Q: Dear Regina, My grand-dad has been forgetting a few things here and there and I think this is normal as he is 84 years old. What I am troubled about is that he gets upset about not seeing us. We visit daily and he says he has not seen us for months. He is old and I am not too worried, but my parents say he is getting senile. What is the difference with senile and dementia?
A: There are two things I will address in your question, firstly, the difference between senile and dementia.
There is a bit of controversy over the two terms in trying to distinguish them. One thing is clear: that the term senility is an old term used to describe a decline in an older adult’s physical and cognitive health. Some experts say that senility affects areas as brittle bones or bone loss, stiffness, change in posture, decrease strength and wrinkling of skin as well as hearing loss. All of those symptoms are thought to be associated with senility.
Unless the experts can give more details, in my opinion there is no difference in those symptoms with those that are associated with dementia. Towards the end of the dementia process those same symptoms are experienced by people living with dementia caused by Alzheimer’s, Parkinson’s, Lewy Body dementia, FTD and many other causes of dementia, and sometimes the symptoms are early-on which help identify different dementias.
Senile is basically the old terminology of what now is more commonly used as dementia. However, senile nor dementia are diseases; they are a collection of symptoms caused by diseases such as Alzheimer’s, Parkinson’s, FTD and so on.
Secondly, confusion with time and place. This is one of the warning signs. Just because your grand-dad is 84 with these symptoms does not make it normal. Not having a clue that someone visits him is troubling and especially that he himself is troubled that he has not seen you. This is a huge gap in his memory and affects his emotional well-being and a common issue with a perspective of time.
Five minutes can seem like hours or even months. And just because he is 84 does not mean it is Alzheimer’s. It is a dementia symptom but it does not mean he should be given dementia or Alzheimer’s medication. There is more to diagnosing someone with dementia, or a type of dementia, than having symptoms. Find out what is causing the symptoms. Once you get a diagnosis, find out what are your choices for treatment.
Q: Dear Nurse, My mum is living in her own home with a caregiver that comes Monday through Friday. The caregiver is great at keeping her home clean and helping her get dressed and a few other things. However, when all that is done, my mum sits most of the day and when I come to see her she just doesn’t want to do anything more. I have asked the caregiver to exercise with her but this is not happening. I recently read that physical exercise helps people who are living with dementia. I want this done with my mum. For the last month, I have been coming home on my lunch break and taking mum on a walk for 15 minutes and it has been a tremendous improvement. I feel that the caregiver can do more with mum like involve her with preparing some of the meals, but she says mum just can’t do it. She has been with my mum for years. I am not sure how to handle it. Can you suggest anything?
A: As you have stated, according to the research, physical exercise helps people who are living with dementia. An elevated heart rate increases blood flow to the brain, which minimizes cognitive symptoms and improves mood. Certainly some mood-enhancing activities wouldn’t go amiss.
But life in some care homes and private homes do not encourage physical activity. Rooms are vacuumed and beds made, meanwhile, people spend long periods sitting and lying down.
When families receive phone calls at work, bored and lonely, suggestion to go for a walk falls on empty ears as they reply that they have no one to go with. Without someone alongside to motivate and support her, she probably wouldn’t make it out the gate.
This is a familiar story. Unfortunately, this is a horrible cycle. Jobs are hard to come by and no one wants to be responsible for causing someone to lose their job. Unfortunately, I have seen too many times that caregivers refused to help the person that hired them because it is too much work. They have everything planned and this is the way it is: “The person needs help and I am here to help and I will take care of it.”
The caregiver has taken your mum’s independence away. She may need help but the caregiver does everything and doesn’t allow any participation for your mum, which will cause your mum to experience depression, isolation and lack of motivation. Caregivers in this situation do not fear losing their job. They shouldn’t have to but who hired who? Sometimes we have to make hard choices in life and if you want your mum to have a better quality of life with dementia, she will need someone who can understand her as a human — not an object that needs care.
Sorry to say that some people treat their dogs and cats better than I see how caregivers treat the elderly. This needs to change. Just because we get old and need help does not mean we are less of a person or that our voice should not be heard. Believe me when I say, “We continue to learn from our elderly population with high standards, respect and a love that some young folks need to step up to.”