Posted: 6/17/2019
Stress-busting strategies help families cope
Actress Bette Davis once said famously, “Old age is no place for sissies.” For millions of Americans and their family members dealing with Alzheimer’s disease or related types of dementia, truer words were never spoken.
During Brain Health Awareness Month in June, experts at Parkland Health & Hospital System say there are things you can do to lower your risk of developing dementia and there also are strategies to help families of dementia patients deal with this challenging situation.
“People with significant dementia can act and speak normally one moment and be disoriented or confused the next,” said Raja Paspula, MD, senior lead physician at Parkland’s Geriatrics and Senior Care Center. “It can be frustrating for families and caregivers because the disease makes people behave unpredictably. They no longer have proper judgment or impulse control so they can act inappropriately or even put themselves or others at risk of injury.”
According to the National Institutes of Health, people with dementia have significant problems in cognitive function – the ability to think, remember or reason – that interferes with normal activities and relationships. They may also lose their ability to solve problems and control their emotions, and sometimes may have personality changes and behavioral problems. Dementia is not a disease, but the general term for these symptoms.
Most dementia is caused by a neurodegenerative disease. The most common neurodegenerative conditions causing dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and other conditions. Alzheimer’s disease is the most common cause of dementia, accounting for approximately 70% of all cases.
An estimated 5.7 million Americans are living with dementia. The number is expected to grow exponentially, with projections that 13.9 million individuals aged 65 years or older will be diagnosed with Alzheimer’s disease or related dementias in the United States by 2060.
Dementia is a dreaded but not inevitable part of the aging process. Age and heredity are key risk factors that can’t be changed, but up to 35% of all dementias are caused by modifiable risk factors, according to the Alzheimer’s Association.
“A healthy lifestyle can significantly lower one’s risk for dementia,” Dr. Paspula said. “Smoking, hypertension, obesity, physical inactivity, diabetes and excessive alcohol consumption can all increase the odds of developing dementia. Taking care of your body is also good for your brain. If you eat a healthy diet, manage your stress and your weight, monitor your cholesterol and blood pressure, don’t smoke and get regular exercise, you can lower your risk for many serious diseases, including dementia.”
Helping caregivers and families deal with the disease can be complicated because often the patient lacks awareness that they have impairment.
“You can’t always convince your parent or loved one of the dementia symptoms you see,” said Chiffon Kinney, RN with Parkland’s Senor Outreach Services. “‘Dementia denial’ by the parent can make adult children hesitant to confront their parent to discuss important financial, legal or medical issues or to take steps to ensure their safety by taking away their car keys or removing guns from the home. In these cases, we often set up family conferences with the physician and the medical team to help the patient understand dementia and accept help from their caregiver.”
Kinney makes home visits to some Parkland patients with dementia to assess their living situation, including their ability to manage medications, perform daily living tasks and live safely at home. She also teaches dementia classes in Parkland clinics as well as one-to-one in the home for caregivers unable to come to a class.
“We advise families to focus on what they need to do to keep their parent healthy and safe. Learning about the disease can help families deal better with the frustrations and upsetting aspects of caring for their loved one,” she said.
Some dos and don’ts that Parkland experts recommend for dealing with dementia behavior:
• Aggressive actions or speech: remember that your loved one’s actions aren’t intentional. Many times these behaviors are triggered by physical discomfort, fear or being in an uncomfortable situation. Do try to identify the cause and then shift the focus, remaining calm. Don’t engage in an argument.
• Confusion about place or time: Do provide simple explanations and reminders and try to make them feel safe. Don’t get into lengthy explanations or debates.
• Poor judgment: Do assess the problem and offer encouragement or help. Don’t question the person’s ability to handle the matter or argue with them, which can make them angry or defensive.
Other tips that Kinney and Dr. Paspula say are effective:
• Ask your loved one about their preferences and take them into consideration
• Avoid power struggles
• Ask simple, direct questions they can easily answer
• Communicate assertively, not aggressively
• Evaluate your attitude – are you making things worse?
• Focus on the positives – encourage your parent to do what they are still able to do well
• Practice listening and pay attention to visual cues your loved one is giving you
• Be flexible and willing to compromise; try to solve disputes or problems creatively
• Be patient – with yourself and your loved one
For more information about services available at Parkland, visit www.parklandhospital.com