, Author at ReaDementia

Is Dementia Inherited? [Know the Facts]

Trevor Howitt Blog, Causes, Types February 23, 2024February 25, 2024inherited

“Is dementia inherited?” – This query delves into the genetics of dementia, raising important considerations about whether genes play a role in its transmission.

The majority of different types of dementia cannot be inherited by children and grandchildren. However, in some of the rarer types of dementia, scientists believe that there could be a strong genetic link. These are currently being researched.

Having said this, these cases are only a small number in the total cases of dementia. We look now at the different types of dementia asking the question is dementia inherited?

Is Dementia Inherited?

A little bit about genes…

The website dementia.org.au describes the role of genes in the human body:

The genetic material that we each inherit from our parents is packaged into structures called chromosomes.

We have 22 pairs of chromosomes plus two X chromosomes (women) or an X and Y chromosome (men).

Each chromosome contains thousands of genes like beads on a thread. Genes contain information – they are the blueprints for making a person.

Each gene has the instructions for making one tiny aspect of a person.

They are the basic units of heredity that allow specific characteristics (e.g. hair color, height, the tendency to develop diabetes in late life) to be passed from one generation to the next.

A mutation is a change in a gene. Some mutations are beneficial, but many are potentially harmful.

With regard to diseases, some genes are causative. E.g. if a person inherits a gene for a certain form of muscular dystrophy, they will certainly develop that illness in life.

Other genes are so called risk factor genes – they may not irrevocably lead to a person developing a certain illness such as diabetes, high blood pressure or Alzheimer’s disease. Some genes can make this more or less likely.

Source: Dementia.org.au

Alzheimer’s disease

According to Alzheimers.org.uk–

‘In the vast majority of cases (more than 99 in 100), Alzheimer’s disease is not inherited’.

The most important factor with Alzheimer’s is age. This is because the disease becomes more common in people who are in their late seventies and onwards.

If you have a grandparent with Alzheimer’s disease, this does not mean that you will be at any greater risk of developing it yourself.

It has been proven that everyone can reduce the risk of developing Alzheimer’s by keeping your mind active, regularly exercising and eating a really healthy diet. It is also recommended that you drink moderate amounts of alcohol and cut out smoking.

Vascular dementia

Is dementia inherited with Vascular dementia? Vascular dementia in itself is not inheritable. However, some of the underlying health problems that can contribute to this condition can be inherited. These include diabetes and high blood pressure.

Research has shown that certain genes can increase the chances of developing vascular dementia. These genes can be passed from parent to child.

Once again, a keyway to reduce the risk of developing vascular dementia is to embrace a healthy lifestyle with a good diet. Include plenty of leafy green vegetables along with plenty of regular exercise.

Frontotemporal dementia (also known as FTD or Pick’s disease)

This form of dementia is far less common than those listed above, but it is hereditary. This can cause great anxiety in families with a loved one with Frontotemporal dementia (FTD).

Although FTD is not always directly inherited, about one in ten people who develop FTD have at least one close relative with a form of dementia.

The relative could have, Alzheimer’s, FTD or motor neuron disease (amyotrophic lateral sclerosis, known as ALS).

Generally, if there is a relative with FTD or ALS, there is a greater chance of another family member developing what is known as ‘Familial FTD’ and most commonly, this is in its behavioral form rather than primary progressive aphasia type which is only inherited very rarely.

As there are a number of different genes that can cause familial FTD and each gene has a unique pattern of inheritance, it is best to seek the advice of a genetic specialist.

Is dementia inherited with Lewy bodies

Dementia with Lewy bodies (DLB) develops where there is an accumulation of abnormal proteins called ‘Lewy bodies’ in parts of the brain.

Currently, age is considered the greatest risk factor. Current research is being made to see if certain genes may also play a role.

Rare types of dementia that can be inherited

All of these types of dementia are very rare. However, if you are concerned that you or other family members could inherit a form of dementia, it is best to seek the advice of your family doctor and a referral to a genetic specialist.

Young-onset, familial Alzheimer’s disease

In a small number of Alzheimer’s cases, which the Canadian Health Institute puts at about 3%. This is the percentage of people aged 50-60 who can develop Alzheimer’s.

This is referred to as ‘Young Onset Alzheimer’s’ and is often caused by a faulty (mutated) gene inherited from their parents.

Very, very rarely, a person who is even younger, develops Alzheimer’s and this is nearly always caused by a faulty gene.

Huntingdon’s disease

Huntington’s disease (HD) is inherited and causes nerve cells (known as neurons) in parts of the brain to gradually die.

This disease attacks parts of the brain that help to control movement, as well as other areas. People with HD often develop uncontrollable movements and abnormal body positions.

The disease often affects behavior, cognitive skills and emotions. HD usually appears in middle-aged people. There is a 50% chance of HD being passed onto children if one parent has the faulty gene.

Familial Prion disease.

Approximately 10–15 percent of people with prion disease have a genetic form.

Genetic Creutzfeldt-Jakob disease (CJD) is a single gene disorder due to mutations in the prion gene (PRNP) on chromosome 20.

Presently more than 20 alterations in the DNA sequence in the gene have been reported. The characteristics of the disease correlate with the different mutation types.

Several other changes in the PRNP gene (called polymorphisms) do not cause prion diseases directly but may affect a person’s risk of developing these diseases or alter the course of the disease.

Genetic prion disease follows an autosomal dominant inheritance pattern. This means that if you carry a prion-disease-causing mutation, each of your children has a 50 percent (1 in 2) chance to inherit the same mutation.

Source: Memory.ucsf.edu

Final thoughts – Is Dementia Inherited?

When discussing – “is dementia inherited”, in the vast majority of cases it is not, but in the types that can be caused by a faulty gene there is a greater risk – especially as the faulty gene is always the dominant gene.

If you have concerns about anything you have read in this article, it is best to seek the advice of your family doctor.

Is Dementia Progressive? Unlocking the Truth

Trevor Howitt Blog, Stages February 1, 2024dementia progression, stages of dementia

Is dementia progressive? The short answer is ‘yes’. All types of dementia are progressive.

The signs and symptoms may be mild at first, but they do worsen over time.

Each person with dementia is unique so the speed in which their dementia progresses will vary to those of other people and their experiences as the disease progresses will be very individual too.

At present, dementia is always progressive, but scientists the world over are currently searching for ways to prevent the disease and to slow its progression.

The solutions to both of these are urgent as the number of people with dementia steadily rises.

‘Life expectancy with dementia is increasing year on year as scientists and doctors find better ways to manage the disease. However, because of the nature of its progression dementia is known as a ‘life limiting’ illness’. Source

Why is dementia progressive? In this article we explain why, and we offer suggestions on how to help slow the progression of the disease.

What causes dementia?

‘Dementia’ is an umbrella term used to describe a variety of medical conditions that affect the brain including Alzheimer’s, vascular dementia, dementia with Lewy Bodies and Frontotemporal dementia.

When a person is in the early stages of dementia only a small part of their brain is damaged, and they may have only a few minor symptoms. As the disease spreads to more parts of the brain, it is unable to work as well and the areas that have already been damaged become worse.

The patient’s early symptoms may get worse and new symptoms appear affecting not only their cognitive ability and memory, but also speech, behavior and mobility.

How is the progression of dementia measured?

Many doctors refer to three stages of dementia – early, middle and late or mild, moderate and severe. Those specializing in dementia have divided the progression of the disease into seven different stages to help the loved ones of the dementia patient to understand how the dementia will progress.

