Loved ones have dementia: how to communicate with them? 7 tips from doctors

In the modern world, many older people develop senile dementia, characterized by persistent dementia due to organic damage to the brain. A sick person loses skills in all areas of life and requires constant attention from close relatives.

Relatives of an elderly person should know about the basic rules of communication and care for a sick relative in order to make his life easier.

General points

After confirmation of such a diagnosis, it is necessary to take care of further treatment, care, and psychological assistance.
Specialists whose help you need

Dementia is difficult to manage in older adults due to their reluctance to visit a doctor, take medications, or undergo diagnostic tests. In this case, only a relative or psychologist can convince you of the need for treatment.

If a grandparent has dementia, you need to do something, but not give up and let the disease take its course. It is necessary to take advantage of all opportunities to slow down its development and improve the quality of human life.

Senile insanity: what should relatives do?

So, your loved one has been diagnosed with senile insanity. What to do in such a situation? We suggest not to panic and use our tips:

- Give gifts for holidays and memorable dates. Even if it seems to you that the patient does not need anything, and he has everything. Buy grandma a handbag, something tasty, a handkerchief. Believe me, the elderly person will be pleased.

So, you have learned what senile insanity is, as well as about the symptoms and treatment of this disease.

About the disease

The Mental Health Research Center notes that the incidence of signs of senile dementia in women and men increases with age. In the age group of 60-70 years old, about 1.5% of people have characteristic signs of the disease, and in the group from 80 to 90 years old - 20% of older people.

Decline in cognitive function is considered a physiological process of aging, and therefore patients do not seek medical help or receive any treatment. This situation causes the progression of neurodegenerative or vascular changes in the brain, leading to increased symptoms of senile dementia.

According to research, older women suffer from dementia several times more often than men. Experts cannot explain this, but suggest that there is a connection with emotional and mental instability.

The main causes of violation are considered to be the following:

• Atherosclerotic changes in the blood vessels of the brain, provoking a disruption of its blood supply and the death of individual neurons.
• Brain injury, which leads to the destruction of neural connections and their replacement with connective tissue.
• Ischemic or hemorrhagic stroke, accompanied by hemorrhage in certain areas of the brain. In this case, neurons die in large numbers, which certainly leads to disruption of thought processes.
• Atrophic changes in brain cells and disruption of their connections, as well as the conduction of nerve impulses.
• Uncontrolled use of large doses of medications over many years. Usually the cause is antidepressants, antihypertensive drugs, and drugs for the treatment of arrhythmia.
• Neurological diseases that cause regular damage to nerve cells.

The article discusses the main symptoms and signs of senile dementia.
In addition, this condition often develops in women who have more than 3 children. This is associated with the effect of pregnancy on processes in the brain. Experts even identify the disease encephalopathy of pregnancy, which in many cases affects thought processes.

Senile dementia (symptoms and signs in women may be combined with other conditions) rarely develops as a single mental disorder. In most cases, it is accompanied by other disorders.

Effective prevention of senile dementia

Medicine does not yet know methods that can completely eliminate the risk of senile dementia, but the effectiveness of some measures that reduce the likelihood of the disease has been scientifically proven.

The diagnosis of senile dementia is much less common in people who:

• adhere to the principles of proper nutrition, monitor the level of cholesterol in the blood;
• do not smoke and drink alcoholic beverages very moderately;
• exercise regularly.

Activities that require intellectual stress help prevent the development of cognitive disorders. Among those who like to read, solve crosswords, play chess and solve logical problems, there are very few patients with senile dementia. The risk of senile dementia is also reduced for those whose hobbies involve fine motor skills of the fingers - fans of knitting, bead weaving and assembling pictures from puzzles.

The topic of senile dementia has been well studied by experts and, based on the results of numerous studies, it is possible to formulate recommendations that will minimize the risk of this disease.

1. Diet It has been noted that among the residents of Italy, Greece and other Mediterranean countries there are many long-livers and few cases of senile dementia (compared to other territories). Scientists believe that one of the reasons is the peculiarities of the diet, which is dominated by fish and seafood, olive oil, fresh vegetables and wine.
   Including the following products in your daily menu will help reduce the risk of senile dementia:

   - greens (salads, dill, parsley, cilantro);

   - berries (blackberries, blueberries, strawberries, raspberries, blueberries);

   - nuts (walnuts, cashews, almonds, peanuts, Brazilian);

   - legumes (peas, chickpeas, beans, soybeans, lentils);

   — fish (mackerel, hake, pollock, herring, tuna, carp, crucian carp, pelengas);

   - olive oil;

   - dry red wine;

   - poultry meat - turkey, chicken, guinea fowl;

   - whole grains.

