If you have ever questioned how can a psychologist help a person with dementia, this in-depth overview explains it all.
Dementia is a neurodegenerative disorder whose causes are complex and not yet entirely understood by the scientific community.
Its main symptoms include a progressive decline in cognitive skills, out of which memory is the most impaired one.
Dementia also leads to changes in behavior which can become more evident once memory systems are progressively more affected.
A diagnosis of dementia can be highly overwhelming both for the individual, as well as for their family members.
Caring for someone diagnosed with this disorder can be HIGHLY DEMANDING. It requires ongoing support and supervision of all aspects of the individual’s life.
For this reason, it is necessary that multiple healthcare professionals are involved in the assessment, treatment, and supervision of someone who has received a diagnosis of any neurodegenerative disease, such as dementia.
Seeing a Psychologist About Dementia
A Psychologist is a qualified professional who is able to provide an initial cognitive assessment and diagnosis of dementia.
Psychologists administer batteries of standardized memory assessments.
These DETERMINE whether someone is at risk of cognitive impairment, already has full symptoms of dementia, or simply experiences memory loss due to normal aging.
Memory and cognitive assessments can sound nerve-wracking.
However, their purpose is solely to determine whether someone has a significant change in their ability to remember essential information and to perform basic cognitive functions, such as numerical tasks, language processing, memory retrieval, and many others.
Psychologists USE THE SCORE that someone obtains on all cognitive assessments as clinical evidence for their overall assessment which will conclude a potential dementia diagnosis.
Following cognitive assessments, individuals are also assessed in terms of their behavioral patterns in their daily life.
A psychologist provides essential information
At this stage, family members can also assist the psychology appointment in order to provide essential information about the individual’s symptoms.
Psychologists can ask questions about the patient’s sleeping patterns, their daily routine, signs of forgetfulness, changes to eating patterns, their social interactions, and other causes of concerns observed by both the individual and their family members.
Many individuals who present the onset of memory decline will pick up on the SUBTLE CHANGES in their memory function and in their behavior even before these are noticed by others.
Psychologists conduct throughout mental health and behavioral assessments in order to rule out other potential causes of memory loss.
For example, it is scientifically proven that memory loss is caused by other mental disorders, such as depression or sleep disturbances.
This is why seeing a psychologist is essential in determining whether a diagnosis of dementia is needed or whether there are other underlying causes that lead to memory impairment.
Dementia Screening Process
Psychologists use older adult specific tools that can help the other clinicians determine whether more in-depth assessment is required.
There are various types of screening instruments, such as:
Cognitive Screening Tests
These include the Modified Mini-Mental State Examination (MMSE) developed by Teng and Chui, 1987; the Addenbrooke’s Cognitive Examination-Revised (ACE-R); the Rowland Universal Dementia Assessment Scale (RUDAS); and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), which is a useful informant-based measure of cognitive functioning.
Affective Screening
Common screening tests for older adults include the Geriatric Depression Scale and the Geriatric Inventory.
They assess the mental health of seniors who are at risk of cognitive and memory decline.
Caregiver Screening
Because caregivers are essential in the TREATMENT PLAN of someone with dementia, psychologists can also administer screening tools to check their mental state.
Amongst some common caregiver screening tools are the Zarit Burden Inventory (ZBI; Zarit, Orr & Zaritt, 1985) and the Positive Aspects of Caregiving Measures (Tarlow et al., 2004) who is designed to capture both the challenging and the positive aspects of caregiving.
Developing a Treatment Plan
Receiving a dementia diagnosis can be frightening and overwhelming for everyone involved in the care of the individual.
Psychologists PROVIDE SUPPORT throughout the process of coping with dementia.
Since this degenerative disorder is also associated with behavioral and emotional symptoms, psychologists can help minimize the changes in mood and behavior associated with memory impairment.
They work with the care team and with the family members to design strategies that can be applied in the living environment of the person with dementia.
Such as putting procedures in place that allow the individual to function at their MAXIMUM capacity.
Some individuals who are diagnosed with dementia might experience hearing loss besides other symptoms. This makes communication with their family members even more difficult.
A psychologists offers tools and techniques
Psychologists can PROVIDE tools and techniques that they can implement in their communication with the individual.
These can entail communicating with the person with dementia in a more SENSITIVE manner.
Using a tone of voice and speech pace that allows the individual to effectively process language while minimizing the frustration and feelings of hopelessness that can arise out of communication issues.
In some cases, individuals with dementia might require support with their decision-making process.
Receiving a diagnosis for neurodegenerative disease can often imply that the individual needs to make some adjustments in their living environment.
Also in their daily habits and routine, and even in their social life.
Psychologists can provide support to help the individual IDENTIFY their personal preferences for things like home health aides they might require, the support services they want to access, or even financial and legal planning.
There are cases when the individual with dementia and even their family members are confused about the changes that happen in their life.
They can be unsure about their needs in terms of healthcare support and other services.
