Dementia – Alzheimer’s Disease

Dementia means that in different ways it becomes difficult to remember and to interpret one’s surroundings. You may then need to undergo a dementia study and if you are ill there is a lot of support to be had. The most common type of dementia is Alzheimer’s disease, as nerve cells disappear in one or more of the brain’s areas.

Other common dementia diseases besides Alzheimer’s disease are blood vessel dementia, Lewy Body dementia,  and lobe dementia.

Symptoms of Alzheimer’s disease

Early symptoms of Alzheimer’s disease tend to be problems with memory and a changed perception of time. Other symptoms are that it can be difficult to find words and can feel anxious, dejected and incompetent. It is common for people to be aware of their difficulties and therefore retreat and avoid contact with others. More early symptoms are that it becomes difficult to keep up with TV programs or to understand the context when reading the newspaper. One can find it difficult to be alone, even for shorter moments. This is because you can no longer judge how long a relative has been away.

Difficult to handle everyday chores

Later in the illness, it becomes more difficult to perform practical tasks such as paying bills, planning food purchases, shopping, cooking or traveling on your own. Many people find it difficult to recognize themselves and to find, first outdoors but later also in their own home.

Eventually, you may find it harder to stay clean, to shower and to wash. Sometimes you can become aggressive and suspicious. When you have trouble remembering and following reasoning, you can get a different idea of ​​how things are compared to the outside world.

Alzheimer’s and other memory problems

It is common to have slightly worse memory at older ages, and it can be difficult to determine if you have just become oblivious or if you have had Alzheimer’s disease. It is very uncommon for people under 50 to have Alzheimer’s disease.

When you have memory problems, it can be especially difficult to remember everyday events, such as where you put the keys. Stress, sleep problems, depression, and a high workload can temporarily impair memory. Through medical examinations, a doctor can determine early on whether the memory problems are due to Alzheimer’s disease.

Confusion – extreme stress on the brain

Sudden confusion can sometimes be caused by the brain being subjected to extreme stress through stress, temporary oxygen deficiency or bodily discomforts such as an infection, anemia or pain. Some drugs may also be behind. Other causes may be changes in life, such as a change of home.

The brain’s way of functioning is disturbed and it becomes difficult to think clearly, speak, understand and cope with daily life. It is common in the elderly, but it is especially common if you already have a brain disease, such as a dementia disease. This can then be noticed by suddenly deteriorating in functions that you usually manage and seem more confused than before.

Night can be turned into day and it is difficult to concentrate on doing one thing at a time. Many just walk around picking their stuff or talking incoherently. Sometimes you can have hallucinations when you feel like seeing or hearing things that are not in reality. 

When should I seek care?

If you feel confused, have difficulty thinking or have memory disorders for more than a month, you should contact a health care center. It is important to find out what the problems are because they can have causes that can be treated, such as depression or low metabolism.

In order for you or your relatives to find out how you feel, you can consider three questions:

  • Is my memory as good as before so that daily life works?
  • Does my ability to solve problems, think, reason and plan work?
  • Has my mood and mood changed?

If the answers to any of these questions indicate that you are not feeling well, you should be examined by a doctor and possibly have a  dementia study showing whether you have any dementia.

You can seek care at any healthcare center you want throughout the country. You also have the opportunity to have a regular doctor’s contact at the health center.

Investigations

If you have a memory problem, you will have to go through a survey to find out what it is. First, you have to tell yourself and a relative about a problem with a doctor. The doctor wants to know what the symptoms are and how they have changed. It provides an important guide to what causes memory problems.

Then you will be examined in several different steps:

  • The entire body is carefully examined. The doctor pays special attention to the brain. Memory functions, thought functions, vision, language and emotion functions are tested.
  • Simple blood tests are taken to check the metabolism and to check if you may be deficient in vitamin B12 or disrupted calcium levels. Low metabolism, lack of vitamin B12 as well as high levels of lime, can impair brain functions.
  • Often, you also have to undergo a magnetic camera examination or a layer X-ray, called computed tomography, of the brain. Such examinations can show if there are changes in the brain. Cognitive tests such as MMSE-SR and clock tests are also common. A study called CT is also usually done to exclude other diseases. 
  • In an extended investigation, the fluid that surrounds and protects the brain is also examined. This fluid is also found in the spinal cord in the spine. A sample is taken through a stick at the back end. The test can reveal if there are proteins that have leaked from damaged nerve cells. In particular, this study may be important in early disease stages, as many other studies show values ​​that are as they should be.

