August 5, 2014
Dementia Support gave back to the community last month with a special workshop conducted at North York General Hospital. After an outstanding success at the ER of NYGH, another training session was conducted for the staff at North York General Hospital on the 5 West wing, using the Montessori Methods For Dementia Implementation. This session was intended to help make better the life of those who are in hospital for months. There were two sessions during the day which took place at NYGH in the McGovern Boardroom. The sessions were well attended, and the participants were very engaged in the experience.
January 13, 2014
Dementia includes a group of symptoms, the most prominent of which is memory difficulty with additional problems in at least one other area of cognitive functioning, including language, attention, problem solving, spatial skills, judgment, planning, or organization.
These cognitive problems are a noticeable change compared to the person’s cognitive functioning earlier in life and are severe enough to get in the way of normal daily living, such as social and occupational activities.
A good analogy to the term dementia is “fever.”
Fever refers to an elevated temperature, indicating that a person is sick. But it does not give any information about what is causing the sickness. In the same way, dementia means that there is something wrong with a person’s brain, but it does not provide any information about what is causing the memory or cognitive difficulties. Dementia is not a disease; it is the clinical presentation or symptoms of a disease.
There are many possible causes of dementia. Some causes are reversible, such as certain thyroid conditions or vitamin deficiencies. If these underlying problems are identified and treated, then the dementia reverses and the person can return to normal functioning.
However, most causes of dementia are not reversible. Rather, they are degenerative diseases of the brain that get worse over time. The most common cause of dementia is AD, accounting for as many as 70-80% of all cases of dementia.
As people get older, the prevalence of AD increases, with approximately 50% of people age 85 and older having the disease. It is important to note, however, that although AD is extremely common in later years of life, it is not part of normal aging. For that matter, dementia is not part of normal aging. If someone has dementia (due to whatever underlying cause), it represents an important problem in need of appropriate diagnosis and treatment by a well-trained healthcare provider who specializes in degenerative disease
Rather, there can be early or mild stages of AD, which then progress to moderate and severe stages of the disease.
One reason for the confusion about dementia and AD is that it is not possible to diagnose AD with 100% accuracy while someone is alive. Rather, AD can only truly be diagnosed after death, upon autopsy when the brain tissue is carefully examined by a specialized doctor .
During life, a patient can be diagnosed with “probable AD.” This term is used by doctors and researchers to indicate that, based on the person’s symptoms, the course of the symptoms, and the results of various tests, it is very likely that the person will show pathological features of AD when the brain tissue is examined following death.
November 12, 2013
Dear families and friends,
This week, once again, there was news of a tragic incident in which a nursing home resident was found dead after an alleged attack by his elderly roommate.
Having specialized in the field of elder care for over 10 years, I would like to emphasize the importance of the application of Montessori principles to the everyday life of dementia patients.
The benefits of the Montessori methods include the following:
Residents in long-term care facilities often seek attention due to boredom and confusion. When these needs are not met in a healthy manner, they grow increasingly frustrated and negative behaviours emerge.
Keeping dementia-sufferers busy and engaged, with meaningful activities, reduces their anxiety and frustration so tragic incidents can be avoided. What’s more, these activities can be successfully adapted for use in used in hospital, institutional or home settings.
For more information about the Montessori methods we utilize at our facilities on a regular basis, please check:
Let’s provide the best care for our elders, until a dementia cure can be found.
The Heartfelt Story of a Daughter
When I was in graduate school, I had to take a seminar on Petrarch, the Italian poet of the 14 th century.
I hadn’t thought about him much in the last nearly 40 years but, while thinking about tonight, I remembered that our professor had said that Petrarch was a poet for older people. He dealt with the illusory and ephemeral nature of our existence and I made the connection because this is, to a great extent, what dementia is about. It’s about how we relate to people who are no longer who they used to be – people who had personalities, habits, foibles, a sense of humour, most of which are vanishing or have vanished. And in a world which values individualism, it is very disconcerting to see people slowly lose theirs. Who are they now that their character has disappeared?
