The Many Different Dimensions of Dementia

By CarePatrol of Baltimore

Most of us have heard of Alzheimer’s disease and have a sense of the debilitating affects that it has on a person. It is often the term that come’s to mind when we hear the word “dementia”. What most of us don’t know, is that there are more than 10 types of dementia, of which Alzheimer’s is but one iteration.

We work with many clients seeking memory care. As consultants and placement specialists, the CarePatrol Baltimore Team needs to be well versed in the different types of dementia. The CarePatrol Team must have a deep understanding of the communities in our region that specialize in, or have accommodations to meet, the needs of the various types and intensities of dementia patients. For this reason, as the Founder of CarePatrol Baltimore, I recently became certified as a dementia care trainer.  

Memory loss is a primary indicator of dementia, symptoms such as depression, confusion, coordination problems and others may also be present. This is caused in all cases by changes in the brain. Changes that may also affect personality, behavior, and the ability to perform basic tasks. The changes, often caused by disease, are typically not reversible and affect language and decision making in addition to memory, depending on the areas of the brain that are impacted. 1
Some symptoms are caused by the dementia, and some are a co-morbidity that need their own treatment program separate from the dementia. An example being depression. Depression often goes hand in hand with dementia but is a wholly separate disorder and requires its own treatment plan. 
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There are lists available online that break down the different types of dementia. We think this one by Healthline does a good job: 
https://www.healthline.com/health/types-dementia  
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For memory care placement, it is important to have a whole picture of the symptoms being displayed by the patient. Different types of dementia are caused by different brain afflictions, a lack of blood flow (Vascular), an attachment of proteins to nerves in the brain (Parkinson’s, Lewy body), and bleeding in the brain (Wernicke). It can also be caused by a combination of causes.  We do a thorough intake assessment to have the best and complete picture of the individual. Not all patients exhibit all symptoms of their type of dementia. And in some cases, a formal diagnosis is not available. The symptoms become more important to understand as we work towards the safest living solution. 

The primary symptoms we look to accommodate and factor into the decision-making process include:

• Disorientation and confusion – clearly defined areas, circular hallways to avoid dead ends, and visual labeling are necessary aspects for patients exhibiting these symptoms. This is one of the earliest and most common symptoms of dementia. 2
• Language difficulty – forgetting words, losing track of conversation, lost ability for reasoning and judgement. This symptom requires care givers to be patient and empathetic. Often having to repeat themselves over and over, and providing direction for simple tasks. 
• Hallucinations and visual problems – Understandably, this symptom can create panic and confusion in the patient. Experience dealing with hallucinations prepares a community for what your loved one is going through. 
• Sleep disturbances – difficulty falling asleep, waking in the night, and falling asleep suddenly during the day can all wreak havoc on a patient. Safety as well as overall health is at risk with patients who suffer from sleep disturbances.
• Behavior problems such as violence or sexual undertones– i.e., thinking someone else is their spouse, thinking a care provider is a home intruder, or other more far out behaviors are often one of the symptoms that cause patients not to be accepted to a care center. Lewy Body Dementia and Vascular dementia patients are often not accepted at some communities because of these behavior problems. Knowing the extent of the symptoms and the capabilities of the community is the best way to find a good fit for the patient.
• Wandering – 6 in 10 people with dementia will wander according to the Alzheimer’s association3. This very common symptom of dementia requires safety precautions such as enclosed outdoor areas, tracking bracelets, key coded doors and elevators, and alert systems. This is one of the highest areas of difficulty for memory care communities. 
• Fall risk – difficulty in walking, weakness, and trembles are all common symptoms. Fainting is also a possibility. It is imperative that communities remove all fall hazards and rooms are set up with fall prevention in mind. Rug removal, no wires to trip over or uneven floors. 

In addition to managing these symptoms, it is important to provide cognitive stimulation, healthy meals, and encouragement to eat, and a means of activity appropriate for the patient. Also, be informed about how they handle difficult behaviors. You do not want a memory community that relies on anti-psychotic medications. Discuss whether advanced care is available. Dementia is usually a progressive disorder. There are a lot of considerations that go into memory care placement. Reach out for a consultation, we are here to help. 

1.        https://www.healthline.com/health/types-dementia  
2.        https://www.aarp.org/aarp/caregiving 
3.        
 https://www.alz.org/help-support/caregiving/stages-behaviors/wandering