This chapter suggests that dementia may be less common in rural than in urban areas, and some types of dementia may be more common in some countries. It helps to have an account from a relative or other informant if one suspects dementia. As dementia progresses, the patient's own awareness and ability to give a clear history diminishes. Dementia can be divided into two main categories. Those conditions where the dementia is reversible include dehydration, vitamin B deficiency due to poor nutrition or secondary to alcohol abuse, hypothyroidism and head injury. Delirium in acute illness, after surgery, or associated with sleep deprivation can be confused with dementia, but tends to be of shorter duration and relieved by correction of the precipitating event. A small proportion of people with dementia have an underlying abnormality, such as a brain tumour, that when treated improves cognitive function. Sometimes depression and dementia are confused, particularly in people who become withdrawn and inactive.
An Overview of Dementia
The term dementia has represented many different meanings and connotations over time. The word itself comes from Latin and literally means to be “without a mind.” It is an ancient term that appears as both a disease state in Roman medical texts and a form of political sarcasm in the philosophical works of Cicero. In the past two centuries, dementia has been used to refer to a brain disease characterized by chronic intellectual impairment. In some of the first diagnostic schemes, dementia was referred to as an organic mental syndrome or an organic brain syndrome. The prefixes presenile and senile were frequently used to refer to disease states that developed before or after 65 years of age, respectively, and eventually the term senility became synonymous with dementia. Although dementia is still the most commonly used diagnostic term, revisions in the diagnostic nomenclature have replaced it with neurocognitive disorder . The term dementia will be retained in this book since it continues to be widely used and understood.
Conceptions of persons and dementia
This chapter explores older complex of ideas to a particular condition, dementia, with the intention of both examining some of the implications for dementia itself and also of using this more detailed and practical context to explore some issues of general relevance. The conceptualisation of dementia and ways of dealing with people who are affected should therefore be redirected to nurturing the person, rather than attending to particular facets of dementia in terms of loss. Attention will now be turned to a commonly adopted mode of conceptualising persons which has parallels with that relating to impaired capacity. Essentialist approach has an obvious relevance to dementia, especially for those who regard the central feature of the condition as the loss of mental ability. In the twentieth century dementia has also become shaped and classified in relation to biomedical ideas, which derive from the same rationalist tradition and so also claim to be value free.
Spirituality, quality of life, and depression in older people with dementia
Published in Journal of Religion, Spirituality & Aging, 2018
This study aimed to observe dementia’s role in the relationship between spirituality, quality of life, and depression in aging. The sample included 61 participants between 65 and 98 years old, separated into two groups: participants diagnosed with dementia (N = 31) and control participants (N = 30). There was no significant difference in spirituality between demented and control participants; however, different patterns of correlation were observed between spirituality, depression, and quality of life in these groups. Although the level of spirituality did not differ despite dementia, this pathology would appear to play a role in the relationship between spirituality, quality of life, and depression.
Social Ecological Perspectives of Tube-Feeding Older Adults with Advanced Dementia: A Systematic Literature Review
Published in Journal of Nutrition in Gerontology and Geriatrics, 2017
Dementia is a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Feeding tubes are often prescribed; however, this practice can lead to complications. The purpose of this systematic review was to examine the use of feeding tubes in elderly demented patients from a social ecological perspective. Results indicated that family members often receive inadequate decision-making education. Many health care professionals lack knowledge of evidence-based guidelines pertaining to feeding tube use. Organizational and financial reimbursement structures influence feeding tube use. Feeding practices for patients with advanced dementia is a complex issue, warranting approaches that target each level of the Social Ecological Model.
Resilience in Families Caring for a Family Member Diagnosed with Dementia
Published in Educational Gerontology, 2015
The aim of this study was to identify and explore factors associated with family resilience in families caring for a demented family member. A mixed-methods approach was utilized to collect data from a convenience sample of spouses acting as primary caregivers of patients and living in the Cape Metropolitan area of the Western Cape, South Africa. The sample was comprised of families in which a spouse (n = 44) was caring for a partner with dementia. The quantitative data analysis was conducted using analyses of variance, Pearson's product-moment correlation coefficients, and a best-subsets multiple regression analysis. Qualitative data were analyzed using thematic content analysis. It was found that social support, positive communication patterns, acceptance, optimism, family hardiness, family connectedness, and the effective management of symptoms facilitated the resilience process in these families. In addition to expanding the current literature regarding family resilience, the findings of this study could be used to develop interventions tailored to the needs of these families caring for dementia patients to create a family environment that enhances adjustment and adaptation.