Alzheimer's disease

The term dementia is used to describe a group of symptoms including decline in memory, thinking and communication skills, and the gradual loss of skills needed to carry out daily activities. These symptoms are caused by structural and chemical changes in the brain as a result of physical diseases such as Alzheimer's disease. Amnesia – problems with everyday memory with difficulty remembering events that have recently occurred Concentration, planning, and organizing – difficulties making decisions, solving problems, or carrying out a series of tasks Language – difficulties understanding what people are saying and/or finding the right word for something

It's normal to forget, but sometimes it's important to look deeper”

What most people don't know is that there are many conditions that can mimic dementia. It's one thing to walk out of ASDA (a British supermarket chain) and not remember where you parked, it's another to walk out of there and not know if your car is red, green or blue.


Becoming disoriented and frequently forgetting the names of people, places, appointments, and important events Experiencing mood swings due to frustration Increased memory loss Becoming more withdrawn – due to loss of confidence or communication problems Daily difficulties coping Difficulties Cognition generally declines steadily over time Occurs due to tangles of proteins in the brain's blood vessels Problems Rapid thinking, concentration and communication Depression and anxiety associated with dementia Symptoms of stroke such as physical weakness or paralysis Periods of severe acute confusion – prone to delirium Tends to progress into a recessive presentation due to vascular events such as stroke Damage blood vessels and restrict blood flow to areas of the brain Experience problems with attention and alertness They often have spatial disorientation and difficulty planning ahead and coordinating mental activities. It shares characteristics similar to Parkinson's disease including slowness, muscle stiffness, trembling and trembling, changes in voice and lack of facial expressions, and hallucinations/delusions. Confusion can quickly fluctuate from Extremely to clearly confused Very sensitive to antipsychotic medications Can form paranoid beliefs – people steal them Caused by clumps of proteins that develop inside nerve cells that block messages in the brain. They reduce levels of chemical transmitters and cause nerve cell death. Lack of insight and loss of the ability to empathize with others You are likely to experience difficulties with language and emotional responses. Be open when coming out previously and withdraw when coming out previously Acting inappropriately/impulsively behaviors More likely to lose inhibitions – verbally and physically Can become aggressive Develop routines – eg compulsive rituals Caused by damage to the frontal/temporal lobes of the brain. It is also sometimes referred to as “snapshot disease.”

How common is it?

As people live longer, the number of people with dementia is expected to increase. Nationally for some countries, it is estimated that the numbers will almost double over the next 30 years to 1.7 million people with dementia in the UK (Alzheimer's Society 2009) and it is estimated that 61% of people with dementia are women and 39% are men ( Alzheimer's Research 2014) This is thought to be because women are more likely to live longer and age is the biggest risk factor for dementia. 1 in 14 people over 65 have diagnosed dementia 1 in 6 over 80


There is growing evidence to suggest that certain medical conditions such as high blood pressure, diabetes and obesity may increase the risk of dementia. A healthy lifestyle may reduce risk (Alzheimer's Society, 2014) Health Promotion Bulletin – Healthy Living Exercise Reduce Alcohol Intake Poor Nutrition Smoking Obesity The research is weak at the moment – there is no direct link that any one thing will cause dementia but as with... Heart disease etc. A healthy lifestyle will reduce the risks Why is dementia diagnosed and treated early? Improving quality of life Early diagnosis and intervention improves the quality of life for people with dementia Early intervention has a positive impact on family caregivers' quality of life Counseling can be helpful in the early stages for the person receiving the diagnosis. Allows patients/families to make informed decisions about care Can plan for the future eg Legal Power of Attorney (LPA) Delay and prevent unnecessary admissions to care homes Diagnosis Blood tests to rule out any physical health causes of memory impairment History taking –
Talk to the person and the person who knows them Well Cognitive Tests of Mental Abilities (ACE-III) Brain scans Diagnosis may take weeks/months Living a single life A diagnosis of dementia may bring some challenges, but it is still possible to live well with some simple changes and procedures. People with dementia want to continue to go about their daily lives and feel included in their local community, but sometimes they need a helping hand to do this. This may include supporting people to adapt their homes, promoting independence and social inclusion in their local area. The Importance of Communication Communication is at the core of everything we do in our lives. It enables us to express a need, want or desire and allows us to share information and be social.
The ability of a person with dementia to communicate depends on the progression of the disease Common problems in communication Difficulty finding words Lack of understanding of language and concepts Repeating words over and over Unable to say Name of object Losing train of thought Reading skills deteriorate Writing saying too little Gestures more than talking Difficulties processing information or instructions Decision making/judgment Behaviors we can challenge 90% of people with dementia experience behavioral and psychological symptoms at some point (Alzheimer’s Association 2013) . Cohen-Mansfield (2001) suggests that challenging behavior in dementia often reflects someone's attempt to signal that a need is not being met at the moment. A person's personality suffers through the course of dementia and their individuality will emerge at different stages and stages of their illness How the person lived their life – religion, diet, how they coped with the past/coping mechanisms Causes of difficult behavior Physical cause – dehydration, constipation, infection Cognitive – communication problems, confusion Emotional – fear Environment Anxiety – Noises, lights, unfamiliar surroundings How challenging behaviors may appear Challenging behavior appears due to an unmet need. It may result from an individual feeling threatened, afraid, or anxious, or experiencing delusions or hallucinations, or it may be a response to a difficult situation or a misinterpretation of the actions of others. It may simply be the result of an individual trying to express hunger, thirst, or pain. Example “Maureen” Sudden onset of confusion/deterioration in perception. Generally, treat the cause, and symptoms improve. Delirium Assessment Tool AT (now on fall pathway) People with dementia are more likely to develop delirium - (cognitive reserve) Delirium alert codes  are now in place. Active red brain delirium, purple brain At risk for delirium/history of delirium. The new delirium care plan is available in 'Nursing Patient Safety' care plans, (Acute Disorientation Nursing Care Plan) Family, Carers and Friends The majority of people with dementia are cared for by their families. It is important that the carer is supported to maintain their health and wellbeing. The Prime Minister’s Dementia Challenge includes looking to sensitize carers of people with dementia and provide them with access to respite, education, training and emotional and psychological support so that they feel able to take on their own caring responsibilities and get through life alongside care.” Available to caregivers who support the patient while they are in hospital. A discount can be allowed on the meal in the restaurant, a person can request the provision of suite meals, and reduced parking costs. Two named carers/family members can be available (available at the sharing point). What is Dementia Friends? Dementia Friends is the UK's largest ever initiative to change the way people think, act and talk about dementia. It is led by the Alzheimer's Society as part of its work to create 'dementia-friendly communities'. It aims to help people understand what dementia is, how it can affect a person and how we can help people with dementia. You can become a Dementia Friend by going to the Alzheimer's Society website where you will find more information The Dementia Friends program aims to change the way people think, act and talk about dementia. It is run by the Alzheimer's Society, as part of its work to create 'dementia friendly communities'. By understanding more about dementia and committing to action,
Friends of the Dementia Society believe there are five things everyone should know about dementia, which are: Dementia is not a normal part of aging. It is caused by brain diseases. It's about more than just losing your memory. There's more to it than just having dementia. It is possible to get along well with life