The Effects of Dementia on Patients and Family

Running head: THE EFFECTS OF DEMENTIA 1
The Effects of Dementia
Sara Meier
Alvernia University

THE EFFECTS OF DEMENTIA 2
Abstract
Dementia is a serious disease that affects millions of elderly persons each year. It is the sixth
leading cause of death in the United States, but there are only a handful of ways that it can be
treated. The symptoms of dementia can vary depending on what stage the affected person has
progressed to. Symptoms can vary from confusion, to not remembering who certain members of
their family are. Because there are not many treatment options for dementia, it is important to
educate the public on how to recognize the symptoms and how to care for a family member who
has been diagnosed with this progressive illness.

The Effects of Dementia on Patients and Family
Every year nursing homes and independent care facilities receive new patients, most of
whom are moved into a home or care facility because they have been diagnosed with dementia
(Dementia, 2015). “Worldwide, 47.5 million people have dementia and there are 7.7 million
new cases each year” (Dementia, 2015, p.1). Dementia is a syndrome in which deterioration in
cognitive function occurs either progressively or chronically beyond what is affected during the
normal aging process (Dementia, 2015). “It affects memory, thinking, orientation,
comprehension, calculation, learning capacity, language, and judgement. Consciousness is not
affected” (Dementia, 2015, p.1). These are not the only symptoms of dementia. It also affects
deterioration in emotional control, social behavior, and motivation; these symptoms make
dementia a major cause of disability and dependency worldwide (Dementia, 2015).
The progression of dementia is categorized into three different categories: early, middle,
and late stages (Dementia, 2015). The early stage is the least severe of the three; it shows
symptoms such as forgetfulness, losing track of time, and becoming lost in familiar places
(Dementia, 2015). The middle stage of the progression shows symptoms that become more
restrictive, such as becoming forgetful of recent events and peoples’ names, becoming lost at
home, increasing difficulty with communication, needing help with personal care, and behavior
changes including, but not limited to, mindless wandering and often repeating questions
(Dementia, 2015). The late stage of dementia is the hardest for most to cope with (Dementia,
2015). This is when the memory disturbances become serious, and physical aspects become
more evident (Dementia, 2015). The symptoms include being unaware of the time and place,
having difficulty recognizing one’s loved ones, having an increased need for help with activities
of daily living, and experiencing more behavior changes (Dementia, 2015).

Dementia is more than just one disease, but rather it is a term used to identify multiple
diseases that cause the same symptoms (CDC, 2013). It is important for family members and
care-givers of someone with dementia to be aware of the type of dementia they are being
affected by (Nursing Standard, 2014). Some of the diseases that are categorized under dementia
are Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, mixed dementia,
Parkinson’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, normal pressure
hydrocephalus, Huntington’s disease and Wernicke-Korsakoff syndrome ("Types of Dementia”,
2015). Alzheimer’s disease accounts for about 60 to 80 percent of dementia cases and is
characterized by symptoms such as difficulty remembering recent events or names, impaired
communication, poor judgment, and difficulty speaking, swallowing and walking ("Types of
Dementia”, 2015).
Vascular dementia is known as multi-infarct or post-stroke dementia and accounts for
about 10 percent of dementia cases ("Types of Dementia”, 2015). Symptoms for vascular
dementia include impaired judgement or ability to make decision ("Types of Dementia”, 2015).
Lew body dementia consists of symptoms such as hallucinations that are usually but not always
visual (Porcher, 2013). They most often come about when the person is in a very confused state.
REM sleep behavior disorder is also common in Lew body dementia (Porcher, 2013). When
REM sleep is disturbed the patient will move, speak, or make gestures during REM sleep that
could cause them to feel less rested when they awake (Porcher, 2013). This disease generally
affects individuals who are sixty years of age or older (CDC, 2013). When an individual reaches
the age of sixty-five, the chance of developing Alzheimer’s disease doubles every five years
(CDC, 2013). “Alzheimer’s disease is the sixth leading cause of death in the United States and is
the fifth leading cause among persons age 65 and older” (CDC, 2013, p. 1).

