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Understanding the Three Ds: Dementia, Delirium, and Depression

Monday , March 22 , 2021

Understanding the Three Ds: Dementia, Delirium, and Depression

Older adults are at high risk for depression and cognitive disorders such as dementia and delirium. Clarifying the diagnosis is the first step to effective treatment – but it’s not always easy. 

Delirium and depression can cause cognitive changes that may be mistaken for dementia, such as poor memory. And people who have dementia often develop signs of depression, like poor appetite and low self-esteem. 

There is also the genuine possibility that an older adult may have a combination of all three issues concurrently. 

So, how can you tell the difference between dementia, delirium, and depression in older people, to ensure they receive the proper care? Keep reading to learn more about the signs and symptoms of each condition. And make sure to sign up for our “Understanding the 3 Ds” webinar at the bottom! 

Delirium

Delirium is a neuropsychiatric syndrome that causes sudden changes to a person’s thinking and attention, causing them to become confused. Episodes of delirium are common among older adults, especially those who are ill, in the hospital, or recovering from surgery. The condition develops acutely and is temporary and reversible. 

The most common symptom is inattention, though a person experiencing delirium may also suffer from difficulty with orientation, memory, or language and thought. Hallucinations or illusions may also be present. 

Depression

Depression is a common mood disorder. In fact, according to the World Health Organization, over more than 264 million people suffer from the illness, and it’s the leading cause of disability worldwide. 

The diagnosis of depression depends on the presence of two main symptoms: persistent and pervasive low mood and loss of interest or pleasure in usual activities. Other signs include: 

  • Increased fatigue and sleep problems
  • Anxiety
  • Irritability (primarily in men)
  • Changes in appetite or weight
  • Uncontrolled emotions

Symptoms are of clinical significance when they interfere with everyday activities and last for at least two weeks. 

Along with apathy, depression is one of the most common symptoms in Alzheimer’s Disease – especially those with Lewy bodies. 

Dementia

Dementia is not a single disease but an umbrella term covering a wide range of medical conditions, including Alzheimer’s. According to the National Institute on Aging, “Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Signs of dementia can vary greatly, but some common examples include: 

  • Problems with short-term memory
  • Increased confusion
  • Reduced concentration
  • Personality or behavior changes
  • Depression or apathy

Complications in Diagnosis

Symptoms of delirium, depression, and dementia can be pretty similar. For instance, delirium and depression may present with apathy and withdrawal, while delirium and dementia are characterized by confusion and disorientation. 

To further complicate matters, delirium and depression often occur in a person with dementia, so it is common to have all three issues at once. 

Differentiating delirium from depression and dementia requires knowing the characteristic features of each condition and knowing the patient’s history (either personally or from a family member or friend). 

The Victoria State Government has a helpful chart with a side-by-side analysis of all three conditions and their key features. 

Attend a FREE ComForCare Workshop

ComForCare is offering a free virtual workshop on Wednesday, March 31st, from 1:00 pm – 2:30 pm. 

The workshop entitled “Understanding the 3 Ds: Dementia, Delirium, and Depression” will count as one continuing education credit for social workers and case managers and 1.5 contact hours for RNs/LPNs.

By the end of the program, participants will be able to: 

  • Distinguish between dementia, delirium, and depression and the causes and prevalence of each
  • Recognize the signs and symptoms that overlap across all three conditions, as well as the differences that set them apart
  • Identify common scenarios in which combinations of conditions may occur
  • Explain why people need a thorough evaluation of any changes in mental status, including those already diagnosed with dementia
  • Take the appropriate actions to connect families and individuals to evaluations and resources if dementia, delirium, or depression are suspected

Go to bit.ly/delirium2021 to sign up today! 

Posted in: Aging

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60 Fun Activities for Dementia Patients and Their Caregivers

Monday , October 12 , 2020

60 Fun Activities for Dementia Patients and Their Caregivers

Being a family caregiver is a highly rewarding experience, but it can be challenging at times. Caregivers of dementia patients, especially, can feel like they work and work and work and don’t make a difference.

That doesn’t have to be the case.

Part of being a great caregiver is learning about activities that will help engage someone who has been diagnosed with dementia or Alzheimer’s, regardless of the level of the disease. Staying active and engaged is beneficial for both physical and cognitive health and can help ease anxious or aggressive behaviors. On top of that, activities done together can help form a bond of trust and security between the caregiver and their loved one.

Of course, many caregivers are thrown into the role by chance and have no formal training or education.

If you’re like the millions of other adults unexpectedly caring for an older friend or family member, you likely have no idea which activities are appropriate for a dementia patient and which are not.

To help keep you and your loved one busy and engaged, we’ve rounded up a list of 60 meaningful activities you can take part in together. Keep reading to learn more:

 

Planning Dementia Friendly Activities 

Where is a good place to begin when planning activities for a loved one with dementia? A good rule is to meet them where they are. Some good guidelines include:

  • Avoid pointing out what they can no longer do. Focus on options that compensate for skills they may have lost. For example, if your loved one can no longer read, try browsing together for audio books that they might enjoy. Use a computer or phone?
  • Keep track of skills and abilities. Keeping track of the skills and abilities as they deteriorate is vital. Can your loved one able to go to the grocery store and shop? Can they plan and cook a simple meal?
  • Be aware of physical limitations. Many older adults, not just those with dementia, suffer from changes to hearing, eyesight, flexibility, and more. Some physical limitations may require modifications to activities so they are still suitable.
  • Plan appropriate social events. People with dementia often feel anxious or overwhelmed in large gatherings or an unfamiliar environment. Try to set up gatherings with smaller groups or in a 1-to-1 setting to keep things comfortable.
  • Focus on enjoyment not success. What does your loved one find entertaining? Find activities that they naturally enjoy and lose your preconceived notions of how it “should” be done to alleviate stress.