Psychologist and occupational therapist

If the diagnosis is unclear or uncertain, you may need to undergo more examinations. Psychologists can do a deeper examination of your intellectual functions.

If needed, an occupational therapist can assess your daily life to see what is difficult and what works. The occupational therapist maps the entire life situation. This knowledge is important in order to be able to plan help from social services and health care with relatives.

A right to receive information

You will need to know who to contact and when to find out the answers after sampling and surveys. You should also find out where to turn if you get worse.

The healthcare staff should tell you what treatment options are available. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment. This way you can help decide which treatment is right for you.

In order for you to be active in your care and make decisions, it is important that you understand the information you receive. The healthcare staff is obliged to make sure that you do so. Ask questions. You can also ask to have the information written down so you can read it peacefully.

Treatment for Alzheimer’s disease

Most people with Alzheimer’s disease can be cared for at home. It is not possible to recover from the disease, but there are drugs that partially alleviate the symptoms. Some people may notice clear improvements, for example in concentration, memory or linguistic ability. Many times the drugs help the brain’s various centers to function longer than if you are not receiving treatment.

The so-called acetylcholinesterase inhibitors strengthen a brain signaling system that has been damaged by dementia. The active substances donepezil, found in the drug Aricept, rivastigmine found in Exelon and galantamine, found in Reminyl, can reduce symptoms of Alzheimer’s disease and improve thinking and memory.

The active substance memantine, which is found in the drug Ebixa, affects another system that has been damaged by the dementia disease and can thus reduce the intellectual symptoms.

The drugs cannot cure, but they can relieve the symptoms during the time you are taking the medication. The mental symptoms that some people with Alzheimer’s have, such as depression, hallucinations, delusions, anxiety, and anxiety, can also be treated with medication.

Side effects of treatment for Alzheimer’s disease

The drugs that act by strengthening the signaling system with acetylcholine can cause side effects from the gastrointestinal tract since acetylcholine is also present. The stools can become loose and you can feel nausea. Most often, the side effects are transient. Memantine (Ebixa) rarely produces any side effects.

If you have Alzheimer’s disease you slowly get worse and it becomes increasingly difficult to interpret your own body signals. Eventually, it becomes increasingly difficult to get food, even if you get help, and the body becomes weaker.

You who have Alzheimer’s disease, as well as your relatives, need information and knowledge about the disease and the consequences it has at different stages. In some parts of the country, it is arranged so that you can get a contact person in the health care and elderly care. The contact person monitors the development of the disease and gets to know the needs you have as dementia sufferers. If you talk about worries and problems in time, you can get help before the situation becomes more difficult to manage.

What happens in the body?

Dementia involves problems with memory and interpreting impressions from the senses and the surroundings. Furthermore, it is more difficult to think and to do things.

Alzheimer’s disease is one of several dementia diseases. 

In the brain are different areas that have different tasks. The temporal lobe controls memory and the brain lobe analyzes the information from the senses. The forehead lobe is needed for the judgment, insight, concentration ability and speech to work well. The nightclub controls visual impressions.

In Alzheimer’s disease, nerve cells disappear in one or more of these brain regions.

The nerve cells die

It is the nerve cells in especially the temporal and brain lobes that disappear. First, the protrusion of the nerve cell and its contact points with other cells disappear. Eventually, the entire nerve cell dies. There are several possible explanations for the destruction of nerve cells:

  • A harmful protein, beta-amyloid, is stored in the brain. This storage may be due to hereditary chromosome changes, but it is very uncommon.
  • There are small threads, neurofibrils, in the nerve cell. These are needed for the structure of the nerve cell. If you get Alzheimer’s disease, these fibrils change, which also contributes to the loss of nerve cells.

