Alzheimer’s disease is one type of dementia. There are many different types of dementia, which is a physical disease that attacks the brain by destroying brain cells. All types of dementia affect the brain but the difference in how they progress can vary.
What is Alzheimer’s disease?
Alzheimer’s disease causes problems with thinking, memory and towards the later stages, motor skills. Symptoms slowly progress and may not be recognised at first. Most of us associate it with memory loss, but it is not just about losing memories. In the early stages people with the condition may become forgetful, but towards the later stages, it can prevent communication and movement. Everyone will experience Alzheimer’s disease differently and symptoms may get better or worse from day to day as they gradually decline. The progression of Alzheimer’s disease can be described as walking down a hill slowly.
During a Dementia Friends session to new staff, David Barenskie, Head of Dementia Care at Green Tree Court, used the analogy of understanding brain cells as being like fairy lights on a Christmas Tree. Each light corresponds to skills or abilities such as sequencing (understanding the correct order to do something), communication and motor skills. The person’s progression through each stage of dementia will cause these lights to flicker. The lights may flicker on and off and sometimes going out completely. As the brain controls everything we do – from thinking to remembering to speaking to moving – when these fairy light flicker or go off it affects the persons ability to carry out the skill associated with the part of the brain affected.
It’s important to remember that Alzheimer’s is not just a natural part of ageing. If you’ve been diagnosed with Alzheimer’s disease, the Alzheimer’s Society can provide lots of information and support or call their helpline on: 0300 222 11 22.
Who is affected by Alzheimer’s disease?
According to the NHS Alzheimer’s disease is most common in people over the age of 65. The risk of Alzheimer’s disease and other types of dementia increases as you get older. It affects around 1 in 14 people over the age of 65 and 1 in every 6 people over the age of 80. However, around 1 in every 20 cases of Alzheimer’s disease affects younger people aged 40 to 65.
What is dementia?
David Barenskie: “Dementia is not a disease in itself, but is the name we give to a range of symptoms where thinking and remembering go into decline. It’s an umbrella term for a whole range of conditions that affect the brain in this way. Alzheimer’s is just one of many diseases which cause dementia.”
The two most common causes of dementia are:
- Alzheimer’s disease
- Vascular dementia
Alzheimer’s disease accounts for around 62% of dementia cases and has no known cause. It’s a progressive brain disorder that slowly leads to confusion, memory loss, impaired judgement, personality changes and difficulty communicating. Dementia is normally diagnosed towards the mid to late stages of Alzheimer’s disease.
Around 17% of people living with dementia have vascular dementia. In vascular dementia, there is an interruption of the flow of blood to the brain caused by the hardening of arteries in the brain. It can often affect movement and things like bladder control. Someone with vascular dementia can continue as they are with little change in symptoms for a period of time and then suddenly experience deterioration after an interruption of blood flow to the brain.
What are the symptoms of Alzheimer’s disease?
Everyone experiences Alzheimer’s differently, but early symptoms of the disease can include:
- Forgetting recent conversations or events
- Misplacing items
- Forgetting the names of places and objects, or have trouble thinking of the right word
- Repeating the same question several times
- Finding it harder to make decisions
- Become less flexible about changes and not wanting to try new things
- Mood changes, such as increased anxiety or agitation
Remember that some of the common symptoms of early Alzheimer’s disease can be caused by other conditions or medication.
How do I know if I have Alzheimer’s disease or dementia?
If you think you or someone you know may have Alzheimer’s disease or dementia, you should speak to your GP. They can assess your symptoms and, if they suspect Alzheimer’s disease or dementia, they might refer you to a specialist memory service.
Staff at a memory clinic can include:
- a nurse – usually a trained mental health nurse who specialises in diagnosing and caring for people with dementia
- a psychologist – a healthcare professional who specialises in the assessment and treatment of mental health conditions
- a psychiatrist – a qualified medical doctor who has training in treating mental health conditions
- a neurologist – a specialist in treating conditions that affect the nervous system (the brain and spinal cord)
- a geriatrician – a physician with specialist training in the care of older people
- a social worker – a trained member of staff able to advise and assist with accessing social services within the local area
- an occupational therapist – a member of staff with specialist skills in assessing and supporting people with dementia and their families with adjusting to disabilities
One way that they may assess your metal abilities is by using the mini mental state examination (MMSE). In this simple test, you’ll be asked to carry out activities like memorising a list of objects.
Your specialist may also refer you for a brain scan. This could be a:
- computerised tomography (CT) scan – In this scan, several X-rays of your brain are taken at slightly different angles and a computer is used to put the images together
- magnetic resonance imaging (MRI) scan – During this scan, a strong magnetic field and radio waves are used to produce detailed images of the inside of your brain
Can Alzheimer’s disease and dementia be treated?