2. Air
   The atmosphere polluted by exhausts from industrial enterprises and motor vehicles negatively affects the cognitive health of residents of megacities. In large cities, more cases of senile dementia are recorded than in ecologically clean areas.
3. Alcohol
   Excessive consumption of alcoholic beverages is harmful to the body. Alcohol, especially strong alcohol, is categorically not compatible with the principles of a healthy diet and is not recommended for use for the effective prevention of senile dementia.

   However, there are research results from Italian scientists, according to which, in elderly people over 65 years of age who regularly consumed dry wine, cognitive impairment was noted less frequently than in absolute abstainers. Doctors explain this by the positive effects of small doses of alcohol on the cardiovascular system and the antioxidant effects of wine.

4. Vitamin D
   Studies of the effect of vitamin D were carried out in different countries, and the results of experiments clearly confirmed that its low content in the blood serum greatly increases the risk of senile dementia.

   Vitamin D has a positive effect on the condition of blood vessels in the brain and stimulates white blood cells, the function of which is to cleanse the body of amyloid accumulations, a protein that causes memory loss and provokes the development of Alzheimer's disease.

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   The source of vitamin D is sunlight and fatty fish. If you cannot obtain enough vitamin D naturally, you must take it in the form of dietary supplements.

5. Mood
   Senile dementia is more susceptible to emotionally unstable people who take even minor troubles to heart throughout their lives. In order to prevent senile dementia, it is recommended to react more calmly to stress, everyday troubles, and family discord.

6. Sleep patterns
   Sleep disturbances can also trigger the development of Alzheimer's disease and other types of senile dementia. Insomnia leads to the fact that the body is not cleansed of toxins that appear as a result of the breakdown of proteins. Their accumulation in tissues has a degenerative effect on brain cells.
7. Physical activity
   To maintain normal condition, the body needs movement. It stimulates active blood circulation and oxygen supply to the brain. This does not mean that you need to exhaust yourself by running marathon distances, we are talking about the doctor-recommended 8-10 thousand walking steps daily.
8. Environment Loneliness
   has an indirect influence on the development of senile dementia. Older people living away from relatives are more likely to suffer from cognitive impairment. Of course, older people surrounded by children and grandchildren are also not immune to this diagnosis, but in general they are less at risk of senile dementia. Constantly being immersed in the daily activities of the younger generation allows them to maintain clarity of mind and interest in life longer.

Changes in everyday life and relationships with relatives

Relatives of a person diagnosed with dementia should be prepared for the following changes in personality and behavior:

• a decrease in intellectual abilities, as a result of which the style of communication with family changes;
• loss of short-term memory, a person forgets where he put his things, accuses others of stealing, does everything to provoke others;
• refusal to eat during dementia forces unpleasant procedures of force-feeding or intravenous administration of nutrients, which negatively affects family relationships;
• loss of long-term memory, stops recognizing friends and relatives, forgets events in life, does the same actions over and over again;
• changes in character, gross personality changes are noted, a radical change in preferences, dementia makes even the most gentle people aggressive.

All this makes relationships with the patient much more difficult. Relatives of people with dementia note that they become like little children: capricious, selfish, unable to take care of themselves, and doing stupid things. In later stages, people with dementia do things that are incomprehensible to relatives and become distant and alien.

Onset of dementia

Dementia is a multifactorial disease that develops when several risk factors combine. It is believed that the pathology is partly related to genetic predisposition, since cases of occurrence are often identified in relatives.

Autoimmune processes leading to damage to the nerve membranes and brain cells are a common mechanism for the development of dementia in the elderly and senile. In such cases, there is a progressive decline in neurons, which leads to a decrease in memory, attention and other functions of the nervous system.

