When there is an elderly person in the family with senile dementia, it is quite understandable for relatives to want to know how long they live with such a diagnosis, what organs and systems of the body are affected by this disease, how to deal with it and whether it is possible to prolong life.
Timely measures taken will help not only prolong life, but also make it of the highest quality possible.
What kind of disease is this?
Dementia is a pathology characterized by changes in the cognitive sphere.
The disease occurs with deterioration in perception, memory and thinking, as well as behavioral disorders (loss of the ability to take care of oneself, take care of one’s life and health, etc.).
Dementia is a progressive disease that often leads to disability. What should relatives do if one of their family members has been diagnosed with this disease?
Carry out care yourself or place the patient in a specialized institution?
These are questions of ethics , financial status and the ability to stay with the patient around the clock.
By choosing a boarding house for elderly people with dementia, relatives will provide them with qualified care and appropriate treatment. You can take care of such patients at home, periodically visiting doctors and undergoing examinations.
Although dementia most often affects older people and affects about 5 million people worldwide, it is not a result of natural aging. This is a pathology that needs treatment. The disease completely disappears in very rare cases, but it is possible to slow down its development by using complex measures - combining the advantages of pharmacological agents and psychotherapy.
Organization of the life of a person with insanity
Dementia (dementia) is the loss of previously acquired skills and abilities by a person, and the inability to acquire new ones. The disease is a consequence of disorders of the cardiovascular and nervous systems.
According to statistics, every third elderly person on Earth suffers from this disease.
At the initial stage, the patient does not lose everyday skills and can live independently. In the later stages, the patient becomes completely asocial: he cannot eat, wash, or dress himself.
It becomes difficult for relatives to be side by side with such a patient.
Unfortunately, the process is irreversible. Relatives will have to accept that the patient’s condition will only worsen.
If loved ones do not have financial or housing problems, this greatly facilitates caring for the patient. Otherwise, the situation becomes catastrophic.
What should relatives do if their loved one is diagnosed with senile dementia? First of all, it is necessary to choose the right tactics of behavior and organize the life of a sick person in order to alleviate his condition and not become depressed.
Arrangement of living space
As long as a person is able to take care of himself, he can be left alone. At the same time, it is necessary to ensure the most comfortable and safe living conditions:
- Remove all dangerous electrical appliances, close sockets, and turn off the gas.
- Arrange furniture so that there is free space for movement. Patients often lose orientation in space and may fall. Therefore, the risk of falls should be minimized.
- Place necessary things in easily accessible places, and place household items wisely.
- Purchase anti-slip bath mats, corner covers and other means to organize a safe home.
- Remove medications from the house so that a person who is not aware of his actions cannot cause irreparable harm to himself.
Nutrition, daily routine
The patient should always have enough food and dishes ready to eat.
A person can no longer prepare food on his own, but can warm it up in the microwave, so food must be placed in containers in advance so that it can be easily heated.
Pre-cut bread, cheese, and vegetables so that the elderly person does not have to use a knife. Buy unbreakable dishes.
A daily routine will help make patient care easier. It is necessary to teach the patient to go to bed, eat and walk at the same time.
Social adaptation
Often relatives try to limit the patient’s communication with other people by locking him at home. It is not right. At the initial stage, such patients can still communicate, this helps them postpone the severe stage of the disease.
Patients need to walk in the fresh air and do as much physical exercise as possible. If possible, they should attend clubs and clubs for the elderly.
This has a positive effect on their psycho-emotional state and prevents insomnia.
Fighting wandering
People with dementia are prone to wandering and wandering. At the same time, they are poorly oriented in space and forget the way home.
They may get lost or get hit by a car. Interesting activities and hobbies will help prevent this.
It is necessary to warn neighbors so that they report that the sick person has gone outside. It is better to purchase a special bracelet that will signal all movements of a person.
These recommendations are suitable for patients at an early stage of the disease. At later stages, patients cannot take care of themselves, even eat food. They often have urinary incontinence.
