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As dementia progresses, some patients exhibit seemingly childish behaviours such as mood swings, tantrums, irrationality, forgetfulness and vocabulary problems which are similar to behaviours seen in young children.
Such regression takes place because the brain cells of dementia patients are damaged to the extent that it interferes with the cells’ ability to communicate with each other. When brain cells cannot communicate normally – a person’s thinking, behaviour and feelings may be affected.
For example, the brain starts to forget the things they have learned and has trouble arranging information in the right order. Patients may also forget what they’ve just said, where they put something and get confused when they do tasks with many steps. Some dementia patients will also lose interest in activities they used to enjoy.
As dementia affects more of the brain, patients start to become even more forgetful – such as not recognizing objects or having trouble with steps to complete a task. What was once easy has become challenging, causing them to feel frustrated and depressed.
Eventually, they may forget all that they have learned over their lifetime. They may face challenges doing everyday tasks such as getting dressed, washing, eating or going to the toilet. They may not know where they are, get lost easily and cannot keep themselves safe. These dementia patients will need a lot more help and support from their family members – just like when they were children.
READ ALSO: Does Dementia Run In Families?
Stages Of Dementia
1. No Dementia
Before dementia manifests itself in the way an individual behaves, there may be changes already taking place in the brain for several years. When symptoms of forgetfulness first develop, it may be so subtle that it goes unnoticed by patients and those around them. At this stage, patients simply appear to be mildly forgetful of where familiar objects are placed or the names of familiar people, and , it can be challenging to distinguish this from normal age-related mental deterioration.
When degeneration of the brain progresses , patients develop “mild cognitive decline”. At this point, friends and family begin to notice that something does not feel “quite right” with them. Patients with mild cognitive decline are more forgetful and may have accompanying symptoms of poor concentration concentrate, poor work performance, verbal repetition, a tendency to get lost more frequently and difficulty finding words to express themselves. This stage, which can last anywhere from two to seven years, is the window during which caregivers need to pay close attention in order to pick up the subtle signs of cognitive decline. Early identification and evaluatino by a doctor will allow them to receive early intervention.
2. Early-Stage Dementia
Patients at this stage suffer from moderate cognitive decline with signs and symptoms of dementia becoming more obvious. They have more problems with making plans and remembering recent events (e.g. such as what they ate earlier) . These patients may also have difficulty handling money and getting around on their own.
3. Mid-Stage Dementia
At this stage of dementia, patients suffer from severe cognitive decline and the symptoms are obvious and easily identifiable. These dementia patients can no longer perform the basic activities of daily living independently and will need some assistance . They have more significant memory deficiencies – confusing times and days and are unable to recall important details such as telephone numbers and addresses. However, they usually recognize family and friends and remember events from years ago, especially their childhood with greater clarity.
As dementia deteriorates throughout this stage, patients may even lose the ability to communicate. They may become even more dependent on others to help them with their activities of daily living such as feeding, washing, dressing and toileting. For this reason, they usually require constant supervision from loved ones at home. In addition, patients may go through mental and personality changes; they may become easily anxious or agitation, or manifest delusional or obsessive behaviours. These are not not only stressful for their caregivers but can also result in behaviours that are dangerous to themselves or those around them.
4. Late Stage Dementia
In this final stage, patients’ physical and cognitive abilities will have diminished further, resulting in them round-the-clock care and the support of professional carers. They spend most of their time in bed and may no longer be able to speak or communicate. Caregivers must provide comfort and improve the patient’s quality of life.
READ ALSO: Supporting The Caregiver
Factors affecting decline
As dementia progresses, it worsens over time. However, the speed of deterioration differs from person to person. It is impossible to predict how quickly a person’s dementia will progress as dementia progression rates vary greatly from person to person due to factors such as:
- Type of dementia – Alzheimer’s disease, which is a form of dementia, tends to progress more slowly than the other types.
- Age – Alzheimer’s disease generally progresses more slowly in older people over 65 than in younger people. Young-onset dementia tends to progress more rapidly.
- Health risks – Dementia progresses more quickly if the patient has other conditions, such as heart disease, diabetes or high blood pressure which are not well-managed.
Most forms of dementia usually progress slowly and gradually and patients stay independent for several years. Rapidly progressive dementias, a form of dementia that progresses quickly over weeks or months, are less common.
It’s hard for family members to watch their loved ones revert to becoming child-like but dementia patients need our understanding, respect and tender loving care even more as they walk through this challenging journey.
For more information about St Luke's Hospital - Dementia Care, click here to learn more.
St Luke’s Hospital has recently launched an interactive film to raise awareness on the challenges and care available for persons living with dementia and their caregivers.
Click here to watch the film.
Reference: https://www.health.harvard.edu/blog/sleep-well-and-reduce-your-risk-of-dementia-and-death-2021050322508
