The things no one tells you about Dementia…
As dementia becomes a more well known issue in our older generation there are still many aspects of this disease which are not often clearly expressed and explained to carers and family members. We all know the usual symptoms such as memory, confusion, judgement and understanding problems. However this has an effect on other aspects of the sufferer, issues such as incontinence, nutrition as well as skin irritation. We at Kerry Cares have seen many of these symptoms in clients, causing families and carers alike to be concerned and confused on how to manage these problems. Here are some of the most common issues….
Psychological
psychological problems can begin with personality shifts. This would include things like becomming withdrawn, irritable and suspicious of family, friends and carers. Other problems to look out for are depression, anxiety, apathy and mood swings. Much of these will depend on the day and are not ever present. Sleep disturbance is also generally high. Frequently waking in the night and sleeping more during the day are not uncommon.
Physical
As awareness and memory fades mobility will become a bigger issue. Stiffness and balance issues are not uncommon with falls becoming more likely with disease progression.
Eating and swallowing can become a bigger problem with disease progression with dysphagia not uncommon. These can lead to malnutrition as well as choking which can cause aspiration pneumonia. These are over an above the initial concern of forgetting to eat altogether.
Incontinence in bladder and bowel is more common in later stages of dementia, however they can begin earlier especially during the night.
A Vulnerable immune system is common, this can lead to increased infections especially UTI and chest infections.
Skin complaints
Dry and itchy skin in dementia is a very common occurrence. Skin aging naturally looses the natural oils and moisture, this is often aggravated in dementia sufferers. When awareness fades, it can lead to itching and picking which can cause skin infections. Another concern is skin ulcers and pressure ulcers, especially as daily movement reduces and the sufferer becomes less mobile. As aging skin bruises and tears more easily it is important to be aware of the potential for wounds to be worse with dementia sufferers.
How to help with psychological…
Some of our top tips with psychological changes are:
1. Always remain calm and patient – and yes we know this can be difficult. Tone of voice and body language are more important here. Try to be reassuring.
2. Avoid arguing or correcting the sufferer. Again providing as much reassurance as possible. Enter their reality and ask them simple questions about their feelings on the subject. Often feeling heard and validated can be reassurance enough.
3. Acknowledge and respond to emotions. Always listen to what is being said, acknowledge that you have heard and understood what is being said and respond with kindness and empathy.
4. Use clear understandable language. Try to keep communication clear and short.
5. Distraction and redirection. These are critical when you see the topic is causing distress. Very often to distract with another topic and redirect can ease the distress and calm the situation.
6. Maintain a consistent routine. The more routine there is for the sufferer the easier it is as the disease progresses. Changes are often not handled well. Try to stay to the same people at the same times.
7. Â Encourage physical activity. Â This can help with the boredom and frustration which often leads to the less desirable behaviours.Â
How to help with physical complaints…
Top tips for common physical complaints:
1. Integrate activity into the daily routine. Walking around the house and doing light housework are very good activities.
2. Ensure the environment is safe. Reduce tripping hazards, install grab rails and other mobility aids such as raised toilet seats and shower seats.
3. Use walking aids such as rollators and walkers.
4. Do not over assist. Try to encourage the sufferer to do as much for themselves as possible to maintain independence and muscle strength.
5. Ensure a calm environment while eating. Ensure the sufferer is sitting up right in a comfortable 90 degree chair while eating and for 30 minutes after eating.
6. For later stage dementia, offer small amounts of food and ensure the mouthful is completed before offering more.
7. Food texture can be adjusted should the need arise. Softer moist foods can make eating easier.
8. Offer a variety of finger foods for those who struggle with cutlery or who pace/wander.
9. Use herbs, spices and colour to make food appealing and palatable as dementia can affect taste and smell.
10. If coughing and choking during eating occur, it is always best to consult your GP. A speech therapist can assist and should this fail, food will need to be adjusted to through the IDDSI levels to find the consistency to maintain nutrition.
11. Ensure a ready supply of incontinence pants/pads is available. We recommend contacting the GP for a referral to the incontinence team of district nurses.
12. Maintain adequate hydration. Often lack of hydration can cause UTI and water infections which are dangerous in the elderly. Please speak to us about the Jelly drops if you feel these can help (click the link for more information).
13. Avoid bladder irritants such as tea, coffee and alcohol.
14. Ensure a high fibre diet with plenty of fresh fruit and vegetables. This helps reduce constipation which is a leading cause of bowel incontinence.
15. Encourage gentle exercise, this can help maintain healthy bowel movements.
16. By maintaining healthy nutrition, hydration and exercise, the immune system is in a better position to fight off infection, this is no different for dementia sufferers. Aided by hygiene in personal care, oral and environment infections can be reduced.
How to help the skin….
Our top tips for skin irritation:
1. Use gentle, fragrance free products for skin, maintaining an effective cleaning and moisturising regime can help.
2. Do not rub the skin with towels, always pat the skin dry to avoid irritation and damage.
3. Apply hypoallergenic fragrance free moisturiser to the affected area. It is advisable to do this while the skin is still damp to lock in moisture.
4. Ensure enough water is being drunk during the day. This helps keep the skin moisturised from within.
5. Ensure nails are kept short and clean to avoid causing infection. Soft cotton gloves can also help reduce damage caused by scratching and picking.
6. Wear loose fitting clothing made of natural fibres such as cotton to reduce irritation.
7. Keep an eye out for pressure ulcers, ensure incontinence pads are changed regularly with a barrier cream applied. Use pressure cushions to relieve pressure. Try to reposition every 2 hours in later stages to prevent the sores from beginning.
Please note : This is not medical advice and should your loved one be experiencing any of these it is always best to consult your GP first.
A special note from Kerry Cares…
We at Kerry Cares understand that dementia in any form is a frightening and confusing illness for any family to cope with. We have worked with a many people in this position. By sharing our knowledge and experience with you we hope to assist you in dealing with the terrible illness which is dementia. We have discovered that Dementia symptoms focused on by many are the cognitive decline with little being discussed around other issues which present themselves. Please do not hesitate to reach out should you be experiencing some of these issues and would like to discuss ways which we have found helpful in dealing with them.
We would also like to take this opportunity to invite anyone finding a family members dementia too much to cope with to reach out, sometimes giving yourself a few hours break a day can help maintain the well-being you need to cope. We have many packages and services which may help in this regard.
The link below will take you to the Alzheimer’s society page which is always full of useful information for sufferers, family, friends and carers.
The most important thing to let you know is :
You are not alone. There are people who care and want to help. Please reach out and share your burden.
Best wishes
Kerry Moran
Owner
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