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Understanding age and dementia

In recent years, we've become painfully aware that as age increases, so too does the potential for the onset of dementia. It's a scary prospect, but maybe not as scary as we've made it.

Although Alzheimer's disease and dementia are often used interchangeably, they shouldn't be.

The Big Ugly of dementia is an umbrella that has a number of smaller uglies strung under it. A little more than half of all dementias are Alzheimer's.

There are a number of other forms, including diseases that have dementia components, such as Huntington's, Parkinson's, Lewy body, vascular dementia and strokes.

About 90 percent of all dementias are irreversible, but a few -- such as some depressions and so-called "hospital dementia" -- can be reversed.

The Alzheimer's Association (www.alz.org) defines dementia as "a general term for loss of memory and other intellectual abilities serious enough to interfere with daily life."

We're just beginning to scratch the surface on what "old-timer's disease" really is, but it's safe to say it has quickly become one of the most feared prospects of aging. Some of those fears are overblown.

A 2006 study in Australia estimated that only 1 percent of those aged 60 to 65 suffer from dementia. Between 75 and 79, the incidence was just 6 percent, though it climbs to 45 percent for those 95 or older.

If you're caregiving for a parent with dementia, here are four ways to cope:

1. Get into their reality

While working in Denver, I often found myself "waiting for the bus" with a resident, who, in her mind, was always needing to leave to take care of her children. There was no bus and her children were all fully grown, but that didn't matter. I waited with her and asked her to tell me more about her kids. That was her reality, and in it she could function with at least the appearance of normalcy.

2. Know their age

As many dementias progress, memories regress. Families often are upset when they come to visit and find mom isn't wearing her glasses anymore. "She always wore glasses," they protest. Maybe not.

In her mind, she's much younger now, and maybe at the age she is, she didn't wear glasses.

3. Don't argue, guide

People with dementia can be stubborn, and the more you try to push them to do something the harder they'll resist. Speak to them simply. Pause to let things sink in. Don't hurry them or scold them, let alone try to "reason" with them. They're not likely to make the connections that seem obvious to you.

I remember how hard it sometimes was to get someone with Alzheimer's to shower.

"I don't want to shower," they'd say with maddening simplicity. "But you have to," family members would argue, managing only to further frustrate themselves. Better to say, "I don't like to either, but tomorrow is Sunday and you told me we had to be clean for church."

Diversion works for some. With others, if you know the age they're currently at and something about the conditions in which they grew up, you can try to link to memories from an earlier time.

Maybe they didn't shower when they were younger, but the prospect of a bath meets no resistance at all. A key phrase to use is "You may be right." It alleviates resistance.

4. Turn off the TV

People with dementia often have trouble processing, or even understanding, things they see on television. The images look real but happen so much faster. In too many care facilities, I see the TV used as an electronic baby-sitter, with no thought to what people with dementia are seeing. I've seen a resident in a memory-care home get up and look behind the TV to find out where people are hiding.

Often, what they're seeing on TV shows are situations they think they must solve. If a character asks another for money, they worry about where to send a check. An exception to the rule are movies, especially familiar ones with no commercials.

It's not true, but most Americans believe it: Getting old means our cognitive abilities decline. Forever. For your parents, this may well be their single greatest fear as they age.

Contrary to the enduring myths, however, loss of intellect, memory and creative problem-solving doesn't happen suddenly (or slowly, for that matter) just because we "get old."

In fact, it isn't a necessary part of aging at all, unless the Big Ugly of dementia becomes part of their life.

Aging with disease is quite different than normal aging.

Kari Berit (www.KariBerit.com) is the author of "The Unexpected Caregiver: How Boomers Can Keep Mom & Dad Active, Safe and Independent.

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