Coping with dementia: overview – Part 1

Dementia, the most prevalent form of which is Alzheimer’s, is a condition affecting about 50 million people worldwide, with around 10 million new cases reported each year. This, the first in a three-part series, is based on information provided by the Associação Alzheimer Portugal, which is devoted to helping those with the illness and those close to them.

Alzheimer’s is a neurodegenerative disease that slowly and progressively destroys brain cells. The disease affects memory and mental functioning, such as thought and speech. It often leads to other problems such as confusion, mood swings and disorientation in time and space.

At first, the symptoms may be slight and go unnoticed by the family or others. As the disease progresses, however, the symptoms become more and more noticeable. Memory loss is one of the most important.

Especially at an early stage, a person with dementia may try to hide some of the consequences of memory loss out of embarrassment or shame. Later, they may no longer be aware of memory problems and their shortcomings.

It is normal for a person with dementia to ask repetitive questions. Since their recent memory is more affected, we should try to maintain a positive attitude with much patience. Try to answer as if the person were asking us the question for the first time. When we tire of answering the same question, one strategy to adopt is to divert the person’s attention to something else, or to occupy them in some other way.

In coping with memory loss:
▪ Try to maintain a positive attitude and foster calm.
▪ Do not take the behaviour to heart.
▪ Avoid drawing too much attention to mistakes and problems.

Problems due to memory loss can be avoided by creating routines with things at home and then not making unnecessary changes.

As the disease progresses, people with dementia need more assistance for their personal hygiene. They may lose the ability to use objects such as combs and toothbrushes. They may also forget what these objects are and, more importantly, what their purpose is.

They may forget there is a task to be done, have the impression that they have already done it, or lose interest in keeping everything clean and looking good.
The fact that a person needs more help does not necessarily mean that he or she will enjoy receiving it. The person may resent being dependent on you and feel that their privacy is being invaded.

It is very important to encourage independence. We must support and help the person with dementia in their daily activities, but we must not replace them and do things for them unnecessarily. It is important that the person with dementia performs tasks if possible, even if it takes longer. Anything that the person fails to do or practice will soon be forgotten or the ability lost.

There are various ways of providing assistance depending on the level of understanding and capacity of the person with dementia. For example, you can let the person wash themselves, providing just a little help when necessary, or you can explain or demonstrate, step by step, what to do.

One idea would be to prepare everything first – such as a clean change of clothes, run the bath water, preheat the bathroom, arrange the towels, shampoo and soap – and then leave them to wash themselves if this is possible.

Next week: dementia communication and legalities.

By Len Port

Len Port is a journalist and author based in the Algarve. Follow Len’s reflections on current affairs in Portugal on his blog: algarvenewswatch.blogspot.pt