Dementia Support at Home

Understanding Dementia

Oran provides dementia support at home.

Dementia is the collective name for a group of conditions that relate to decreased brain functioning, often resulting in similar symptoms.

Whilst many dementia conditions are not curable, medication and certain types of therapy have been shown to decrease the rate of progression.

What causes dementia?

Many types of dementia are caused by brain cells dying and being unable to grow back again. The brain cells naturally reduce in number as we get older, but dementia can result where there is accelerated degeneration. 

Clumps of proteins can also form in the brain which result in loss of brain cells and they also affect the number of neurotransmitters in the brain and the chemicals that are used to transmit the messages. 

Other types of dementia can be due to genetics, interruptions in the blood supply to the brain, infections to the brain and alcohol induced damage to the brain tissue. 

Certain types of dementia can be misdiagnosed because the symptoms are often similar across the dementia spectrum. It is important to get a correct diagnosis, with an expert at assessing dementia, as there are different treatments for the different types of dementia and incorrect treatments can have an adverse affect.  

What Are the Main Symptoms of Dementia?

If you, or a loved one, is displaying some of the symptoms of dementia and need some support you can speak to one of our experts today for no obligation advice 01334 652987

Alzheimer’s Dementia 

What is Alzheimer’s Dementia?


Alzheimer’s is the most common illness associated with dementia. Although treatment cannot cure or reverse the decline, it can help slow down its progress so an early diagnosis is recommended. Alzheimer’s disease is the most common of all the diseases that cause dementia and is present in about 55% of all dementia cases.

What are the symptoms of Alzheimer’s disease?
The most important thing to remember is that Alzheimer’s symptoms are the same as with other causes of dementia, some of which may actually be curable: such as an infection, anaemia, or a thyroid problem. Alternatively, they could be caused by very different factors like stress, alcohol abuse or depression. So the symptoms alone are not reliable in arriving at a diagnosis. Also remember that any one symptom could have a perfectly mundane explanation – and that brains do tend to simply slow down with age.
That said, the usual symptoms include the following functional and personality factors:
How does Alzheimer’s disease affect the brain?

In the brain, messages are sent along networks of brain cells via tiny chemical messengers. Alzheimer’s disease produces tiny ‘plaques’ (disc-like particles) and tangles of fibrous material (called tau) that block the chemical messengers from moving along the brain cell networks. This impairs brain function – making it more difficult to create memories, to plan and to reason. As more plaques and tangles develop, brain cells start to die and the brain actually gets gradually smaller.

What is the cause of Alzheimer’s disease?

There is no single cause of Alzheimer’s. Pollution, viruses, heredity and repeated head injury may all contribute – even underuse of the brain could be a factor. (Aluminium was once considered to be a cause, but this is now doubted.)

Age is the most common factor with Alzheimer’s and there does also appear to be a hereditary element in many cases. But there is still no way to predict who will or won’t get the disease.

The importance of getting a professional diagnosis:

Diagnosis is essential to discovering whether the cause of the symptoms is curable or not. Also, the sooner Alzheimer’s is identified, the more effective treatment could be and the slower the subsequent degeneration.

A positive diagnosis will also open the door to support services geared to dementia sufferers and their carers – and allow the individual and their family to plan for the future.

What medications are there for Alzheimer’s disease treatment?

While there are now various drugs that can be prescribed, none of them is a cure – they can only slow down the development of the dementia.

The drugs work by slowing down the breakdown of the brain’s chemical messenger, acetylcholine, and temporarily stabilises or improves brain function. However, the drugs do not work equally well for everyone – one may work better than another for a particular individual.

Simply call our care team in confidence on 01334 652987 and we can talk through a plan to support you with the issues you are struggling with.

Fronto-temporal Lobar Degeneration (FTLD) 

FTLD affects adults aged 40-60 and early symptoms can be similar to depression or Alzheimer’s disease.Specialist diagnosis is required as drug’s used for Alzheimer’s are not effective and can make the symptoms worse.

 

Symptoms and treatment of FTLD

FTLD is the term used to describe a group of dementias that affect the frontal lobes (the front top part of the brain) and/or the temporal lobes (the lower left and right sides of the brain). FTLD is the third most common kind of dementia in under 65 year olds.

 

The most common types of FTLD are:

Behavioural variant fronto-temporal dementia (also known as Pick’s disease) – accounts for 60% of FTD.

Patients suffering from FTDs may show personality change and impaired or altered social behaviour and a loss of inhibition. They may neglect personal hygiene, show signs of obsessive behaviour and have difficulties with spoken language, among other symptoms.

Semantic dementia – accounts for 20% of FTLD dementia.

