Dementia impacts nearly every aspect of an individual's life. While memory loss is a symptom of dementia, there has to be at least one other significant cognitive impairment for a dementia diagnosis. For example, the person might also have problems with language or have difficulty with complex thinking. As dementia advances, numerous quality-of-life issues arise. Most of the burden of coping with these issues falls to the caregiver.
Safety
The forgetfulness that accompanies dementia presents numerous safety hazards. Changes in routines and surroundings have to be made to ensure that the dementia patient stays safe and does not cause harm to himself or others. Once a diagnosis of dementia is made, the individual's driving ability must be carefully monitored. Some dementia patients refuse to stop driving, even though they can no longer be considered safe drivers. The family may have to enlist the help of the physician to prevent their loved one from driving.
A confused person might wander away and become lost. Forgetfulness can lead to leaving the stove turned on, or taking too much medication.
Hygiene
Activities such as bathing, brushing teeth, shaving, and getting dressed involve complex thought processes and a sequence of decisions. The ability to perform personal care and grooming tasks can become increasingly difficult for the person with dementia. In the early stages of dementia, the person may only need a reminder or help finding an item. In the later stages, greater assistance from the caregiver will be required. It is best to encourage the patient to help and participate in personal hygiene. Some patients develop an aversion to bathing and grooming.
Legal Considerations
As dementia progresses, the individual's ability to make decisions declines. It can become necessary for a caregiver to make the legal decisions for the person with dementia. Of course, the person with dementia may not recognize this need, and this can lead to a complex legal situation that will require the assistance of a family lawyer.
Communication
Dementia profoundly affects an individual's ability to communicate. The person can find questions confusing, and it is common to mix up words or to struggle to think of the correct word. Particularly during the early stages of dementia, the person's inability to effectively communicate can frustrate or upset the individual as well as the caregiver. A caregiver should try to create a relaxed environment, learn about nonverbal communication, and aim for realistic expectations.
Behavior
The behavioral changes that accompany the syndrome can irritate or upset family members. An individual with dementia will often overreact to a situation with strong emotion. Aggressive, combative behaviors can occur. Sometimes people with dementia undress themselves at inappropriate times. Some people with dementia experience hallucinations or develop paranoia.
References
- Los Angeles County Department of Mental Health: Dementia: Definition and Natural History
- "The 36-Hour Day"; Nancy L. Mace and Peter V. Rabins; 2006
- "What If It's Not Alzheimer's? A Caregiver's Guide to Dementia"; Lisa Radin and Gary Radin; 2008
- Family Caregiver Alliance: Dementia and Driving