Among the provoking factors are:

• vascular pathologies (atherosclerosis and arteritis of cerebral vessels, arterial aneurysms), leading to a decrease in the delivery of nutrients and oxygen to the nervous tissue (such ischemia underlies vascular dementia);
• neuroinfections (meningitis, encephalitis) and chronic infectious diseases in the body lead either to direct damage to the structures of the central nervous system or cause the development of autoimmune damage;
• malignant neoplasms;
• chronic intoxication with alcohol (alcoholic dementia), salts of heavy metals, etc.;
• traumatic brain injuries;
• mental illnesses.

Based on the identified cause of dementia, doctors classify dementia into three main types:

• vascular, associated with damage to cerebral vessels and ischemia;
• neurodegenerative, observed in Alzheimer's, Parkinson's and Pick's diseases;
• mixed, when combining two of these components.

Such a classification is necessary, since the specific form of the disease will determine how to treat the pathology.

Clinical picture

The first signs of senile dementia appear in people after 65 years of age. Moreover, the disease occurs 2-3 times more often in women than in men. The property of this pathology is a tendency to constant progression.

An early symptom is a change in certain personality traits. Older people become suspicious, stingy and overly stubborn. Many gradually develop selfishness, coldness towards even close relatives and emotional coldness. Such symptoms develop slowly, which may explain the infrequent seeking of medical help.

Over time, cognitive functions are impaired: the ability for abstract thinking and creativity is lost, criticism disappears, new knowledge and skills are not consolidated. Memory changes are a characteristic manifestation of neurodegenerative and senile dementia. First of all, memory for recent events suffers, however, amnesia progresses during the course of the disease and the patient loses life experience, skills and knowledge.

Subsequent progression is characterized by a violation of orientation in time. Patients often perceive themselves at a younger age, and the people around them at their earlier stages of life. Gradually, the patient ceases to recognize his relatives and begins to confuse them. In the last stages of dementia, the patient is unable to recognize himself in the mirror, as he associates himself with a younger age.

With pronounced pathological changes in the brain, patients develop delusional ideas. Thoughts that they are being robbed by loved ones and people around them interfere with normal communication. A person often puts money, food, and household items in secluded places because he is afraid that he will be robbed, or he becomes poor for other reasons.

People with senile dementia experience more age-related changes in their bodies than people of a similar age without dementia. The most typical symptoms are exhaustion of the body, decreased skin turgor, baldness and various diseases of the internal organs, including neurological disorders.

Physical and mental exhaustion leads to the fact that somatic diseases progress rapidly, often causing the death of patients.

Memory support

Make an album of memories. For people with dementia, remembering some details of their lives is a challenge. It is especially difficult for them to remember new information, for example, the names of newborn grandchildren. And this really depresses them.

An album of memories is a good help. It should contain descriptions and pictures of important moments in a person’s life from birth to the present.

You can take a small, approximately 10x15 cm photo album that is easy to carry. Next to the photo write a comment about who it is, in what year and what place it is. Write legibly, avoid capital letters. A comment could be, for example, like this: “My daughter Nina at the age of two on the beach in Crimea.”

Try to get the person to look at this album often to revive his memories: leave the album, for example, open in the living room. Update its content!

Make reminder posters. Create an "Important People" poster. Place photographs of the main people in the sick person's life, frame the poster and hang it on the wall.

Make a plan for the day together . It is difficult for someone living with dementia to plan their day. He may know that he needs to do something, but he doesn't remember what it is. Even vacuuming the room can be quite problematic for him. This can lead to anxiety, feelings of worthlessness, even despair, depression or withdrawal.

Remember: feeling needed is important for all people - old and young, healthy and sick..

Put together a “to-do list ” that needs to be completed during the day. It should be in a visible place (on the refrigerator or on the living room door).

Suggest keeping a journal. This helps to remember what recently happened. Remind them to look at their diary more often, let it be the first thing the person does in the morning. Encourage keeping your diary in the same place (for example, next to your phone). It may be best to store it open.

How to alleviate the suffering of a patient without going crazy yourself

Caring for a person with dementia is a physically, financially and psychologically challenging process. Watching a loved one's mind fade away makes this process unbearable.