These seven stages are important to understand, especially as the dementia patient has no control over them.

Because each person is unique, how the dementia progresses and how quickly it does, will vary. It is also important to be aware of the first signs of dementia so that action can be taken early on to get the condition diagnosed.

The 7 progressive stages of dementia

1. Normal behavior

In the earliest stages of the disease, many people have no symptoms even though there are changes taking place in their brain. It may well be several years before they display signs and symptoms of the disease.

2. Becoming forgetful

Whilst many older people occasional forget diary dates or where they have left their reading glasses, when a person has dementia, they will begin to forget things very easily and regularly lose things in their home.

At this stage, many people believe this is still just a sign of getting older and is an age-related problem.

3. A noticeable mild cognitive decline

This stage of the disease can often last 5-7 times and during this time the first signs that things may not be alright begin to appear.

The person’s memory loss seems more than age-related deterioration and they seem to be frequently forgetting many things – even important appointments on the calendar.

4. Moderate and very noticeable cognitive decline

It is at this stage that most people with dementia are diagnosed. The signs and symptoms by now are apparent to both family members and friends.

The person with dementia may have problem remembering to eat meals or to pay bills on time and everyday life is becoming challenging.

5. Moderately severe cognitive decline.

As the disease progresses and your loved one reaches this stage it is viewed as the beginning of the later stage of dementia.

Your loved one can probably no longer wash or dress themselves easily.

They will struggle to remember things like their telephone number but will remember events from their childhood very clearly.

They will still recognize family members and friends at this stage, which usually lasts 1.5 – 2 years.

6. Severe cognitive decline

This is the beginning of the final stages of dementia and your loved one will require round-the-clock attention.

They will definitely need help washing and getting dressed but could be incontinent too.

They will get easily disorientated and can suffer from mood swings becoming angry and aggressive which is extremely hard to deal with.

Dementia patients at this stage can still usually recognise their loved ones.

This stage lasts on average 2- 2.5 years. Many dementia patients pass away during this stage – usually because of other health problems.

7. Very severe cognitive decline

By this stage, the dementia patient is having problems speaking and expressing their thoughts.

They need constant assistance throughout the day especially with feeding and may well need support during the night if they cannot sleep or start to wander.

Many dementia patients at this stage are being supported by professional carers.

A free booklet about the seven stages of dementia and how you can support your loved one at each stage can be downloaded using the above link.

Are there ways to halt the progression of dementia?

Medications can be used to temporarily improve the symptoms of dementia.
Adapt your home so that your loved one can remain as mobile and independent as possible for as long as possible.
Regular exercise including walking, swimming, cycling and gardening have all been proven to help dementia patients to keep their balance and mobility. If you prefer there are a variety of different exercises to do to maintain balance and flexibility.
Encourage activities such as dancing, painting and singing as these will help you loved one to stay engaged.
Establish a good daily routine as this will help your loved one to feel secure and less anxious. Have mealtimes at the same time each day and if you enjoy a walk together, make this at the same time each day too.
Increase your conversations with your loved one. This can be challenging but make your sentences short, direct and easy to understand. Encourage them to talk too but never argue or get cross if their memories are inaccurate – it is not their fault.
Make a calendar for your loved one to help them remember up and coming events. Complete a daily journal each evening to help them to recall what has happened during the day.

There are many other ways to keep your loved one engaged so that they enjoy the best quality of life.

These include music therapy, caring for a pet and aromatherapy as the senses of touch and smell are heightened as dementia progresses.

How to cope when you are caring for someone with progressive dementia.

Having a loved one with dementia takes its toll on everyone in the family, especially the main carer. If that is you, it is important you look after yourself too.

The first step is to learn as much as you can about dementia and its progression.

If you have questions, don’t be scared to ask them of your doctor, social workers and other healthcare professionals.

Find out what support services there are in your community and if there is a local support group.

Do these include respite care in case you become ill or exhausted? If there are not community services available, ask family members or friends for help to give you a regular break.

Take good care of yourself as well as your loved one – physically, mentally and emotionally.

Is dementia progressive? Final Thoughts

Dementia is indeed a progressive illness. It tends to worsen over time, increasingly impacting a person’s cognitive abilities, memory, behavior, and overall functioning.

The rate of progression varies among people, being dependent on the specific type of dementia they have.

Generally, with all types of dementia, the symptoms will become more severe as the disease advances. As dementia progresses, people may experience increasing difficulty with everyday tasks, speaking, and with memory.

It’s important for those with dementia, their caregivers and family, to understand why is dementia progressive and the progressive nature of the disease. Accordingly, they should seek appropriate support to help manage the effects at each stage of the disease.

Unraveling the Mystery: Is Alzheimer’s Type 3 Diabetes?

Trevor Howitt Blog, Causes December 19, 2023December 19, 2023diabetes, type 3 diabetes

Is there a link between diabetes and Alzheimer’s

In this article we discuss the most recent research investigating the question, is Alzheimer’s type 3 diabetes?

Most people have heard of Type 1 Diabetes which is an autoimmune disease that occurs when the body fails to produce its own insulin. This causes the body’s sugar levels to be too high. Many people with Type 1 Diabetes have to have regular insulin injections.

Type 2 Diabetes is different in the fact that the body develops an insulin resistance and does not use insulin properly. Again, this leads to raised sugar levels. Both types of diabetes are chronic conditions.

Recently, there have been some references to Alzheimer’s being Type 3 Diabetes, so what is this all about?

Is Alzheimer’s Type 3 Diabetes?

The term ‘type 3 diabetes’ is one that has been coined by the world’s health press in reference to Alzheimer’s disease because this common neurogenerative disease has been found to be linked to insulin resistance – which of course is a problem found in type 2 diabetics.

Explain more, why is Alzheimer’s Type 3 diabetes

At this stage, the term ‘type 3 diabetes’ is being used by researchers rather than doctors. There are many studies taking place around the world on the different types of dementia.

A growing number of researchers are exploring the links between insulin resistance in the brain and cognitive decline which is found in Alzheimer’s disease and other forms of dementia.

Researchers are also studying to see if there are any links between type 2 diabetes and Alzheimer’s disease.

It has already been proven that people with type 2 diabetes have an increased risk of developing several different types of dementia.

Is there a link between diabetes and Alzheimer’s Disease?

Scientists are currently studying a number of possible links between diabetes and Alzheimer’s.

Some scientists believe that Alzheimer’s could be caused by insulin resistance in the brain, but as yet, this has not been proven.

Other research is investigating whether diabetes cause any chemical imbalances in the brain.

It is known that high blood sugars can cause inflammation and scientists are exploring what impact the inflammation can have – especially as this could be a possible trigger for vascular dementia. This link though, has yet to be proven.

A second line of research is studying the damage caused to blood vessels when type 2 diabetes is not diagnosed early enough.

Many people with the condition are unaware that they have it. This leads to a delay in their diagnosis and treatment and an increase in the chance of damage to their blood vessels.

Again, this makes those with diabetes undiagnosed, and uncontrolled diabetes more likely to be as risk of vascular dementia with a query mark that there could be an increased risk of Alzheimer’s too.

Healthline.com states that-

‘According to a 2022 review of research, people who have type 2 diabetes may be up to 45% to 90% more likely to develop Alzheimer’s disease or another type of dementia, such as vascular dementia’.