Judy asked me to speak to you tonight because my mother has advanced dementia and is living at L’Chaim. But before I talk about her, I’d like to talk about my late father who also became demented. My father was a surgeon, spoke five languages and was a bridge champion (my mother was his tournament partner). He was wonderful and we adored him. When he was 78, the whole family took a trip to London. We decided to go to Windsor Castle one morning but Dad preferred to spend it at the University of London Medical School’s bookstore which happened to be right across the street from the hotel. After we came back and told him about our fabulous outing, he announced to us that he had Alzheimer’s. He had spent the whole morning reading about geriatric neurology and this was his conclusion. We couldn’t believe it – his memory was fine, he didn’t forgetting things. But he insisted he was right. In the end, it turned out not to be Alzheimer’s but stroke-induced dementia aka vascular dementia. Close enough, though. I was very close to my father and called him frequently. “How are you, Daddy?, I would ask – and he would reply “The disease is progressing.” I used to wonder when he would no longer be able to report this to me and what he must have been feeling, knowing what was happening to him. When he consulted a geriatrician who asked him to write the sentence “Canada is a big country”, he wrote down “It is difficult.”
I’ll tell you about an incident that occurred when the disease had indeed progressed. One evening around 9, I was home and the phone rang. It was my father and there was fear in his voice.
The conversation went like this:
Daddy: Roberta, I don’t know where I am.
Roberta: What do you mean you don’t know where you are? You’re at home.
Daddy: Roberta, I don’t know where I am.
Roberta: Where is Mommy?
Daddy: I don’t know.
Roberta: Are you in a room with kitchen cupboards or with a bed?
Daddy: With a bed.
Roberta: Daddy, this is what we’re going to do. In a minute, you’re going to hang up and I will phone you back but don’t pick up the phone. OK? Let it ring.
I phoned, as I said I would, and my mother who was watching TV in the den answered and I told her to go to the bedroom and bring my dad to the den to sit with her.
Now, if you think about it, this is a very strange story. My father knew how to dial my number and knew that I was on the other end and yet he did not know that he was in his bedroom, in his own apartment. It’s truly paradoxical. And that’s the thing about dementia, it’s about living with paradoxes and ironies. – And it’s about diminishment, like having your driver’s license taken away or waking up one morning and no longer knowing how to make coffee, something you’ve done for 60 years. It’s strange and it’s cruel and frightening – and logic does not apply. And now, you, the adult child, have to parent your own parent. But how do you parent someone who isn’t a child? Another paradox.
My mother’s dementia is somewhat different and its causes are complex. Suffice it to say that she too suffered declining cognitive abilities. She began by getting help at home which ultimately extended to having caregivers 24/7. But that did not last and I sold her condo and moved her to live with me and my husband. But after a time,
as her disease progressed, being together became more and more difficult. How do you handle someone who asks you the same question every 15 seconds? And what do you do when you feel yourself going downhill? At one point, my son who is a psychiatrist said to me: “You know mom, everyone has an emotional bank account, and when that account runs dry, it is very hard to refill.” And that’s when I started to look for a place that would give my mother the kind of environment she needed. And this is why I chose L’Chaim.
In Shakespeare’s Hamlet, Hamlet says “I must be cruel to be kind.” Another paradox. Yet I can relate to it. I had to be cruel – by inflicting psychic pain on myself – to be kind to my mother and find her a place to live the life that she needs at this moment of her life. She frequently says: “I want to go home” as do many who suffer from dementia. But
home does not mean a place, home is a state of mind. “I want to go home” is a metaphor and it means “I want to be as I used to be,” “I want to be well”.
My mother complains to me that she has made no friends at L’Chaim. But how could she? She can hardly communicate anymore. She still understands three languages, only she can barely find a word in any of them. Her neighbours can’t communicate very well either. They are all shadows, incarnate shadows, who others live in their bodies and have feelings – another paradox. When I come to visit at L’Chaim, I always observe my mother for a few moments before she knows I’m there. I invariably see that she is engaged in whatever activity she is involved in and she seems content.
