One in ten of the UK population aged over 65 and one in five of the over 75s has dementia. With a growing, ageing population, dementia is clearly a condition which is touching the lives of people, directly and indirectly, more and more. The Government is becoming increasingly concerned about its rise, not least because a considerable number of acute NHS beds in wards up and down the country are occupied by dementia patients. With steady increases in dementia, extra community support and nursing homes specialising in dementia care are also needed, putting extra strain on an already stretched health service.
There are many different forms of dementia, and that’s why it’s important to make the distinction between dementia as a chronic condition and “confusion” which is a result of the benign forgetfulness of old age or the result of a toxic confusional state (delirium) brought on by other less serious health conditions, such as urinary tract infections. Chronic forms of dementia include Alzheimer’s, senile dementia (progressive brain degeneration), multi-infarct dementia (caused by strokes), Pick’s Disease (fronto-temporal atrophy), Creutzfeld-Jakob Disease (CJD) and Lewy Body Disease, a variation of Parkinson’s Disease.
The symptoms of dementia can include the following: memory loss (immediate, short-term (more likely) and long-term); disorientation for time, place and person; confabulation; nominal aphasia (unable to think of the word for things); expressive dysphasia (having difficulty in putting words together); paranoid ideas; restlessness; agitation; wandering and aggression.
Handling people with memory loss can be challenging and requires tremendous patience. As a start, it is important to exclude loss of hearing and loss of vision as a cause for their behaviour. Never approach a person with memory loss without telling them who you are, or approach them suddenly, as this can provoke confused aggression. Always remember that what you tell a person with dementia will be quickly forgotten and may therefore need to be repeated several times. It may also be repeated inaccurately – or made up altogether (confabulation)!
At present there is no specific treatment to restore memory loss associated with dementia. There are, however, drugs (acetylcholinesterase inhibitors) which can delay the dementing process but which do not prevent the illness deteriorating over time. In the early stages of dementia patients can realise they are losing their memory and often become depressed and anxious. Sometimes anti-depressants and tranquillisers can be helpful in dealing with these feelings. Recently there has been some success in developing new drugs to treat the causes of dementia by altering the structure of the brain, but these are not yet available. In the meantime, treatments such as reality orientation, family therapy, day care, community care (community psychiatric nurses, social workers and community health teams for the elderly), respite care and long-term care are offered to dementia patients.
Dementia can have a devastating effect – not just on the patient, but also on their family and close friends. It can cause arguments, and a strain on relationships as children (mostly daughters) are suddenly caring for parents, and in some families a ‘dumping’ syndrome, where the family “dumps” the elderly person at the A & E Department at the hospital and refuses to take them home again. It can also cause great financial strain as families may need to provide and pay for a carer or care home. There can also be a sense of bereavement experienced by people close to the dementia patient as the person slowly changes personality, and in some cases causing a change of lifestyle. This is particularly the case with pre-senile dementia, where a partner may feel they’re forced to become a carer before their time. These can all in turn have a detrimental effect on the mental health of those closest to the dementia patient, causing depression and anxiety.
Private Psychiatry offers treatment for the depression and anxiety often experienced by dementia patients and their families when coping with the effects of this life-changing illness. Private Psychiatry also provides assessment and treatment of dementia itself.
If you or someone close to you feels they need help in coming to terms with the effects of dementia, or if you have an elderly relative with dementia, who needs assessment and treatment, please get in touch to make an appointment.