Dealing with Dementia, Alzheimer's DiseaseSunday, September 19, 2021
BY KIMBERLEY HIBBERT
TUESDAY, September 21 is World Alzheimer's Day and will be celebrated under the theme 'Know Dementia, Know Alzheimer's', as part of an international campaign led by Alzheimer's Disease International (ADI) to raise awareness about dementia and challenge stigma.
Alzheimer's disease is the most well known and common form of dementia, but not everyone with dementia has Alzheimer's disease. The ADI is the global federation of over 100 Alzheimer's and dementia associations across the world. Related partners, including Strengthening Responses to Dementia in Developing Countries (STRiDE) Jamaica, are encouraging everyone to know dementia and know alzheimer's by spotting the warning signs of dementia and seeking information, advice and support which can all potentially lead to a timely diagnosis.
However, Dr Ishatar Govia, clinical psychologist and country lead for STRiDE Jamaica, told Jamaica Observer's Your Health Your Wealth that receiving a diagnosis of dementia can be a challenging and difficult process and varies greatly around the world. Dr Govia said the stigma which still surrounds dementia means that many people avoid seeking a diagnosis until the later stages of the condition.
Rochelle Amour, research fellow with STRiDE Jamaica, pointed out that regarding local prevalence, in 2015 there was an estimation by the Mona Ageing and Wellness Centre that over 41,000 persons with dementia live in Jamaica. This far surpasses the 2010 estimate of 19,000 and is likely to increase exponentially due to rapid population ageing.
By 2050 about 90 million of the 131 million expected to develop dementia will be from lower- and middle-income countries (LMICs). The Caribbean and Latin American population is one of the fastest ageing populations, according to the WHO.
Armour said while there are no exhaustive prevalence studies to determine the exact figure, in most LMICs diagnosis rates are quite low due to, for example, the fact that globally, over half of doctors surveyed believe that dementia is a normal part of ageing.
Regarding deaths, in many countries, due to comorbidity, stigma and myths that dementia is a normal part of ageing, dementia is not always categorically included on death certificates. In addition, dementia is not always individually identified on mental health clinic records in the public sector, which further adds to the challenges in determining prevalence and death rates. Armour said these kinds of myths contribute to stigma among the general public and very few people seek help until, or unless the disease gets to an advanced stage.
The theme for this year encourages people to identify signs and symptoms to allow for more timely diagnosis, which we know helps families to plan and cope better with the disease.
According to the ADI, some warning signs include memory loss, difficulty performing familiar tasks, problems with language, disorientation to time and place, poor or decreased judgement, problems keeping track of things, misplacing things, changes in mood and behaviour, trouble with images and spatial relationships and withdrawal from work or social activities.
Information from STRiDE Jamaica indicate that Alzheimer's can cause people to act in different and unpredictable ways. Some individuals become anxious or aggressive, while others repeat certain questions or gestures. Many misinterpret what they hear and some may also experience confusion, sudden suspicions of others, trouble sleeping, wander and get lost.
According to STRiDE, these behaviours may be related to physical pain or discomfort due to infection, medication side effects, hunger or thirst that the person is unable to communicate directly; overstimulation — loud noises or a busy environment; unfamiliar surroundings — new places or the inability to recognise home; complicated tasks — difficulty with activities or chores; frustrating interactions — inability to communicate effectively may cause fear, sadness or anxiety.
It is important to understand that the person is not trying to be difficult but may simply be trying to communicate with you. Therefore, do not take aggression personally. Remember that the person is not fully aware of what they are doing.
Below, STRiDE Jamaica shares tips on responding to unpredictable behaviour in individuals who develop dementia.
1. Be a detective
Look and listen to see what the person is trying to communicate. Rule out physical pain or discomfort — including side effects of a new medication, constipation, irritated skin or infection — then try to think about what happened right before which may have triggered the behaviour.
2. Stay calm
Using a calm tone, try to reassure the person. Be positive and reassuring. Let the person feed off of your calm emotions; do not let their aggressive words or actions set the tone.
3. Ensure safety
Make sure you and the person are safe. If you think the person might harm themselves or others, seek assistance. If you call emergency services, be sure to alert them that the person has dementia and is not in full control of their actions.
Everyday tips for dealing with loved ones with dementia include:
1. Involve the person in activities
Engage the person in art, music or other activities to promote relaxation.
2. Modify the environment
Decrease noise and distractions or relocate the person to help reduce anxiety.
3. Find outlets for energy
The individual may simply be bored and need a distraction. Engage the person in an activity like chores, taking a walk or working on a puzzle.
4. Use memory aids
Offer reminders like notes, photographs, clocks or calendars to help with confusion.
5. Do not argue
Allow the individual to express his or her ideas and acknowledge what was said. Offer an answer, but keep it brief and simple.
6. Inform others
Make sure friends, family and neighbours know that the person has dementia and that wandering may occur.
7. Make the home safe
Install handle bars or non-slip mats to prevent falls, and install sturdy locks or an alarm.
Dr Govia encouraged individuals to follow STRiDE Jamaica on Twitter @StrideJamaica and take advantage of free care management consultations by emailing the group at firstname.lastname@example.org or calling 876-472-9552.