The way out of the situation is to hire a nurse with a medical education. She will feed the patient, give him medications prescribed by the doctor on time, help him perform hygiene procedures, and accompany him on walks.
Often patients reach such a state that they become dangerous to themselves and others. They experience attacks of aggression, hallucinations, and can attack their relatives.
Then the best solution would be to place the patient in a medical facility that specializes in caring for patients with dementia. This will maintain spiritual balance among relatives and prevent nervous breakdowns and depression.
ICD-10 code
Medical science classifies the disease as an organic dysfunction that occurs with psychological disorders of thinking, memory, and behavior; it gives it another name - dementia .
This violation has its own typology and codes ( F00-F09 ). 1. Senile dementia caused by Alzheimer's disease ( F00 ) is considered a poorly understood phenomenon, its causes are practically unknown. This type of dementia has a slow but steadily progressive course. 2. Vascular dementia, the symptoms and treatment of which depend on the underlying disease, is coded F01. This is a secondary pathology, it is the result of brain damage as a result of strokes, atherosclerosis or trauma (bruises, wounds, contusions). With timely initiation of therapy for this form of dementia, the cognitive sphere is partially restored. And although patients cannot carry out complex mental operations (counting money, analyzing what they read, etc.), they successfully take care of themselves (visit the toilet, take a shower and eat, etc.). 3. Dementia caused by other diseases ( F02 ) is associated with tumor processes, neuronal damage due to infections, inflammatory and degenerative diseases. 4. Cases of dementia of unspecified genesis (origin) according to code F03 , occur against the background of psychosis and depression.
ICD-10 gives a definition of each type of dementia known to science and a brief explanation of it.
Alcoholic, idiopathic or inorganic forms of dementia received their own individual code and description in it.
The impact of concomitant diseases in marasmus on longevity
Death occurs not as a result of senile dementia, but as a result of concomitant diseases.
One of the most severe diseases associated with dementia is atherosclerosis , most often accompanied by hypertension, and often also diabetes mellitus.
The presence of such a “bouquet” does not at all contribute to prolongation of life, since the likelihood of a stroke is high, the mortality rate of which is up to 1/4 of all cases immediately after a stroke. After 1-2 years, the number of deaths reaches 50%.
If degradation and personality disorder are caused by alcoholism, then a very likely companion may be cirrhosis of the liver ; with drug addiction - HIV infection, sepsis, Kaposi's sarcoma, and other deadly diseases that leave no chance for a long life.
Weakened senile people lie for a long time, which leads to pneumonia.
Such a concomitant illness in weak-minded elderly people who are weak and unable to understand and carry out doctor’s orders in the absence of proper care does not allow us to hope for a favorable outcome of the disease.
According to statistics, 2/3 of all deaths due to marasmus are caused by pneumonia.
The situation is aggravated if a person affected by senile dementia, who has lost the ability to speak and communicate, is not able to explain what exactly hurts, what are the manifestations of the accompanying illness.
Thus, a common infection of the genitourinary system, for example, develops into a chronic stage, causing a lot of discomfort and eventually affecting the kidneys.
What else you need to know about senile dementia:
- what types of diseases occur and what are the reasons for their development;
- what methods of treating the disease are used and what kind of help the relatives of the sick person involve.
Causes
1. Alzheimer's disease, which accounts for more than 60% of dementia in old age. 2 Pick's disease or frontotemporal dementia affects mature people aged 40-45 years. 3. Progressive vascular pathologies (arteritis, atherosclerosis) or metabolic disorders (diabetes mellitus, obesity). 4. Intoxication, against the background of which mental impairment develops, caused by the massive death of neuron cells under the influence of biological toxins (in infections) or chemical reagents (in poisoning, alcoholism, drug addiction). 5. Neoplasms and injuries. In these cases, the degeneration of normal tissue causes a pronounced impairment of the cognitive functions and behavior of patients. 6. Epilepsy. Some forms of this disease can cause progressive dementia. 7. Psychoses, often with exacerbation of mental illnesses, schizophrenic dementia manifests itself. 8. Chronic lack of oxygen in diseases of the lungs, heart, kidneys, and blood. 9. Dementia with Lewy bodies (degenerated protein fractions) affects people at any age, contributing to the degeneration of healthy brain tissue.
