If you’re wondering what to expect with dementia progression, you’re not alone. Dementia is a progressive, physiological, degenerative brain disease, and currently, there is no cure. Dementia affects the part of our brain that controls our memory, language, and thoughts. The disease is going to affect your loved ones in primarily four ways: Short term memory, the ability to think rationally and speak clearly, the ability to listen and process information logically, and the ability to care for themselves physically.
1. Short term memory
People living with dementia won’t remember things they said or did minutes or even seconds ago. It is very common for them to repeat themselves over and over again. They aren’t doing this intentionally to annoy you. They truly aren’t aware they are repeating themselves for the tenth or twentieth time.
Memory loss can be helped by using calendars, notes, and gentle reminders. Try to avoid saying, “Don’t you remember?” – because they don’t. They are not repeating things on purpose.
2. Ability to think rationally and speak clearly
People living with dementia may say and do things that won’t make sense or aren’t true. For example, they have a tendency to be accusatory – accuse you (primary caregiver) of things you didn’t do, such as stealing money out of their wallet. Or, they may hide things in bizarre places, such as hiding their keys in a Kleenex box or putting their purse in a bag in the far corner of a closet. They won’t remember they did these things so they will accuse you of hiding their keys or their purse. We refer to these accusations as “dementia accusations.” Their brain creates an alternate version of reality in order to make sense of the way things are.
The ability to think rationally and speak clearly can be helped by understanding the situation. Try not to get angry or resentful. It’s the brain disease that is taking these abilities away, not your loved one.
3. Ability to listen and process information logically
At some point, you’re not going to be able to reason with a person living with dementia. In other words, you’re not going to be able to have a rational conversation. As the disease progresses, their ability to listen and process information logically declines. Dementia affects the brain’s ability to process and retrieve information. At some point, they lose their ability to understand what you are saying to them and they won’t be able to respond appropriately to normal conversation.
The ability to listen and process information logically cannot be changed, but talking slower, using fewer words and shorter sentences, and making eye contact is very beneficial and helpful.
4. Ability to care for themselves physically
One of the hallmarks of dementia progression is that people living with dementia slowly lose their ability to perform daily activities, such as brushing their teeth, combing their hair, dressing, bathing, and toileting. As the disease progresses, their ability to physically take care of themselves declines. What we consider to be simple tasks become very difficult and complex for them to perform. As a matter of fact, some of these activities can become extremely challenging and difficult to deal with.
The ability to care for themselves physically is exceedingly difficult and requires your caring for their basic needs. It can be humiliating for your loved one to not be able to do these things any longer, and it may be very demeaning for them. Remember that your loved one is still there, and they need your support, love, care, patience, and compassion more than ever with these personal tasks.
These four things may begin to be obvious as the disease progresses. Your goal as a caregiver is to figure out how to mitigate them for the best quality of life.
Dementia progression is sad, difficult, and taxing. Understanding the disease, and the journey you are on helps you in planning ahead, putting together a support team and making the time you have together as loving, meaningful, and as easy on you as possible.
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