OTHER DISORDERS
Dementia is an umbrella used term to describe a range of neurological conditions, all of which result in a decline in brain function due to physical changes in the brain.
Alzheimer's Disease and Vascular Dementia are the two most common types of dementia.
Etymology: de- (“out of one’s”) + -mēns (“mind”) + -ia (nominative abstract noun)
It was once thought that dementia only affected “old people” who had taken leave of their minds. Others thought that dementia was Alzheimer’s disease. In a bid to move away from these stigmatisations, there was a move to recognise dementia for what is was: a major neurocognitive disorder (NCD).
The term “major NCD” more accurately reflects the many different causes and manifestations of significant cognitive impairment that can affect people at any age.
Diagnosing Major Neurocognitive Disorder (Dementia)
Alzheimer's and other types of dementia are clinically diagnosed (which means it is a clinical decision rather than simply taking a laboratory test). A diagnosis is based on your medical history, brain imaging scans and blood test screens, and psychological assessments to study changes in characteristics or thinking, daily functioning and behaviours. A clinical diagnosis can be made with a high degree of certainty. But it's harder to determine the exact type of dementia because the symptoms and brain changes of different dementias may overlap. In some cases it may be necessary to see a specialist such as a neurologist or neuropsychologist.
In summary, there is no one symptom or test to determine if someone has dementia.
Major Neurocognitive Disorder
(or commonly known as “Dementia”)
Credit: CNA Insider
He Ain’t heavy; but is he my brother?
Behavioural and personality changes often accompany major NCD. These changes occur because of brain cell death. The types of behaviour changes observed are dependent on which part of the brain is losing cells.
For example, the frontal lobes in the brain control our ability to focus, pay attention, plan ahead, problem-solve and manage our impulses (late night shopping anyone). When cells in the frontal lobes of the brain are lost, it comes harder to stay focused or control their impulses.
Depending on which parts of the brain are affected, you family member or loved one may not behave as he or she did in the past. You may not recognise the behaviours and mannerisms, but he or she is still very much the person you know and love.
Caring for your loved one
An important concern for many is how one may provide appropriate care for persons suffering from dementia. One effective model is termed the “person-centred care” approach, where the sufferer’s characteristics as a unique person is recognised and his or her preferences emphasised, instead of focusing on the person’s “lost” abilities and attributes. Person-centred care recognises that a person should not be defined by their condition and that underneath the diagnosis and condition, there is (still) a person. This approach has been found to reduce the sense of helplessness in sufferers and lower the incidence of depression.
The key principle behind person-centred care is that it looks at behaviours as a way for the person with dementia to communicate his or her needs.
It focuses on identifying which unmet need causes the behaviour. It is like communicating with a person who doesn’t share your language or culture. Person-centred care requires that medical and mental health professionals, and caregivers, shift their mental model of care by acknowledging that persons with dementia retain their personal beliefs, life experiences and relationships: things that make up who they are as a person. We just need to find a way to understand and communicate with them.
Most importantly, person-centred care ensures their quality of life and dignity is maintained through the course of their condition.
Don’t forget the caregivers…
The benefits of a person-centred approach also flow through to caregivers, empowering them with the confidence to continue providing high-quality care to their loved ones. More importantly, health care professionals delivering person-centred care in nursing homes found that this approach improved job satisfaction, reduced emotional exhaustion and increased the sense of accomplishment among professionals.
It easy to see why it is important to ensure that caregivers receive ample support.