Petrarch writes in Sonnet 26 of his Lyrical Poems:
Grizzled and white the old man leaves
the sweet place, where he has provided for his life,
and leaves the little family, filled with dismay
that sees its dear father failing it:
Shakespeare and Petrarch grasped what dementia is all about. But most of us are not poets and, for us, “It is difficult.”
November 11, 2013
Diagnosing Dementia early
Dementia is one of the most feared health conditions. People with dementia and their families are sometimes reluctant to seek advice when concerned about memory or other problems. But there are many potential benefits to getting medical advice if you’re worried. Being diagnosed early is important for many reasons. It helps you to get the right treatments and to find the best sources of support, as well as to make decisions about the future.
It may not be clear why someone has problems with memory or has a change in behavior. These problems may be because of dementia, or down to other reasons such as poor sleep, low mood, medications or other medical conditions. This uncertainty can be distressing for both the person experiencing difficulties, and their family and friends. While a diagnosis of dementia can be devastating news, an explanation of what the problem is and what can be done about it can help people feel empowered and reduce some of the worry caused by uncertainty. Some people find it helpful to discuss with doctors and nurses how the dementia may affect them or their loved one in the future, and there is advice available about how to stay independent and live well with dementia.
Dementia is not a single condition – it refers to difficulties with thinking and memory that may be caused by several different underlying diseases. This is one reason why not everyone with dementia experiences the same problems.
Identifying that there is a problem, and then diagnosing the underlying cause is important for guiding treatment and accessing services.
Some causes of dementia are treatable and reversible (either partially or fully, depending on the nature of the problem). Conditions such as anxiety and depression, some vitamin deficiencies, side effects of medications and certain brain tumors fall into this category.
Treating high blood pressure, high cholesterol and poorly controlled diabetes is also important, as is stopping smoking and keeping to a healthy weight. These factors (known as risk factors) all contribute strongly to vascular dementia, and may make Alzheimer’s disease worse. Your GP will be able to assess your risk factors, advise if treatment is needed and monitor you.
Whether or not there are specific treatments for the cause of the dementia affecting you, having the correct diagnosis is important for getting the right advice and support. There is a lot of help and information available both for people with dementia and their friends, relatives and carers.
October 26, 2013
Published by Judy Cohen
Carers come from all walks of life. There are millions of people around the world that provide care on an unpaid basis for a relative, friend or neighbour in need of support due to old age, disability, frailty or illness. The population of carers is dynamic: at least a third of all people will fulfil a caring role at some point in their lives. At least half of all carers are in full or part time employment and some care for more than one person. Carers save the world economy billions of $ a year.
When people need help with their day-to-day living they often turn to their family and friends. Looking after each other is something that we do. Dependent on the dementia, carers will help with personal things like getting someone washed and dressed, administering their medication, taking control of running the household and finances.
It is important to maintain the independence of and enhance the quality of life for both the carer and the person with dementia. It will encourage them to concentrate on the things that can be done rather than the those which have been lost.
For many people caring comes unexpectedly and in a few short months your life can be turned upside down. Some people are caring round the clock, 24 hours a day. How caring affects you depends on how much you are doing, what else is going on in your life and to some extent what kind of a person you are.
Caring can be a rich source of satisfaction in people’s lives. It can be life-affirming. It can help deepen and strengthen relationships. It can teach you a multitude of skills and help you realise potential you never thought you had.
But without the right support caring can have a negative outcome. Research has shown that becoming a carer can have many impacts on a person’s life. When caring is intensive and unsupported you can struggle to stay healthy and maintain your relationships with friends and family. Other effects can include social isolation and poor health through stress and physical injury and worry over financial costs.
Join the Caring For The Caregivers- free support group, every last Wednesday of the month
at 7pm. help at Dementia Support Day Centre 1140 Sheppard Ave West# 12. Toronto, Ont
September 10, 2013
August 13, 2013