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For a start what does dementia mean? Very simply for such a complex area, it is an illness of the brain. What is the difference between Alzheimer’s and dementia? The word dementia is an umbrella term, which covers all the various dementias including Alzheimer’s. Alzheimer’s is the one widely recognized, and accounts for about sixty per cent, of all the dementias. Dementia is a term that is used to describe a collection of symptoms including memory loss, problems with reasoning and communication skills, and a reduction in a person's abilities and skills in carrying out daily activities such as washing, dressing, cooking and caring for self.
Memory loss - this can be one of the first symptoms that people notice. The observations people report include - noticing their loved ones forgetting things that have happened earlier in the day, getting confused about messages and who people are, getting lost whilst out and about, repeating themselves, and appearing not to be paying attention or following conversations.
Problems with communication - Some people experience problems with expressing themselves, talking and understanding things. They get confused about words and might use the wrong words for common things and mix words up. Reading and understanding written text can become problematic. There are a number of different types of dementia the most common being Alzheimer's disease, vascular dementia, Fronto temporal dementia and Dementia with Lewy bodies. Some people get diagnosed as having mixed dementia; this is when the presentation shows the person to have elements of more than one type of dementia. Dementia is a progressive condition, which means the symptoms will gradually get worse. This progression will vary from person to person and each person will experience dementia in a different way. Although the person will have some of the above symptoms, the degree to which they affect an individual will vary and not all people will have all of these symptoms.
The temporal lobe of the brain if affected by dementia will mean the sufferer will ‘forget’ every day functions, and how to perform them, relatives names and faces, their ‘past’ life, and friends they have known for years. Simple tasks that they used to perform with ease, become difficult to perform, and they have to ‘learn’ how to do them again. Sufferers can forget conversations and instructions, and need to be reminded on a regular basis, and given ‘prompts’ to remind them the topic of conversation, or what they are supposed be doing next for example. The frontal lobe of the brain if affected by dementia can mean that the sufferer is ‘unaware’ that their behaviour is unacceptable, or not the ‘norm’.
The sufferer can become agitated very quickly, and suffer from depression. They may be unaware of apparent dangers, and unable to recognise what is ‘acceptable’ or ‘unacceptable’ behaviours. They may have violent outbursts, and exhibit ‘threatening’ behaviour to others. The parietal lobe of the brain if affected by dementia affects language skills. This means that communication skills could be reduced. The person may not be able to ‘find’ the appropriate words to use, or may not understand questions asked of them. They may not relate ‘words’ to the correct ‘objects’ for instance if they pick up a cup, but call it a ‘pot’.
Depression, memory problems, and delirium may be mistaken for dementia because these are often the onset symptoms of dementia, and therefore may be mistaken for the start of dementia in the elderly. Some symptoms of dementia are similar to symptoms of some mental health conditions. It is important that a comprehensive assessment is carried out if service users start to display symptoms such as confusion, poor memory or apathy. These could be indicators of dementia, but they could also be symptoms of depression, or other mental health conditions.
The medical model of dementia is of mental decline. This approach makes it hard to focus on maximising a person’s abilities and improving their quality of life. Putting physical problems and emotional states down to brain damage, the medical model overlooks the social world of people with dementia, and concentrates on the illness, rather than the person.
The social model of dementia sees the ‘person’ rather than the illness or disease. It puts the focus on what a person ‘can do’, (positives), instead of focussing on what the person can no longer do (negatives). The social model looks at ways to improve the quality of life, and experiences of dementia, and provide techniques for the dementia sufferer, to live a fulfilling and rewarding life. The social model recognises and includes the individual’s social, recreational, spiritual needs, instead of just their medical or personal care needs.
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