Just forgetful or already demented?Dementia is more than just forgetting something. It is precisely said the degradation of memory, which coincides with disorders in various areas such as thinking ability, orientation, language and the behavior.
In contrast to "normal" forgetfulness, dementia patients not only lose details, but find it difficult to retain connections and processes. Not being able to do everyday things on their own and no longer being able to orient themselves in their actually familiar surroundings are signs of dementia.
Dementia is the generic term, Alzheimer's the best known form
The best known form of dementia is Alzheimer's disease. It is one of the so-called neurodegenerative diseases in which there is a gradual loss of nerve cells.
As a result, there is a progressive deterioration of mental abilities, accompanied by speech disorders and often by changes in social behavior and personality. The exact cause of Alzheimer's disease is very complex. Not yet fully understood.
Dementia in numbers
In Germany, about 1.5 million people suffer from dementia. Basically, it can be said that the frequency of dementia increases with age. It is known that less than 2 % of 60 to 69 year olds suffer from dementia. On the other hand, more than 30% of people aged 90 and older suffer from dementia. Over two-thirds of those who suffer are women.
At 60%, Alzheimer's disease is the most common form of dementia, followed by vascular dementia (15%) and a mixed form of vascular and Alzheimer's dementia (15%). Less common are Lewy body dementia, Parkinson's dementia, and metabolic dementias. The term "dementia" comes from the Latin "dementia". Means "without mind. The physician Alois Alzheimer (1864-1915) can be considered the discoverer of dementia. Based on observations and the detailed examination of the brain after the death of the patient, he diagnosed a disease of the cerebral cortex and later described it as the "disease of forgetting.
Thus, he became the eponym and an important brain researcher due to his detailed protocols of symptoms, which were not provable at the time, but proved to be consistent today.
Dementia: Recognizing symptoms early helps
Dementia usually begins gradually. Recognizing these early and in good time helps patients and relatives to cope with them. In addition, in exceptional situations (surgery with anesthesia, infection, etc.), dementia may occur.) to rapid deterioration come.
For a diagnosis of dementia, the symptoms must have existed for at least six months according to the diagnostic criteria of the World Health Organization. It is not uncommon for the emotional changes to be accompanied by physical impairments.
Typically, the disease shows patterns of different symptoms, such as. B.
– Forgetfulness& confusion – depression – aggressiveness& irritability – personality changes – hallucinations& Delusions – Speech difficulties – Spatial and temporal disorientation – Problems in everyday life – Decreasing activity – Loss of sense of smell
Further symptoms can be sleep disturbances and disturbances of the day-night rhythm, appetite and eating disorders as well as swallowing disorders and especially in the late stage also incontinence. It is also typical that dementia patients walk around restlessly.
Precautions to slow down the degradation process
The sooner the diagnosis is made, the better precautions can be taken to help the patient live with it and slow/delay the deterioration process. It helps to remember preserved abilities and to promote them. Exercise is also useful, z.B.:
– Doing sports – going for walks – climbing stairs
As further it would be helpful
– Combining exercise and memory training – it supports brain activity – Eating a balanced diet and drinking enough – Having risk factors like diabetes and blood prere properly adjusted – Connecting by talking to other people – Planning an activating and structured daily schedule
Causes of dementia
Where does it come from, the disease of forgetting?? Dementia is an acquired (d. h. not congenital) weakness of the brain with clear consciousness. It is manifested by a lack of ability to perform everyday tasks. Causes changes in habitual behavior. In mild or moderate dementia, many abilities are still preserved.
In mild or moderate dementia, many abilities are still preserved.
Individual symptoms vary widely in severity, such as. B. the loss of memory. Dementia can also be caused by consequences of a pre-existing disease, some of which affect only the brain, others the entire organism.
What these causes have in common is that they affect large parts or multiple functional areas of the brain, resulting in z. B. may be caused by a failure of nerve cells, or by the interruption of the connections between them.
As a result, it is not just a single brain function that is impaired, such as memory or language, but the complex interplay of the reception, evaluation, storage, and processing of information. Therefore, the effects on behavior. On the ability to perform everyday tasks conspicuously.
Alzheimer's dementia
Around two-thirds of all cases of dementia are caused by the non-hereditary form of Alzheimer's disease, which is almost always diagnosed after the age of 60. Occurs between the ages of 30 and 60.
It causes loss of nerve cells and nerve cell contacts, especially in the temporal and parietal lobes of the brain, producing a pattern of symptoms characterized by disturbances in short-term memory and orientation skills.
Vascular dementia of the small vessels
This is caused by a progressive narrowing of the smallest blood vessels that supply the deeper structures of the brain. Due to these circulatory disturbances, according to. After the fiber connections between the different sections of the cerebral cortex have perished.
Restrictions of attention, slowing down of the intellectual tempo and mood swings are the consequence.
Risk factors
The risk of developing dementia increases sharply at an advanced age. But there are other factors that can favor the development of the disease. In addition to hereditary factors and the female sex, other factors include high blood prere, diabetes mellitus and low mental activity.
