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Posted: Monday, January 20, 2020

Discussing Dementia

Recently, many of us traveled to visit family members for the holidays. In some cases, that meant seeing older relatives we don’t get to see as often as we’d like. And if you noticed some differences in their behavior or cognitive abilities, it may be time to consider having an important discussion. Dementia is a progressive illness that impacts millions of families nationwide, affecting everything from memory to language to the ability to perform routine tasks. It cannot be reversed and tends to only get worse, meaning that over time, patients with dementia may lose the ability to take care of themselves. This makes assistance from family members more important than ever before, which is why it is so important for families to not only be educated about dementia, but also to know what to do after a dementia diagnosis.

“Dementia has touched all families in some form or another,” said Dr. Kevin James with Blount Senior Care Partners. “In many cases, families already know how severe and life-changing a dementia diagnosis will be, but not all families have had the necessary education to be prepared for the amount of time and effort a dementia patient requires. For example, while there are many different causes of dementia, Alzheimer’s happens to be the most common cause. Often, patients or their family members will express how glad they are to be diagnosed with dementia and not Alzheimer’s, when in fact Alzheimer’s leads to a loss of brain cells that then leads to dementia,” he explained. “This tells me that I have work to do on the education front to help patients and family members understand what they’re up against. I find people are starved for information and answers, so even though I often end up giving them devastating news, they are very appreciative to learn more,” he added.

“I try to be as honest as I can with people when I diagnose them with dementia,” James said. “Very often by the time people see me, they have known something was wrong with their loved one for quite a while, so I’m simply confirming those suspicions and giving them a name. Initially, dementia patients will need more assistance with complex tasks, such as paying bills, driving, shopping, cooking and administering their own medications. As the disease progresses, though, they need assistance with more basic tasks, such as dressing, using the bathroom and bathing. Ultimately, this can progress to them needing help with all types of self-care, including feeding themselves. Sometimes, in severe cases, patients lose the ability to communicate meaningfully and require 24/7 care,” he explained. “Medicines can be important and even helpful, but they are not the most important part of treating dementia, in my opinion. The medicines available do not stop the illness and do not prolong survival. We have growing evidence that a healthy diet and consistent physical activity actually can slow the progression of dementia,” he added.

“It’s important to know that, while dementia is common, is not a normal part of aging,” James continued. “If you feel your loved one may be experiencing dementia, talk to your family physician. With mild dementia, patients very often do not show any symptoms during routine office visits, and primary care physicians will not know to dig deeper unless they get information from a family member,” he said. “The average life expectancy following a dementia diagnosis is four to eight years, though some patients can live as long as 20 years. Still, it is a terminal disease, and I’m always upfront with patients about that. I think it is vital that they understand the nature of the illness so that they and their families can assess how they wish to approach the years ahead. The focus often becomes quality of life rather than quantity of life,” he added.

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