How to reconcile and live with those who are nearby
How to come to terms with the fact that your beloved grandparent has dementia? If you have a relative with dementia, you may think that their death will bring you relief. After this you will feel remorse.
You must understand that such thoughts can arise in every person in the current situation. Given the stress, this is quite natural.
To prevent your depression from developing, communicate with people who are in the same situation, support each other. Contact a psychologist if you feel the need.
Remember that those around you have not experienced similar experiences, and they will not be able to understand you. Find a sympathetic friend to whom you can always pour out your heart.
Don't forget that you are not alone in this world. Consult with doctors, do not hesitate to ask friends and relatives for help.
It is on the principle of collective mutual assistance that this article was written; it contains advice from experienced caregivers who were able to survive all the trials that have now befallen you.
Tips for caring for someone with dementia:
Symptoms and signs
Dementia in older people, the symptoms of which can appear gradually or abruptly, is in most cases characterized by:
- memory lapses;
- decreased ability to perceive and analyze new information, master new motor and everyday skills;
- loss of spatial orientation;
- changes in character, emotional mood, ways of interacting with others; — narrowing the circle of contacts and interests;
- the appearance of confusion, hallucinations, delusions;
- severe disturbances in sleep and wakefulness.
Presenile dementia develops in old age and is characterized by a more acute development. Senile dementia (senile) is less aggressive, but with steady progression.
The severity of clinical signs of dementia depends on the form and severity of the disease.
The first signs of senile dementia
Dementia begins to manifest itself unnoticed; all its symptoms cannot be characterized as vivid.
The first signs of dementia may be:
- Tremors or poor hand motor skills occur: fingers are difficult to obey, objects may fall out of the hands.
- Signs of immaturity and foolishness also appear in everyday behavior. There are speech impairments: patients very often “talk”, they can forget a thought in the middle of a sentence, what they were talking about at the beginning, and the like.
- A clear sign is that the patient is negligent in matters of personal hygiene, for example, does not brush his teeth, does not comb his hair, forgets to put on some clothes, and so on.
Stages of development and life expectancy
The disease usually has several stages in development:
1. Initial . Signs of dementia are barely noticeable, these are: - instant forgetfulness (failure is observed immediately upon receipt of new information); - deterioration in temporal and spatial orientation; - insomnia, emotional decline (expressions of joy and sadness are reduced, the person has an apathetic appearance). 2. Early . It occurs with difficulties in choosing words when speaking and writing, forgetting the names and locations of things. Lack of understanding of other people’s thoughts when communicating (requests, reasoning), the emotional state of the interlocutor. The ability to self-care is partially reduced (they cannot do laundry, cook food, clean the room, etc.). Atypical changes in character are observed, tearfulness, aggression, withdrawal into oneself or, conversely, hysterical attacks, a desire to gather more “spectators” around oneself may appear. 2. Intermediate . During this period, sick people lose spatial orientation, sometimes do not respond to calls to them, lose the ability to perform household services, often forget the names of loved ones and cannot remember events from the past. It is possible that such a course of the disease will require constant monitoring of the lives of patients, since they can unknowingly cause harm to themselves and others (leave the water in the tap, gas open, go outside and get lost, etc.). 3. Late .
The last stage of dementia before death occurs with immobilization of patients, urinary and fecal incontinence, loss of memory and the ability to adequately perceive reality. In some forms of dementia (Alzheimer's type, alcoholic or schizophrenic), as well as in its mixed course, delusions of persecution, hallucinations, phobias, and mania are observed.
Early stage dementia
As the process of destruction and disorganization of neurons in the brain intensifies, the disease moves into the next stage of development, and its manifestations intensify.
At the early stage of developing dementia, mental impairment increases. If you ask to read a short text and then retell it, the person will not cope with the task.
At this stage, cases of forgetfulness of recent events and disorientation in familiar areas become more frequent.
