Maximising quality of life for people living with dementia

More than two-thirds of elderly Australians in residential care experience some form of cognitive impairment.

Despite its prevalence, there is a lot of misunderstanding about dementia.

Making the most of life for dementia patients

Dementia is a serious condition that is estimated to affect 487,500 Australians at any given time. According to dementia.org.au, it is estimated that almost 1.6 million Australians are involved in the care of someone living with dementia.

How can you help improve the quality of life for someone living with dementia or cognitive impairment?

Dispelling dementia myths

Dementia is NOT a normal part of ageing

Cognitive decline may be a normal part of an ageing brain, but dementia is not a normal part of growing old.

Dementia is a catch-all term for a group of neurodegenerative diseases that can affect younger people as well as the elderly. Dementia can cause serious impairments that dementia-free Australians of all ages do not suffer with.

Dementia is NOT untreatable

While there is no cure for dementia yet, that does not make it untreatable.

Early symptoms can be managed, and systems can be put in place to improve the well-being of someone with dementia.

If caught soon enough, there are lifestyle changes that can help slow the impact of dementia and maintain quality of life for as long as possible.

Dementia is NOT necessarily inherited

 While some causes of dementia might have a genetic basis, many forms of the disease are not hereditary.

dementia.org.au explains that “Having a close relative with Alzheimer’s disease is not evidence of a genetic link. People who are influenced by risk factor genes are only slightly more likely to develop the disease than the average population.”

What is Dementia?

With the common myths out of the way, it is valuable to discuss what dementia actually is.

As a catch-all term, dementia is best described as referring to a suite of symptoms that are caused by various diseases that affect the brain. Dementia can affect thinking, behaviour and the ability to perform everyday tasks. As dementia escalates, it can make it difficult for the sufferer to engage in their normal social or work life.

Symptoms of dementia can vary but will often include:

• Memory loss, poor judgement, and confusion
• Difficulty speaking, understanding and expressing thoughts, or reading and writing
• Trouble speaking, understanding others and expressing thoughts
• Decline in reading and writing ability
• Getting lost, even in familiar surroundings
• Repeating the same questions
• Calling familiar objects by strange names
• Hallucinations and paranoia
• Balance issues
• Impulsive behaviour
• Apathy
• Failure to recognise loved ones
• Failure to perform everyday tasks

The most common types of dementia are:

• Alzheimer’s disease
• Vascular dementia
• Dementia with Lewy bodies
• Fronto Temporal Lobar Degeneration (FTLD)
• Huntington’s disease
• Alcohol-related dementia (Korsakoff’s syndrome)
• Creutzfeldt-Jakob disease

How is dementia treated?

As noted earlier, there is no cure for dementia. If you or a loved one are living with dementia, it must be treated and managed. The following treatments and activities help those living with dementia to enjoy a high quality of life.

Medication

There are medications available to help the behavioural and psychological symptoms for those living with dementia. Again, these medications are a treatment and not a cure. As these are powerful drugs, they should not be taken without a thorough consultation with a doctor.

Other medical therapies are also being explored. These include:

• Anti-inflammatories
• Ginkgo Biloba
• Folate and vitamin B12
• Vitamin E
• Statins

Some of these treatments remain at the experimental stage and their efficacy is yet to be fully determined. Some people swear by Brahmi, a herbal ‘memory booster’, for instance, but there is so far no scientific evidence to show this product actually works.

Staying active

Outside of medical interventions, one strategy that has shown great value in helping those living with dementia to improve their quality of life is staying active. This means dementia patients should find ways to keep their bodies moving and their minds busy every day.

Physical activity

Physical activity is beneficial for all Australians, regardless of their age or cognitive health. For those living with dementia though, it can be even more so.

When you do something physical, it helps connect neurons in your brain that retain information. This is called muscle memory. Muscle memory is why when you perform the same physical activity so many times that it becomes instinctual. Your body remembers what to do, even if you aren’t consciously thinking about it.

Physical activity that produces muscle memory can be beneficial for Australians with cognitive impairments. It can allow those living with dementia to continue performing simple tasks for much longer because it bypasses complex cognitive functions and allows the body to work on its own.

Mental activity

 The general principle behind keeping an active mind for those living with dementia, is ‘use it or lose it’ because if you don’t keep the neurons firing in your brain, they stop working as hard for you. The scientific jury is still out on many ‘brain training’ activities that are promoted online, but the truth is, that basic mental activity is essential to brain function.

