Dementia is a general term for a decline in mental ability severe enough to interfere with daily life.
Memory loss is an example. Alzheimer's is the most common type of dementia.
Approximately 10 million Americans suffer from dementia.
In this segment, Beth will discuss the most common types of Dementia, the common symptoms and behaviors during the course of the disease as well as tips for caregivers.
Diagnosis and Treatment of Dementia
Featured Speaker:
Beth Ulrich, ACSW, LCSW
Beth B. Ulrich, ACSW, LCSW joined the Centra Senior Psychiatric Program as Community Liaison to Long-Term Care in September, 2011. She provides evaluations and consultations in addition to interventions such as behavioral management and psychotherapy in an effort to assist patients, families and staff with the often difficult transition and adjustment to living in a long-term care facility. She received her Bachelor’s Degree and Master’s Degree in Social Work from Florida State University and is a Licensed Clinical Social Worker in the state of Virginia. She was the Director of Social Work for Centra for over 20 years before becoming the Program Manager for the county satellite outpatient clinics at Horizon Behavioral Health. Her experience has a combined focus in Social Work Discharge Planning and Case Management as well as Clinical Social Work for seriously mentally ill adults and geriatrics. Transcription:
Diagnosis and Treatment of Dementia
Bill Klaproth (Host): Dementia is a disorder of the brain that impairs memory and function. What are the most common types of dementia, and what are the symptoms? What are the behaviors? And certainly, what are tips for caregivers? All great questions. Here with us is Beth Ulrich. She is the community liaison to long-term care at the Centra Senior Psychiatric Program. Her experience has a combined focus on social work discharge planning and case management as well as clinical social work for seriously mentally ill adults in geriatrics. Beth, thanks so much for being on with us today. Let’s just start right at the beginning. What is dementia?
Beth Ulrich (Guest): Well, dementia is defined as irreversible chronic brain failure that results in the loss of mental ability that involve memory, reasoning, learning, and judgment, including impairment of both short-term and long-term memory.
Bill: Wow! Brain failure. I’ve never heard it described that way, but that really does encapsulate what dementia is. Beth, is Alzheimer’s the most common form of dementia? I think that’s what we hear the most about.
Beth: Yes, Alzheimer’s is the most common form. I’m afraid that people sometimes categorize dementia all under that heading. However, there are several other types of dementia, and sometimes, people even have a combination of say, for example, Alzheimer’s in addition to vascular dementia.
Bill: What are the different types then? Because you just touched on something which I think is very important. What are the different types of dementia? Because we all seem to think, “Oh, they’ve got dementia, they’ve definitely got Alzheimer’s.” But maybe if you can just quickly touch on the different forms of dementia.
Beth: Well, the primary forms that we treat in our program include, of course, Alzheimer disease, which as we were saying, is the most common. This is an irreversible progressive brain disease that slowly destroys memory and thinking skills and, ultimately, the ability to carry out the simplest of tasks. It is caused by plaque, which are abnormal clumps, and tangles, which are bundles of fiber in the brain. Another common form of dementia is vascular dementia, which is typically related to having had strokes or TIA. Alzheimer’s has a steady progression and is somewhat subtle in terms of its initial symptoms and the changes that we notice in individuals. Vascular dementia takes on more of a steppingstone type of a progression as people have strokes and TIAs. Another common form of dementia is Lewy body dementia, which is a rapidly progressive form of dementia. And the onset is often earlier than the typical Alzheimer’s or vascular dementia. We see that in individuals who are perhaps in their late 40s or even early 50s. Symptoms include memory problems, poor judgment, excessive daytime drowsiness, and visual hallucination.
Bill: Okay. Obviously, there’s a lot of forms, and now you’re trying to get to the symptoms, which I think is really important. Because a lot of us as we age, we have memory problems. We forget where the keys are, and there’s a lot of us that probably go, “Oh my God! Am I getting this? I forgot where my keys are. It took me five minutes to find them. Oh my God! Is something wrong with my brain?” Can you tell us what is normal—you’re just getting older and you’re going to forget things more often? And when is it, “Oh, boy. Something may be wrong”? Can you explain that to us?
Beth: Well, as you say, I think it’s normal for people as they get older to sometimes misplace things or maybe forget an individual’s name or a telephone number. But sometimes these are some of the subtle hints that there may be something more serious happening. There are also personality changes that may develop in the early stages of dementia. I think it’s important to at least be aware of the fact that while there are certain behaviors and symptoms that are simply signs of normal aging, it may also be important to be at least somewhat vigilant about being aware of whether or not these particular types of symptoms might increase or worsen as time goes by.
