Dementia: Recognizing and understanding signs and stages
Most people associate dementia primarily with pronounced forgetfulness. This is an important identifying feature, but only one of many.
Recognizing the 10 most important signs of dementia
1. Forgetfulness and confusion
What was your little grandson's name again? Did you really tell me that yesterday? And where is my bathroom? One of the first signs of dementia is increasing forgetfulness and confusion. Knowledge of things we normally take for granted gradually disappears. Your own home and your own family can suddenly seem foreign.
2. Problems coping with everyday life
Suddenly, familiar everyday tasks no longer work, and complex connections can no longer be recognized. The patient is suddenly no longer able to shop or do laundry alone. They forget things that were no problem their entire life. This can lead to dangers in everyday life: They might forget to turn off the stove or leave the house and not find their way back.
3. Loss of orientation
Even in the early stages of the disease, a typical sign of dementia is a loss of spatial and temporal orientation. People often do their business in the trash because they no longer know where the toilet is. When you visit them at their scheduled appointment, they may be completely surprised and no longer remember what day it is. When asked what year it is, quite a few respond with dates from their childhood or adolescence.
4. Language difficulties
It's on the tip of my tongue... As memory loss progresses, so does vocabulary. Wrong words are used, words that don't come to mind at the time are omitted, or the entire sentence becomes unintelligible. Sometimes, in the advanced stages of Alzheimer's disease, communication is almost impossible.
5. Aggressiveness and irritability
It's not uncommon for a once friendly senior to suddenly become an aggressive, argumentative person, perhaps even insulting, spitting at, kicking, or hitting their own relatives. This, too, is not uncommon in the context of dementia. This is not malicious intent on the part of the patient, and it's not meant personally.
6. Personality changes
Even independent of aggressive tendencies, people with dementia often develop personality traits that were previously unknown. For example, an active and fun-loving person may become tired and sluggish, while a cheerful family member may suddenly become anxious and tearful.
7. Depression
Depression with pronounced sadness, hopelessness and lack of motivation can occur together with dementia or be a precursor.
8. Hallucinations or delusions
In some forms of dementia, people may also see or hear things that aren't real. For example, they might suddenly reach into the air to shoo away an imaginary fly or see small animals in the corner of the room. Delusions can also occur, in which patients believe, for example, that caregivers are trying to poison them or that they are being watched by the secret service.
9. Loss of sense of smell
Patients with dementia, especially those with Parkinson's syndrome, often lose their sense of smell and, with it, their sense of taste. They may no longer enjoy their favorite foods or be unable to smell food that's burnt on the stove.
10. Restricting daily activities
Especially in the early stages of the disease, those affected are more likely to notice the signs of dementia themselves and realize that many things no longer function as they used to. To conceal the first signs of dementia, they restrict everyday activities: They stop taking the bus into town for fear of not being able to find their way back. Or they cancel their beloved game night because they can no longer concentrate and follow the game.
It's getting worse - stages of dementia
As a caregiver, you know it: Just as all people are different, so are patients with dementia. Everyone exhibits different symptoms of dementia, which can change over time. Although this results in a unique clinical picture for each individual, dementia is roughly divided into three stages: mild, moderate, and severe.
With mild dementia, it is no longer possible to carry out all of the usual everyday activities, but an independent life is still possible. Typical signs of dementia in this stage are mood swings; those affected are easily irritable or depressed. With moderate dementia , simple everyday tasks can still be managed, but they can no longer respond appropriately to complex situations. Those affected are usually dependent on outside help and can no longer live completely independently. In most cases, however, they do not require constant supervision. Typical symptoms of dementia in this phase are restlessness, aggressive behavior, screaming, fidgeting, or a disturbed day-night rhythm. If the disease progresses to the severe phase, patients usually require complete care. Independent management of everyday activities is no longer possible, and thoughts can often no longer be communicated.
Scientists sometimes describe the progression of dementia as a case of "reverse childhood development." People with dementia lose their acquired skills in the reverse order of how a child learns them during normal development. While at first, they may only lose objects, as time progresses, assistance with even simple tasks like washing or using the toilet becomes necessary. Eventually, even speech and the ability to walk confidently are lost again.