Dementia

The National Institute of Neurological Disorders and Stroke defines Dementia as:
“… [A] word for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. People with dementia may not be able to think well enough to do normal activities, such as getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there.”

A dry and unemotional definition, but a very personal and upsetting diagnosis for those afflicted with it and especially for their families. Suddenly, the responsibility to care for someone who has always cared for you becomes a challenge very few families are prepared for. As with other diseases of old age, like Alzheimer’s, dementia requires learning certain care strategies that can help both you and your loved one cope better day to day. These might include:

Learn all you can about the disease so that you know what to expect and how to cope with changes in your loved one’s condition.
Learn how to effectively communicate with your loved one.
Practice patience. It’s the one virtue all family members will need in abundance.
Avoid caregiver burnout. Be sure to take time for yourself.

But eventually the love and care of a committed family will need to be augmented by outside help. Few New Jersey home care agencies have more experience in caring for dementia sufferers than Accredited Health Services. We’ve been there before, with families just like yours, helping them cope with this difficult disease. While there is no cure, our New Jersey home health aides have been specially trained to ease the burden on families by being sensitive to the changing needs of their loved one as the disease progresses.

Having a home health aide there with you who has seen it all before, who can answer your questions based on hundreds of hours of experience, who is reliable and professional, and who cares for your loved one with sensitivity, has proven to be a great comfort to all our Accredited Health Services clients.

What kind of training and supervision do our certified home health aides receive?
At Accredited Health Services (AHS), we understand that in order to provide quality care, we must maintain continuity of care and provide our clients with an educated caregiver.

Accredited Health Service Certified Home Health Aides (CHAA’s) receive not only education reinforcement upon hire, but throughout their employment. Upon orientation to Accredited Health Services, all CHHA’s receive reinforcement education on Alzheimer, Dementia, Stroke and Traumatic Brain Injury Disease processes and caregiver management. Further education includes the anatomy, physiology and psychological effect of these specific diseases is included in our annual training sessions.

Despite there being similarities in any given disease, the affect the disease has on a person can be quite different. Therefore, during the CHHA’s care, they are evaluated and supervised by our experienced Field RN Supervisors. This too promotes individualized care planning and allows our home health aide’s to ask specific questions pertaining to the client and their disease and receive individualized education.

Finally, Accredited takes training one step further, going beyond accreditation requirements. Those CHHA’s who have been noted to take the extra steps to assure client/ family caregiver satisfaction are given additional, interactive training on multiple diseases including those listed above. AHS recognizes the special nuances of these diseases which include memory and functional impairments and how this sometimes leads to moments of frustration, anger, sadness or despair for both the patient and their family. Detailed education on specific difficult symptom management is provided and includes role playing, providing the Aide with accurate, educated response training.

The Seven Stages of Dementia

The time to seek outside help, of course, will vary from family to family. But knowing what to expect down the road can help you set your expectations for your own abilities to provide care, and allow you to anticipate when outside help will be needed so you can begin to research and contact homecare agencies.

Stage 1:
No Cognitive Impairment. Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.

Stage 2:
Very Mild Cognitive Decline. Individuals at this stage feel as if they have memory lapses, especially in forgetting words or names or the location of keys, eyeglasses, or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.

Stage 3:
Mild Cognitive Decline. Friends, family or co-workers begin to notice deficiencies.
Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview.
Common difficulties include:

Word- or name-finding problems noticeable to family or close
associates.
Decreased ability to remember names when introduced to new people.
Performance issues in social or work settings noticeable to family,
friends or co-workers.
Reading a passage and retaining little material.
Losing or misplacing a valuable object.
Decline in ability to plan or organize.

Stage 4:
Moderate Cognitive Decline. At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:

Decreased knowledge of recent occasions or current events.
Impaired ability to perform challenging mental arithmetic – for example, to count backward from 100 by 7s.
Decreased capacity to perform complex tasks, such as marketing, planning dinner for guests or paying bills and managing finances.
Reduced memory of personal history.
The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations.

Stage 5:
Moderately Severe Cognitive Decline. Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:

Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated.
Become confused about where they are or about the date, day of the week, or season.
Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s.
Need help choosing proper clothing for the season or the occasion.
Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children.
Usually require no assistance with eating or using the toilet.

Stage 6:
Severe Cognitive Decline. Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

Lose most awareness of recent experiences and events as well as of their surroundings.
Recollect their personal history imperfectly, although they generally recall their own name.
Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces.
Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet.
Experience disruption of their normal sleep/waking cycle.
Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly).
Have increasing episodes of urinary or fecal incontinence.
Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding.
Tend to wander and become lost.

Stage 7:
Very Severe Cognitive Decline. This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.

Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered.
Individuals need help with eating and toileting and there is general incontinence of urine.
Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.