Dementia and Alzheimer’s disease are both irreversible. That means there is no cure. But there are a number of options that can sometimes help to manage the conditions as effectively as possible.
Managing Alzheimer’s disease and dementia effectively
There are a number of medications that can be prescribed for people in the early to mid-stages of Alzheimer’s disease, including, donepezil, galantamine, and rivastigmine (known as AChE inhibitors). People who cannot take AChE inhibitors or with a later stage of the disease may be offered Memantine.
These drugs may help to alleviate some symptoms or slow down the progression of the disease. Like all drugs, it’s important to remember that there may be side affects. Discuss your medication options carefully with your doctor to make sure you are taking the best treatment for you.
A holistic approach
There are other steps that can be taken to help make living every day with Alzheimer’s disease or dementia easier. Simple changes to your home or choices of activities can ease or manage depression, confusion, and anxiety that can sometimes lead to challenging behaviour.
A dementia-friendly environment is one that is designed to be simple and safe for people with dementia to move around in. By being easier to move in, it promotes independence. And because there is less frustration, it can be calmer. IRIDIS is an app developed by Stirling University Dementia Services Development Centre that can be used by professionals or individuals to make a space more dementia friendly. Download it from Google Play here.
Activities like cooking, gardening and arts and crafts can make you feel good, offer a chance for self-expression and give a sense of purpose. Other therapies, like Pets As Therapy, can also create a spark of interest and increase sociability to help reduce feelings of isolation.
A person-centred approach to care
A person centred approach has been proved to support people with dementia to live a more fulfilling life. Highlighted as good practice by the National Institute for Health and Care Excellence (NICE), it recognises that there is no ‘one size fits all’ when it comes to dealing with dementia.
Rather than relying on medication, this approach aims to reduce the stresses caused by some of the symptoms of the disease and keep individuals active and sociable to help maintain higher self-esteem.
At Green Tree Court we take a person-centred approach to care. This means we always:
- treat the person with dignity and respect
- understand their history, lifestyle, culture, and preferences, including their likes, dislikes, hobbies and interests
- look at situations from the point of view of the person with dementia
- provide opportunities for the person to have conversations and relationships with other people
- ensure the person has the chance to try new things or take part in activities they enjoy.
David Barenskie: “Our personalised approach to dementia care includes offering one-to-one care. This allows us to make the time for individuals to elaborate their needs and wishes. Or, for anyone unable to make this clear, this approach also means our trained team can anticipate needs in a timely manner, which helps to reduce any stress that may occur. We also organise a wide range of meaningful activities and events at Green Tree Court, all designed to help residents to do something they enjoy. This helps to give residents a greater sense of purpose and sparks conversations with others – essential for helping to maintain well-being.”
Why is it important to understand the type of dementia you or a loved one has?
David Barenskie: “By understanding the type of dementia you can anticipate how things might change. That allows us to support individuals in the best way.”
Living well with dementia
Practical tips to make every day easier:
- Keep a notepad handy and write down things you want to remember
- Put a weekly timetable up on the wall to help you to remember appointments
- Put essentials like keys somewhere obvious, such as a large bowl in the kitchen
- Label cupboards and doors clearly so you can easily find what you’re looking for
- Use sticky notes to remind you of things. For example, put a note by the door to remind you to take your keys if you’re going out
- programme people’s names and numbers into your mobile telephone
- Use an alarm on your phone to help you to remember
- Make sure you’ve got essential safety devices, like smoke alarms and carbon monoxide alarms, installed in your home
Having dementia doesn’t automatically mean you won’t be able to drive. However, just with any condition that could affect your driving, you do need to inform the DVLA or you could face a fine of £1,000. Contact them by calling 0300 7906806 or get in touch online.
Other things to bear in mind
People with dementia and Alzheimer’s disease can continue to live well for many years after an initial diagnosis. However, there is no cure as it is a progressive disease. That means it makes sense to plan for the future and the time when you may not be able to make important decisions for yourself.
This could include considering:
- Advance statements or Living Wills – these set down your preferences and beliefs regarding your future care. It enables people to carry out your wishes in the future when you may not be able to communicate them
- Lasting power of attorney – this lets you legally appoint one or more people to make decisions on your behalf regarding your healthcare, finances or property. You’ll need to choose your ‘attorneys’ the person or people you want make these decisions and send them an LP3 form to fill in. Once they have been notified, you’ll need to register online or by filling in a paper form and sending it to: Office of the Public Guardian, PO Box 16185, Birmingham, B2 2WH
Finding a specialist nursing home for people living with Alzheimer’s disease and dementia
At some point, you or a loved one may need specialist 24-hour care. Green Tree Court is a modern, purpose-built nursing care home in Exeter offering specialist dementia services. It has been awarded ‘Outstanding’ by the Care Quality Commission (CQC). For more details please get in touch on 01392 240400.