for the better. These are some approaches counselors adopt:
- Dementia patients are likely to pick up emotional cues and get aggressive if they find something negative. A counsellor with the use of posture, body language, and facial expression can convey a positive meaning.
- Rectifying a patient’s speech by encouraging them to speak slowly and clearly.
- Use of mimicry through gestures to convey meaning.
One can soon learn a patient’s need and feelings by paying attention to these behaviors.
Dementia affects the life of an individual, but it also affects the lives of their family and friends. To improve the quality of life and care for patients and their loved ones with Therappo’s online counselling. For patients with early signs of dementia, Therappo’s counselling help in coping up with fear and anxiety issues. To ensure the right care and support in the future, counselling can help these by putting measures in the right place.
Remember their love, when they no longer remember!