To minimize this negative impact, it is recommended to do the following:

1. Treats the patient condescendingly. It is important to remember that this illness leaves an imprint on his consciousness and character, and his words and actions should not be taken to heart.
2. Talk to the person at a slow pace, do it without aggression. People with dementia tend to forget the meaning of words, take longer to process what they hear, and can be emotionally hurt by a harsh tone.
3. Question formulation. It should sound simple and clear, preferably the answer to it should be “yes” or “no”.
4. Events from the patient’s life are gradually forgotten; he remembers more ancient events better. When talking with him, it is more effective to appeal to memories than to recent events. Talking about long-standing events has a calming effect on such a person.
5. Confront your own feelings of guilt and refrain from expressing negative emotions in front of the patient. You should not try to overcome the situation on your own; you should accept help from others and share your experiences with loved ones.
6. Remember that besides the illness of a loved one, there is another life. In order not to burn out emotionally or become depressed, it is recommended to continue doing work, hobbies, and personal life.

A diagnosis of senile dementia forces one to take many steps to combat the disease and maintain the same family relationships. To survive this struggle, it is important not to place this burden on one person, as is often the case.

Do not neglect psychological help. It is needed both by the patient with dementia and his relatives. It's hard to constantly be around someone who is slowly losing their mind. This leaves an imprint on the psyche of any person; if you do not find a way out for negative emotions, you can find the emergence of problems in the family and personal relationships.

Therapy

Treatment of senile dementia is a complex and exhausting process for loved ones. It is impossible to stop the development of dementia. Proper care and supportive medications slow down the onset of degenerative changes in brain tissue, which significantly improves the quality of life of the patient and the people with whom he lives.

Doctors recommend treatment not in medical institutions, but at home, where the patient’s familiar environment will alleviate his condition. In the hospital, a person can experience stress and new emotional experiences, which is why their health will quickly deteriorate and dementia will steadily progress.

A sedentary lifestyle is contraindicated for the patient. Therefore, you should not stay in bed all the time. It is necessary that he perform usual household chores, for example, cleaning, preparing food. If your condition allows, long walks in the fresh air are useful.

Due to constant employment, relatives are often unable to provide proper care. In such cases, the patient is sent to specialized boarding schools. Such institutions are also approached in cases of advanced stages of dementia.

Regular, balanced and rational nutrition is necessary. If a person is constantly in bed, then the bed should be equipped with a special table. He needs to sleep at least eight hours a day, and more if desired. Before going to bed, you should take him out into the fresh air or at least into the corridor.

Since vision deteriorates due to dementia and age, the likelihood of injury at home increases. Therefore, loved ones should remove all unnecessary objects from the room and put protection on all corners.

The bathroom must be equipped with special handrails and care should be taken to ensure that the floor is not slippery. Wear slippers on your feet, but not flip-flops.

In the initial stages of development, nootropic drugs can be used. They help to increase the adaptation of the nervous system to stress, increase mental activity, stimulate memory, and reduce tissue needs for oxygen:

1. If sleep is disturbed, tranquilizers are prescribed in small doses to facilitate the process of falling asleep.
2. Severe depressive moods are treated with antidepressants.

All people whose relatives have similar problems are interested in how to help a loved one and not go crazy themselves with senile dementia. To do this, it is recommended to seek help from psychotherapy. It is useful not only for the patient, but also for those who care for him.

Course of the pathology

To facilitate the process of making a diagnosis and selecting therapy, doctors distinguish the stages of senile dementia:

1. The initial stage is rarely diagnosed. The patient experiences a decrease in intelligence while maintaining self-criticism. The person notes that he begins to think more slowly and is unable to maintain concentration for a long time, however, he does not consult a doctor. This is due to the fact that the changes are associated with normal aging, and not with dementia.
2. With subsequent progression of the disease in the absence of treatment, there is a pronounced decrease in intelligence, the patient loses self-criticism, which can cause harm to himself or the people around him. Relatives should not leave him alone, despite the fact that self-care and personal hygiene skills are preserved.
3. Severe dementia changes a person’s personality; he stops recognizing loved ones. Patients with terminal dementia are unable to care for themselves and require round-the-clock care from relatives or special caregivers.

Dementia care facilities

The patient's relatives must provide her with full and constant care. In the early stages, it is enough to remind the patient about the rules of hygiene and suggest finding certain things. As the disease progresses, it is necessary to establish complete control over the woman's life.