Risk factors at a glance
With regard to the currently known risk factors for the development of dementia, a distinction must be made between those that cannot be influenced (e.g. B. age, gender, hereditary factors) and those which can be influenced (e.g. B. smoking, obesity). In older age, Alzheimer's disease is the most common cause of dementia.
In the more rare cases of younger dementia patients, for example, hereditary nerve diseases (z. B. Huntington's disease), infections (z. B. HIV) or nerve damage caused by alcohol or other substances play a role.
Higher age
The greatest risk factor for developing dementia is age. In the second half of life, the risk of dementia increases sharply: In the group of 65- to 69-year-olds, less than two percent are still affected, while 35 percent of those over 90 already suffer from dementia.
Female gender
More than two thirds of all dementia patients are women. This is apparently due to the longer life expectancy of women. Hormonal factors are responsible.
Hereditary factors
Genetic factors can also promote the development of dementia. If first-degree relatives (parents, siblings, children) are affected, the risk of contracting the disease is multiplied. In addition, there are rarer, hereditary forms of Alzheimer's disease, which cause Alzheimer's dementia to occur between the ages of 30 and 60 and to progress rapidly.
Low mental activity and few social contacts
People with a passive lifestyle and those who have little social contact have an increased risk of dementia.
Craniocerebral injuries
Head injuries involving the brain are known to be a risk factor for dementia. Studies have shown that dementia patients have increased deposits of certain proteins (amyloid deposits), which are also considered to be an important characteristic of Alzheimer's disease.
Excessive alcohol consumption
Too much alcohol can not only lead to mild memory problems, but also promote the development of dementia.
Vascular (vessel-related) risk factors and diseases
All factors that increase the risk of cardiovascular disease also increase the risk of dementia. These include, for example, high blood prere, lipometabolic disorders, diabetes mellitus, severe obesity and smoking.
Communicating properly – help and challenge in everyday life
Families and caregivers will find it easier to deal with dementia if they know about the type and possible course of the disease, as will the person affected. Anything that makes getting along easier is welcome to the patient and his or her family and helpers. One thing above all must be taken to heart: communicate correctly.
Good dementia care includes proper communication.
Good dementia care includes proper communication. Even if it becomes more difficult as the disease progresses, because patients become more and more forgetful and can no longer remember names, dates, and word meanings. Understanding and patience of fellow human beings are then required.
Give your memory a helping hand.
You can help your memory with cleverly placed notes. A clearly visible notice on the front door, for example, can remind you to put your keys and wallet in your pocket before you leave the house. The reminder function on your cell phone can also be of good service here – for example, you can have it remind you of important appointments.
Keep a memory book.
Here, photos with a short note (type of event, name, etc.) make it easier for you to take part in the event.) of important events and people from the patient's life promote communication and thus enhance memory performance
Give structure to everyday life.
Fixed structures help with orientation. Try to plan your daily routine as well as possible and maintain a regular rhythm, especially at mealtimes and bedtimes. A weekly schedule makes it easier for you to keep track of everything: Make a note of all the things you need to do each week, such as shopping or doing the laundry. Also record doctor's appointments or appointments. Practical: Copy templates for weekly plans can be found on the Internet.
Plan for the future.
Most dementia diseases are not curable. This is a fact that all patients must face at some time or another. Take your future into your own hands now and use the time to clarify important questions and make fundamental decisions. Powers of attorney, living wills, the will, living arrangements and the organization of finances, for example, play an important role here. This creates safety – for you. Also for your relatives.
Staying active.
Regular exercise, shared activities with family and friends, familiar hobbies such as dancing, pottery or going to concerts also give the brain important impulses. If you like to go for a walk and have problems with orientation, you can arrange to meet someone for a round in the fresh air. Meanwhile, there are also supervised travel groups for people with incipient dementia.
Provide security.
Smoke detectors, special stove fuses or an iron that switches off automatically – these are now important tools for protecting yourself from dangerous situations. Also eliminate tripping hazards in the apartment and provide good lighting in the hallway and living rooms. A good advice is also to leave a spare key with a neighbor you trust. Also arrange with your family or a close friend to check in at a certain time each day. Special home emergency call systems, where an emergency call is sent out at the push of a button, are available, for example, from the Red Cross.
Telephone: store speed dial numbers.
Save important phone numbers as speed dial numbers: For example, specify that dialing 1 will dial your family's phone number, pressing 2 will dial your primary care physician's number, and so on. Important: Post a note with the relevant speed dial numbers on a notice board next to the telephone so that it is clearly visible. Older people often find it difficult to use small buttons – in this case, so-called senior citizens' cell phones or telephones with particularly large buttons can make it easier to use them.
Be open about your illness.