Are blood vessel damage, insulin resistance in the brain, and elevated blood sugar levels all connected to diabetes and potential contributors to dementia? Furthermore, is Alzheimer’s type 3 diabetes? Let’s delve further…

Insulin and Alzheimer’s Disease

A paper published by the National Library of Medicine in February 2022, makes interesting reading as the authors point out that the incidence of both type 2 diabetes and Alzheimer’s disease are rapidly increasing –

‘Globally, the incidence of type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD) epidemics is increasing rapidly and has huge financial and emotional costs.

The purpose of the current review article is to discuss the shared pathophysiological connections between AD and T2DM.

Research findings are presented to underline the vital role that insulin plays in the brain’s neurotransmitters, homeostasis of energy, as well as memory capacity.

The findings of this review indicate the existence of a mechanistic interplay between AD pathogenesis with T2DM and, especially, disrupted insulin signaling.

AD and T2DM are interlinked with insulin resistance, neuroinflammation, oxidative stress, advanced glycosylation end products (AGEs), mitochondrial dysfunction and metabolic syndrome.

Beta-amyloid, tau protein and amylin can accumulate in T2DM and AD brains. Given that the T2DM patients are not routinely evaluated in terms of their cognitive status, they are rarely treated for cognitive impairment.

Similarly, AD patients are not routinely evaluated for high levels of insulin or for T2DM. Studies suggesting AD as a metabolic disease caused by insulin resistance in the brain also offer strong support for the hypothesis that AD is a type 3 diabetes.’ Reference

Is Alzheimer’s Type 3 Diabetes? (Tests)

Certainly, it seems possible that researchers will find that families with history of type 2 diabetes could have a higher risk of developing Alzheimer’s disease or another type of dementia.

It is important that in future frequent tests are made of sugar levels and insulin resistance not only of patients with type 2 diabetes but also Alzheimer’s disease as there is increasing evidence that there could be a significant link between the two diseases and could lead to some new treatments.

At present it is important that all types of research continue….

Preventative measures that can be taken

In the meantime, as research continues, it is important that anyone who suspects that they could have either type 2 diabetes or Alzheimer’s seeks advice from their doctor. Also, ensure that they have a healthy lifestyle to help prevent either. Or, if they are diagnosed, to slow down the progression of the disease for as long as possible and importantly, minimize organ damage.

Adopt a healthy diet with foods that are rich in protein and fiber and low in sugar and saturated fats.
Monitor your blood sugar levels as recommended by your doctor.
Keep an eye on your cholesterol levels too.
Take any medication you have been prescribed according to the schedule from your doctor.
Exercise for 30 minutes most days – walking, swimming, cycling, tennis and jogging are all good or following an exercise program in your home or local gym.
Keep your body weight down – to the recommended weight for your age and frame.

Final Thoughts – Is Alzheimer’s type 3 diabetes?

In conclusion, there have been several research studies proposing that Alzheimer’s disease be categorized as a form of diabetes, termed type 3 diabetes.

However, whilst this concept is explored in research, the term ’type 3 diabetes’ is not officially recognized by National health organizations, nor the American Diabetes Association.

Is Alzheimer’s type 3 diabetes… this is yet to be proven.

Balance Exercises for Dementia Patients

Trevor Howitt Blog November 19, 2023balance exercises

Why do dementia patients need balance exercises

In this article we discuss balance exercises for dementia patients and the key role that this type of exercise plays with maintaining quality of life.

Having a healthy lifestyle with plenty of physical exercise is important for everyone as they get older. Regular exercise helps keep muscles strong and their coordination working well. Also, exercise stimulates blood flow, cell growth and repair and reduces the risk of heart disease and stroke.

Regular exercise can also improve sleeping patterns. Exercise is good for dementia patients who also benefit from activities that maintain their strength and flexibility.

Balance Exercises for Dementia Patients

What is meant by aerobic exercise?

Aerobic exercise is one that is low impact that usually takes place over a period of time such as walking and swimming. Aerobic exercise also includes jogging, cycling and dancing and ideally everyone should complete 30 minutes of this type of exercise most days.

What are strength exercises?

Strength exercises are designed to maintain strength in muscles and tendons – particularly those in the lower body which give support to posture. These exercises also positively impact bone density and the flexibility of tendons. This type of exercise is often called ‘resistance training’ and can include the use of weights and resistance bands.

Balance exercises for dementia patients – Why are they important?

It is important for dementia patients to maintain their quality of life for as long as possible and this includes their mobility.

Balancing exercises help to ensure this. They strengthen the spine and the muscles and as well as maintaining balance. These exercises also improve coordination.

Most importantly, maintaining good balance in dementia patients, helps to reduce the risk of falls.

Balance exercises for dementia patients include bending and stretching. Yoga, Pilates and Tai Chi are all excellent for this. Regularly attending one of these classes has the added benefit of participants being able to socialize too.

If it is not possible for your loved one to take part in a class, they can exercise in the home setting.

It is best to seek advice from your doctor before you start exercising with your loved one so that you understand what type of exercises and the duration will be optimum.

It is important that your loved one enjoys the exercises so that they can be incorporated in their daily routine.

Simple balance exercises for dementia patients

It can be very beneficial to encourage your loved one to complete some of these balance exercises every day – or as often as they can comfortably during the week. Twice weekly being the minimum goal.

These balance exercises for dementia patients require no special equipment other than a sturdy chair or kitchen work surface. It is best that your loved one wears sturdy shoes. If your loved one feels discomfort from the exercise, stop straight away and try again later.

1. Sitting and standing

It is very important for them be able to get up from a chair easily. This simple exercise will help your loved one to maintain their balance for doing so.

Place the chair so that there is space all around it and get your loved one to stand up and sit down on the chair five times. Once they are doing this well, you can increase the number to ten times.

2. Raining heels off the ground

Get your loved one to stand facing the back of the chair with their hands resting on top of the chair back and their feet slightly apart.

Encourage them to lift their heels off the ground for the count of three and then to lower them again. Start with completing this exercise five times and build this number up to ten.

3. Standing on one leg

This exercise is also completed facing the back of the chair, holding on to the top of the chair with both hands for support. Feet should be together.

The left leg is kept firmly on the ground while the right leg is bent slightly and raised off the ground for the count of three before being lowered again.

The exercise is repeated standing on the right leg and raising the left leg.

4. Marching

This can be done standing behind the chair, holding the top of the chair back or holding onto a kitchen counter.

With the legs slightly apart, encourage your loved one to march up and down on the spot slowly ten times.
This number can be increased slowly and steadily to 20 and the speed of the marching can be increased too.

5. Three-way kicks

For this exercise, your loved one needs to stand straight with their feet slightly apart in front of a work surface or similar for support – if needed.

Get them to lift their left leg in front of them, hold for the count of three and then replace it in the starting position.

Lift the same leg (left) to the side, hold it while you count to three and then replace it in the original position.

Lastly, get them to lift the same leg (left) behind them, hold for the count of three and then replace it in the original position.

Encourage them to repeat these three movements using their right leg. If possible, this exercise should be repeated three times.

Other good balancing exercises to try can be found here.

Are there other benefits dementia patients get from regular exercise?

Exercise brings many other benefits for dementia patients and should be continued for as long as possible. As well as preventing the mobility problems associated with inactivity, exercise can improve your loved one’s mood and reduce stress and depression.

Evidence suggests that only a small number of people aged over 65 – fewer than 20% – engage in an adequate level of physical activity, while people who have dementia are even less likely to engage in such activity.

