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1. Dementia
Awareness
Ahmad Thanin

2. Introduction
the word ‘dementia’ describes a set of symptoms that can
include memory loss and difficulties with thinking, problem-
solving or language, and can also affect mood and behavior.
Dementia occurs when the brain is damaged, and certain
symptoms will depend on which parts of the brain are
damaged.
Dementia is progressive, so symptoms will get worse over
time. Around one million people in the UK may be living
with dementia. There is currently no cure.

3. Dementia
from the
inside
Dementia is caused by damage to
the brain.
Damage usually starts slowly and
gets worse over time, as cells begin
to die.
If you don’t have dementia, it’s hard
to imagine what it’s like.

4. Common signs and symptoms of dementia
Confusion
Memory
problems
Disorientation Hallucinations
Physical
coordination
problems
Lapses (or
jumps) in time
Feelings of
fear and
distress
Feelings of
low self-
esteem

5. What other problems do people experience
with dementia?
• A person’s likes, dislikes and interests might change; they may lose their inhibitions and behave in new
and surprising ways.
Changes in behavior
• A previously sociable person might become withdrawn and depressed, or suddenly become frustrated
and angry.
Personality changes
• Speaking and understanding speech could be affected.
Difficulties with communication
• Problems with use of tools and equipment.
Difficulties with problem-solving and decision-making

6. Why might a person living with dementia behave
differently, or seem to change personality?
Changes in the brain can be
frightening, causing feelings of
distress
Experiencing dementia can be
frightening at times.
When this happens it’s the job as
care-givers to help the person feel
safe and not anxious.
Dementia might also liberate a
person from previous ways of
thinking, so they decide to try new
hobbies and activities.

7. Types of
dementia
• Alzheimer’s.
• Vascular Dementia.
• Lewy Body Dementia.
• mixed dementias

8. Alzheimer’s
This is the most common type of dementia. Six
out of every 10 people with dementia have
Alzheimer’s disease.
It’s caused by build-up of proteins in the brain and
is characterised by progressive loss of memory
(especially recent memories), and the ability to
carry out everyday activities.
This can often result in people becoming
depressed, confused and irritable as they struggle
to understand what is happening.

10. Causes and
symptoms
• Build-up of proteins in the brain
Primary cause
• Memory problems
• Loss of problem-solving skills
• Confusion and restlessness.
• Speech and movement difficulties
General symptoms

11. Vascular Dementia
Vascular Dementia is the second most common
form of dementia and is caused by loss of blood
flow to the brain, often as a result of a stroke. It
can start suddenly or progress slowly over time.
The main symptoms, as the condition develops,
are increasing difficulty with concentration,
reasoning and planning, memory loss and
sometimes mood or changes in behaviour

12. Causes and
symptoms
• Loss of blood flow to the brain
Primary cause
• Memory problems
• Loss of problem-solving skills
• Confusion and restlessness.
• Speech and movement difficulties
• Depression
• Problems with urination
General symptoms

13. Lewy Body Dementia
Lewy Body Dementia is caused by a build-up of proteins in the brain. It is
characterised by unexpected swings in behaviour, from alertness to confusion
or tiredness.
People often suffer from sleep problems and hallucinations, which can be
highly distressing, and movement problems can also occur that are similar to
Parkinson’s disease.
Memory is often less affected with this dementia in its early stages.

14. Causes and
symptoms
• Build-up of proteins in the brain
Primary cause
• Confusion and restlessness.
• Hallucinations
• Sleep disorder
• Speech and movement difficulties
• Dizziness
General symptoms

15. Mixed Dementias
Some people develop mixed dementias, where one or more of the dementias occur.
• A person with an existing disease such as Parkinson’s or Huntingdon’s may be more likely to develop
dementia.
• Korsakoff’s Syndrome results in dementia-like symptoms brought on by alcohol misuse; unlike all other
forms of dementia, it can be stopped.
Fronto-temporal Dementia, including Pick’s disease, is caused by damage to parts of
the brain most commonly associated with speech, language and behaviour.
• People with this condition often confuse or forget words, and can develop unusual behaviours from a loss
of inhibition, develop repetitive behaviour or overeat, or become subdued and withdrawn.
• They may eventually stop talking altogether and become mute.
• People living with this dementia may also develop physical symptoms similar to Parkinson’s disease.