You shouldn't leave her alone. Later, it is necessary not only to remind the patient about the rules of personal hygiene, but also to help her perform manipulations. With complete immobility and loss of interest in life, full care is required, including feeding, combing, washing, changing underwear and bed linen, and diapers.

What to do if relatives cannot be with the patient around the clock? Hospitalization for dementia is provided only in a few cases when the patient's condition threatens his life. At the same time, he needs constant supervision and care, which includes feeding, assistance in everyday life, and hygiene measures.

All this can be achieved at home, having enough time and endurance to put aside work, personal interests and leisure. This pace of life is not suitable for most of the relatives of a person with dementia.

The second option is to hire a nurse who can do all these actions and constantly be with the patient while relatives are not at home. When choosing a nurse, you should pay attention to her experience and desire to contact older sick people. Medical education is not at all necessary for such an employee.

Another way out of the situation is to place a person with senile dementia in a specialized institution. This could be a state hospice, a boarding house or a private institution. When choosing a place to place a patient with dementia, you should pay attention to the following features:

1. Price. There must be grounds for free placement of a relative in a public institution (incurable fatal pathology, insurance, etc.). These requirements are individual for different types of medical institutions. When planning placement, it is worth contacting the administration of the institution and clarifying the possibilities of care at public expense. In other cases, placing a patient in a boarding house will be paid.
2. Quality of services. Private boarding houses boast the highest quality of care for the elderly. Here you can choose the type of food, place your relative in a comfortable room with all the amenities and count on a friendly and sympathetic attitude. But the cost of services of such boarding houses and nursing homes is much higher.
3. Close to home. Patients with dementia in a boarding house need to be visited from time to time. They need to know that their families remember them and love them. To see each other more often, it is better to choose an institution closer to you.

If the family of a person with dementia is unable to provide adequate care, they can contact their local social services authorities. Their contacts can be found both from the attending physician and in other institutions working with pensioners. For dementia in older people, the following proposals are made to solve the problem: hospitalization of patients with dementia, free accommodation in a boarding house (if there is space) or a free nurse.

Five ways to stop dementia

James Gallagher BBC Science Correspondent

Image caption This is what a dementia-affected brain looks like

Dementia is often called “a global disaster waiting to happen” and the leading health problem of our generation.

Every four seconds, someone on Earth is diagnosed with dementia, with the number of people suffering from the disease expected to soar from the current 44 million to 135 million by 2050. This disease costs the world $604 billion every year.

G8 health ministers are meeting in London this week to discuss how to combat the devastating disease.

British Prime Minister David Cameron has pledged to double funding for research into dementia, also known as Alzheimer's disease and senile dementia.

So, assuming scientists had a bag of money and all the political support they needed, what could they do to combat this disease?

Early diagnosis

• This is a general term for a number of diseases in which brain cells die
• Damage to memory, speech, thinking, decreased ability to understand and make decisions
• Alzheimer's disease is the most common disease, accounting for 62% of all dementia patients
• The disease intensifies over time and leads to complete disability of patients
• The disease is incurable

The key to fighting dementia will be early diagnosis. When a doctor tells a patient that he or she has dementia, it may seem to the patient that the disease is in its earliest stages. In fact, this is not necessarily the case.

Memory problems begin to appear only 10-15 years after the onset of the disease. By this point, a fifth of the brain's key memory centers are typically already dead.

This explains why medications are ineffective in most cases - the disease is diagnosed too late.

Professor Nick Fox, from the National Neurology and Neurosurgery Hospital in London, believes the focus should be on early treatment.

Some results have already been achieved in this area. However, the most difficult aspect is using the results to combat the development of dementia.

A study is also being conducted to determine the composition of chemicals in the blood that indicate the onset of the disease.

It should be added that dementia represents a range of diseases. Alzheimer's disease, vascular dementia and dementia with Lewy bodies (as abnormal protein formations are called) have similar symptoms but different treatments. Thus, scientists will need to use different technologies for each type of disease.

Stop Brain Dying

Until they invented a medicine that could stop or even slow down dementia.

Two types of drugs to combat Alzheimer's disease - solanezumab and bapinezumab - have not brought expected results in improving brain function.

However, some are of the opinion that the drug solanezumab will work in the early stages of the disease. Therefore, new trials are aimed at monitoring patients with mild forms of senile dementia.