If it is possible, regular exercise should be introduced into daily life when your loved one has the early stages of dementia as it will be easier to continue once their condition progresses.

In the later stages of dementia, you will find that you will need help and support from other people – including trained staff – if you are going to continue regular exercise with your loved one.

It is best to check with your doctor before starting any regular exercise and also as your loved one’s condition progresses.

Even in the later stages of dementia, there are several simple – but effective- exercises that can still be done to help mobility.

Benefits

Encouraging your loved one to stand often during the day is very beneficial. This will help with both their balance and posture.

If they can move around too, this is good as helps maintain balance and keep their leg muscles strong. It is fine for them to use some support if needed.

Lying absolutely flat on the bed for 30 minutes each day helps to stretch the spine and abdominal muscles and relaxes the neck muscles.

Getting your loved one to sit unsupported for a few minutes every day is also beneficial. It strengthens stomach and back muscles which are both important for posture.

Encouraging your loved one to enjoy regular exercise for as long as possible is very important, but never leave then unattended whilst they do, to minimize the chance of falls.

Incorporating balance exercises for dementia patients into daily routine will give great benefits. They help with quality of life, reduce falls, stimulate blood flow and help with overall health.

Making Your Home Dementia Friendly

Trevor Howitt Blog November 15, 2023November 15, 2023dementia friendly home, making your home dementia friendly

Living in your own home gives everyone more independence and if your loved one has dementia this is definitely something you would like them to do for as long as possible. Making your home dementia friendly will bring bonuses and these include the fact that you will both be able to continue with your usual routine and shared activities plus family and friends can drop in and say ‘hello’ whenever.

Modifying your home will help make it physically safe for your loved one and also more mentally stimulating. Importantly, the changes will help minimize their feelings of anxiety and frustration.

Making Your Home Dementia Friendly

Why you need to make your home dementia friendly?

The Age UK website explains why it is essential to make some changes to your home when your loved one has dementia-

Dementia can affect a person’s memory and ability to coordinate, recognize objects, and interpret their environment. In addition, they may have other health conditions which can affect their sight, mobility, and independence. This can have a significant impact on the person’s daily life including how they function within their own home. However, with some simple adjustments you can make a home easier to manage and more ‘dementia friendly’. AgeUK.com

Before you begin adapting your home to make it dementia friendly, it is best to discuss ideas with your doctor and other health professionals who care for your loved one, as each person with dementia is different, with different needs and challenges.

Here is our list of 8 points for consideration: –

1. Make mobility easy

It is important that your loved one can navigate around your home easily, especially if they have mobility issues and are using a walking frame.

When making your home dementia friendly, it is important to check the layout of your furniture to ensure that it is as straightforward as possible. Less is definitely more, and it is important to have wide clear spaces leading to the bathroom, bedroom and kitchen.

Remove all rugs as they will be a trip hazard
Patterns and colors can be confusing so best to keep patterns to a minimum and ensure that the color of your floors contrasts with that of the walls.
Make your stairs save by painting the handrail a strong contrasting color and outlining the edges of each stair with the same color.
If you are making changes to your floor colors with a pot of paint, choose colors that cannot be mistaken for anything else- black could look like a hole and blue could be mistaken for water etc.
Matt flooring is best as a person with dementia can easily think that a shiny floor is wet and dangerous.
Ensure all flexes are firmly fixed so that they are not a trip hazard.
Some people with dementia find mirrors disorientating and even upsetting if they do not recognize themselves, so it is best to check their positioning.

2. Making your home dementia friendly by streamlining your home

Minimize the number of modern gadgets you use as they can be confusing.
Minimize soft furnishings including cushions and throws.
Allocate one drawer for all important items such as car keys, glasses.
Stick picture labels on the important drawers and cupboards to help your loved one find things. Always stick them a little lower than normal as dementia patients tend to look downwards.
Lock all hazardous items away.
Keep the doors between all rooms open and stick a picture label on each door in case your loved one feels disorientated.

3. In the kitchen/ dining area

Make sure that all frequently used items are easy to locate such as using brightly colored tea towels and hand towels.
Check that all appliances are as safe as possible using sensors and safety timers.
Use plastic wherever possible for storage in the kitchen.
Patterned plates can be confusing so plain ones are far better to use and white is ideal as the food will be easy to see.
Keep table settings as simple as possible with plain colored place mats or tablecloth.
Limit distractions at mealtimes such as the television.

4. In the bathroom

Pin a drawing on the door that clearly shows that it is the bathroom/ toilet. If you have a separate toilet, do the same on the door.
Remove the door lock and replace with a hanging two-sided card – one side red and the other, green which can be easily flipped over.
Make sure all personal hygiene products are easily accessible.
Place all medication in a locked cabinet.
Make sure hot and cold taps are clearly marked.
Install grab rails for your bath or shower.
Make sure the non-slip bathmat is in a contrasting color along with the shower curtain and toilet seat for easy recognition.
Make sure that the roll of toilet paper is within easy reach from the toilet seat.
Clearly mark the toilet flush so that it can be easily located.

5. In the bedroom

The path from the bed to the toilet should be easy to negotiate at any time of day or night.
Invest in some night lights to lead the way to the toilet.
Choose a plain contrasting color for bed linen so that the bed is easy to find.
Install touch bedside lamps as they are easier to use.

6. Lighting

Lighting is very important for someone with dementia as it helps to define the day from the night, and this helps to relieve their anxiety as dusk falls.

This is a well-known problem and is called ‘late day confusion’ and can cause confusion and agitation. It is triggered by the changing amount of daylight.

Using lights with dimmer switches in your dementia friendly home will mean that you can make the transition from day to evening much more gently and this will help your loved one.

Ensure that all your windows are clean and that they let in the maximum amount of natural daylight.
Always close curtains at night.
Guide the way to the toilet and on the stairs using additional lighting or automatic light sensors.
Make sure all light switches are easily accessible and that they are obvious as they are painted in a contrasting color.

7. Family and friends

It is important to keep your loved one engaged, but they may well need help to remember faces and names.

Keep a large calendar with all your appointments and family plans written on it.
Invest in a large digital clock which gives the day, date and time plus states whether it is ‘am or ‘pm’.
Make sure your telephone is easy to use with large buttons. Add family telephone numbers into the phone’s directory. Make a large poster with the person’s name, photograph and number on the autodial.
Keep plenty of photographs around and pin captions on the frames explaining the occasion and the date.
Pin a list of emergency telephone numbers on the wall by the telephone.

8. Out in the garden

Your loved one will definitely benefit from spending time outside in the fresh air and if they enjoy gardening, this is an ideal activity for them to continue.

Ensure all pathways and lawns are flat to avoid falls.
Make sure the garden is secure so that there is no chance for them to wander.
If your loved one has mobility difficulties but loves gardening, consider having a flower bed raised for them to enjoy.
Create a nice sheltered outside sitting area so that you can spend more time outside together.
If you are planning to use the garden in the evening, is the lighting adequate?

Keep reviewing the situation

As your loved one’s dementia progresses, it is important to keep reviewing how safe your home is and whether any further adjustments need to be made.

Keeping an eye on your loved one’s general health is important. Have their eyes and hearing regularly tested and ensure that they wear good fitting shoes – even indoors as this helps reduce the chance of falls.

Regular podiatry appointments will help keep their feet in good condition too. Try and keep them as active as possible and certainly ensure they do some appropriate exercises every day.