It is likely that anyone who fails to keep their mind stimulated will lose cognitive function to some degree. For those whose cognition is already in steep decline, this is even more important.

Activities that can help manage dementia

Harness muscle memory

 One simple tip that can make life much easier for those living with dementia is to utilise muscle memory.

If you are relocating a loved one to an aged care facility, make sure their new environment matches their old home as closely as possible. This makes it easier for them to perform small physical tasks without stress.

It can be as simple as ensuring the television remote sits in the same place as it used to. Thinking about television will trigger your loved one’s hand to head to where they expect the remote to be. One small element of stress is removed if the remote is waiting in the right place.

Whatever can be done to use muscle memory is invaluable, from where the kettle goes to which direction the bathroom is in.

Activities

 There are lots of activities that you can enjoy with your loved one to help with their dementia.

The best activities for dementia patients will contain the three following factors:

• Familiarity: When your brain doesn’t process new memories properly, you need to be around things that are familiar.
• Activity for the mind or body: As stated, the mind and body need to be active to stay fit.
• A calm environment: Too much stimulation can be overwhelming (more on this later).

With these factors in mind here are some activities that you can do with your loved one:

• Walking: A short walk somewhere familiar is ideal for dementia patients.
• Listen to music: Music is extremely evocative. Spending some time listening to oldies from your loved one’s era can help to stimulate memories and bring joy.
• Dance: Dancing to favourite tunes is a brilliant mix of physical activity and mental stimulation.
• Outings: Early-stage dementia patients can benefit from trips to familiar places. Avoid anywhere too crowded. A trip to another relative’s home or a favourite (quiet) cafe can be a positive experience.
• Do some sorting: It may sound simple but grabbing a bag of buttons or nuts and bolts can help create a beneficial activity. Sorting the buttons, bolts, or whatever works for your loved one is an excellent cognitive activity.
• Cooking or making food: There is a lot of muscle memory involved in cooking. If your loved one was a whizz in the kitchen, cooking or baking together can be a beneficial activity.
• Jigsaw puzzles and simple games: Assembling a jigsaw puzzle or playing basic card games is an ideal mental activity for those in earlier stages of dementia. Jigsaws are also helpful for fine motor skills.
• Yoga: Senior yoga is very gentle and is usually performed from a sitting or kneeling position to minimise the chances of a fall.
• Water exercise: Exercising in the water is the perfect way to stay fit while keeping pressure off ageing joints.

Whatever activity you choose, remember it is about the process. Focus on enjoying the participation rather than achieving an outcome. If you choose to do some art, then whether or not your loved one produces a masterpiece is irrelevant. The activity itself is the goal so emphasise fun, not artistic ability.

Activities that tap into the memories of your loved one are also among the best. Whether you are cooking or listening to music, try to make it a favourite dish or familiar song.

Be creative. Think about your loved one and the hobbies they have always enjoyed. You will be able to come up with plenty of activities of your own.

Finally, don’t make it too easy. Your loved one is not a child and will likely not appreciate being given an activity meant for a toddler. Work towards that sweet spot of challenging but not daunting.

What to avoid

 The main thing to avoid when choosing activities for those living with dementia is overstimulation. Large crowds and too much noise can be very overwhelming and can cause undue stress. Keep things calm and basic.

Also try to steer clear of arguments and confrontations. Those living with dementia often have trouble managing their emotions, and outbursts are possible. Trying to argue with a dementia patient is fruitless and will only cause stress for you both.

Remember that they are struggling with a disease that makes it hard for them to behave normally. You can’t take what a dementia patient says to heart. Remain calm and placid and wait for emotions to settle.

Aged care facilities for dementia patients

 With over a third of residents having some form of dementia, it is not surprising that most quality residential aged care homes now offer dementia-specific wings.

In these wings, dementia patients will be offered activities that might include:

• Music and art therapy
• Aqua exercise
• Games nights
• Sing-a-longs
• Dance nights
• Physical therapies
• Massage

Dementia-friendly activities are added to premium medical and psychological care. Often, the design of the dementia wing will be specific to create a calm and familiar environment. Security measures will be in place but subtle, so residents still have a sense of autonomy.

If you have a loved one who is struggling to live independently due to dementia, an aged care facility will often be the most comfortable, supportive, and safe place.

Aged Care Decisions provides assistance to families at every stage of the aged care or home care journey. We work with over 1200 facilities and assist over 6000 families every month, 100% free of charge.