5 Fun Activities for Someone with Dementia 

Keeping in mind that every dementia patient has different preferences and abilities, there are some activities that will likely be enjoyed by all. Some accommodation may be required, but here are some of our favorites:

  • Teach the Caregiver: Ask your loved one to teach you something he/she loves to do and/or an activity he/she has known or done for such a long time that they still remember it. Have them demonstrate a skill he/she can still do through “muscle memory,” such as tell you about what life was like in the past or something he/she is passionate about. Your loved one may need to show you, versus tell you, a story, depending upon their language abilities. Encourage this method of storytelling.
  • Read a Book Together: Read a book to your loved one. Let them pick the topic area. Pick one with emotional and sensory content to help with comprehension. Short chapters and a great plot help, too.
  • Hand Massage: Reduces anxiety, perception of pain and difficult behaviors. Begin by covering your loved one’s hands with a wet, warm washcloth for a minute. Massage using a scented cream or lotion they enjoy. Lavender is a good scent as it is both stimulating and relaxing. Always be gentle – older adults’ skin can bruise easily. Follow this protocol: http://www.ecarediary.com/viewblog.aspx?BlogID=620
  • Sniff the Spices: Select up to five herbs and spices from your loved one’s kitchen and ask, “I want to learn more about these spices. Can you teach me? Let’s smell them together.” Smell them one at a time. Imagine together what kinds of foods they would go with. Ask if they remember using these spices in dishes served during holidays and family gatherings.
  • I Made a Difference: In what way has your loved one made a difference to others such as his/her spouse, children, parents, siblings, friends, community, co-workers? How did they contribute to their field of work? This is an important part of life review and can help self-esteem and life satisfaction. Share the ways you’ve made a difference, too, if this is helpful and acceptable to both of you.

By being aware of your loved one’s interests and capabilities, you can build a list of activities that will keep them engaged and encouraged. For our full list of 60 Meaningful Activities to do With Dementia Patients, please contact us at (908) 927-0500 or email us here.

Posted in: Dementia

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Creating Dementia Friendly Communities

Monday , August 10 , 2020

Creating Dementia Friendly Communities

People with dementia often feel that society fails to understand the condition that they live with, how it impacts them, or how to understand them. As their disease progresses, they often withdraw from society rather than feel ostracized.

It is our job to prompt people to think about how businesses and communities can become more aware of and understanding about these people and the condition they live with. First responders, bank personnel, store clerks, restaurant staff – all of us, really – can contribute to a more helpful and humane environment for those who suffer from dementia and their caregivers.

The solution may lie in creating dementia-friendly communities.

What is a Dementia-Friendly Community?

Every single person in a dementia-friendly community, regardless of their role, is informed and respectful of individuals with the disease and the families and caregivers that provide them support.

Dementia-friendly communities are vital in helping people with dementia live well and maintain a connection to others. They are equipped to support the people living with dementia and their caregivers, and they allow those affected to remain in the community at large and to engage and thrive in day-to-day living.

According to Alzheimer’s Disease International, there are four essential elements needed to support a dementia-friendly community: People, communities, organizations, and partnerships.

This is what they have to say:

People

Dementia friendly communities should be shaped around information about the social and economic impacts of dementia, and the needs and opinions of people living with dementia, together with input from their caregivers. By ensuring that initiatives are inclusive of people living with dementia at all stages of development, we can succeed in giving them the sense of respect, dignity, and purpose they seek.

Communities

There is a need to tackle the stigma and social isolation associated with dementia through strategies to engage and include people with dementia in community activities. The availability of accessible community activities that are appropriate to the needs of people living with dementia, along with suitable transport options, are important for a community to become dementia friendly. The engagement of people living with dementia in existing community activities rather than only specialized activities is also important. Providing people with dementia the opportunity to remain in their homes and within their communities should be a guiding principle.

These are the opportunities we all have a right to expect: Paid or unpaid activities, social opportunities though sporting activities such as golf, meeting with friends, participation in community activities such as choirs and walking clubs, access to retail, banking and other services.

A physical environment that supports the needs of people living with dementia is also critical. It needs to be accessible and easy to navigate. Pathways, signage, and lighting all need special consideration.

Organizations

For people living with dementia to remain engaged within their communities, businesses and organizations need to demonstrate awareness, respect, and responsiveness. Encouraging organizations to establish dementia-friendly approaches and implement strategies that help people with dementia will contribute to a dementia friendly society.

A timely diagnosis of dementia and early treatment is a critical component of a dementia-friendly community. This allows for delivering dementia-friendly services that respond to the unique needs of people with dementia at the right place and the right time.

Partnerships

The establishment of dementia-friendly communities as a social action initiative needs cross-sectoral support and collective action to effect change. It is no one organization’s sole responsibility to effect change of this scale, therefore collective commitment to this cause and working in collaboration and partnership is critical. The strengths and focus of organizations within a community need to be identified and built into the plan for establishing a dementia friendly society.

Posted in: Dementia

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