16. Mixed
Dementias
Causes and
symptoms
• Alzheimer's, Lewy Body & Vascular Dementia
Primary cause
• Memory problems
• Loss of problem-solving skills
• Confusion and restlessness
• Hallucinations
• Sleep disorder
• Speech and movement difficulties
• Depression
• Dizziness
General symptoms

17. Fronto-
temporal
Causes and
symptoms
• Shrinkage of lobes in the brain
Primary cause
• Speech and movement difficulties
• Compulsive and socially
inappropriate behaviour.
• Overeating
General symptoms

18. Korsakoff’s
Causes and
symptoms
Primary cause
•Lack of Vitamin B1
General symptoms
•Memory problems
•Confusion and restlessness

19. Similar conditions
• is characterized by movement problems (tremor and difficulty with walking) and speech problems.
• Some people with Parkinson's disease go on to develop dementia.
Parkinson's disease
• when a person becomes confused due to conditions such as dehydration and infection their confusion can be
misdiagnosed as dementia.
Delirium
• lack of B-Vitamins, thyroid problems, low blood sugar and sodium or calcium imbalance can all cause
symptoms that might be misinterpreted as indicating dementia.
Other medical conditions
• memory generally deteriorates as we get older.
• If our memory deteriorates that doesn’t mean we have dementia.
Poor memory

20. Diagnosis of dementia
Most people, or carers, will initially see their GP to discuss concerns.
A doctor may offer a preliminary diagnosis before referring the person to a
memory clinic or specialist.
It gives people an opportunity to plan for the future.
Diagnosis can result in treatment that controls symptoms and delays
progression.

21. Reducing the risk
Identifying and managing health conditions (such as diabetes,
high cholesterol and high blood pressure) can reduce your risk.
Living a healthy lifestyle, by exercising and reducing or cutting
out alcohol and cigarettes can reduce your risk.
Eating fresh (unprocessed) foods like wholegrains, pulses,
fruits, vegetables and fish can reduce your risk.

22. Remember
Memory loss does not indicate dementia and is a normal part of ageing.
Dementia isn't a normal part of the ageing process – it's caused by significant changes in
the brain.
Memory loss varies with the type of dementia.
It might not be the first symptom, or even the worst symptom experienced by a person.

23. Meaningful activity in care homes
People don’t stop
enjoying hobbies and
interests just because
they have dementia.
We all need to be
involved in activities we
enjoy to give our lives
meaning.
Meaningful activity is an
essential aspect of living
well.

24. Activities for people living at
home
Many people living with dementia in their own homes
can still engage in the activities they enjoy and continue
to be active.
At some point, they will probably need support in
adapting their homes to enable them to keep safe, and
promote their independence.
Individuals can also be supported to avoid isolation by
maintaining a social life and involvement in their local
community.

25. The Impact of Dementia
• Dementia affects not only a person's
health, but the number of choices they
can make about their daily lives.
• Mrs. Munslow's care worker (in the
photo) made the effort to offer a choice
about whether to communicate.
• She said "May I?" before joining in
the 'conversation’.
• This might seem a small thing to do,
but if you have limited choices small
things are very important!

26. The Impact of
Dementia
• The majority of care for people
with dementia happens within the
family.
• However, many family carers
report that this results in high
levels of stress, depression and
social isolation.

27. The Impact of Dementia
• Dementia is the most significant health
and care issue of our age.
• Helping increasing numbers of patients
puts pressure on our health and care
services but the way we care for people
with dementia says a great deal about
who we are as a society (i.e. our values
and compassion for people who cannot
care for themselves).