Due to the rising average of persons affected by dementia, there has been a shift in the
health care system that aims to improve care for the affected and ensure their quality of life is at
or above the patient’s and family’s standards (Zadelhoff, Widdershoven, Van Rossum, Abma.
2011). A study was conducted in order to better understand the details of dementia in its natural
setting and how the patients and families are affected by the disease (Zadelhoff, et al., 2011).
They found that the patients affected by dementia generally do better with activities of daily
living in group homes where they can interact with other residents rather than living at home or
with a few family members (Zadelhoff, et al., 2011). During this study the researchers conducted
interviews that showed the residents feel at home in their group homes (Zadelhoff, et al., 2011).
The residents often gather together in the living room to have conversations over coffee or read
magazines amongst one another (Zadelhoff, et al., 2011). Being part of group homes allows the
family to participate in their everyday life while being free of the burden of caring for their
relative who is affected by dementia (Zadelhoff, et al., 2011).
There is some stress that comes with caring for a family member who is affected by
dementia. Whether they are in the beginning stage or they are in the late stage of their disease, it
can be difficult or even frustrating to care for them. Not only does being a caregiver for
someone with dementia cause stress, but it can cause a decrease in psychological health
(Brodaty, Donkin, 2009). This could both increase the caregiver’s mortality risk, and also lessen
the degree of care the patient is receiving from the caregiver (Brodaty, Donkin, 2009). There
have been numerous studies that show that caring for a person with dementia can negative
effects on the psychological health of a caregiver. Social isolation is an ongoing issue with
caregivers. They often lack the social contact and support they need which can cause them to
experience a feeling of social isolation (Brodaty, Donkin, 2009). While caring for someone who

has dementia, it is harder to pursue leisure activities and hobbies they enjoy participating in
(Brodaty, Donkin, 2009). “Caregivers who are more satisfied with their social interactions show
fewer negative psychological symptoms” (Brodaty, Donkin, 2009). It is also proven that
dementia caregivers are at an increased risk of developing health problems such as
cardiovascular problems, lower immunity, poorer immune response to vaccine, slower wound
healing, and higher levels of chronic conditions (Brodaty, Donkin, 2009). Caring for someone
with dementia can also cause a strain on one’s mental health to the point where they are more
likely to start smoking cigarettes, drinking alcohol, and have poor sleep patterns (Brodaty,
Donkin, 2009).
Family members that are not caregivers are also affected by the ongoing changes with
their family, and around their home environment. Guilt is a common feeling among those with
family members who have dementia. They could feel guilty about the past and how that family
member might have been treated, or by their feeling of embarrassment for their family member’s
odd behavior, or for not wanting to take on the responsibility of caring for that person ("Impact
on family and friends”, 2014). If it comes to the point in time where the family member with
dementia goes into residential care it is common for the rest of the family to feel guilty for not
caring for them longer than they already had ("Impact on family and friends”, 2014).
When someone’s family member is diagnosed with dementia it can cause a feeling of
grief or loss for that person’s family. The family is faced with feeling as though they have lost
the person they were before the diagnosis ("Impact on family and friends”, 2014). Grief comes
at different times for everyone, and each person experiences grief in a different way, but it is
often caused by similar events such as the loss of the future that they were planning with their
family ("Impact on family and friends”, 2014). Family dinners at the grandparents’ house may

not be an option anymore because Grandma is not well enough to use the stove, or perhaps
holidays are different because Grandpa does not remember all of his grandchildren. The
slightest change in the outlook for the future could cause a feeling of grief and loss.
Anger is also a feeling that is associated with a familial diagnosis of dementia. Anger
comes with the new job of being a caregiver, or the fact that some family members will not help
with the new burden ("Impact on family and friends”, 2014). It is normal to feel distress,
frustration, exhaustion and annoyance with the affected person; but it is important to remember
that depending on the stage they are in, they are no longer in control of their actions or what they
have to say ("Impact on family and friends”, 2014).
With the aging population increasing as America’s life expectancy increases “efforts to
foster recognition of dementia and its treatments and to destigmatize them are emerging as an
increasingly important facet of public health intervention” (Chapman et al., 2006). Currently a
change in demographics is showing that there is a declining birth rate and an increasing average
life span. Because of this, the number of people aged sixty five years and older is expected to
increase from 35 million in the year 2000 to 71 million people in the year 2030 (Chapman et al.,
2006). The number of people who are eighty years and older is also expected to change from 9.3
million people in 2000 to 19.5 million in 2030 (Chapman et al., 2006). This shows that the
number of aged adults is going to increase dramatically making it exceptionally important to be
aware of the risks that come with age and future illnesses such as dementia (Chapman et al.,
2006). It has been reported that 20% of older adults have a psychiatric disorder and one of the
most common of these psychiatric disorders is dementia (Chapman et al., 2006). Dementia is a
source of great suffering for many people inflicted with the illness, but there are new
opportunities for intervention. One of the common causes of dementia is the destruction of the