These should include getting up from their favorite chair and sitting down in it and also getting in and out of bed as safely as possible.

Final thoughts – Making your home dementia friendly

Making your home dementia friendly will certainly be a challenge but is something well worth doing as it will ensure that your loved one enjoys the best quality of life – at home with you….

An excellent free fact sheet on making your home dementia friendly is available online from
the Alzheimer’s Society in the UK.

What is Pseudodementia? [Diagnosis, Treatment]

Trevor Howitt Blog, Causes September 3, 2023November 19, 2023depression, pseudodementia

What is pseudodementia? Pseudodementia is a mental illness of cognitive decline that has a number of the same symptoms that are found in people with dementia and does resemble dementia.

In this article we delve deeply into the question, what is pseudodementia, looking at the history of the condition, diagnosis and treatment.

Usually, pseudodementia has other underlying causes – with depression being a very common one. The patient’s symptoms must be carefully assessed so that they get the correct diagnosis and treatment.

Interestingly, treating some of the underlying causes can effectively reduce some of the symptoms and with continued support, the person’s condition can greatly improve . So, what are the causes of pseudodementia?

What is Pseudodementia?

When was the term pseudodementia first used?

Leslie Gordon Kiloh was an Australian doctor who was born in London in 1917. He completed his medical training at King’s College, London and after the Second World War he returned to the hospital and worked in the Neurology Department with some of the UK’s most eminent neurologists.

Kiloh wrote a number of influential papers on depression and the classification of depressive illnesses during his time at King’s College .

‘The term pseudo-dementia (PDEM) was coined by Kiloh (1961) to describe the cases, which closely mimicked the picture of dementia’. The National Library of Medicine

The National Library of Medicine continues by explaining that the term –

‘has been used a little loosely for describing the cognitive deficits in depression, especially, which is found in old age’.

What is pseudodementia? – understanding the symptoms

Pseudodementia can certainly appear very similar to dementia, but importantly, is not caused by neurological degradation. Commonly it has its roots in a mood-related condition such as depression and these conditions can be treated.

A patient with pseudodementia can have the following symptoms:

Difficulties with speech and words
Lapses of memory or memory loss
Difficulty keeping focused on something
Difficulty moderating their emotions
Struggle with being organized and unable to plan

All of the above symptoms are also commonly found in people with dementia which makes it very difficult for a doctor to make an accurate diagnosis.

If a person is presenting with these symptoms, but they are linked to depression, they may well have some of the following symptoms too:

A loss of interest in their favourite activities and pastimes
Period of feeling blue that last for a number of weeks each time
No interest in being sociable and seeing friends
Have suicidal thoughts
Suffer from insomnia or hypersomnia (excessively tired during the day and
sleeping many hours at night)
A marked loss of appetite

This medical condition does occur in people as they age. Many doctors believe that depression can also cause cognitive impairment. It is well known that dementia can also cause depression.

As well as depression, there are several other mental conditions that can cause similar symptoms that need careful diagnosis.

What is pseudodementia? – getting a diagnosis

Not surprisingly, doctors find it incredibly difficult to differentiate between dementia and pseudodementia. As they are often trying to make the diagnosis with an older patient, this can make it even harder. In addition, some doctors feel that the term ‘pseudodementia’ describes the symptoms and is not the correct name for the condition.

Doctors usually try to rule out all other medical conditions before they consider whether their patient could have pseudodementia. This usually takes time as the doctor wants to discount a number of cognitive impairments first.

To make the diagnosis even more challenging, their patient could have both dementia and depression at the same time. So, a number of tests need to be carried out.

‘Pseudodementia is a term used to describe patients who appear to be demented but are actually severely depressed.

Differences from genuine dementia can be subtle; patients with pseudodementia usually have a pre-existing history of depression with acute onset (often after a specific event), emphasize and appear more distressed about the cognitive deficits, and have preserved attention.

If the diagnosis of depression is suspected, patients should be asked about thoughts of suicidality and their social support structure.

Appropriate consultation and follow-up with a psychiatrist or social worker or hospitalization may be necessary to ensure the patient’s safety’

Source: Sciencedirect.com

Diagnostic tests

The tests that the doctor will want to complete usually include :

The use of speech and language
Visual perception
Problem solving skills and other cognitive tests
Attention span and difficulties
Movement and balance

Blood tests are usually carried out to ensure that the patient does not have an underactive thyroid or Vitamin B12 deficiency. Both of these conditions can cause a number of similar symptoms to pseudodementia.

A brain scan is the most important test to have done as the results for dementia or pseudodementia will be very clearly different because of the changes in brain structure and function found in people with dementia.

According to the Healthline website, in people with dementia, there can be 10-50% loss of brain volume.

Interestingly, family members may spot a difference in their loved ones behaviour. People with dementia usually try to hide any memory loss. However, people with pseudodementia may well highlight their difficulties.

Treating pseudodementia

Once the doctor has made the diagnosis of pseudodementia, they will be keen to start treatment to address the underlying cause which is usually depression.

Depression can be successfully minimised but the treatment must be tailor-made for the individual and usually comprises of both psychotherapy sessions and medication.

A popular type of therapy used is Cognitive Behavioural Therapy (CBT) and the suggested medication may be a course of antidepressants.

Unfortunately, at present there is no cure for dementia, but the symptoms of dementia can be managed for a while.

With cases of pseudodementia, treatment of the underlying depression, often results in a significant improvement in the patient’s condition if not a total reversal in their symptoms.

‘Across multiple studies, between 10%- 90% of people who were at one time diagnosed with pseudodementia were later found to have irreversible or neurodegenerative forms of dementia’. Healthline .com

If you enjoyed reading our blog on ‘What is Pseudodementia’ then you may also find value in our other article that gives an overview of pseudodementia.

Dementia Wandering (Tips For Caregivers)

Trevor Howitt Blog August 26, 2023September 6, 2023dementia wandering, wandering

People with dementia often feel the need to walk about – even though they do not know where they are going and may have no purpose in their walk. They simply feel the need to walk. Researchers have given this type of behaviour the name ‘Dementia wandering’.

How common is dementia wandering?

According to the Practical Neurology website, wandering is common in people with Dementia-

‘Wandering is a complex behavioural phenomenon that is frequent in dementia. Approximately twenty percent of community-dwelling individuals with dementia and sixty percent of those living in institutionalized settings are reported to wander. Most definitions of wandering incorporate a variety of dementia-related locomotion activities, including elopement (i.e., attempts to escape), repetitive pacing, and becoming lost’.

The article continues with a stark fact. It explains that the terms ‘critical wandering’ and ‘missing incidents’ are being used to describe when a person with Dementia wanders and becomes lost.

The main concern this brings is that the mortality rate in these situations is 20% – which makes dementia wandering the most dangerous problem linked with this disease.

What are the causes of dementia wandering?

Whilst research continues to establish the reasons and wandering patterns occurring in people with Dementia, some scientists believe that they are searching for something they once treasured or trying to get back to a moment in time when they were particularly happy – such as a favourite holiday destination or job.

Other scientists believe that dementia wandering patients do so because they are feeling agitated and restless.

On its website, The Alzheimer’s Association explains –

‘Alzheimer’s disease causes people to lose their ability to recognize familiar faces and places. It’s common for people living with dementia to wander or become lost or confused about their location, and it can occur at any stage of the disease. Six in ten people living with dementia will wander at least once; many do so repeatedly. Although common, wandering can be dangerous — even life-threatening — and the stress of this risk weighs heavily on caregivers and family’.