Bill: Okay. Now, when is the point that you go see a doctor, when you say, this is more than just being normally forgetful? What is that point where you say, “I need to call somebody and check this out”?
Beth: Well, I think it’s important to have annual or regular checkups with your doctor, and during the course of those checks have issues related to brain function addressed. There are certain simple diagnostic tools that we use such as the Mini Mental Status exam and other evaluations that are just part of the general medical exam that could point to early symptoms of dementia.
Bill: If you are diagnosed with dementia or Alzheimer’s, what are the treatment options? Have those advanced over the years?
Beth: Well, certainly there have. There have been new medications that have been implemented for patients, and there is certainly so much more education for caregivers and family members, not only in helping them recognize the early symptoms of dementia but also give them better tools in order to provide appropriate intervention for dementia.
Bill: Beth, if someone you love has been diagnosed with dementia or Alzheimer’s, what are the tips for a caregiver in this situation?
Beth: Well, certainly I think that it’s important initially for a caregiver who may not even identify him or herself as a caregiver to be aware of some of the early signs and symptoms of dementia. Often, when we talk to family members, they identify that what they’re experiencing from the patient came on suddenly. But as we take a more comprehensive history of some of the changes in behaviors and memory and other levels of functioning, it becomes quite obvious that the disease may have developed several years ago in the earliest of stages. I think it’s important for all of us to be better educated about some of the things to look for in terms of the early signs of dementia. Then as time goes by and the caregiver becomes more aware of the needs of the patient, it’s very important to avail yourself to the educational materials—and they are abundant now, which is wonderful. There are some wonderful books out that are specifically written for caregivers. There are support groups, and there are just so many opportunities for caregivers to learn how to enter the patient’s world and learn how to communicate with the patient much more successfully. It seems to me that what we were doing and how we were interacting with individuals and family members when they did not have the disease is almost the opposite of what you do when the patient has the disease. For example, behavioral techniques that we used to use with children to help them to learn appropriate behaviors are not at all appropriate in dealing with people with dementia. You really need to meet them where they are and enter their world and allow them to move in their own world and be accepting of that and be understanding of that and be patient with that.
Bill: Well, it’s good to know as we learn more about this, the ways of treating it are changing, and at least it seems like we’re starting to get the edge on how to deal with somebody that has dementia or Alzheimer’s, which is very good news.
Beth: Right, exactly.
Bill: Beth, thanks so much for being out with us today. One more quick question. Why should people come to Centra Health for their mental health needs?
Beth: We have such a comprehensive opportunity for patients from the time that they’re young children until they’re in their senior years. We have both inpatient and outpatient services with a variety of clinicians who have varying levels of expertise to provide. As I say, just a comprehensive opportunity for patients who are dealing with mental health problems.
Bill: All right, Beth. Thank you so much. We really appreciate your time today. For more information on dementia and Alzheimer’s, please visit centrahealth.com. That’s centrahealth.com. This is Centra Healthy Radio. I’m Bill Klaproth. Thanks for listening.
Diagnosis and Treatment of Dementia
Bill Klaproth (Host): Dementia is a disorder of the brain that impairs memory and function. What are the most common types of dementia, and what are the symptoms? What are the behaviors? And certainly, what are tips for caregivers? All great questions. Here with us is Beth Ulrich. She is the community liaison to long-term care at the Centra Senior Psychiatric Program. Her experience has a combined focus on social work discharge planning and case management as well as clinical social work for seriously mentally ill adults in geriatrics. Beth, thanks so much for being on with us today. Let’s just start right at the beginning. What is dementia?
Beth Ulrich (Guest): Well, dementia is defined as irreversible chronic brain failure that results in the loss of mental ability that involve memory, reasoning, learning, and judgment, including impairment of both short-term and long-term memory.
Bill: Wow! Brain failure. I’ve never heard it described that way, but that really does encapsulate what dementia is. Beth, is Alzheimer’s the most common form of dementia? I think that’s what we hear the most about.
Beth: Yes, Alzheimer’s is the most common form. I’m afraid that people sometimes categorize dementia all under that heading. However, there are several other types of dementia, and sometimes, people even have a combination of say, for example, Alzheimer’s in addition to vascular dementia.
Bill: What are the different types then? Because you just touched on something which I think is very important. What are the different types of dementia? Because we all seem to think, “Oh, they’ve got dementia, they’ve definitely got Alzheimer’s.” But maybe if you can just quickly touch on the different forms of dementia.