Dr Eric Carran, director of the UK Alzheimer's Research Institute, believes that if the drug works, it will be used in the same way that statins are used today for heart patients.

Curing dementia seems like a distant dream, but even slowing the progression of the disease can radically change the patient's life.

Treatment of symptoms

One of the medications that slows the progression of dementia is memantine. It was recently developed and approved for use in the US in 2003. Since then, nothing new has been developed.

Of course, there are other drugs that help people live with dementia, but they are not enough.

Dr Ronald Pietersen, director of the Alzheimer's Research Institute in the US, told the BBC: "There is a need to develop drugs that treat symptoms and slow the progression of the disease in the same way as after a heart attack."

Reducing the risk of disease

To reduce the risk of lung cancer, you must first quit smoking. To avoid a heart attack, you need to lead an active lifestyle and eat right. What should you do to avoid getting senile dementia? Alas, there is no answer to this question.

Age is undoubtedly a risk factor. In Britain, one in three people aged 95 or over suffers from dementia, but no one knows how to help these people.

“It is important to monitor the heart to reduce damage to blood vessels. So avoid obesity, don't smoke, exercise regularly, and keep your cholesterol, blood sugar and blood pressure in check,” advises Professor Peter Passmore from Queen's University Belfast.

Quality patient care

Senile dementia is extremely costly to society. But medical bills are only a small part of the damage, considering the time a patient's family spends caring for the patient and the often associated loss of earnings.

Therefore, part of the research is aimed at developing an approach that would allow patients to remain independent for as long as possible. A study of the disease has shown that with proper training of medical personnel, patients' medication intake can be reduced by half.

Dr Doug Brown, from the Alzheimer's Society, says serious research into care and support is important to improve the lives of people with dementia.

Source: https://www.bbc.com/russian/science/2013/12/131212_dementia_five_ways

Diagnostic examination

Establishing an accurate diagnosis, as well as clarifying the form of dementia, requires a comprehensive diagnosis. As a rule, an initial visit to a doctor is an indication for the following studies:

• mental status assessment;
• studying the characteristics of the life history and disease, including identifying risk factors;
• neuropsychological analysis.

Mental status and cognitive skills are assessed using special questionnaires and tests aimed at analyzing memory, speech, writing, counting, attention, etc. This approach is especially relevant in cases of suspected Alzheimer’s disease, which is characterized by a primary lesion of these abilities.

Required laboratory tests:

• general urinalysis;
• clinical blood test;
• biochemical blood test with determination of the level of liver enzymes (AlAT, AST, alkaline phosphatase), creatinine and urea (allows you to assess kidney function);
• studying the level of calcium in the blood, vitamin B12 and thyroid hormones.

The diagnostic plan includes electrocardiography and EEG, aimed at a general assessment of the condition of the heart muscle and brain.

What is senile insanity

Senile insanity is accompanied by irreversible changes that affect the body at the cellular level. Gradually, the death of neurons occurs, which ensure mental and mental activity. For this reason, a patient with senile insanity cannot control his daily actions, learn, or remember anything. The most unpleasant phenomenon that accompanies the disease is a sudden change in personality. As a rule, changes are negative.

Senile insanity can be primary or secondary. Secondary disease is caused by neurological problems, for example, alcoholism, drug addiction, etc. Senile insanity more often affects women than men. Medical research shows that every year there are more and more patients with this diagnosis. Unfortunately, senile insanity can also appear in those who are still of working age.

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According to researchers, senile insanity occurs due to a dysfunction of the immune regulatory mechanism. This causes the production of special autoimmune complexes that negatively affect the brain. Senile insanity is transmitted genetically. The cause of dementia can be primary or secondary. The primary lesion is characterized by independent destruction of the cerebral cortex. The lesion characterizes the following diseases:

Alzheimer's disease, Pica;

Dementia with Lewy body formation.

Secondary senile marasmus appears as a consequence of another disease:

Chronic vascular insufficiency (atherosclerosis, severe and long-term hypertension);

Severe intoxication, including alcohol;

Neoplasms of the brain.

Sometimes senile insanity appears as a result of the following factors:

Endocrine pathologies, severe kidney damage;

Past autoimmune diseases.

In some cases, senile insanity is a consequence of a combination of the above factors.

