Dementia is a progressive, degenerative brain disease that eventually affects a person’s ability to live independently. There are many types of dementia, although Alzheimer’s disease is the most common type. Delirium and depression can be confused with dementia and a thorough evaluation should rule out other causes of cognitive loss prior to making a diagnosis of dementia.
Although people with dementia often exhibit behaviors that are challenging for family and professional caregivers alike, the behaviors are caused by damage to the brain and are not intentional. Challenging behaviors can be caused by unmet needs and are often a means of communication. By carefully observing what occurs before and after a behavior, a caregiver should be able to identify the underlying need and determine how to address the challenging behavior.
People with dementia need to be treated with kindness and with the knowledge that they can still enjoy life. Physical and chemical restraints should be used only as a last resort and for the shortest possible time. There are many proven alternatives to physical and chemical restraints that are the mainstays of individualized care.
Activities of daily living are disrupted in people with dementia. As the dementia progresses, caregivers must step in and assist with personal care and household management. They must also design individual and group activities that provide a sense of accomplishment and well-being.
Caregiver training is an essential component for anyone caring for a person with dementia. Family caregivers play a critical and often-overlooked role in the care of loved ones with dementia—especially in the early-to-moderate stages. Caregivers often experience stress, which does not abate simply by placing their family member in a care facility. In a facility, professional caregivers must be trained to view the person with dementia in the context of a family.
Facilities built around a philosophy of person-centered care can have a profound and positive effect on challenging behaviors associated with dementia. Providing a safe, clean, home-like environment in which residents and staff work together has been shown to improve outcomes in those with dementia.
Caregivers—both family and professional—experience many ethical conflicts when caring for a person with dementia. Education and training in ethical decision making and conflict resolution are invaluable tools to improve the experience of those with dementia.