Dementia: Missing Puzzle Pieces

My grandmother went from being a dominant figure in the family to a silent shadow in a matter of few years. She had Alzheimer’s dementia, something that I would constantly be involved in during my practice. It is on the rise and so here is some helpful information for passing through life with dementia either in yourself or in a loved one.

What is Dementia?

It is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. There are many different types of dementia, but 60 to 80 percent of it is because of Alzheimer’s dementia. Here are the types of dementia:

- Alzheimer’s dementia: this is the most common, mostly we do not know the exact reasons, but there are genetic causes which means that this can be passed on from parent to child. 
- Vascular dementia: this is the second most common form of dementia and is caused by decreased blood supply to the brain 
- Lewy body dementia: this is a type of degenerative disease with some distinctive symptoms such as visual hallucinations 
- Frontotemporal dementias: these are a group of neuro degenerative dementias causing changes in social behavior, personality and aphasia
- Mixed: combination of two or more different types of dementia listed above

Some of the warning signs that maybe apparent earlier on are:
1. Memory loss that affects day to day life- for example- relying on memory aids, repeating questions, forgetting important things, such as names and telephone numbers
2. Planning or solving problems: this will cause issues with handling bills and finances 
3. Difficulty completing familiar tasks
4. Time or place confusion- getting lost or failing to keep appointments
5. Difficulty with vision and spatial judgements- this increases risks for falls 
6. Problems with words during speaking and writing 
7. Misplacing things
8. Judgement issues
9. Social withdrawal
10. Mood changes and personality changes

Most of these symptoms are noticed by family, but it is common to perceive in oneself.
Once you realize that there may be a problem, please contact your health care provider – we will do blood tests to rule out any reversible causes for memory loss such as thyroid issues or vitamin deficiencies, consider doing a brain imaging and also a possible referral to a neuropsychologist for an in-depth discussion on day to day functioning and assessment of cognitive status. Based on these if you do have dementia there are some medications that are available to slow the progression of disease. So it is important for early diagnosis and treatment. 

When it comes to dementia, avoid denial. Be open about the diagnosis and seek help early. A support system for the patient and caregiver is also very important. Building three circles: 1. immediate family and friends, 2. health care team, 3. social support structure that would give respite and time off for caregivers. So unlike other common diseases, dealing with dementia needs more insight into the condition, patience to tide through tough times and help, in whatever form available. 

Seek Resources 

Support is crucial when dealing with dementia in a loved one and there are many local resources and support networks to help:
1. The Alzheimer’s and related Dementia Support Group: This is for all those caring for those diagnosed with Alzheimer’s or related dementia and not for patients.  Group meetings are held on the 3rd Monday of each month from 4:30pm-6:00pm in the Fellowship Hall at the First Lutheran Church located at 3600 25th St. in Columbus. The group is led by Mary Ellen Wyman, Executive Director of a former Alzheimer’s Association Chapter. 
2. The Alzheimer’s Association which is a national agency with a 24 x7 helpline – 800-272-3900. The website, alz.org offers a lot of information about the condition, resources and free online caregiver education programs.
3. Just Friends, the Adult Day Care at the Mill Race Center- open Monday to Friday, charges based on a sliding, income based scale. They provide activity based care for early to mid-stage dementia who are not in need of constant one-on-one assistance. 
4. Nursing facilities that offer short term stay for respite care 

Dementia is a progressive disease with challenges for the entire family. It changes a lot of what you could do and places restrictions on this every day. The more we understand the disease, the better care we can offer to those afflicted with it. It is a new way of life that we have to adopt and accept. With acceptance, there will be new possibilities and with new possibilities, hope! 

Ramasundaram_Sivagama_2015





 Dr. Sivagama Valli Ramasundaram, MD, FACP, is a internal medicine doctor at CRH Family and Internal Medicine.

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