What is dementia?
Dementia is an umbrella term used to define a broad range of brain diseases that affect a person’s ability to think and remember. These diseases may also affect a person’s use of language and their ability to function as before. Emotional and social difficulties are also common in those with dementia. All types of dementia are progressive, so they will worsen over time.
The most common type of dementia is Alzheimer’s disease, which makes up 50-70% of dementia cases. Vascular dementia makes up 25% of cases and dementia with Lewy bodies 15%.
Dementia usually affects people aged 65 and over. When dementia occurs in people younger than 65, this is known as early onset dementia. Dementia can’t be cured, however if it is detected early there is treatment available to slow down the progress of the disease and extend the period of usual mental function.
It is estimated that there will be one million people with dementia in the UK by 2025. There are 670,000 people in the UK who act as carers for people with dementia.
Symptoms of dementia:
The symptoms of dementia vary across individuals. A person with dementia will usually have difficulty with some or all of the following:
- Memory: long and short-term memory may be affected
- Thinking: difficulty with problem solving or reduced ability to find the correct words
- Balance and spatial awareness
- Speech and language
- Behavioural and psychological problems such as depression, anxiety, anger
- Orientation: losing track of the time or day, being confused as to where they are
Dementia and mental health
Approximately 30% of those with dementia have depression, with 15% experiencing anxiety. A diagnosis of dementia can be shocking and scary. The nature of dementia means that a person’s condition will deteriorate over time, and continually having to come to terms with this progress as your ability to do things or remember things declines can be immensely upsetting and stressful.
Living with dementia might also be isolating and often, especially if there is a lack of an emotional support network, a person with dementia may feel very lonely and lost.
Dementia may also bring about personality changes, such as becoming quick to anger or, conversely, becoming highly apathetic. These personality changes can be difficult for the person with dementia to understand and can also cause problems within their relationships.
The Stages of Dementia
Mild cognitive impairment
The earliest stage of dementia is called Mild Cognitive Impairment. A person with MCI may have some difficulty with remembering things and finding words, but in general their daily life is not affected. These warning signs often go unremarked and people only realise there were signs and symptoms of dementia when they look back.
A person can have MCI without it meaning that they are bound to get dementia. MCI can also occur as a result of psychological problems, certain physical illnesses or as the side effect to certain medications.
In the early stages of dementia, the person will be exhibiting symptoms that are noticeable to those around them. How these symptoms manifest will depend on the person and the type of dementia they have. They may have difficulty remembering to do chores around the house, such as the laundry, or have trouble finding the right words to describe things. Other signs may include repeating things, getting lost or confused, and becoming socially withdrawn.
In Alzheimer’s the predominant symptom in the early stages is memory difficulty. This may affect short and long term memory and the ability to find words. In other types of dementia, like dementia with Lewy bodies and frontotemporal dementia, personality changes and difficulty organising tasks might be amongst the first signs and symptoms.
Generally in the middle stages, the symptoms that were revealed in the early stages tend to worsen. The rate of decline will vary for each individual. Often a person with middle stages of dementia will require assistance with daily living.
A person with late stage dementia likely needs 24-hour supervision, to ensure their personal safety. With late stage dementia, a person is at risk of no longer being aware of everyday dangers, such as a hot stove, or checking for cars when they cross the road. They may also not be able to address their daily needs, such as the need to eat, go to the bathroom, sleep.
What benefits a person with dementia?
Staying as active as possible is important for a person with dementia: mentally, physically and socially. A person’s need for these activities and the sense of self-worth they bring does not disappear when they get dementia. Consider trying activities that include reminiscing or storytelling to boost wellbeing. Cognitive rehabilitation can help maintain a person’s mental functioning and improve their confidence.
Trying to keep up with hobbies and the things a person enjoyed before developing dementia is a good idea. Listening to music, painting, dancing, being mindful of sights and smells; the senses don't necessarily fail, even when cognitive function is weakened.
There is also much that can be done around the house to help someone with dementia continue to live as independently as possible.
Living independently with dementia
It is good to keep living independently for as long as possible, and many people with dementia succeed in living at home. It is important to acknowledge the progressive nature of dementia and accept that support will be needed from outside. Friends, family and health professionals can help with daily tasks.
A person with dementia’s home may also need to be adapted to suit their new needs and to ensure their continued mobility and safety.
Assistive technology is available to people with dementia. This might include things like daily living aids, which help people with tasks such as eating and drinking, and telecare options, such as sensors and detectors that send an automatic signal to a carer.
How can counselling or therapy help a person with dementia?
Therapy and counselling could help alleviate the symptoms of depression, anxiety, stress and emotional instability that may be part of someone’s journey with dementia. Counselling provides a space where the person with dementia can talk openly about their fears and confusion without being worried about being judged. Being able to speak about your life makes life easier to deal with, in any situation. For a person living with dementia, counselling or therapy can help them come to terms with their diagnosis and how the future looks for them.
Therapy or counselling is well suited to people with dementia, as the focus is on the individual, on their experience and story. This is important as each person with dementia experiences the disease differently. As dementia is in many ways an intensely personal disease, affecting your memories, ability to communicate and independence, it can be intensely beneficial for a person with dementia to have a space in which they can focus on themselves as an individual.
Counselling and therapy can also be an immense support for those who are acting as a carer for a loved one with dementia. You can find out more about the impact of being a carer and how counselling can help here.
Last updated on 17 March 2016