If your loved one is inclined to wander, it is important to know the reasons that may trigger their need to do so-

Common reasons people with dementia wander:

They have not retained the fact that you asked them to stay in the house or car.
They are feeling agitated and unsettled.
The wandering has been prompted by a change in routine.
It could have been triggered by something they overheard.
They are searching for a favourite place or time from the past.

You may be able to pick up on some subtle signs that your loved one could start wandering. In conversation, they may express to you the need for them to go somewhere – like to work or shopping.

It could be that they no longer recognise their surroundings, even if it is the home that you have shared for many years. Sometimes a person with Dementia can wander because they get confused and disoriented.

They may be searching for a certain place such as the bathroom and not find it. You may well find that you have to regularly remind them where different rooms are – picture signs pinned on the door can help.

You may discover that when they are feeling restless or agitated they may not simply be able to keep still.

Devices to assist caregivers with loved ones who wander

	Product	Features
	Bed Alarm for Elderly Dementia Patients	Motion sensor Portable pager Fall prevention Easy to install Wireless
	Caregiver Pager, Wireless Panic Buttons Elderly Monitoring Assistance	Intercom Waterproof Durable 58 loud chimes Easy to install 500ft wireless
	4pc Security Home Camera	24/7 full HD recording Enhanced night vision Video alarm system AI identification Home app for family
	Smart Caregiver Corporation Cordless Bed Exit Monitoring System Alarm with Bed Pressure Sensing Pad	Prevent falls & wandering Wireless portable (300ft) Pressure pad and monitor
	Elderly Cellular Medical Alert Device\| Wearable Panic Button Necklace \| Medical Alert Systems for Seniors	Fall detection 2-way communication Waterproof 5 emergency contacts Lifetime warranty
	Elderly Cellular Medical Alert Device \| Medical Alert Smartwatch	Fall detector 2-way communication Heart rate, blood pressure, oxygen monitor Lifetime warranty

What can be done to prevent your loved one wandering?

There are a number of practical things that should be put in place to ensure that it is difficult for your loved one to wander.

These are important to initiate because of the serious risk that they could fall and injury themselves on one of their ‘walkabouts’.

The most important thing you can do is to create a safe and secure environment for them. You will need to install locks on all doors leading outside and windows. Locks using a security number are best.

Make sure you have somewhere safe to keep your house and car keys. Your loved one may forget that they no longer drive.

Child proof catches can prove useful on bathroom cabinets and drawers containing medication and sharp kitchen utensils.

It is sensible to make sure that furniture in your home is easy to navigate and that there is plenty of lighting – including at night if your loved one tries to reach the bathroom.

It is practical to ensure that your loved one has enough to eat and drink during the day. This is so that you can take the practical step of offering them their last drink about two hours before bedtime. This will reduce their need to get up at night to use the bathroom.

Can restless behaviour be managed?

It is quite a challenge to keep your loved one engaged throughout the day and certainly requires plenty of good planning. However, keeping them occupied will help them to feel calmer and less agitated.

Avoid busy places such as shopping malls where they may well quickly feel disorientated. If they are in new surroundings, do not leave them on their own

Ensuring that your love one gets adequate sleep can also really help. A good way to help this is by getting daily exercise together.

If the weather is good, nothing is better than enjoying a walk in the countryside. If your loved one has an interest in swimming or gardening these are ideal pastimes too and will help tire your loved one.

For the final hour before bed, sitting together listening to music as this will help prepare your loved one for bed.

Make sure that the lighting in your lounge is not too bright. Being soft and mellow will send the signal that bedtime is approaching.

If you find that your loved one seems more confused than normal or is restless and agitated, it is well worth having a word with their doctor.

What to do in case of emergency

Keep a list with the telephone number for the Police and family and friends who live by on the wall by the telephone. Think through an emergency plan – should the worse happen – and discuss with key friends and neighbours.

Ask them to always contact you should they see your loved one out and about on their own.

Compile a list of the likely places that your loved one could try to find. Such places as favourite places/restaurants, your old home, where they used to work etc.

Make sure you have a recent photograph of your loved one that you can show Police officers.

If your loved one has wandered and you cannot speedily locate them within 10-15 minutes, contact the local Police. Tell them that your loved one has Dementia.

Contact your key neighbours and friends and get them to help you search the locality. It is interesting to note that the direction that your loved one probably wandered is the same as their dominant hand.

Check the local vicinity really well as most wanderers are found within two kilometres/ one mile of home.

Closing Thoughts – dementia wandering

As cognitive decline increases, it may become unsafe for your loved one with dementia to live at home — especially if they are at risk of wandering.

Although dementia wandering is one of the most dangerous behaviors that people with memory loss will face, there are ways to prevent or manage the risk.

Our aim is to educate and inform caregivers in order to help you remain confidence in the face of this challenging disease.

Medication to Help Dementia Patients Sleep

Trevor Howitt Blog August 15, 2023November 19, 2023sleep medication

This article will help you understanding challenges dementia patients may have with sleep. We will look at solutions, including when is medication to help dementia patients sleep necessary.

Medication To Help Dementia Patients Sleep

Many dementia patients have problems, both getting to sleep and staying asleep. Some experience changes in their sleep patterns too.

At present, scientists do not fully understand the reasons for this but believe they are linked to the changes in memory and behaviour and the impact dementia has on the brain.

Trying to manage these sleep changes in your loved one is challenging. It is important to try coping strategies that do not use medication.

Although many doctors prefer not to prescribe medication to help dementia patients sleep, in some cases it becomes necessary.

Natural Medications to Help Dementia Patients Sleep

	Brand	Features
	Thisworks Sleep Plus Pillow Spray	Fast-acting natural rest With essential oils Superblend Spray over pillow, pajamas & linen
	Isagenix Sleep Support&renewal Spray,	2.0 fl. oz./60mL
	AIOBEECY Sleep Patches, Easy Sleep Leading to Sweet Dreams, Natural Sleep	60 patches 100% drug free Easy to use All natural ingredients High quality sleep
	Apollo Neuro Wearable \| Stress Relief Band and Natural Sleep Aid Device to Improve Sleep	Better sleep Reduce stress Calm & relaxed Energy boost Find focus
	Natrol Melatonin Fast Dissolve Tablets, Helps You Fall Asleep Faster	Strengthen immune system Drug free Stay asleep longer Dissolve in mouth Strawberry

Are sleeping problems common in dementia patients?

Many people who do not have dementia do experience changes in their sleeping patterns as they get older. Many find that they need less sleep.

Older dementia patients often incur sleeping problems too. However, these tend too be more frequent and more severe.

Some dementia patients have sleep problems in the early stages of the disease, but sleeping problems become much more common in the later stages.

Persons with dementia experience excessive daytime sleepiness associated with fragmented sleep at night. As a result, persons with dementia often have frequent, short duration naps throughout the day to make-up for lost sleep at night. Additionally, other medically-diagnosed sleep disturbances occur frequently in persons with dementia’. Source

Difficulty getting to sleep and staying asleep

Many dementia patients find it hard to settle down to sleep at night. If this is the case with your loved one, it is important not to give them any caffeine drinks (coffee, tea, cola etc.) for several hours prior to bedtime.

Television can also prove too stimulating. It may well be best to turn it off for the hour before bedtime and listen to relaxing music instead.