Exactly how these mechanisms are connected is not yet clear, but research has shown that beta-amyloid can contribute to the alteration of the neurofibrils.

High blood pressure increases the risk

Researchers have yet to come up with any way to prevent Alzheimer’s disease. However, it is clear that there are various circumstances that increase the risk of getting the disease. For example, it may be too high blood pressure. Therefore, the risk of getting the disease can be reduced if you get treatment for high blood pressure already in middle age.

Living with Alzheimer’s disease

At the beginning of the disease, the memory becomes worse. Eventually, you will also have problems interpreting, among other things, sensory impressions, understanding the surroundings and deciding what is appropriate to do and say in social situations. You will find it difficult to manage your bills, read the newspaper, watch a TV program and get involved in anything at all. After a few years, you often can’t manage yourself, but need help with everyday chores and planning the day.

As the memory gets worse, it is common for you to ask the same questions over and over, worry and get a distorted picture of reality. Sometimes you may get hallucinations when you find yourself seeing and hearing things that are not in reality. It often makes everyday life difficult for close relatives. At the same time, the sick person usually feels the best way of living at home in his habitual environment. For the related and the ill, balancing between different needs can be difficult.

Increasing social interaction

Many couples, with one having Alzheimer’s disease, describe how they are getting less and less social life as the disease gets worse. Those who are ill feel easily outside and inferior, which often leads to them preferably avoiding meeting other people. It is important to try to counteract such development and, as far as possible, to stick to social networks and opportunities for stimulation.

The symptoms can be alleviated

Some people with Alzheimer’s disease, together with their relatives, develop a special way of life to facilitate everyday life together. It can be a life of clear and recurring routines. It is important to try to maintain a good social interaction.

There are many ways to compensate for bad memory. One way is to take a long time when trying to imprint something into your memory. For example, you can use support words to remember what you have learned. It is important that you can concentrate on the task and not be disturbed. But memory training often produces limited results. For example, if you train the memory for phone numbers, you’ll be fine with that, but may still have the same difficulty remembering names and faces.

What you eat matters

A unilateral or poorly composed diet can cause vitamin deficiency, which in turn can damage brain cells. This may lead to poor memory or other health problems. Alcohol in excessive amounts is a well-known cause of brain damage and memory problems. 

Often you live at home first

Once you have been diagnosed, the planning of the care and care you need begins. You or your relatives talk to doctors, nurses and assistance officers from the municipality. If you receive care early, there are good opportunities to receive support so that you can be cared for at home. If needed, you can get help from the municipality’s healthcare staff.

If you have Alzheimer’s disease you usually have regular contact with your doctor and direct contact with a district nurse. Sometimes there is a special nurse linked to a team in the municipality that takes care of the care. This means that you can reach the same nurse for the needs that arise during the illness.

The most common thing is to continue living in their home with a relative. You receive a home visit by a district nurse or nurse together with a nurse, or by caregivers. 

Every person in need of care, whether in the home or in a special place of residence, has the right to have an individually prepared care plan, where a relative or a good man should be involved if you cannot yourself. Special accommodation can be a service house or a nursing home. 

Home Health Care 

If you need medical care but have difficulty getting to the health center, you can get home health care. Then you will be visited regularly by a district nurse, nurse or under-nurse in your home. It may be, for example, if you need daily help with your medication. In many municipalities, there are special dementia nurses that you can get advice and support from. These nurses also have close contact with the nursing staff.

Daytime activities

In many places, there is a special daycare for people with dementia. For example, daycare can be located in a service house or in connection with a group residence. Everyone eats together and can participate in various activities based on their own circumstances.

Day operations are usually open Monday to Friday. You can be there one to five days a week depending on your needs. In some municipalities, day operations are also open on certain evenings and weekends. You can often get to and from daycare with travel service, but it can vary depending on which municipality you live in.

Support for related parties

If you live at home, you can often get good help from the person or people you live with. It can be your life partner, family, relatives or friends. But a relative may need support in their task of helping, and also have the opportunity to carry out cases on their own. Staff from the home service can come home and relieve a relative who needs relaxation, has been invited, is going out and shopping or doing other business.