Early dementia is accompanied by:
- pronounced emotional lability (from aggression to complacency);
- the appearance of anxiety, apathy, depression;
- increasing memory impairment.
At an early stage, tearfulness and irritability may appear. The person becomes apathetic and drowsy. With vascular dementia, dizziness, attacks of uncontrollable anger, or, conversely, periods of euphoria are noted.
The character of a person also changes. Negative traits appear in him or existing ones intensify, such as stubbornness, indifference to others, fussiness, and rudeness.
Brain dysfunction at the end of the stage of early dementia manifests itself:
- loss of the ability to tell time using an analog clock;
- the appearance of problems at work (can’t remember faces, doesn’t assimilate new information, doesn’t remember where he put important documents);
- difficulties with driving a car.
As a result of the loss of work skills at the early stage of dementia, a person may lose his job, which aggravates the course of the disease and accelerates the transition to a more severe stage. Relatives of the patient at this stage of the disease can provide effective assistance.
How to help with early dementia
The task of treatment at the stage of early dementia is complicated by the fact that the patient often denies the disease. It will take a lot of patience from those around him to convince him to take medications, follow a daily routine, follow a diet, perform feasible physical exercises and train his memory.
Early dementia - stage features and solutions
To help the patient, you need to:
- Identify the cause of the disease, for which you will need to visit a psychiatrist or neurologist.
- Check ability in everyday life (ability to use gas, electrical appliances).
- Provide extended care, including cooking and cleaning the house.
- Monitor the intake of prescribed medications.
- Teach all family members how to care for the sick.
- Coordinate the actions of relatives and friends to care for the ward (draw up a schedule of medical and hygienic procedures, walks, memory training).
- Coordinate the actions of relatives and caring staff at the patient’s place of attachment (in a clinic or hospital).
A person with dementia needs to be provided with emotional support. It is important to ensure the possibility of constant contact with the patient, spend more time with him, and communicate more often by phone.
Relatives should be able to independently assess memory loss at each stage of the disease. To do this, you can use special tests for dementia, and to slow down the process of neuron destruction, neurologists recommend performing brain exercises.
Memory training
During the stage of MCI and early dementia, thinking is improved by memory training. The patient can do the exercises on his own, but it is best if he trains his memory at home with a close relative or friend.
To improve brain activity, perform exercises:
- Learning words.
- Working with images of objects (repetition of names).
- Reading and repeating sentences and entire semantic passages.
- Solving logical problems.
- Direct and reverse counting.
Training in familiar home conditions is more comfortable than training outside the home or with strangers. An unusual environment and the presence of hospital staff can increase the level of anxiety and cause stiffness and fear in the patient. This contributes to increased disorientation in space and confusion.
Overwork, lack of adequate sleep, travel, or a change of residence can accelerate the increase in symptoms of dementia. Although new experiences are necessary to stimulate brain activity, in large quantities they can cause stress.
Treatment
Treatment of the disease includes medications and psychotherapeutic techniques.
- Pharmacological drugs are used to improve the nutrition of brain tissue and enrich it with oxygen.
- Psychotherapy for better socialization of patients in society.
Since dementia is caused by certain diseases or conditions, the basis of treatment is their correction.
in women requires close attention they get sick more often than men. Therefore, when diagnosing, it is important to study the hormonal background of women, and when treating, take into account that their emotional sphere is more mobile and requires the use of sedative and antidepressant medications.
Therapy for dementia in children (with mental retardation, psychosis, cerebral palsy, tumors and other diseases) has been carried out for many years. In case of vascular pathologies and traumatic injuries, progress and improvement of the child’s cognitive functions and memory are possible.
In complex cases, degeneration processes can be temporarily “slowed down” and the quality of life of young patients can be improved.
Using non-drug methods, specialists try to correct the emotional sphere of patients and their behavioral reactions.
For this purpose:
- psychotherapy (supportive, with techniques for recalling pleasant memories from the past, sensory, music, art therapy, animation, etc.);
- psychocorrection (exercises for the formation of stable stereotypes of behavior in everyday life and society, orientation in space and time, training of self-service skills).
