Once the early part of dementia sets in, we start to see signs of depression. Sometimes patients will have paranoia and they won’t have a big appetite, which can obviously affect their body. Their ability to keep up with grooming and hygiene slowly declines, and they may even forget to take their medications.
Dementia
Dementia refers to loss of cognitive function that affects memory along with the ability to think, solve problems and control emotions. Dementia itself is not a disease, but describes a group of symptoms caused by a brain disorder. There are numerous causes of dementia, including Alzheimer's disease, Huntingdon's disease and stroke. Since personality changes are common, living with dementia can be difficult for patients and caregivers alike. Learn more about dementia challenges and solutions with expert advice from Sharecare.
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In people with dementia, other mental health conditions, such as post-traumatic stress disorder (PTSD), that are not adequately treated can lead to social withdrawal, loss of appetite and depression. Depression in itself can cause a wasting away if it is untreated. People with depression can experience the following neurovegetative (involuntary) signs of depression: they don’t want to eat, they’re not sleeping terribly well or they’re sleeping all the time, they are refusing to interact and are becoming deconditioned (losing physical fitness).
It’s very important to have a consultation with a geriatric psychiatrist who can effectively tease out how much the untreated PTSD, for example, is leading to depression, withdrawal, disengagement or loss of appetite versus the dementia, which in itself in the end stages can be the cause. -
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UCLA Health answeredThere’s an increased risk of death for dementia caregivers. One study found that it was increased as much as 63% over the course of four years, particularly in caregivers reporting strain and stress pertaining to their caregiving experiences. Interestingly, though, this risk of death was not increased in caregivers who did not report strain.
Some caregivers were able to manage their role for whatever reason -- perhaps their relative was not sick, perhaps the caregivers had a higher innate resilience, or perhaps they learned skills that helped them to cope. If they did not report that they experienced subjective strain from their caregiving role, then they were not at an increased risk of death.
Clinically speaking, we often observed that the caregiver dies before his or her relative with dementia. This may be due to the increased stress on the caregiver. Whereas the care recipient doesn’t know what’s going on a lot of the time, the caregivers are acutely aware of the ins and outs, and are responsible for managing them. That does take a toll. -
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One of the first things you can do if you think a loved one with dementia is not driving safely is to actually observe him or her driving. The next step is to have conversations about his or her driving. Then, over time, one can strike up longer and more serious conversations.
You may have to actually address him or her when a time comes when he or she cannot drive safely. The idea is to have this conversation earlier rather than later. This is a process, and it’s important to begin early. Start with a small conversation, and work your way up to a more heartfelt conversation. Share your concerns with your loved ones, and be frank. For example, “I’m worried about how you merged onto the freeway -- I am concerned that you could get into an accident.”
When discussion fails or in situations where driving must stop immediately, one can take the keys away, disable or sell the vehicle or remove the vehicle from the premises. If the car is removed, some caregivers will explain that the car is in the repair shop (and it stays there essentially indefinitely). Because literally taking keys away can be upsetting. Another approach is to replace the working keys with a set of imposter keys. -
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If a person with dementia doesn't want children around, it's better not to force the issue. What happens frequently with dementia or Alzheimer’s disease -- a form of dementia -- is that is a lot of censoring functions that people have, or the kinds of things that keep them steady and even, tend to go away. Therefore, they may suddenly not enjoy children anymore. In this situation, shorter visits, so the kids aren’t there that long, are better. The person with dementia may simply not enjoy the same dose of children any longer. -
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Dementia is a disease of aging. Very few people who are younger than 65 develop dementia. Almost half the senior population older than 85 has dementia.
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In people with dementia or cognitive impairment and older adults who may be more frail, zolpidem (Ambien), a sleep medication, can be fairly dangerous in terms of increasing the risk for confusion and falls.
Zolpidem is a sedative hypnotic related to benzodiazepines and has a similar method of action. However, it does not have as much of a potential for abuse and is frequently used as a safer alternative. Doctors tend to stay away from it as a first-line treatment for individuals with dementia who are having sleep disturbances. -
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A person may be diagnosed with dementia early in the course of the disease, and it may be up to ten years before he or she succumbs to it. There are a couple of milestones that indicate a person with dementia is approaching the end of life. The first is becoming non-ambulatory -- when people with dementia stop walking. The other is when they stop eating.