Semantic dementia is caused by a shrinking of the temporal lobe of the brain, and affects our knowledge of objects, people, concepts and words (known as the semantic memory). It affects a slightly older group than the other dementias in this group, usually striking between the ages of 50 and 65.

People with semantic dementia may find they forget the meaning of words, and fail to recognise faces and objects. They may even find it hard to recognise familiar sounds, smells and tastes. Their speech is not affected however, and their autobiographical memories are often unaffected.

Progressive nonfluent aphasia – accounts for 20% of FTLD dementia

In primary progressive aphasia (PPA) the main sign is a breakdown in speech and language. Over a fairly long period of time the sufferer will lose their ability to speak, read, write, and/or understand what they hear. This is because the disease affects the part of the brain that controls our ability to use language. As with the FTDs, this illness mainly affects adults between 40 and 60.

 

What causes FTLD?

These dementias are caused by damage or atrophy to the front and temporal lobes of the brain, while the rest of the brain remains undamaged. Between one-third and a half of patients have a family history of the disease. The cause of non-inherited FTLD is not known.

 

The importance of specialist diagnosis:

FTLD dementias are sometimes mistaken for mental illnesses, such as depression or Alzheimer’s disease, because of the nature of the early symptoms.

Specialists can diagnose the conditions by taking very detailed histories and arranging cognitive and other tests. Although a positive diagnosis is not possible through blood tests, these may help rule out other conditions. CT and other scans may also help specialists determine the extent of damage to the brain.

 

Treatment of FTLD

At present there is no cure for FTLD dementias, and it is not possible to slow the progression of the diseases. Drugs used for Alzheimer’s disease, such as Donepezil / Aricept, are not effective in treating FTLD and may even make symptoms worse.

The aim of treatment is therefore to lessen the effect of the symptoms. This is one reason why a proper diagnosis is so important. The more that is known about the person’s condition, the easier it is to help them and their families cope, particularly with the behavioural changes associated with these diseases.

Some useful therapies:

  • Patients with FTD and semantic dementia sometimes benefit from treatment with SSRI antidepressants.
  • Behavioural therapy may be helpful in reinforcing positive behaviour in patients showing challenging symptoms.
  • Spectacles and hearing aids may help in the case of hearing and visual impairment.
  • Speech therapists may be helpful for language problems.
  • Carers and relatives of FTLD sufferers may benefit from help in developing coping strategies to deal with the person’s altered behaviour rather than confronting them directly.

How Oran Care can help

Simply call our clinical team in confidence on 01334 652987 for support to live a better life at home

Mild Cognitive Impairment 

Mild Cognitive Impairment is when a person has some memory loss but they don’t have dementia.Although we can all be affected by ‘senior moments’ the Alzheimer’s Society studies show that 10-15% of people with MCI go on to develop dementia. 

Moreover, underlying conditions can cause MCI such as high blood pressure, depression or sleep apnoea so it is important to obtain an assessment with a specialist.

 

What is mild cognitive impairment (MCI)?

Mild cognitive impairment is a general term that describes some loss of cognitive function that does not qualify as dementia.

The memory loss is observable to the person with mild cognitive impairment and to those around them, and may be diagnosed through testing, but there are no other symptoms of dementia present.

What causes mild cognitive impairment?

It is important to stress that, while everyone has problems remembering things from time to time, particularly as they get older, they normally score adequately on memory tests so cannot be regarded as suffering from MCI.

There are many reasons why someone would experience a memory loss strong enough to be diagnosed with MCI, including stress, depression or a physical condition (examples include high blood pressure and sleep apnoea).

Some people with MCI may, however, be in the very early stages of Alzheimer’s disease or another form of dementia, and this is why correct and early diagnosis is important.

Symptoms of mild cognitive impairment

Mild cognitive function can affect judgement, sequential activities, visual perception and other abilities.

People with MCI do not lose these abilities but they have problems with their memory. They may forget the names of people they have just met or conversations they had a short time ago, while remembering distant events very clearly. They often forget appointments and may find it difficult to follow the thread of a book or film. They may become more irritable than usual, and lose their way even in a familiar environment.

The importance of specialist diagnosis?

According to the Alzheimer’s Society studies carried out in memory clinics showed that 10-15% of people with mild cognitive impairment went on to develop dementia in the following years.

For this reason, it is very important to diagnose people with MCI. The earlier they are diagnosed the easier it is for doctors to keep an eye on them so that if they develop dementia symptoms they can be treated early.

Treatment of MCI

There is no specific treatment for MCI, but in cases where the impairment is a precursor of Alzheimer’s disease, medications intended for Alzheimer’s disease may be effective.

For underlying conditions that may give rise to MCI, such as depression, sleep apnoea and high blood pressure, treating the main condition usually improves the MCI symptoms.