Beth: Well, the primary forms that we treat in our program include, of course, Alzheimer disease, which as we were saying, is the most common. This is an irreversible progressive brain disease that slowly destroys memory and thinking skills and, ultimately, the ability to carry out the simplest of tasks. It is caused by plaque, which are abnormal clumps, and tangles, which are bundles of fiber in the brain. Another common form of dementia is vascular dementia, which is typically related to having had strokes or TIA. Alzheimer’s has a steady progression and is somewhat subtle in terms of its initial symptoms and the changes that we notice in individuals. Vascular dementia takes on more of a steppingstone type of a progression as people have strokes and TIAs. Another common form of dementia is Lewy body dementia, which is a rapidly progressive form of dementia. And the onset is often earlier than the typical Alzheimer’s or vascular dementia. We see that in individuals who are perhaps in their late 40s or even early 50s. Symptoms include memory problems, poor judgment, excessive daytime drowsiness, and visual hallucination.
Bill: Okay. Obviously, there’s a lot of forms, and now you’re trying to get to the symptoms, which I think is really important. Because a lot of us as we age, we have memory problems. We forget where the keys are, and there’s a lot of us that probably go, “Oh my God! Am I getting this? I forgot where my keys are. It took me five minutes to find them. Oh my God! Is something wrong with my brain?” Can you tell us what is normal—you’re just getting older and you’re going to forget things more often? And when is it, “Oh, boy. Something may be wrong”? Can you explain that to us?
Beth: Well, as you say, I think it’s normal for people as they get older to sometimes misplace things or maybe forget an individual’s name or a telephone number. But sometimes these are some of the subtle hints that there may be something more serious happening. There are also personality changes that may develop in the early stages of dementia. I think it’s important to at least be aware of the fact that while there are certain behaviors and symptoms that are simply signs of normal aging, it may also be important to be at least somewhat vigilant about being aware of whether or not these particular types of symptoms might increase or worsen as time goes by.
Bill: Okay. Now, when is the point that you go see a doctor, when you say, this is more than just being normally forgetful? What is that point where you say, “I need to call somebody and check this out”?
Beth: Well, I think it’s important to have annual or regular checkups with your doctor, and during the course of those checks have issues related to brain function addressed. There are certain simple diagnostic tools that we use such as the Mini Mental Status exam and other evaluations that are just part of the general medical exam that could point to early symptoms of dementia.
Bill: If you are diagnosed with dementia or Alzheimer’s, what are the treatment options? Have those advanced over the years?
Beth: Well, certainly there have. There have been new medications that have been implemented for patients, and there is certainly so much more education for caregivers and family members, not only in helping them recognize the early symptoms of dementia but also give them better tools in order to provide appropriate intervention for dementia.
Bill: Beth, if someone you love has been diagnosed with dementia or Alzheimer’s, what are the tips for a caregiver in this situation?
Beth: Well, certainly I think that it’s important initially for a caregiver who may not even identify him or herself as a caregiver to be aware of some of the early signs and symptoms of dementia. Often, when we talk to family members, they identify that what they’re experiencing from the patient came on suddenly. But as we take a more comprehensive history of some of the changes in behaviors and memory and other levels of functioning, it becomes quite obvious that the disease may have developed several years ago in the earliest of stages. I think it’s important for all of us to be better educated about some of the things to look for in terms of the early signs of dementia. Then as time goes by and the caregiver becomes more aware of the needs of the patient, it’s very important to avail yourself to the educational materials—and they are abundant now, which is wonderful. There are some wonderful books out that are specifically written for caregivers. There are support groups, and there are just so many opportunities for caregivers to learn how to enter the patient’s world and learn how to communicate with the patient much more successfully. It seems to me that what we were doing and how we were interacting with individuals and family members when they did not have the disease is almost the opposite of what you do when the patient has the disease. For example, behavioral techniques that we used to use with children to help them to learn appropriate behaviors are not at all appropriate in dealing with people with dementia. You really need to meet them where they are and enter their world and allow them to move in their own world and be accepting of that and be understanding of that and be patient with that.
Bill: Well, it’s good to know as we learn more about this, the ways of treating it are changing, and at least it seems like we’re starting to get the edge on how to deal with somebody that has dementia or Alzheimer’s, which is very good news.
Beth: Right, exactly.
Bill: Beth, thanks so much for being out with us today. One more quick question. Why should people come to Centra Health for their mental health needs?
Beth: We have such a comprehensive opportunity for patients from the time that they’re young children until they’re in their senior years. We have both inpatient and outpatient services with a variety of clinicians who have varying levels of expertise to provide. As I say, just a comprehensive opportunity for patients who are dealing with mental health problems.
Bill: All right, Beth. Thank you so much. We really appreciate your time today. For more information on dementia and Alzheimer’s, please visit centrahealth.com. That’s centrahealth.com. This is Centra Healthy Radio. I’m Bill Klaproth. Thanks for listening.