HCA Midwest Health - December 03, 2017

My grandpa asks the same questions over and over again and it can be very frustrating, especially for my grandma. I know he has dementia, but can't anything be done? I don't want it to affect her health too.

Caring for a loved one with dementia can be difficult and frustrating at times. Knowing the disease has no cure and will progressively worsen can be overwhelming. And the level of help dementia patients require may leave caregivers feeling exhausted—both mentally and physically.

Planning can help with caregiver exhaustion. Knowing that a loved one’s memory can wax and wane on any given day, having a routine can help offset the frustration. Calendars and daily routines can be some of the best tools to use daily. Start each day with a calendar of what is happening. Even if it is to document meals, TV shows or people visiting. Establish a daily routine. For example, getting up, brushing teeth, exercise, review calendar, eat breakfast and so on. It is also helpful to put notes around the home, such as on the refrigerator, doors or draws. The notes can serve as reminders and help them locate things and perform activities.

Also, learning what patients may be experiencing can ease some of the burden. A loved one with dementia may feel anxious, lost, easily frustrated, suspicious, or helpless which can affect how they react. With a greater understanding of the disease and its progression, caregivers are better prepared to communicate with the patient and handle the more frustrating aspects of care.

What is dementia?

Dementia is a chronic disorder of mental processes that affect memory, personality and reasoning. Alzheimers dementia is the most common form of dementia. Dementia starts off mildly and can progressively worsen over time. It is often first recognized when a person is unable to recall how to perform familiar tasks. Examples of this could include paying bills properly, cooking a dinner, recalling people they have known for a long time, finding their way home, choosing words to complete a sentence, or repeating the same thing. Progression can include personality and behavioral changes such increased irritability, anxiety, depression, rapid mood swings, confusion, fearfulness, suspiciousness, aggression and agitation. At some point in the process it will impair a person’s ability to perform daily activities such as taking showers, getting dressed and feeding oneself.

How is dementia diagnosed and measured?

Dementia is diagnosed by a physical examination, a thorough review of a patient’s medical history and medications, imaging, and an evaluation of daily functioning and changes in behavior. Often doctors will order lab tests that include B12, folate and thyroid studies. Many times a baseline imaging of the head is performed to rule out any reversible causes. Another tool used by medical professionals is a bedside cognitive assessment (Mini Mental State Exam, SLUMS, or MOCA). The quick question exam provides a snapshot of a patient’s memory and is often repeated at doctor visits to measure any changes in memory. It can also provide insight into possible reversible medical issues like infections or mood disorders such as depression that may be occurring.

Caregivers can help the patient’s medical care team by identifying new or worsening symptoms. Keeping a journal with this information and sharing it with the patient’s physician can be especially helpful.

What can be done for caregivers?

Caring for a loved one with dementia can be very stressful. Dementia patients may not remember who their spouse or family members are, and also may become aggressive. It can be very difficult for caregivers to understand or remember that it’s the disease is causing this behavior and that it is not really their loved one. Caregiver communication techniques can help to create a less frustrating environment for everyone. Some tips are:

  • Not arguing – Their reality might not be reality. Remember, this is the disease. It is about helping, not being correct
  • Diffusing the situation – If they are upset, apologize even though you may not be at fault. If they are worried, reassure instead of lecturing
  • Making up stories – If they want to drive, answer that it is broken instead of saying they can’t
  • Redirecting – Change the subject or environment to refocus their attention
  • Asking – Instead of posing things as commands to your loved one, pose things as requests
  • Reminiscing – Do not get frustrated if your loved one cannot remember things. Instead, focus on reminiscing with them about what they do remember
  • Repeating – Repeat questions or statements as necessary instead of saying things like “I already told you”
  • Staying Positive – Keep a positive outlook on the situation and give yourself breaks as needed to be able to stay positive (see below)

It is important that caregivers monitor their own stress levels and seek help from family, friends, respite care, support groups, daycare centers or home health agencies when needed. Although transitions to nursing care centers can be overwhelming, the caregiver needs to be as healthy as possible to be able to continue to provide support. It’s imperative that caregivers make time for themselves. Failing to do so can result in depression and high blood pressure, among other issues.

Additionally, if caregivers decided to admit their loved one into a memory care unit and are having feelings of guilt or remorse, they should seek advice from a medical professional.

Dementia diagnosis and care in Kansas City

If you suspect a loved one could have dementia, it may be time for a professional evaluation. The HCA Midwest Health Neuroscience Institute is one of the Kansas City area’s premier treatment resources for neurologic conditions. With six hospitals and over 30 specialists in the area, we are committed to ensuring patients have access to the closest, most convenient and appropriate point of care. Dementia evaluation is available at:

To make an appointment with a Neuroscience Institute Specialist, call (877) 456-7979.

If you have any questions about the progression of dementia, or for help finding the appropriate doctor for a patient or caregiver, HCA Midwest Health offers a service where you can speak for a registered nurse 24 hours a day, 7 days a week, free of charge. Just call 1-800-386-9355.

tags: neuro care , t4b