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Where Do They Go

Growing up, everyone who knew my father considered him Iron Man and the one who would definitely be the last man standing among our family members. He was a big guy, physically strong, and although he never finished high school, had more common sense than anyone I have ever met. He could build anything, loved the outdoors, especially fishing, and possessed a kindness and understanding which he put a great deal of effort into hiding.

Drawing of an old man diagnosed with senile dementia

Later in his life he began to have a little trouble remembering things. These hiccups in his memory progressed to the point where he would confuse me with my brother and mixed up his grandchildren’s names. Perhaps the strangest occurrence was when he took my mother to play bingo one evening and when it came time to pick her up, he wasn’t there. After calling the local police, he was found just driving around the city with no idea where he was going. He wasn’t lost or driving recklessly he just out driving.

Conversations with him became more and more difficult, he would drift off and begin talking about events which took place during his youth.

For many of us, the people we have always known suddenly begin to change or disappear. Where to they go? Why? What is happening? What are the signs they are leavings us?

I am just one of the millions of Americans who was forced to come to terms with an older relative afflicted with Dementia. What is happening to these people we care about can be confusing and unsettling.

Dementia is an umbrella term used to describe a decline in memory or brain function that impacts an individual’s daily life. This is different from the normal decrease in short-term memory most people experience as they age. Dementia is caused by changes in the brain which impact cognitive function, and it can be associated with types of dementia many of us are familiar with, such as Alzheimer’s, Parkinson’s, and Huntington’s disease. There are a number of causes and different type of dementia. For additional information, visit: https://www.dementia.org/causes

According to the website Dementia.org, there are seven stages of dementia and they state, “in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down”.

As the Dementia.org website also points out: “Learning the stages of dementia can help with identifying signs and symptoms early on”. This knowledge can assist those affected with the early stages to get proper care and can aid caregivers in understanding what to expect in future stages.

Stage 1: (stages 1-3 known as pre-dementia stages)

  • Normal functioning stage.
  • Patient doesn’t show noteworthy memory problems.

Stage 2: Age Associated Memory Impairment

  • Occasional forgetting where an object was placed.
  • Forgetting familiar names.

Although this is common as a normal part of the aging process, this decline in memory can be an early sign of degenerated dementia.

Stage 3: Mild Cognitive Impairment

This is the stage where clear reasoning problems begin to manifest themselves.

  • Getting lost easily.
  • A marked reduction in work productivity.
  • Misplacing or losing important items.
  • Difficulty concentrating.
  • Frequent inability to remember friends or family member names.
  • Struggling to remember instructions or information from a book.

This is the stage where the individual may begin to have minor anxiety as the symptoms are now beginning to interfere with their life. It is at this stage of the disease people are encouraged to seek a clinical diagnosis.

Stage 4:

At this stage, the sufferer begins to become socially withdrawn and has signs of personality and mood changes. Denial of the condition is common.

  • Decreased knowledge of current/or recent events.
  • Difficulty remembering things about one’s personal history.
  • Inability to handle finances, or to do any planning.
  • Disorientation.
  • Recognizing people and faces becomes a struggle.

At this stage, patients will have no trouble with familiar faces and familiar locations, but often patients will avoid challenging situations to prevent stress and anxiety or to hide condition.

At this point my father would not give up his driver’s license, but gave up is car. He was relying more and more on my mother to remember people and names. His memories of his own life were being distorted. My brother took over my parent’s finances and was scheduling doctor’s appointments and ordering prescriptions. Perhaps the hardest change for all of us, was his change in temperament. He became aggressive, he unexpectedly would disagree with anything and at the same time gave little thought to what he said to people or how he said it. In general, he could become mean at times. He was in a nursing home now and occasionally was confused as to how and why he there, but he would forget being there was his idea. I wish we had known more about dementia at the time, it may have helped us to understand.

Stage 5:

At this stage some assistance is required to carry out daily activities.

  • Inability to remember major details such as close family member’s names or home addresses and phone numbers.
  • Disorientation about time and place.
  • Trouble or inability to make decisions.
  • Forget basic information about themselves.

Although stage 5 can interfere with daily life styles, those with 5th stage dementia do not seem to need assistance with basic functions such as using the bathroom or eating. Most still have the ability to remember their name and the name of their spouse.

Stage 6:

Entering stage 6, patients begin to forget the names of their spouse, their children or primary caregivers and in all likelihood will require full time care.

  • Delusional behavior
  • Obsessive behaviors and symptoms.
  • Anxiety, aggression and agitation.
  • Loss of will power.

Patients may begin to wander, have difficulty sleeping and in some cases will experience hallucinations.

Before my father’s passing, he was well into stage 6. He was having difficulties sleeping and was starting to have hallucinations. He at times had aggressive behavior and anxiety as well as obsessive behavior.

Stage 7:

Along with the loss of motor skills, patients will progressively lose the ability to speak during the course of stage 7. Loved ones and caregivers will need to help the patient with walking, eating and use of the bathroom.

Most cases of dementia may be reversible. Sometimes dementia-like conditions may be caused by underlying conditions which may be treatable.

On the Dementia.org website they write: “The more aware you are of these steps, the quicker you will be able to react and seek help, either for yourself or for a loved one.”

Self Help:

For the many forms of dementia, is there anything we can do to help ourselves to lessen our chances of developing dementia? There are no guarantees but the following are suggestions which may help. Research suggest:

  1. Stay physically Active
  2. Stay socially active
  3. Participate in mentally stimulating activities i.e. learn languages, continue education
  4. Quit smoking and minimize drug use
  5. Eat a healthy diet (research has found that a Mediterranean style diet is most beneficial)
  6. Manage cardiovascular diseases

Dementia.org states: “These measures aren’t only for individuals who want to prevent dementia, these life style changes are also beneficial for those who are already diagnosed, as positive changes can slow the progression of dementia.”

Hereditary:

One final comment for anyone, who, like myself, wondered, is dementia passed on through our DNA?

According to University Healthnews.com: The more family members you have who are affected by certain types of dementia, including Alzheimer’s, the greater your risk becomes. So, strictly speaking, is dementia hereditary?

Dementia statistics suggest that genetic background is certainly a factor – but not the only factor”.

Please Note: The article was written to inform and for awareness. SAIL is not a Healthcare provider, nor is any member of its staff. The information provided is not meant to be a substitute for diagnosis and treatment by a Physician, licensed professional, or therapist. Any information provided in this article is the opinions of the author and not that of the author’s employer or the employer’s staff.

For Additional Information Visit:

Molli, Grossman, PhD. (2018). Stages of Dementia. https://www.kindlycare.com/stages-of-dementia/

Works Cited:

Healthcare Brands. (2020). Dementia. Retrieved from: https://www.dementia.org

Vitek, Jimison, Susan. (2018). Is Dementia Hereditary? Genetics May Play a Role, But Other Factors Contribute. Retrieved from: https://universityhealthnews.com/daily/memory/is-dementia-hereditary/

Image Source:

Retrieved from: https://en.wikipedia.org/wiki/Dementia

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