How to Understand & Manage Dementia Symptoms

Dementia is a multifaceted neurological disorder that affects millions of people worldwide. Dementia is found in almost 10 percent of U.S. adults ages 65 and older, and the rate climbs to 35% for people in their 90s. The most prevalent subtype of dementia is Alzheimer’s disease, which affects more than 6 million Americans; which costs the United States approximately $345 billion each year.

Dementia presents a range of symptoms, each of which evolves as the condition progresses. Regardless of your role in a dementia patient’s life, it’s extremely important to understanding these symptoms for early detection, intervention, and compassionate caregiving. Read on to learn more about the 9 common symptoms and how to help.

Memory Loss

Memory loss is often the most recognizable symptom of dementia and Alzheimer’s disease. Individuals may forget recent conversations, appointments or other important events. As this occurs, you may notice them repeatedly asking the same questions. In the early stages, they may struggle to recall names or familiar places, progressively losing the ability to form new memories.

How to Help with Memory Loss: 

• Use pictures and written descriptions to help maintain records of recent events and conversations. Encourage individuals with early memory loss to use a diary, journal or calendar to record moments of their life, which they can refer to later.
• Give simple answers to questions and patiently repeat yourself if needed. It isn’t helpful to explain that you’ve repeated yourself, nor if they’ve heard the information already.
• Give context to your questions in case they can’t remember what they’ve already done. For example, it would be better to say, “It must be a while since you ate lunch, are you hungry?” instead of “Have you had lunch today?”

Disorientation and Confusion

People with dementia frequently experience disorientation, which occurs when someone is confused about the time, where they are, or even who they are. They may forget the current date, season, mumble, and show an inability to focus their attention. This symptom can lead to confusion, anxiety and agitation, thus making daily activities challenging.

How to Help with Disorientation:

• Choose your words and expressions carefully. It may be difficult for disoriented dementia patients to understand terms like “half an hour” or “noon,” so work on changing how you address time or use a physical clock to point at time.
  
• Link reminders to emotional content, such as this month being “the one after your birthday.” Using emotionally relevant cues will help individuals remain oriented about time and places.

Impaired Judgment and Decision Making

Dementia can impair a person's judgment and decision-making abilities. They may make poor financial choices, exhibit risky behavior, or neglect personal hygiene. These changes can have significant consequences for their safety and well-being.

How to Help with Impaired Judgment:

• Reinforce positive behavior such as giving praise, rewards, and using stickers as reminders.
  
• Review current prescriptions and consider new medications. Several prescription drugs are approved by the FDA for Alzheimer’s and dementia. Consult with a doctor to determine the best course of action this symptom.

Language Difficulties

Language problems are prevalent in dementia, especially when trying to find the right words to express what to say. People may repeat themselves in conversation or have difficulty following and understanding complex instructions. These kind of communication challenges can eventually lead to frustration and isolation.

How to Help with Language Difficulties:

• Relax and minimize background noise when communicating. Dementia patients can find it difficult to concentrate in any environment, especially if there is a lot of background noise. Remember to ask permission to quiet something, if you are communicating with someone in their home.
  
• Identify the emotional state of the response when you speak to them. This will help you navigate around conversation topics.

Personality and Behavior Changes

Dementia can cause noticeable shifts in personality and behavior. Individuals may become more irritable, anxious, or apathetic. They may lose interest in hobbies or activities they once enjoyed, making it difficult for loved ones to connect with them emotionally. They may become easily frustrated, lash out verbally or physically, or exhibit restlessness. Identifying and managing these behaviors is essential for caregiver and patient safety.

How to Help with Personality Changes: 

• Create a daily routine that is structured and predictable. Routine is an important source of comfort for dementia patients.
  
• Speak calmly and be reassuring by listening to their concerns and frustrations. Validate their feelings to help them know you both heard and understand them.
  
• Keep photographs and objects nearby that the person loves, which will also help them feel more secure.

Inability to Recognize Familiar Faces

A striking symptom of dementia is the inability to recognize familiar faces, including those of close family members. This can lead to feelings of isolation and distress, as well as strained relationships with loved ones.

How to Help with Facial Recognition: 

• Be vocal and use visual clues. Being vocal is helpful for dementia patients because your voice is familiar to them.
• Don’t begin a conversation with a question, because this will often immediately raise anxiety and levels of confusion. Instead, begin with, “Hi, my name is Andrew. I am your husband."

Difficulty with Coordination and Motor Skills

As dementia progresses, individuals may experience motor skill impairments. Simple tasks like dressing, eating, or using utensils become increasingly challenging. This loss of independence can be emotionally distressing. 

How to Help with Motor Skills:

• Perform relaxation techniques, such as yoga or meditation, which teach better posture and movement.
  
• Prioritize tasks they have to do first, or finish one task before starting another. This helps keep dementia patients on track with projects, no matter small or big.

Wandering

Wandering is a common behavior in dementia, especially during the middle and late stages. Individuals may wander aimlessly and get lost, posing safety risks. Caregivers often employ strategies to prevent wandering, such as locking doors or using tracking devices.

How to Help with Wandering:

• Identify the time of day the wandering occurs. Plan things to do during this time (such as activities or exercises) to help reduce anxiety, agitation and restlessness.
• Reassure them if they feel lost or abandoned. Let them know you are there.

Caregivers, healthcare professionals, and loved ones must approach dementia with patience and a commitment to maintaining the individual's dignity and quality of life. Strategies such as cognitive stimulation, medication management, and creating a supportive environment can make a significant difference in the well-being of those living with dementia.

Continued research and advancements in dementia care offer hope for better treatments and interventions in the future. Until then, raising awareness and fostering a compassionate understanding of dementia is vital in addressing the challenges faced by individuals and their families on this difficult journey.

Hallucinations and Delusions

In some cases, dementia can lead to hallucinations (seeing or hearing things that aren't there) and delusions (false beliefs). These experiences can be frightening and disorienting for individuals with dementia and require careful management.

How to Help with Hallucinations:

• Avoid arguing with the dementia patient about what they see or hear. Maintain eye contact and nod your head slightly to let them know you accept them. Comfort them if they are afraid.
  
  
• Distract the person, such as moving to another room or going outside for a walk.

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