In this respect, psychological services can help them identify their needs, preferences, and vulnerable areas where they REQUIRE specialist support.
Providing Psychological and Emotional Support
Another area where psychologists can intervene when someone has received a diagnosis of a neurodegenerative disorder is their emotional and mental well-being.
Like any diagnosis, dementia can create confusion, sadness, anxiety, and other disturbing emotions both in the diagnosed individual and in their family members.
They might experience an initial reaction of shock, followed by DENIAL and GRIEF.
These emotional states can be challenging to overcome, as individuals and their families are still adjusting to the new circumstances of their life.
In this respect, psychologists can provide strategies to manage THESE emotions.
And help those involved in the life of the person with dementia find useful coping strategies for challenging moments.
Counseling interventions
It is not uncommon that someone with a dementia diagnosis also experiences co-morbid mental health problems.
These include depression, anxiety, or sleep disturbances.
Psychologists can provide counseling interventions that ENCOURAGE the person to explore their underlying emotions and feelings.
Also to adopt HEALTH strategies in which they can manage their emotional and behavioral symptoms.
Furthermore, some seniors who are not used to being dependent on the support of those around them might experience intense feelings of guilt for being “a burden” for those around them.
They might feel inefficient and unable to provide for their basic needs.
This can lead to feelings of helplessness and even depression.
Psychologists will help individuals reframe their thoughts with regards to their diagnosis and to accept the circumstances of their life.
Since this acceptance can sometimes be a challenging process due to individuals not being able to accept help, it requires the intervention of a specialist who can direct people during this process.
Implementing the Treatment Plan
When working with a psychologist, the individual with dementia and those involved in their care might discuss the current strategies THAT ARE WORKING and potential area where new ones can be implemented.
They might also discuss with the psychologist potential behaviors that the person with dementia can improve in order to increase their sense of independence and their functionality.
The psychologist might also ask the individual or the caregiver to adopt strategies that minimize their memory decline, such as practicing memory tools.
These can help individuals ORGANIZE their daily routines and tasks.
On top of that, they also help them better manage their symptoms associated with memory loss.
The TOOLS that a psychologist might SUGGEST the individual to implement are:
- Using visual cues around their house for reminders of daily tasks that need to be carried out, such as doing the dishes, cleaning, etc.
- Using an alarm for when they need to be reminded to take their medicines
- Keeping daily and weekly planners for enjoyable activities such as gardening, socializing, going for walks, cooking, etc.
- Using memory tools like to-do-lists and calendars to remember important appointments, events, and birthdays
- Taking up cognitive activities that stimulate memory, such as puzzles, word games, or learning a new hobby
Practical advice to customize the environment
Besides offering an overview of the treatment plan to the person with dementia and to their caregivers, psychologists also help family members to customize their environment according to their needs and goals.
For example, psychologists might provide practical advice about what someone with dementia might need in the place where they live in order to function well.
They might also discuss with family members essential information that they need to be aware of. Such as safety tips, treatment goals, and general information on how they can best support the person with dementia.
Some family members might not be aware of all the spectrum of symptoms of dementia, and as a result, they might be SURPRISED by the changes in the behavior of those diagnosed.
In this respect, a psychologist can prepare family members about the progress of dementia.
He or she can give them a general overview of what they should expect both in terms of the disease progression, as well as of the treatment outcomes.
Caregiver Support
Caring for someone who has a diagnosis of dementia can be an emotionally burdening task.
A significant percentage of dementia caregivers report experiencing emotional stress and even symptoms of depression.
The high demands of providing physical support to the individual combined with continuous supervision and with the emotional cost of noticing the changes caused by dementia can be VERY OVERWHELMING for someone offering care.
This is the reason why it is equally important that caregivers receive regular supervision from a psychologist and report any decline in their mental health.
Because they have a great deal of responsibility towards the person diagnosed with depression, caregivers need to ensure that they remain mentally and physically strong.
Psychologists can monitor the mental well-being of caregivers and assess their needs in terms of mental health and social support.
They can also suggest tools that caregivers can use to improve their well-being such as:
- Finding adaptive ways to manage stress and to reduce the impact of emotional burnout on their physical health
- Accepting the changes that the individual with dementia is going through
- Encouraging caregivers to stay in close contact with other family members and seek support whenever they need to
Conclusion
To conclude, there are MANY AREAS in the life of someone with dementia where a psychologist can intervene.
Psychologists can undertake a variety of tasks, starting with a basic assessment of dementia symptoms.
They offering psychoeducation and counseling to caregivers and family members, and helping patients manage behavioral symptoms.
Furthermore, psychologists are the best-suited health professionals to provide EVIDENCE-BASED treatments for other co-occurring psychological disorders that someone with dementia might suffer from besides cognitive decline.
However, psychologists can also act as reliable support resources.
They are able to provide suggestions to improve the daily functioning and quality of life of the individual, as well as of their caregivers.
