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Author Topic: Can you tell me more about dementia?  (Read 1959 times)

Offline thedoc

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Can you tell me more about dementia?
« on: 22/07/2015 13:50:01 »
Howard asked the Naked Scientists:
   
I work at a dementia care facility, more like a boutique hotel in Somerset West, Cape Town. I would like to inquire whether you can forward me any information/research on dementia to broaden my knowledge.

 i am a great fan of your talk show on Cape Radio every Friday morning.
What do you think?
« Last Edit: 22/07/2015 13:50:01 by _system »


 

Offline Pecos_Bill

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Re: Can you tell me more about dementia?
« Reply #1 on: 22/07/2015 19:42:10 »
Well, Howard. One aspect of dementia is that people lose their short term memory and keep repeating the same question. When I would visit my 89 year old mother our conversation always went like this..

"When did you get here? Just now, Mom [60 second pause] When did you get here? Just now, Mom[60 second pause]When did you get here?"

Of course those damned cigarettes had left her with a pCO2 worse than a dying sailor on the "Kursk" so we never knew how much of that was hypoxia or Alzheimer's"

Interestingly, long term memory is largely spared. Mom used to sing, "The Wee Cooper of Fife" to me as a child. I bought her a CD of Jean Redpath singing it and she perked right up and had a singalong....Then she asked me when I had gotten there.

Nickety-nackety-noo -noo-noo

PS: If the people who own that place aren't running an ongoing inservice training program to teach you about dementia and how to care for these people, it is a safe bet that they are maggots profiteering from the misfortunes of old people. Let me guess. The boss drives a BMW, doesn't he - the wicked dog.
« Last Edit: 22/07/2015 19:47:26 by Pecos_Bill »
 

Offline cheryl j

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Re: Can you tell me more about dementia?
« Reply #2 on: 23/07/2015 03:21:39 »
While Alzheimer's is the most common. there are other forms of dementia, affecting different areas or specific areas of the brain, so patients may not display the same kinds of symptoms or problems. Some other types include:

Other degenerative neurological diseases, such as frontotemporal lobar degeneration, dementia with Lewy bodies, Parkinson's, and Huntington's diseases
Vascular disorders and multi-infarct dementia, which is caused by multiple strokes in the brain
Infections that affect the central nervous system, such as HIV dementia complex and Creutzfeldt-Jakob disease
Chronic drug or alcohol use use
Depression
Certain types of hydrocephalus, an accumulation of fluid within the brain that can result from developmental abnormalities, brain tumors
head trauma

Alzheimer's disease accounts for 50 percent to 70 percent of all dementia.

Dementia can affect many mental processes besides just memory , such as mood, personality, inhibition of inappropriate behavior or speech, reasoning, judgment, language comprehension, or expression.

My mother has dementia, but (so far) her short term memory is reasonably good. She does not ask the same questions over and over, and doesn't wander off and get lost. She recognizes people, and knows the names of common every day objects and what they are used for, or where they are located. You might not even guess she has dementia if you didn't know her in the past. What she can no longer do is think logically or use information she obviously knows to make inferences, which often results in bizarre statements or comments or risky decisions. She has trouble guessing or predicting what other people are feeling or thinking or intending to do, which sometimes results in behavior that can seem callous, rude or even paranoid. She takes statements very literally - she does not understand analogies or metaphorical statements. She can no longer think abstractly or talk at any length "about" an event or topic, even if it is common knowledge or something she was interested in the past.

She hasn't yet been diagnosed. I'm guessing its some sort of frontal lobe problem, because she doesn't fit the typical Alzheimer's profile. I think GPs have difficulty diagnosing patients with these types of deficits if they haven't known them for many years, and may attribute the symptoms to a life long personality disorder or just old-person crankiness, and many of these symptoms probably wouldn't be even apparent in a brief office visit.
 

Offline Pecos_Bill

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Re: Can you tell me more about dementia?
« Reply #3 on: 23/07/2015 08:03:43 »
I cannot recommend leaving a patient with dementia symptoms left to go without a concrete diagnosis. You mention several possible causes of dementia, but you left out one of the most common -- iatrogenic dementia caused by a clueless MD ignoring possible drug interactions --- including over the counter drugs, "medicinal " herbs, and "remedies".

Back in the day, I worked on a closed psych ward as a vocational nurse. The rule was in the case of an elderly patient with dementia - first rule out over the counter  bromide toxicity. While I worked there we "cured" several of them that way - and they were nuttier than a waltzing mouse.

This lady needs to be seen by a professional geriatrician stat (i.e., yesterday). In the UK those critters hang out at the British Geriatrics Society  (www.bgs.org) give them a nudge and see if they can't recommend an MD near you who is hep to the step.

************** For the benefit of the audience

Here is a quick 2 step  way to screen for alzhiemers..

1. Ask them to remember 3 unrelated things, say: Telephone, Iris, and Kate Humble. Then talk about anything whatever for a few minutes and see if they can recall the three items. If they can't recall them, Uh-oh.

2. Ask them to draw a clock face with the numerals in the right place. Then ask them to draw the clock hands for a time you choose.

If they flunk the test, they need to be seen by somebody who knows how the cow eats the cabbage,
« Last Edit: 23/07/2015 08:06:19 by Pecos_Bill »
 

Offline RD

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Re: Can you tell me more about dementia?
« Reply #4 on: 23/07/2015 12:35:48 »
... iatrogenic dementia ...

In the UK, relatives are shocked how demented-Granny has gone downhill so rapidly after entering state-funded residential-care.  The explanation : Granny has been given a cost-effective chemical-cosh of anti-psychotic medication , not because she's psychotic, but because sedating-her reduces the need for costly supervision, and shortens life-expectancy to boot ...

Quote from: alzheimers.org.uk
people with dementia have frequently been prescribed antipsychotic drugs as a first resort and it has been estimated that around two thirds of these prescriptions are inappropriate
http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=548
« Last Edit: 23/07/2015 20:08:05 by RD »
 

Offline Pecos_Bill

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Re: Can you tell me more about dementia?
« Reply #5 on: 23/07/2015 17:31:05 »
An aged man is but a paltry thing,
A tattered coat upon a stick, unless
Soul clap its hands and sing, and louder sing
For every tatter in its mortal dress,
Nor is there singing school but studying
Monuments of its own magnificence;
And therefore I have sailed the seas and come
To the holy city of Byzantium.

It is unfair to blame the facility, prima facie. If you take an alzheimer's patient out of their home patch, it is bound to knock the slats out of them for some much longer time. The alternative is them wandering off. There are cases where they weren't found until the snow melted.

It was once common to tie them into a G chair. I recall one old boy who was so tied because he was obsessed with returning to Oklahoma (1500 miles away) when he couldn't find the dining room. If the staff was distracted with some crisis he would have certainly eloped and been  killed in the traffic -- locked door or not. They would bring them up to sit across from the nurses' station to keep an eye on them.

Now they are sedated (many times oversedated), but you must think of the other patients. One agitated patient can turn the place into a bedlam 24/7 - apart from getting into the utility room and sipping on the floor cleaner.

People will tell me that it is a beautiful day - well, it <<is>> California. But I always reply that they are ALL beautiful.....they never come back.

et in arcadia ego.
« Last Edit: 23/07/2015 20:15:01 by Pecos_Bill »
 

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Re: Can you tell me more about dementia?
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