Staying asleep can be very difficult for dementia patients too. Many will repeatedly wake during the night and stay wake for long periods of time.

Unable to get back to sleep, the dementia patient may call out or start to wander around the house. The results is a disrupted night for everyone.

Without a good night’s sleep, you may well find that your loved one is struggling to stay awake during the day.

A short nap early on can certainly help. However, sleeping longer and later in the day will compound their problems of trying to sleep at night.

Some dementia patients also become agitated and anxious as the sun begins to set. This is called ‘late day confusion’ and is caused by the changing amount of natural daylight. The clever use of indoor lighting using dimmers can help ease the problem.

Experts estimate that in late stages of Alzheimer’s, individuals spend around 40% of their time in bed at night awake and a significant part of their daytime sleeping. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-night-time sleep pattern’. Source

Why the non-drug approach is best

In the first instance, it is definitely best to use the non-drug approach to resolving sleep issues in your loved one.

According to the Alzheimer’s Association, many studies that have been conducted have proved that –

‘sleep medications generally do not improve overall sleep quality for older adults. Use of sleep medications is associated with a greater chance of falls and other risks that may outweigh the benefits of treatment’.

There are many practical things to try to help your loved one to sleep. These include:

Ensuring the bed and the bedroom are comfortable and at the right temperature.
The way to the bathroom is safely lit at night.
That you adhere to a good routine throughout the day and evening.
Your loved one takes some exercise every day.

Medication to help dementia patients sleep

Unfortunately, if none of the ‘natural remedies’ work and if you as the carer are getting too tired and unable to fulfil your daytime role for your loved one, it is time to speak with your doctor.

The problem needs to be discussed fully because of the risks of using sleep inducing medication for older patients with dementia.

Your loved one will have a greater risk of falling, could suffer from greater confusion and there will be a noticeable decline in their ability to care for themselves.

You need to clearly understand the balance between the risks and potential benefits of the suggested medication.

The type of medication that may be prescribed by your doctor will probably be dependent on other behavioural problems experienced with your loved one.

All medication to ease sleeping problems in dementia patients should only be used in the short-term and discontinued as soon as your loved one has a regular sleeping pattern once more.

There are a range of medications used to treat sleep changes in dementia patients and these include include:

Tricyclic antidepressants
Benzodiazepines
Different types of ‘Sleeping pills’
“Atypical” anti-psychotics

Your doctor will only prescribe medication after an in-depth discussion with you as to the side-effects. These may be impaired alertness and coordination, worsening of their depression, more complex sleep issues and respiratory problems.

Final Thoughts – Medication to Help Dementia Patients Sleep

You may find that your doctor will not prescribe medication for sleep disorders in dementia and will refer you to a specialist such as a psychiatrist who specialises in dementia.

This is only likely to happen if the sleep problems are severe and none of the natural treatments have helped.

It is important to remember that if your loved one is given sleep medication that they will be more confused than before and that you will have to be extra vigilant throughout the day…

Helping Alzheimer’s Patients Sleep [Solutions]

Trevor Howitt Blog August 14, 2023November 19, 2023alzeimer's and sleep, sleep problems

Helping Alzheimer's Patients Sleep Easily

Sleeping problems and changes in sleeping patterns are common in people with Alzheimer’s. Scientists are still unsure why, but know that they are often linked to the changes in the brain that are caused by Alzheimer’s. Helping Alzheimer’s patients sleep is an ongoing challenge for medical professionals because the periods of broken sleep tend to be more frequent and more severe.

Getting adequate sleep is important for your loved one but will also benefit you, as you will be able to enjoy a relatively peaceful night’s sleep too.

Helping Alzheimer’s Patients Sleep

What type of changes in sleeping occur?

The common sleep problems include difficulty in getting to sleep and staying asleep at night, and sleepiness during the day.

Many Alzheimer’s patients are awake frequently during the night and then wake prematurely early in the morning. This is all very challenging – and exhausting for the carer.

Many Alzheimer’s patients also find it difficult to get back to sleep if they do waken during the night.

Unfortunately, this often leads to them becoming fidgety in bed and some call out for help, whilst others begin to wander around the house.

All of these things lead to disrupted sleep for everyone in the house. Sleep disturbances do tend to get worse as the Alzheimer’s progresses.

‘Experts estimate that in late stages of Alzheimer’s disease, individuals spend about 40% of their time in bed at night awake and a significant part of their daytime sleeping. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-night-time sleep pattern’. Source

Your loved one may be experiencing a difference in their normal sleep pattern and may want to take a daytime nap, but when this occurs happens, they find that they cannot sleep at night.

It is important to remember that many older people who do not have Alzheimer’s find that they require less sleep and experience changes in the times they fall asleep and wake in the morning.

Later in this article we do provide suggestions for helping Alzheimer’s patients sleep.

Changes due to medical problems

If your loved one is depressed, this could well affect their sleeping problem and is best discussed with your family doctor.

Other problems that can disturb sleep include Obstructive Sleep Apnoea which is a potentially serious condition and is when the breathing pattern alters and the person stops breathing numerous times during the night.

This medical condition is more common in people with Alzheimer’s.

‘Restless Legs Syndrome’ is another cause of broken sleep and this is when the legs twitch and tingle involuntarily.

Sometimes sleep problems can occur when your loved one is suffering from mental and physical exhaustion after a particularly busy day.

Feeling disorientated can also cause sleep difficulties and changes in their body clock.

A number of Alzheimer’s patients become restless and agitated late in the afternoon.

This is a well known problem and is called ‘late day confusion’ and can cause confusion and agitation.

It is triggered by the changing amount of daylight, but luckily can be addressed with the clever use of subtle indoor lighting using dimmer switches or your doctor may advise the use of a Melatonin supplement.

Natural medications

	Brand	Features
	Thisworks Sleep Plus Pillow Spray	Fast-acting natural rest With essential oils Superblend Spray over pillow, pajamas & linen
	Isagenix Sleep Support&renewal Spray,	2.0 fl. oz./60mL
	AIOBEECY Sleep Patches, Easy Sleep Leading to Sweet Dreams, Natural Sleep	60 patches 100% drug free Easy to use All natural ingredients High quality sleep
	Apollo Neuro Wearable \| Stress Relief Band and Natural Sleep Aid Device to Improve Sleep	Better sleep Reduce stress Calm & relaxed Energy boost Find focus
	Natrol Melatonin Fast Dissolve Tablets, Helps You Fall Asleep Faster	Strengthen immune system Drug free Stay asleep longer Dissolve in mouth Strawberry

Ways to get better sleep for those with Alzheimer’s

Helping Alzheimer’s patients sleep: if you are finding that your loved one is getting broken nights, it is well worth trying some of these natural remedies:

● Try and establish a routine and keep mealtimes and bedtime at the same times each day. Make sure the evening meal is at least four hours before bedtime.

● If the sun is shining spend time outdoors together first thing in the morning.

● Enjoy some exercise during the day – walking, swimming and gardening are all good. Do not exercise in the evening within two hours of bedtime.

● Ensure that the bed is comfortable and at the bedroom is at the right temperature and has night lights so they can find their way easily to the toilet during the night.

● Avoid stimulants and do not offer your loved one alcohol or caffeine or let them have nicotine.

● Limit the length of your loved one’s daytime nap.

● Television in the hour before bedtime can prove a problem. Playing soft, soothing music instead will be more beneficial.

