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Dementia

Dementia is a decline in mental ability which affects memory, thinking, problem-solving, concentration and perception. 

Dementia occurs as a result of the death of brain cells or damage in parts of the brain that deal with our thought processes.

 

 

What is dementia?

 

Dementia is a decline in mental ability which affects memory, thinking, problem-solving, concentration and perception.   Some forms of dementia, such as Alzheimer's disease, are degenerative i.e. they get worse over time.  Other forms of dementia, such as vascular dementia, may be non-degenerative i.e. they may not get worse over time.

 

People with dementia can become confused, leading to restless or repetitive behaviour, which can be very distressing for everyone concerned. They may also seem irritable, tearful or agitated.  They may also develop other problems such as depression, disturbed sleep, aggression, inappropriate sexual behaviour and incontinence.

 

Dementia is almost invariably a disease of ageing.  About 1 in 20 people over the age of  65 are affected, and 1 in 5 people over the age of  80.   Dementia in people under 65 is known as early onset or pre-senile dementia and is rare, affecting under 1 in 1000.

 

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What causes dementia?

 

Dementia occurs as a result of the death of brain cells or damage in parts of the brain that deal with our thought processes. This may follow other problems like:

 

  • lack of blood/oxygen supply to these brain areas

  • head injury e.g. from boxing or whip lash after a car crash

  • pressure on the brain e.g. from a tumour

  • hydrocephalus (fluid build-up between the brain and the brain lining)

  • neurological disease e.g. Parkinson's disease, Creutzfeld Jakob disease (CJD)

  • infection e.g. AIDS

  • vitamin deficiency

  • a long period of excessive alcohol intake

 

The most common form of dementia is Alzheimer's disease. We do not know what causes Alzheimer's disease but we do know that ageing seems to be a factor. The second most common type of dementia is vascular or multi-infarct dementia. This occurs as a result of lack of blood and oxygen to the brain in a series of tiny 'strokes'.

 

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Is there a cure?

 

Unfortunately, most types of dementia cannot be cured. The exceptions are those dementias related to vitamin deficiency (which can be treated with supplements) and head injury (which can be treated through surgery).

 

Anti-dementia drugs, such as Aricept and Reminyl,  may be given to alleviate the symptoms of dementia but they cannot cure it.  Medical researchers are currently looking at other medical treatments including anti-oxidants, brain stem cell therapy and a vaccination to stop the build up of plaques in the brain (a hallmark of Alzheimer's disease).

 

Alternative therapies i.e. non-medical interventions such as music therapy, aromatherapy and reminiscence therapy can be of benefit too.

 

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Can dementia be prevented?

 

There are no guaranteed ways of preventing dementia, but you may find it helpful to follow a sensible diet and pursue a healthy lifestyle. Regular physical exercise and supplements like Gingko Biloba can help to ensure that there is always a good supply of blood to the brain.  Please consult your GP before taking such medication. You can also help yourself by keeping your mind active, for example by doing crosswords or puzzles.

 

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Help for carers

 

If you are looking after someone with dementia you may be entitled to specialist help. You can find out details of local support services from your local council or GP or from the nearest Citizen's Advice Bureau. 

  

Social services are responsible for providing a range of help but the help you actually get will depend on your personal circumstances.  Some social services provide more help than others and you may have to pay for some of the services such as home helps or meals-on-wheels. Local authorities do not have a legal obligation to provide care at home if this would cost more than residential or nursing care.

 

If you are out during the day you may want to think about using a day centre.   These provide care and activities (such as reminiscence therapy) for people with dementia.  They are run by local health authorities, social services, voluntary organisations and some nursing and residential homes. Transport to them is often provided. 

  

You may also need to consider residential or nursing care for the person you are looking after. As a carer you are not immune from illness or accidents and you need to plan for the future. 

 

Residential homes provide meals and activities and help residents with washing, dressing, baths etc. However, people with dementia who also have physical problems or whose behaviour cannot be managed by non-professional staff will need the care offered in a nursing home.  How much you pay for residential care will depend on your situation and varies from area to area.

 

You also need to think about your own needs.  Looking after someone with dementia can be emotionally and physically exhausting, especially if you are on your own.  You will need practical and emotional support for yourself as well as regular breaks and holidays.  You may want to think about respite care, when the person you care for goes to stay in a hospital or care home for a short while, perhaps a few days or weeks. Alternatively you may be able to arrange for an alternative carer to come and stay in your house while you are away.

 

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Written in 2000

 

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