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Dementia: Alzheimer’s Disease and Brain Changes

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There are many different types of dementia. The term ‘dementia’ describes the symptoms that occur when the brain is affected by certain diseases or conditions. Some types are far more common than others and they are often named according to the condition that has caused the dementia. Alzheimer’s disease is the most common cause of dementia. During the course of the disease, the chemistry and structure of the brain changes, leading to the death of brain cells. Vascular dementia occurs when the oxygen supply to the brain fails, as brain cells die. The symptoms of vascular dementia can occur either suddenly following a stroke, or over time through a series of small strokes. Dementia with lewy bodies is a form of dementia that gets its name from tiny spherical structures that develop inside nerve cells. Their presence in the brain leads to the degeneration of brain tissue. Fronto-temporal dementia is where the damage is usually focused in the front part of the brain. Personality and behaviour are initially more affected than memory.

People with HIV and AIDS sometimes develop cognitive impairment, particularly in the later stages of their illness. This can lead to a type of dementia called HIV-related cognitive impairment. Korsakoff’s syndrome is a brain disorder that is usually associated with heavy drinking over a long period. Although it is not strictly speaking a dementia, people with the condition experience loss of short term memory. Dementia involves a collection of symptoms including memory loss, personality change, and impaired intellectual functions resulting from disease or trauma to the brain. These changes are not part of normal aging and are severe enough to impact daily living, independence, and relationships. However with dementia, there will likely be noticeable decline in communication, learning, remembering, and problem solving. These changes may occur quickly or very slowly over time. Some of the most common signs and symptoms within all types of dementias are: Memory loss

Impaired judgment
Difficulties with abstract thinking
Faulty reasoning
Inappropriate behavior
Loss of communication skills
Disorientation to time and place
Gait, motor, and balance problems
Neglect of personal care and safety
Hallucinations, paranoia, agitation

People suffering with dementia may find their health and life affected by the disorder. This can be because they may lose mental ability. Memory problems are usually the most obvious symptom in people with dementia. A person with early stages of dementia might go to the shops and then cannot remember what they wanted. It is also common to misplace objects. However, events of the past are often remembered well until the dementia is severe. Many people with dementia can talk about their childhood and early life but as dementia progresses, sometimes memory loss for recent events is severe and the person may appear to be living in the past. They may think of themselves as young and not recognise their true age. Difficulty with self-care usually also develops over time. For example, without help, some people with dementia may not pay much attention to personal hygiene and they may forget to wash or change their clothes. Remembering to take medication can also become an issue which means their symptoms are not controlled.

The person may also have difficulty keeping up their home routines such as shopping, cooking and eating as these tasks may become difficult. This can lead to weight loss which is unhealthy. Driving may be dangerous and not possible for someone with dementia which could interfere with work and social activities. However, as well as the individual suffering from the effects of dementia on themselves, their friends and families may also suffer. Dementia can affect the families of those suffering as it can change the individual and cause families to feel loss. Grief is a response to loss. If someone close develops dementia, families are faced with the loss of the person they used to know and the loss of a relationship. People caring for partners may experience grief at the loss of the future that they had planned to share together. Grief is a very individual feeling and people will feel grief differently at different times. It will not always become easier with the passing of time. As well as this, families may feel a sense of guilt when discovering someone has dementia.

It is common for family members to feel guilty for many things such as feeling guilty for the way the person with dementia was treated in the past, guilty at feeling embarrassed by their odd behaviour, guilty for lost tempers or guilty for not wanting the responsibility of caring for a person with dementia. If the person with dementia goes into hospital or residential care family members may feel guilty that they have not kept them at home for longer, even though everything that could be done has been done. It is common to feel guilty about past promises such as “I’ll always look after you,” when this cannot be met. Anger is another common feeling within families as they may feel angry at having to be a caregiver, angry with others who do not seem to be helping out, angry at the person with dementia for her difficult behaviours and angry at support services.

Feelings of distress, frustration, guilt, exhaustion and annoyance are quite normal as dementia can vastly affect families. Dementia changes family households. One is a shifting of schedules and priorities. Caring for a person with dementia requires an individual to be there around the clock. This can make a spouse or children feel overwhelmed. This is especially true if family members neglect their own needs while caring for a person with dementia. According to the Mayo Clinic, each family member may act differently in response to coping with an individual with dementia. Some family members may feel resentful or angry while others cope by seeking support and information. And others may simply fall into a place of denial and avoid the situation.

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