Simply call our care team in confidence on 01334 652987 and we can talk through a plan to support you with the issues you are struggling with.

Vascular Dementia 

Vascular dementia, after Alzheimer’s disease, is the most common cause of dementia.Although it cannot be cured, an early diagnosis is essential as treatment can be effective and can potentially slow the degeneration. 

What are the causes of vascular dementia?

The body’s blood vessels are collectively called the vascular system. If the brain’s vascular system is damaged and blood cannot reach individual brain cells, these will eventually die, resulting in what we call vascular dementia.

 

Risk factors that may cause or accelerate damage to the brain’s vascular system include:

  • Vascular-related problems including strokes, high blood pressure, heart problems, high cholesterol, diabetes (especially type II) and sleep apnoea (where your breathing stops during sleep).
  • Lifestyle factors such as low exercise levels, heavy drinking, smoking, a fatty diet or neglect of medical conditions.
  • Hereditary factors – a family history of strokes or vascular dementia.
  • Ethnic background – Indian, Bangladeshi, Pakistani, Sri Lankan and African-Caribbean people may be more susceptible.
 
Strokes and vascular dementia

Single major strokes are a leading cause of vascular dementia – in this case known as ‘single-infarct’ dementia.

A series of minor strokes can have the same result – and can be so tiny that the sufferer may not even be aware of them happening. This can lead to ‘multi-infarct’ dementia.

 
Small vessel disease-related dementia

This is caused by damage to the tiny bloody vessels that lie deep in the brain. Symptoms appear gradually and may be accompanied by problems with walking.

 
The importance of getting a professional diagnosis

Diagnosis is essential to discovering whether the cause of the symptoms is curable or not. Also, the sooner the cause is identified – whether vascular dementia or something else – the more effective treatment could be and the slower the subsequent degeneration.

A positive diagnosis will also open the door to support services geared to dementia sufferers and their carers and allow the individual and their family to plan for the future.

Once referred to a qualified specialist, testing will include cognitive tests, an investigation of lifestyle factors, medical history and family history and, if necessary, brain scans. It’s also very helpful for a family member to attend to provide verification or additional information about particular symptoms.

 

What kind of treatments are there for vascular dementia?

While vascular dementia cannot be reversed, there are ways to slow down its advance:

  • Strokes, high blood pressure, high cholesterol, diabetes and heart problems can all be treated with medication. 
  • Lifestyle improvements include stopping smoking, decreasing alcohol intake, improving one’s diet and taking regular exercise. 
  • Physiotherapy, occupational therapy and speech therapy can help a sufferer live a more normal, active life

How Oran Care can help

Simply call our clinical team in confidence on 01334 652987 for support to live a better life at home

What Are the Dementia Treatment Options? 

Medication: If you receive a diagnosis of dementia, your clinician may recommend that you see a psychiatrist if they think that it would be helpful to start taking medication.

Acetylcholinesterase Inhibitors such as Donepezil (Aricept), Rivastigmine (Exelon) and Galantamine (Reminyl) are used to stop the degeneration of a chemical called acetylcholine. People with certain kinds of dementia have low levels of acetylcholine which is used to send messages to nerve cells.

These drugs are often prescribed during the first stages of dementia and up to 70% of people experience decreased symptoms. There are some side effects such as nausea, dizziness and headaches; your prescribing clinician may choose to change the drugs you are prescribed if these side effects are bad.

Memantine (also known as Ebixa) can be prescribed to those in middle to later stages of dementia and is used to protect the brain cells from the effects of a chemical called glutamate which causes cell damage. There are some side effects to memantine, but normally less that for Acetylcholinesterase Inhibitors. You may also be prescribed antidepressants or antipsychotic medications depending on your symptoms.

Psychosocial and Psychological:A combination of therapies will help the individual cope better with their dementia and enjoy a better quality of life.

  • Cognitive stimulation involves taking part in activities and exercises that are designed to improve your memory, problem-solving skills and language ability.
  • Reality orientation therapy is a type of therapy that reduces feelings of mental disorientation, memory loss and confusion, while improving feelings of self-esteem.
  • Behavioural therapy is used to help treat many of the behavioural problems that are associated with dementia, such as depression, aggression and delusional thinking.
  • Behavioural therapy uses a problem-solving approach where possible motivations and reasons for troublesome behaviour are identified. Different strategies are then adopted to try to change that behaviour. Behavioural therapy is usually provided by a carer, who can be a trained friend, relative or an employed carer, supervised by a health professional.

Other beneficial therapies for dementia treatment include physiotherapy, occupational therapy and speech and language therapy.

Please call 01334 652987 to speak to one of our trained advisors about our dementia help and support.