● No medication – especially cholinesterase inhibitors- should be given within two hours of bedtime.

● If your loved one wakens and cannot get back to sleep easily, it is best that they get up.

The use of medication

Sometimes if all the above suggestions have failed, medication for Helping Alzheimer’s patients sleep will be prescribed.

However, this is unusual as it comes with many increased risks for older people such as falling and added confusion.

If medication is used, it will be for a very limited time in order to re-establish the sleeping routine.

If this is the path suggested by your doctor, it is important to fully understand both the benefits and the risks of the suggested medication.

Final Thoughts – Helping Alzheimer’s Patients Sleep

It is very important that you get plenty of quality sleep and rest so that you can cope with the demands of caring for your loved one during the day.

Perhaps you have a family member who can regularly step in and cover for you at night or else there may be help available if you contact your local dementia association.

Our hope is that you now have a better understanding of what causes sleep apnoea with Alzheimer’s. The important point is not to suffer in silence and try and manage by utilizing the tips we’ve suggested with helping Alzheimer’s patients sleep.

Dementia and Bowel Incontinence

Trevor Howitt Blog August 13, 2023August 13, 2023bowel incontinence, dementia and incontinence, incontinence

There is a direct link between dementia and bowel incontinence. A person with dementia is much more likely to have accidents, suffer from incontinence and generally have more difficulties using the toilet.

Often these problems get worse as the condition progresses. Unfortunately, incontinence is not a topic that people talk easily about – but we do! Here we bring you the full low-down on dementia and bowel incontinence plus tips and advice for you to try….

Dementia and Bowel Incontinence

What is the link between dementia and bowel incontinence?

Sometimes incontinence develops in dementia patients because the messages between the brain and bladder and bowel are not working properly or can be triggered by a medical problem such as urinary tract infection (UTI), constipation or – for men – prostate problems.

Sometimes bowel incontinence can be caused by Irritable Bowel Syndrome (IBS). Certain medications for dementia can also trigger bowel incontinence.

What is incontinence?

Incontinence is the term given to when a person does not make it to the toilet in time and experiences a leakage of urine (pee) or faeces (poo). If they are having problems with both, this is described as ‘double incontinence. Urinary incontinence is the most common kind.
When either occurs, it can be very upsetting for dementia patients.

According to Healthline-
‘About 50% of people living with dementia have urinary incontinence. Specifically 60-70% of people with Alzheimer’s disease develop this condition. In addition, 30-50% of nursing home residents living with dementia or memory problems also have faecal incontinence’.

What are the different types of incontinence?

Urinary incontinence

This is the most common type of incontinence and ranges from small, occasional leaks to continuing to pee after leaving the toilet or the total emptying of the bladder away from the toilet..

People with dementia often develop an over-active bladder. They will suddenly feel that their bladder is full and will have an urgency to go to the toilet. They will also want to visit the toilet much more often than they did in the past.

Some dementia patients do suffer from stress incontinence which can cause small, regular leaks.

Faecal incontinence

Again, this type of incontinence ranges from a small leakage of poo to having no control over the emptying of the entire bladder.

This situation is not only distressing for the dementia patient but can be very difficult for their carers to deal with too.

Dementia and bowel incontinence – Why does it develop?

As well as the medical reasons given above, incontinence can develop in a dementia patients for the following reasons too:

They may not recognise the sensation of needing the toilet in adequate time.
As well as not recognising the sensation, they may not be able to alert their carer in time to reach the toilet.
If they have mobility problems, the dementia patient may not reach the toilet in time.
They may not understand a prompt that it is time to visit the toilet.
Dementia patients often resist help to use the toilet.
They get confused when looking for the toilet.
They can feel embarrassed because they have already had an accident.

How can you ease the situation?

There are ways that help minimise the problems of incontinence in dementia patients.

The most important point to remember is that you need to include toilet visits into your routine, but you do need to ask your loved one sensitively if they need the toilet regularly – every two hours.

Also watch for any signs that they might need the toilet. It could be an advantage to install a reminder for you both on your smartphone.

Keep bladder and bowels working well

Encourage your loved one to drink plenty– eight glasses a day is the recommended amount. If they are not drinking enough they will be prone to constipation. If they have an overactive bladder, avoid, coffee, tea and alcohol. Offer water, herbal teas and fresh fruit juices diluted 50/ 50 with water as these will be more soothing.
Get daily exercise together – walking or swimming are both good and will ensure that your loved one’s bowels work well.
Built toilet breaks at certain times into your daily routine and when you go out together, make sure you know in advance where toilets are located.
If your loved one is constipated, gentle laxatives can help and gently massaging their stomach can ease discomfort.

Make your toilet dementia-friendly

Even if you have been living where you are for a number of years, it is important to make the toilet easily identifiable and easy to use for your loved one.

Make the toilet easy to spot with a sign on the door with a picture at eye level. If there are several of you in the house, install a simple sign with red and green sides to show when the toilet is free or occupied.
Ensure that it is easy to reach the toilet – move furniture out of the way and ensure the area is well lit.
Consider investing in a coloured toilet seat so that it is easy for your loved one to recognise. Invest in a raised toilet seat if it will be easier to use and fix some handrails.
Disable the door lock so that your loved one cannot accidentality lock themselves in the toilet.
Avoid confusion with mirrors. Your loved one may not recognise their reflection in the mirror and think there is already someone using the toilet.

And for night-time use too….

Install good lighting from the bedroom to the toilet that is triggered by motion sensors.
If night-time use of the toilet becomes tricky, consider using a commode close to the bed with night lighting.

How best to cope with dementia and bowel incontinence accidents

This is a difficult situation for you both to deal with. Your loved one will feel that they are not in control of their body and that they are losing their dignity.

Many dementia patients find it difficult to accept help with such a private part of their lives.

Needless to say, how your loved one reacts to an accident can vary and they may find it very upsetting.

Be understanding and practical and add a little humour if you think it will help to ease their embarrassment. Having nice easy pull on trousers and shorts with elasticated waists will help too.

Do not be negative in any way- the accident was totally unintentional. If you find it hard to cope with the situation, talk with your GP.

Incontinence and the support you give your loved one will change your relationship and it will become stronger – if you do not let it get in the way.

Personal hygiene is very important

Following an accident, it is important that your loved one cleans themselves properly and you may well need to help them. Remind them gently to wash their hands well.

You may well find that baby wipes are easy and effective to use and these will help prevent skin irritations and fungal infections. Pat the skin dry gently after use with toilet tissue.

Alternatively, wash the wet or soiled area with soap and warm water and pat the skin dry with a soft towel before your loved ones puts on fresh clothes.

If incontinence is becoming an issue, there are some excellent incontinence briefs on the market that contain a highly absorbent pad.

Both day time and night time pads are available and manufacturers have started producing attractive ones for ladies in different colours and patterns.

Re-usable briefs are also available and these are machine washed after each wearing .

If your loved one prefers to wear their own underwear, absorbent pads that slip inside panties are good and if you loved one has stress incontinence, you mat well find that panty liners are adequate.

Final Thoughts – Dementia and Bowel Incontinence

Incontinence usually develops in middle to late stage dementia, but this does vary from one person to the next. If you are concerned that your loved one is becoming incontinent, a visit to your GP will be reassuring as they can assess what the underlying cause is.

Never struggle in silence with dementia and bowel incontinence, there are different health professionals you can approach for help and some excellent products on the market that will make the situation easier to handle.

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