How does dementia develop?
The duration of the stages of dementia and the prognosis for the development of the disease depend on the causes of the pathological condition and the individual characteristics of the nervous system.
Finding out the circumstances of dementia helps to slow down the rate of development of dementia and allows the patient to adapt to the changed living conditions as much as possible. Causes of senile dementia
| Causes | Provoking factors | Preventive measures |
| Alzheimer's disease | Heredity, infectious damage to the nervous system, old age | Treatment of periodontal disease and herpetic infection, physical and intellectual activity |
| Vascular dementia | Hypertonic disease | Monitoring blood pressure, taking medications to lower blood pressure |
| Atherosclerotic lesion of cerebral vessels | Controlling cholesterol levels, diet, taking anti-sclerotic medications | |
| Diabetes mellitus type 2 | Monitoring the biochemical indicator of glucose in the blood, taking glucose-lowering drugs or insulin | |
| Obesity | Correction of excess weight | |
| Mixed type | Combination of heredity, infectious pathology and vascular diseases | Prevention of vascular diseases, adequate treatment of neuroinfections, physical and intellectual exercises |
Dementia of the Alzheimer's type and vascular senile psychosis have similar symptoms and begin gradually. Early treatment offers hope of delaying the rate of psychopathological symptoms and personality disintegration.
Drugs
After a comprehensive examination in a hospital, further treatment at home is possible. Patients are prescribed drugs to treat the underlying disease. The basic treatments for most forms of dementia are:
- inhibitors : (Galantamine, Donepizil), their action is based on the accumulation of acetylcholine in the neurons of the brain, a substance that slows down degenerative processes;
- modulators : (Akatinol, Memantine), these drugs effectively reduce the production of glutamate, a substance that negatively affects brain cells and destroys them;
- antipsychotic , sedatives and antidepressants, their use is justified in case of pronounced changes in the emotional background, the appearance of aggression, anxiety, fears, mania.
- neuroprotectors (Somazin, Cerebrolysin, Cortexin), which improve the trophism of brain tissue, their nutrition and oxygen supply, are effective in vascular pathologies.
With dementia, it is important to begin adequate therapy ; this will allow patients to retain independent skills in everyday life and mental functions longer, and in some forms, restore many lost abilities.
How many years patients receiving treatment live with this diagnosis depends on the form and severity of the disease.
In mild forms, with normal functioning of the cardiovascular system, for many years.
In severe cases, with loss of motor activity, patients die from concomitant complications (sepsis, cardiac, pulmonary or renal failure).
Care at home or boarding house
Dementia is a serious illness and can be difficult to care for for many reasons. If children develop, then the opposite happens to patients. They need constant monitoring and help. Personality changes can make life unbearable for an elderly person with dementia and life becomes hell for those living nearby. Therefore, many people think about special boarding houses where the patient will receive professional assistance.
These institutions will provide all the necessary conditions. But love and affection for a loved one with neurodegenerative disorders stops. A problem arises with the fact that family members are not always able to fully care for the patient around the clock. This is usually due to lack of patience, the need to go to work, lack of knowledge and experience in common with such people.
Patients with dementia behave in a rather specific way, so it is important to learn not to become irritated under the influence of inappropriate reactions of an elderly person.
Due to loss of memory, orientation, deterioration of general condition, a person changes a lot. You can hire a nurse for the sick person who will feed him, monitor the timely intake of medications, and ensure safety. But to slow down the development of the pathological process, professional care is necessary. Therefore, specialized boarding houses have a clear advantage.
Essence of the disease
Dementia is characterized as an ever-increasing mental health disorder that leads to dementia. Pathology occurs when some part of the brain is damaged, which is why various head injuries often lead to its formation.
Typical for older people
- in such cases it is called senile. The danger of senile dementia is that it is much more difficult to correct disorders in the brain of an elderly person than a young person.
The degree of manifestation of symptoms depends on what stage the process is at. Changes occur in the patient's condition: from a simple decrease in concentration and dulling of mental activity to the complete collapse of personality and the impossibility of independent existence.
