What is dementia?
Covid has drawn attention to dementia because a high percentage of people, ( more than 1/4) who died from Covid had this disease.. This has the professionals asking questions and wondering how we look after people once they get a diagnosis. . It is interesting that if you have cancer and pick up Covid in hospital, the death is recorded as a Covid death. But if you have dementia, get pneumonia and die, the death goes down as dementia.
Why is this?
What is it that makes one person important enough to merit attention and respect and another to be more or less ignored?Many of us ask challenging questions such as who are we WITHOUT our memories?If we lose the sense of self, what do we become?And yet, research is constantly showing that even though people can appear to have become non verbal, loose , change personality and their memories,, some creative arts facilitate routes to communication. Songs and poetry learnt years ago can be conjured up and sung or recited and enjoyed.
And people complain about rote learning.!
But rote learning stays in the long time memory. It is becoming increasingly clear that caring support is a great solace to dementia patients and it is a moral failing when people-centered care is not prioritised.
While Covid highlighted the appalling conditions many dementia patients experienced while dying, it is now realised that even before Covid, people with dementia were not being supported to die well. Isolation and loss of connection has a devastating impact on everyone, including those with dementia.
Post Covid, there has been a sharp decline in the diagnosis rate which means it is not being picked up, but going by statistics, doctors know that it is still there, in the community and all those affected struggling to cope. Everyone in the family is affected when one member starts to show the signs.
Dementia is a leading cause of death, accounting for 12.7%. the reasons for this is that it is largely an old person's disease and we are all living longer. However, the diagnosis can have a devastating effect on the family and is particularly difficult for the main carer.. The aim of living with dementia, while laudable is more difficult to implement without direct intervention from the State. Despite the fall in cancer deaths as treatment improves, there is only 1 dementia researcher for every 4 cancer researcher. Cancer attracts more research money. But the researchers who are working in this area are becoming more optimistic. Loss and despair are the common reactions , but a more people-centered approach which means working with the person rather than trying to cure them can bring better outcomes. Staying active, participating in group activities whether singing, dancing , arts and crafts. gamesor playing cards. In one Nursing home, one of the staff introduced the card game 45 and found that many of the dementia patients were able to participate. What is lovely was that she encourages the other players to play to win and amazingly the dementia patients are able to keep up. They might not speak much but they put down the correct cards.
Of the 4,200 people who die of dementia in Ireland each year, only 210 die at home. This is because, often the family can no longer cope, As their loved one has mood swings, has a poor sense of balance, falls over, needs help with everything, becomes less and less verbal and develops difficulties swallowing., the family realising that this is beyond their competency, seeks help by finding a nursing home.
In the beginning the rate of deterioration is small but then gets progressively worse. . Staying hydrated is important and this can become fraught when the patient becomes incontinent..
It is difficult to predict how long the disease takes to progress and ironically, the healthier the patient, the longer it takes. There are stages that can be noted, and it can be disappointing for family members when the patient no longer recognises them. . This is when shared songs, poems and prayers can be the last means of communication. Nature moves at her own pace. We could all learn more patience.