neurons that release the neurotransmitter acetylcholine (Chapman et al., 2006). Acetylcholine is
a neurotransmitter that causes muscle action by transmitting nerve impulses across synapses.
There are medications that can block the enzyme that is responsible for breaking down
acetylcholine and inhibit cholinesterase which is found to increase the acetylcholine levels in the
brain (Chapman et al., 2006). This could slow the progression of some types of dementia, but it
is most effective in the early stages of the disease (Chapman et al., 2006). Another way of
potentially slowing the progression of dementia is physical activity. Dementia patients who are
physically active were associated with a lower risk of cognitive impairment as compared to those
who did not participate in any physical activity (Chapman et al., 2006).
Preventative measures have also been discovered. Reading, playing games, doing
puzzles, and playing a musical instrument have been proven to decrease the risk for dementia
among older adults who are free of any cognitive impairment (Chapman et al., 2006). The future
of dementia is unclear at this time, but there are currently studies being done to determine
whether or not there are preventative measures that can be taken to decrease the risk of
developing dementia (Chapman et al., 2006).
“Dementia is a descriptive term for a collection of symptoms that can be caused by a
number of disorders that affect the brain” (“NINDS”, 2013). It is characterized by symptoms
such as losing track of time, forgetfulness, becoming lost in familiar places, personality and
mood changes. Although Alzheimer’s is the sixth leading cause of death in the United States
there are still ways of treating it, but very few to prevent it (CDC, 2013). Treating it could be as
simple as altering daily routines to include more physical activity (Chapman, et al., 2006). Not
only is this good for the body overall, but it decreases the chance of their being psychological
impairment. Medications can help slow the progression of certain types of dementia, but other

than participating in activities that improve cognition there has not been any significant
breakthrough as to any other preventative measures (Chapman, et al., 2006). When it comes to
having a relative who suffers from dementia it is important to understand that often times they do
not have control over what they are saying or how they are feeling (CDC, 2013). Simple things
such as giving them a compliment on how they look or how well they did on a puzzle can greatly
improve their mood that day (CDC, 2013).
Understanding that confusion is a symptom of dementia could help a great deal with
caring for someone who is affected. Simple tasks like dressing oneself become harder to achieve.
This could cause feelings of frustration and anger towards the patient or family member who has
dementia ("Impact on family and friends”, 2014). Although these feelings are normal to
experience, it is important to know that being patient with anyone who has dementia is the key to
working through the problem. Caring for someone who has dementia can have negative effects
such as anxiety and depression on the primary care person ("Impact on family and friends”,
2014). It is proven that people who care for a family member with dementia are at a greater risk
of developing negative psychological symptoms, but if a care-giver still focuses on their own
social activities, it is less likely that negative psychological symptoms will arise ("Impact on
family and friends,” 2014). It would be beneficial for both the care giver and the patient if the
care giver was in good physical and psychological health. If the care-giver’s health is
deteriorating there is an increased risk that the patient will not be receiving the care they need or
deserve ("Impact on family and friends”, 2014).
Current projections show that the birth rate in America is decreasing while the life
expectancy is increasing. This means that a fairly large portion of our population is going to be
above the age of 65 by the year 2030 (Chapman, et al., 2006). While studies are being done to

determine if there are any effective preventative measures that can be taken the elderly
population is rising. This is why it is important to begin taking measures on education the health
care field and the public alike in ways to recognize the symptoms of dementia and care for those
who are affected by dementia (Chapman, et al., 2006).

References
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