Symptoms of dementia include the following:
- mental abilities deteriorate to varying degrees;
- a person loses previously acquired knowledge;
- skills and abilities are forgotten, difficulties arise with long-practiced actions;
- brain cells are irreversibly damaged.
Whatever the stage of the disease development process, it cannot be completely reversible. It is important to provide the patient with care and the most comfortable conditions possible - this will reduce the amount of stress and reduce the intensity of dementia.
Caring for older people with dementia
Senile dementia progresses gradually in most cases. Symptoms and signs in women do not immediately cause concern for loved ones. They are often attributed to ordinary manifestations characteristic of an elderly person.
The first symptom is memory impairment. The patient is unable to remember events that happened not so long ago. However, most often she is well versed in memories from the past, is able to talk about the smallest details and systematize her thoughts. Further, loved ones may notice a manifestation of sloppiness and a lack of interest in past hobbies.
Disorientation in time also becomes one of the first manifestations. The woman understands where she is, but does not realize the time of day. In addition, difficulties arise when you find yourself in an unfamiliar place.
The thought process slows down. The patient spends more time solving simple everyday tasks. At the same time, such delay provokes nervousness. Another early manifestation of dementia is the refusal of habitual communication with family. The woman begins to avoid meetings and tries to remain alone.
As dementia progresses, symptoms become more severe. They allow specialists to establish an accurate diagnosis and determine the stage of development.
Legal aspects
A diagnosis of dementia raises questions about the patient’s legal capacity. People with mild dementia are considered competent, that is, those who can reason rationally and manage their property. In this case, a guardian is appointed who has the right to dispose of the patient’s property.
But as the disease progresses, the person loses mental clarity and capacity. Its degree is established by a special commission, the main information for which is diagnostic data and information from the attending physician. The patient also needs to undergo a psychiatric examination and undergo diagnostic tests.
The status of incapacity and disability implies payments from the state in the form of a social pension. Therefore, the process is clearly regulated by legal norms and to obtain it it is necessary to go through “all the circles of bureaucratic hell”: collect certificates, conduct tests, and then confirm this status every year when passing a medical and social examination.
The procedure for declaring a person incompetent
| Procedure | Order |
| Collection of documents |
|
| Reasons | A mental disorder as a result of which a citizen cannot control or understand his actions |
| As admitted | Through the court |
| Consequences | Appointment of a guardian who manages the person’s property and is responsible for it |
Legal aspects that need to be addressed if a diagnosis of dementia is made:
- put in order agreements on insurance, loans, leases, etc.;
- make a choice of the person whom the patient would like to see as a guardian, notarize this desire in the form of a power of attorney;
- write or update an already written will, have it certified by a notary;
- put your bank accounts in order; you can set up online banking to pay utility bills on time.
If an older person is diagnosed with dementia, there is a lot that needs to be done. To ensure a decent standard of living for a loved one, you need to make every effort and finance. Doctors, psychologists, lawyers, social workers and, of course, relatives will help you cope with dementia. The main thing is not to despair, but to try to do everything possible to make the last years of a person’s life as comfortable as possible.
Diagnostic examination
Establishing an accurate diagnosis, as well as clarifying the form of dementia, requires a comprehensive diagnosis. As a rule, an initial visit to a doctor is an indication for the following studies:
- mental status assessment;
- studying the characteristics of the life history and disease, including identifying risk factors;
- neuropsychological analysis.
Mental status and cognitive skills are assessed using special questionnaires and tests aimed at analyzing memory, speech, writing, counting, attention, etc. This approach is especially relevant in cases of suspected Alzheimer’s disease, which is characterized by a primary lesion of these abilities.
Required laboratory tests:
- general urinalysis;
- clinical blood test;
- biochemical blood test with determination of the level of liver enzymes (AlAT, AST, alkaline phosphatase), creatinine and urea (allows you to assess kidney function);
- studying the level of calcium in the blood, vitamin B12 and thyroid hormones.
The diagnostic plan includes electrocardiography and EEG, aimed at a general assessment of the condition of the heart muscle and brain.
