“Dementia” in the elderly is often caused by the degeneration of brain cells. Currently, there is no cure. The only possible approach is to slow down the progression of brain degeneration in the mild to moderate stages to prevent severe dementia in the future. Treatment involves medication and other care methods based on the symptoms of the disease to prolong the slowing of brain degeneration. Patients can take care of themselves, or it can be said that treatment is possible if they see a doctor promptly and receive proper treatment, or at least treatment can be effective and partially successful, improving the patient’s quality of life.
Before Treatment, the Cause Must Be Known
It is important to screen first whether the patient truly has dementia because there is also pseudo dementia (Pseudo Dementia) which may be caused by depression. The patient will have anxiety symptoms and lack concentration to remember things as well as normal people. These symptoms may cause those around to misunderstand them as dementia symptoms. However, patients in this group usually show symptoms for a short time and then see a doctor. In contrast, dementia or Alzheimer’s disease takes months to show clearer symptoms. It is essential to observe symptoms from relatives regarding changes that occur.
Treatment of Dementia
When it is confirmed that the patient has dementia, the doctor will perform a physical examination to differentiate diseases by blood tests, brain scans such as CT Scan or MRI, EEG brain wave tests, etc. Once the true cause is known, treatment begins at the root cause. However, the effectiveness of treatment depends on the pathology of the disease. Treatment includes both non-drug and drug therapies.
However, treatment can be effective if memory loss or dementia is caused by a deficiency of certain nutrients, such as a lack of B vitamins, choline deficiency, or patients with metabolic system disorders. When treated or given supplements, these symptoms improve. On the other hand, if dementia is caused by brain degeneration or cerebrovascular problems, these patients usually cannot be cured. Some medications may only help slow down the progression of symptoms.
Non-Drug Treatment of Dementia
Doctors will advise caregivers and family members to build good relationships and provide knowledge about dementia to create understanding and empathy for those with symptoms and to be prepared. It is recommended to arrange a suitable living environment to keep the patient safe from accidents that may happen at any time. When the family understands well, the chances of elderly patients being abandoned or sent to nursing homes alone will decrease.
Drug Treatment of Dementia
Currently, there are medications developed to help improve symptoms in patients with dementia and Alzheimer’s disease. These drugs act to alleviate brain symptoms so that patients can take care of themselves as much as possible. However, these medications must be used as prescribed by a doctor because side effects may occur. Medications to suppress emotional symptoms may also be given. All of these must be under medical supervision, with medication prescribed based on the type and severity of symptoms.
When Caring for Dementia Patients
- Caregivers, relatives, or those around must understand the dementia condition by adhering to principles of not getting angry or upset if the patient behaves inappropriately, not laughing or mocking behaviors as it may trigger symptoms, not forcing the patient to remember or do unfamiliar things. If the patient becomes irritated, stop the behavior immediately. Be flexible, adapt, and accept changes. Lower expectations of the patient. Respect their decisions, such as asking for opinions, informing them, frequently asking about their feelings, talking about the environment, taking care of their well-being, and engaging in activities together such as going on trips, walking, singing, or watching TV.
- Arrange the home environment to be convenient and safe, preventing slippery or risky areas, such as having handrails in the bathroom, dry non-slippery floors, sufficient lighting, and careful handling of sharp objects. Avoid frequently changing the placement of items so the patient stays in a familiar environment. There should be a regular caregiver. Talk to the patient often in a calm voice, repeat speech as needed, and arrange the environment to avoid being too quiet or too noisy.
- Look for abilities the patient still has to help prevent rapid decline, such as gardening, cooking, crafting, doing small household chores, or taking care of pets.
Care According to Stages
- Early Stage Care Patients should take care of themselves as much as possible. Caregivers should focus on educating and supporting patients to be as independent as possible. Caregivers may bring patients to support groups or social groups so patients can meet and exchange self-care knowledge with others and maintain good mental and emotional health. Having pets for enjoyment and relaxation may be encouraged. Caregivers and relatives should plan long-term care for the future to manage care effectively as the patient’s ability to self-care declines.
- Middle Stage Care Caregivers should focus on maintaining the patient’s independence in daily activities as long as possible. Relatives should arrange for caregivers familiar to the patient (if relatives cannot care for the patient) because patients may become anxious when separated from familiar caregivers. The environment should be safe, quiet, and reduce excessive stimuli or activities. Caregivers may need knowledge, support, and counseling on patient care and stress prevention from healthcare teams or nurses, or exchange experiences with other Alzheimer’s caregivers. Planning caregiver rotation is recommended to reduce stress from long-term care.
- Final Stage Relatives or caregivers play a crucial role in providing comprehensive care, doing everything for the patient such as bathing, dressing, feeding, and continuous care covering physical, mental, and social needs to reduce anxiety and fear of abandonment. Seek knowledge, support, and counseling for care when the patient has physical complications, managing problems such as pneumonia, malnutrition, and providing end-of-life care. Care should respect the patient’s beliefs, be present with them, and ensure comfort physically, mentally, socially, and spiritually.