If you need a lot of help and care, you may need to move away from home for periods. Periodically, you can stay for a few weeks in one of the municipality’s accommodations and a few weeks at home, so-called exchange care. How expanded this service is can vary from municipality to municipality. 

In some municipalities, there are family consultants and special support teams for relatives of people with dementia. These teams contact close relatives, inform about the local resources available and can act as call support.

Often there are special group housing

If you get worse, it can eventually be difficult to stay home. It is no longer enough with the help that relatives, in combination with visits by home care staff and health care personnel, can provide. Nor do different arrangements with relief or exchange care feel adequate. You can then move to some type of special accommodation, such as a group residence. In order to be able to move to special accommodation, a new assessment of assistance is required that you or a relative apply for.

In most municipalities, there is a difference between group housing for dementia and group housing for long-term sick. If you are old and have dementia, you may have other illnesses at the same time. The type of group accommodation you will move to depends on whether it is dementia or other illnesses that are being considered. 

When you live in a group home, you have your own contract for your apartment or room. You can furnish with your own furniture and other belongings to make you feel more at home. It is common for eight to ten people to live together. Everyone has their own apartment or room and you share common areas, such as kitchen, dining room and living room. In special accommodations, there are caregivers on-site around the clock.

Information for related parties

It is common for those with dementia to begin to behave differently than before. The most common symptoms seen at the beginning of Alzheimer’s disease are memory disorders that gradually worsen. Sometimes the language is also affected and those who are ill find it difficult to find words and express themselves. Difficulty finding in the surroundings also becomes more prominent.

It is also common for compassion for others to decrease and personal hygiene to deteriorate. Some drugs can affect behavior, so it is good for you as a relative to obtain information about the drugs used by someone with dementia.

Later in the disease, the sick person becomes increasingly shielded from the environment. Often the person can no longer talk or interpret their surroundings and their own body signals. At the same time, those with dementia can function relatively well physically, and for example, be up and running. 

Help to cope with daily life

People with dementia often need a lot of help to cope with their daily lives. Therefore, the planning of care and care should begin as soon as the diagnosis has been established. As a relative, you get to talk to doctors and other health care professionals, as well as assistance assessors from the municipality.

It can be stressful to be close and you can feel sadness and anger. As a relative, you may need a lot of support in your task to help. In some municipalities, there are family consultants and support teams for relatives of people with dementia. They contact and information about the municipal resources that exist and can act as call support.

Support for staying at home

Care needs to be individually tailored. This could mean, for example, that a person with dementia is given extended opportunities for physical activity, which counteracts anxiety and restlessness and stimulates the gastrointestinal functions. The municipality has a great responsibility here.

If you live with a person with dementia, a nurse, nurse or staff from the home service makes regular home visits. Over time, it is usually more difficult for those who are ill to stay at home and it may be necessary to move to special accommodation for people with dementia, such as a form of group housing. Usually, there are several different housing alternatives within a municipality.

Home Help

The municipality’s home service can provide practical help with many everyday activities such as personal hygiene, laundry, cleaning, grocery shopping and more. In many municipalities, there are dementia nurses who can provide advice and support. The nurses also have close contact with the home care staff. The fee for the help you can get varies from municipality to municipality. More detailed information about what different efforts your own home municipality can provide and what these costs you get through your home municipality.

Anyone who has a dementia disease or you as a relative apply for help from the social services in the municipality. The municipality’s aid assessors make an inquiry about the needs that exist and make decisions based on them. The decision may be appealed.

Right to care plan

Every person in need of care, whether in the home or in special housing, should receive an individual care plan. You as a related person or a so-called good man have the right to be involved in the planning if the person who is ill cannot himself. The special accommodation can be, for example, a service house or a nursing home. The text on financial aid when you are ill contains more information about what a good person can help with.

A district nurse or nurse, together with the municipality’s supervisor for the home service, is responsible for the care plan and that the sick person receives the help needed.

Permanent care contact

Anyone who has contact with many different persons within the care can get permanent care contact. It is a person who among other things helps to coordinate care. It is possible to choose a permanent health care provider throughout the country.

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