Legal aspects

A diagnosis of dementia raises questions about the patient’s legal capacity. People with mild dementia are considered competent, that is, those who can reason rationally and manage their property. In this case, a guardian is appointed who has the right to dispose of the patient’s property.

But as the disease progresses, the person loses mental clarity and capacity. Its degree is established by a special commission, the main information for which is diagnostic data and information from the attending physician. The patient also needs to undergo a psychiatric examination and undergo diagnostic tests.

The status of incapacity and disability implies payments from the state in the form of a social pension.
Therefore, the process is clearly regulated by legal norms and to obtain it it is necessary to go through “all the circles of bureaucratic hell”: collect certificates, conduct tests, and then confirm this status every year when passing a medical and social examination. The procedure for declaring a person incompetent

Legal aspects that need to be addressed if a diagnosis of dementia is made:

• put in order agreements on insurance, loans, leases, etc.;
• make a choice of the person whom the patient would like to see as a guardian, notarize this desire in the form of a power of attorney;
• write or update an already written will, have it certified by a notary;
• put your bank accounts in order; you can set up online banking to pay utility bills on time.

If an older person is diagnosed with dementia, there is a lot that needs to be done. To ensure a decent standard of living for a loved one, you need to make every effort and finance. Doctors, psychologists, lawyers, social workers and, of course, relatives will help you cope with dementia. The main thing is not to despair, but to try to do everything possible to make the last years of a person’s life as comfortable as possible.

How to behave with a patient and how to help him

The World Health Organization identifies the following eight principles of support:

1. Always remember how the disease begins to manifest itself and which doctor to contact at the first signs.
2. Support a person when applying to a medical institution, stay with him whenever possible when undergoing diagnostic procedures.
3. Be attentive and sensitive in the communication process, remember that character changes are painful.
4. Strive to increase a person’s level of independence by encouraging it and stimulating activity.
5. If you identify signs of depression, depression, or disorientation, you should help cope with these feelings.
6. You should not refuse the help of specialists: doctors, psychotherapists and social workers.

Stages

Senile dementia (symptoms and signs in women appear with varying degrees of intensity) after the onset of the first manifestations goes through 3 stages of development.

1. The initial stage is characterized by periodic deterioration of thought processes. At the same time, the general condition is not disturbed, the person accepts and understands himself, his actions, and is able to independently perform ordinary household manipulations.
2. The moderate second stage is more pronounced. Sometimes a woman forgets about the basic rules of using simple objects, such as a telephone or a door lock. However, she usually follows the rules of personal hygiene and takes care of herself without outside help.
3. The progressive third stage is considered the most dangerous. The patient becomes a threat to herself and others, forgets about the rules for using cutlery and other things, and relieves herself anywhere.

In the most severe cases, exhaustion of the body is observed; any disease of the internal organs can lead to death.

Forms of the disease and stages of senile dementia

Regardless of the causes of the disease, it is characterized by common symptoms, the main of which can be called memory disorder. The brain in different patients is affected to varying degrees, so there are several forms of senile dementia:

• mild senile dementia, in which social activity decreases, but the ability for everyday self-care is fully preserved;
• moderate senile dementia, it is characterized by loss of skills in using modern technology, the patient finds it difficult to endure prolonged loneliness, but the ability to care for himself is not lost;
• severe senile dementia, when we are talking about complete social maladaptation of an elderly person and inability to self-care.

From an etiological point of view, senile dementia belongs to one of three groups:

• atrophic (primary damage to brain neurons, not associated with vascular disorders, occurring against the background of Alzheimer's disease, Pick's disease or dementia with Lewy bodies);
• vascular (secondary damage to nerve cells due to impaired blood supply to the brain);
• mixed.

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Senile dementia is a progressive type of disease, there are three stages:

1. Initial. Against the background of impaired intellectual activity, the patient understands that he needs treatment. The ability to perform normal household activities is retained - cleaning, preparing food, and performing personal hygiene.
2. Moderate. Intellectual activity deteriorates, the ability to critically assess one’s own condition decreases. Carrying out everyday activities causes difficulty; an elderly person forgets to turn off the gas and electrical appliances, or close the door lock, thereby exposing himself and others to danger. Patients at this stage require constant supervision, but they are still able to eat, wash, and dress independently.
3. Severe dementia. The stage of complete disintegration of personality begins. The patient does not recognize his relatives, does not feel hungry or thirsty, cannot eat on his own, refuses to communicate and loses the ability to think logically. Over time, movement disorders develop, the patient does not walk or chew food. It requires constant care.