28. Supporting carers
Most people with dementia are cared for at home.
• Typically, family carers want to continue in their caring role, despite any
challenges they face.
• So, it’s important that they are supported to maintain their own health
and wellbeing.
Making family carers aware of, and offering them the
opportunity for respite, education, training, emotional and
psychological support, will help them to provide good care.
• It will also help them to understand they are valued partners to you and
other professional care staff

29. Communication in dementia care
People living with dementia face particular challenges around communication.
Dementia may affect a person's ability to understand and use language.
• Language skills may vary from day to day and decline as the condition progresses.
• Effective communication depends on understanding the needs and abilities of each individual.
• Non-verbal communication may become increasingly important as verbal abilities decline.
• Health and care professionals need to be aware of non-verbal communication, such as body language, facial expression and
touch.
The behaviour of a person with dementia (including distressed behaviour and behaviour that challenges)
is also an important form of communication – possibly indicating a person’s feelings and perceptions.
• Recognising this can be a key component of effective communication

30. The importance of talk
• It's important to keep talking with people about their
lives and the things or people that are important to
them.
• Lack of conversation and interpersonal connection with
others can leave a person feeling isolated and lonely.
• By adapting your communication style, it is possible to
communicate with most people until very late stages of
dementia.

31. Adapting communication – I
• Basic guidelines for adapting communication:
• Minimize sensory overload by:
• making sure the room is calm and not noisy (and the
lighting is not too low or too bright)
• Check the person is wearing spectacles and hearing aid (if
necessary)
• Make sure you have the person's attention before talking
to them
• Use calm tones, display no anxiety or impatience
• When explaining instructions, use short sentences
• Speak slowly, don't hurry
• Make time for people to reply

32. Adapting
communication
– II
Communication is a two-way process. Listen
actively, with the intention of understanding the
person better:
• Be warm – both verbally and non-verbally
• Observe and listen…with care
• Be understanding of the person, what's important to them
and their likely needs
As much as 90 per cent of communication with
people with dementia is non-verbal.
You can often grasp a person's meaning by
carefully observing their behaviour and paying
attention to your own non-verbal communication.

33. Adapting communication – III
• As dementia progresses, you will
need to adapt your style and level
of communication to the ability
level of the person.
• Look at the questions and
statement below, and – in your
mind – put them into the order of
difficulty for a person with
moderate to advanced dementia
to understand (and respond to).
• (Start by putting the easiest at
number one, and make a list,
placing the most difficult at
number four.)

34. Severe distress – I
All distressed behavior is a form of communication.
•When a person can't explain what's wrong, they 'act out' their
distress.
•Distress is an indicator of 'unmet need'. ‘Unmet need’ means that the
person needs something before they can be happy, calm and relaxed.
•If you can work out what the person needs, then you can manage the
distress.
Managing severe distress from pain and discomfort is
generally easy if you know what to look for.
•Managing severe distress from confusion, fear and frustration involves
understanding the person well enough to know why they are
confused, fearful and frustrated.

35. How can you get to know a person and why they are in
distress?
Talk to the person to find out as much as possible about their life before they came to the
home.
• A person who used to be afraid of snakes, might be hallucinating snakes now.
• A person who used to enjoy their job, might be frustrated because they are not able to engage in work activities
now.
Talk to the person’s family and friends.
• They may hold the key to understanding why the person is in distress.
Read the person’s care plan and health record.
• This may hold a clue to why the person is in distress and how you can help them now.

36. Severe distress – II
•This is 'redirection,' where you suggest an alternative action.
•It might work, but only if you know you can reach his daughter.
•If you can't reach her, Mr. Banerjee would become more upset, because you've lied to him.
•Beyond redirection, you also need to understand why Mr. Banerjee is upset and trying to leave. Perhaps he is lonely and
wants to go to his home or is afraid of something or someone.
•Or, perhaps he just needs some exercise.
Ask him if he wants you to phone his daughter, so he can speak to her.
•This is 'redirection,' where you suggest an alternative action.
•It might work (and would give you an opportunity to get to know Mr Banerjee while you help him calm down).
•Beyond redirection, you also need to understand why Mr Banerjee is upset and trying to leave. Perhaps he is lonely and
wants to go to his home or is afraid of something or someone.
•Or, perhaps he just needs some exercise.
Tell him you're making a pot of tea and invite him to join you in the communal kitchen.