Many people with dementia are reluctant to talk to family or friends about the disease. At the same time, the support of close caregivers is especially important now and can also simplify many things. Unpleasant misunderstandings due to forgotten birthdays or appointments can also be better avoided if people close to you know about them. By the way: Even in a public environment, it can be helpful to inform others if it takes longer to pay at the supermarket checkout or to fetch a bus ticket – then you can hope for a little more understanding. The Alzheimer's Association offers "understanding cards" for such situations, on which it says "I have dementia. Please be patient. Thank you."In this way, you can discreetly inform the person you are talking to about your illness.
Always put important things in the same place.
Where is the key again? Have I lost my wallet? Who does not know this. It can become increasingly difficult to find your "seven things," especially with the onset of dementia. Therefore, you should get into the habit of always putting important things such as house keys, wallet or glasses in the same place. Over time, this place unconsciously anchors itself in your memory – this can be a good trick to save you the hassle of looking for it.
The help of relatives
Around 80 percent of all dementia patients are cared for and accompanied by their relatives – by (spouses) partners, children and children-in-law, grandchildren or other family members and friends.
Caregivers take on a difficult and responsible task that usually lasts for many years. However, there are many ways to turn the time with the illness into valuable and fulfilling years together.
It is important to,
– Praise the dementia patient when he or she has done something right. Do not criticize for mistakes. Patients often do not notice their own difficulties, this is part of the disease. – Wait patiently for the patient to answer questions or comply with a request. – If possible, phrase questions in such a way that the patient can answer "yes" or "no" to them. Make eye contact before every call. Address the patient by name. – Speak slowly, clearly and in short sentences. – Avoid ironic or satirical remarks – the person with dementia usually does not understand them. – Repeat important information several times and if necessary. Write down, for example, the time you want to leave for a doctor's appointment or a walk. – Avoid discussions. – Ignore accusations and reproaches as much as possible – they are often not meant personally, but only reflect fear, frustration and helplessness. – Do not offer more than two choices (such as food or drinks) – anything else will confuse dementia patients.
An important model for communicating with people with dementia is called validation: trying to reach dementia patients where they are in a sense. They are left in their own world and their opinions and views are not challenged. It is about appreciation and taking the dementia patient seriously (= validation).
No more help than necessary
The slowness of the person with dementia drives relatives to impatience or excessive care. Less help is often more and not taking everything off the patient's hands, but giving him time to do things himself. This not only trains the brain, but also prevents dementia patients from feeling like they are being treated like a child.
Stimulate the senses as a family member. Familiar smells can awaken memories that were thought to have been lost. Stimuli such as touching, tasting, seeing can also stimulate dementia patients.
Provide for the own discharge
Think of yourself as a relative. You have shown patience, strength, time and understanding. This wears you out when dealing with dementia patients. It is exhausting. Demands a lot from the caregivers. Regular rest and relief are therefore very important and give strength for the next round. Get support early on. Take advantage of counseling services (z. B. Care support point, Alzheimer Society).
Therapy and dementia care at TWW
The Department of Psychiatry and Psychotherapy II of the Kliniken im Theodor-Wenzel-Werk provides diagnostics and treatment of all mental illnesses based on current, scientifically founded quality standards. For this purpose, a multi-professional team is available consisting of specialists (for psychiatry, neurology and internal medicine), psychologists and neuropsychologists, special therapists (ergo-, physio- and music therapists), social workers as well as specially trained nursing staff.
One focus is the gerontopsychiatric care of patients in advanced age. Somatic, psychotherapeutic and social psychiatric treatment approaches are combined in the best possible way.
The gerontological psychiatric ward 5
The ward is a special ward for psychiatric illnesses from the age of 65. Year of life. Here we treat the full spectrum of psychiatric illnesses in older age.
Our treatment spectrum includes u. a.:
– Depression – Psychoses – Dementia – Delirium – Dependency disorders – Anxiety and obsessive-compulsive disorders
Diagnostics and therapy
After comprehensive diagnostics (physical and neurological examinations, laboratory, imaging diagnostics, neuropsychological examination and if necessary. CSF puncture), an individual treatment plan is drawn up taking into account the patient's respective resources. Promoting the rhythm of the day and night through day-structuring measures is of great importance. Adequate activity and rest phases are taken into account in therapy planning.
Activating treatment care
One of the main pillars of gerontopsychiatric therapy is activating treatment care for patients who have become needy due to their somatic and mental illnesses. Individual support helps patients to regain their independence.
Therapy services
In addition to the necessary medical, nursing and psychological examinations and treatment measures, various individual and group therapies take place as needed, such as e. B.
– Physiotherapy / ergotherapy / relaxation groups – depression and anxiety management groups – memory groups – breakfast group – biography work and music therapy – animal-assisted therapy
Information and registration
Silvia Zander Registration / Occupancy Management Tel. (030) 8109 – 1177 Fax (030) 8109 – 1178 occupancy [email protected]
Patients and relatives can leave their name and telephone number at this number. The occupancy management or the senior physician will then contact you.
Visiting hours are daily from 15.00 – 20.00 o'clock. Individual visit times are available by appointment.