Forecasts

Early detection of senile dementia makes it possible to select drug and non-drug therapy that supports cognitive functions and maintains the proper level of quality of life. If the diagnosis was made at later stages, then the pathology tends to constantly progress. Speaking about how long people live with such a diagnosis, doctors note that concomitant pathologies are of greatest importance.

In order to avoid the development of senile dementia, it is necessary to adhere to the following rules of prevention:

1. Eliminate risk factors for cardiovascular diseases and diabetes: increase physical activity, eliminate fatty, salty foods, as well as confectionery and baked goods from food, stop smoking and drinking alcohol.
2. Maintain a high level of intellectual activity in adulthood and old age.
3. Treat existing diseases of internal organs, diabetes mellitus, atherosclerosis and hypertension in a timely manner.
4. Undergo regular preventive health examinations, including assessment of cognitive skills.

Prevention of senile dementia is possible, however, the elimination of risk factors should begin at a young age.

With a sluggish course of the disease, the patient can live up to 20 years, but full control and care is necessary. With rapid progression of the condition, life expectancy is reduced to 10 years. With the development of Parkinson's disease, Pick's disease, Huntington's disease, vascular dementia or frontotemporal degeneration, the patient lives from 6 to 8 years with proper care.

The prognosis is always unfavorable because the disease cannot be treated. Senile dementia is a common and dangerous disease. Symptoms and signs appear more often in women than in men. Patients need constant supervision by a doctor and relatives.

Caring for older people with dementia

Senile dementia progresses gradually in most cases. Symptoms and signs in women do not immediately cause concern for loved ones. They are often attributed to ordinary manifestations characteristic of an elderly person.

The first symptom is memory impairment. The patient is unable to remember events that happened not so long ago. However, most often she is well versed in memories from the past, is able to talk about the smallest details and systematize her thoughts. Further, loved ones may notice a manifestation of sloppiness and a lack of interest in past hobbies.

Disorientation in time also becomes one of the first manifestations. The woman understands where she is, but does not realize the time of day. In addition, difficulties arise when you find yourself in an unfamiliar place.

The thought process slows down. The patient spends more time solving simple everyday tasks. At the same time, such delay provokes nervousness. Another early manifestation of dementia is the refusal of habitual communication with family. The woman begins to avoid meetings and tries to remain alone.

As dementia progresses, symptoms become more severe. They allow specialists to establish an accurate diagnosis and determine the stage of development.

Diagnostics

Senile dementia (symptoms and signs in women are taken into account when diagnosing) is not so easy to identify, especially in the early stages. Various methods are used for examination.

Sometimes a DNA test of the patient is required, which helps confirm or exclude a hereditary predisposition. The method is used when symptoms of genetic diseases are present.

Senile insanity, treatment of which is possible

Many of us believe that senility cannot be cured, because medications cannot stop the progression of age-related changes. However, this is not so; senile dementia can and should be treated.

Then the question arises of how to treat senile insanity. First of all, you need to understand that not every type of senile dementia is irreversible. Sometimes a disease goes away if the cause that caused it is eliminated. If marasmus is caused by an incurable disease, there is still a way out. Thanks to modern medications, it is possible to curb the development of negative manifestations of dementia. First of all, you need to see a psychiatrist. He will conduct a study and interview the patient. Only after this can we conclude that atrophic processes are occurring in the brain. Electroencephalography and computed tomography of the brain can also be additionally performed. Remember that only a doctor can diagnose senile insanity.

You should contact a specialist when the first symptoms appear. If senile insanity has become severe, then at the moment an effective treatment method has not yet been discovered. However, symptomatic treatment can improve the patient's condition.

The home environment contributes to the success of treatment. It is important to ensure maximum activity for the patient and involve him in household chores. This will slow down the progression of the disease. If the patient is worried about insomnia or hallucinations, the doctor may prescribe him several psychotropic medications. As a rule, the early stage requires the prescription of nootropics, and then they resort to the use of tranquilizers.