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Dementia Issues

Conditions that Affect Thinking and Memory

An all too common complication of individual and relational lives is a family member’s stroke, traumatic brain injury, or diagnosis of Alzheimer’s or other dementia, such as

New guidelines for mental health professionals encourage use of an overall term of “neurocognitive disorder” to include all the different types of dementia, as well as traumatic brain injury (TBI).

Getting to a diagnosis is important for at least two reasons. First, the process of diagnosing will uncover any disorder that is treatable. Assuming the worst sometimes results in failing to pursue vigorously a process that may lead to improvement. Second, knowing the type of neurocognitive disorder can provide clues to the aspects and speed of progression that will need to be tended to.

Seeking a diagnosis must be accomplished through a physician, most effectively with a neurologist, although there are other medical professionals who specialize in work with neurocognitive disorders. You will want to work with someone who focuses on these types of conditions. At LifeSeasons, diagnosis is not possible. However, a simple prescreening can indicate whether referral to a doctor is appropriate to your concerns.

Old age problemsThe Progression
While a diagnosis can give the person with the diagnosis and others some sense of what cognitive and physical symptoms may be coming, predicting the impact on the life of the person with dementia is impossible. As the late Dr. Wayne Caron used to say, “When you’ve seen one person with dementia, you’ve seen one person with dementia.”

We need to recognize that, despite a specific diagnosis, each person, each progression, and each response combine to create a unique path for the person and his or her caregiver and family members. The unpredictability is a challenge, while the certainty of progression is painful. At the same time, tools are available to help track the decline and to help caregivers and family members assure the right level and types of support and care are available.

There are ways to

Recent research shows, for instance, that the brain changes associated with Alzheimer’s lead to a brain structure that is more attuned to emotional cues. This supports a sometimes-undetected and –untapped emotional life for people who have different cognitive functions than before.

Taking care of elderly womenComplications
The prior relationship between the person with dementia and the others in his or her life also has an impact on how things will go. How the relationship changes with the advance of the disease often depends on many unpredictable aspects of dementia, the person’s personality, the primary caregiver, and family members. Society doesn’t help much, with its existing assumptions about

Even in the face of this aspiration for change about attitudes toward dementia, the fact of the matter is that having one of these issues in your life is more difficult than someone without the experience is likely to imagine.

For the person with a neurocognitive disorder, whether major or mild—and including TBI, there are questions like:

For the caregiver, there are questions like:Confusion

For everyone involved, the key question is

Therapy, counseling, and support can include direct work with the person with dementia, with caregivers, and with the family. Often the most critical person to support through counseling, particularly as changes progress, is the caregiver. Sometimes, though, the care-partners (spouses, parent-child) come to sessions together; sometimes it’s a more complicated set such as a spouse caregiver and his or her son or daughter, who are playing the crucial support role for the caregiver. Sometimes the people who come to the sessions depend on what aspect of a very complicated situation needs attention at a particular time.

Despite who is in the room, a healing, whole-person, whole-family model promotes thriving, a new intimacy, new-found cooperation, and avenues for connection and peace.

Judy’s  clinical experience and competence  with neurocognitive disorders was invigorated by her mentor, the late Dr. Wayne Caron of the University of Minnesota. She has 14 years direct experience with people with Alzheimer’s and other forms of dementia, their caregivers and family members. In addition, she’s seen the variety of situations, relationships, and progressions that lets her tailor tools and treatments to the specific needs and abilities of different people with dementia, caregivers, and families. The desired outcome often depends on a mix of the goals and roles of many people.

Dementia Support and Therapy Groups
When appropriate and when enough people are available to form a support and counseling group, Judy will call together a workgroup that includes people from different families.

Mother and DaughterCaring for Father

Recommended books

Still Alice

A novel that depicts what it’s like for a person with dementia as the disease progresses, this book fosters an understanding that people with the disease still feel like themselves, even as they recognize some of their changes.

Caregiver’s Bible: Managing Behavior Problems in the Elderly

Guidelines for interacting with someone with dementia in ways that do not stimulate problem behaviors and understanding the sources of specific problems and unsafe reactions.

36-Hour Day: A Family Guide to Caring for People who have Alzheimer Disease, Related Dementias, and Memory Loss

Widely-read how-to for realistic coping with day-to-day challenges of Alzheimer’s or other cognitive dysfunction.

The Moral Challenge of Alzheimer Disease: Ethical Issues from Diagnosis to Dying

Provides facts about the progression of the disease as well as suggestions for how to proceed humanely in complicated decisions about quality of life and capacity to make choices.

Dementia Reconsidered: The Person Comes First

Based on research observations of how people with dementia are treated, this book identifies unhelpful ways to interact as well as behaviors that support dignity, happiness, and a sense of connection for the person with the diagnosis. Truly a hallmark of the person-centered care movement.