Health issues - Dementia sufferers
In addition to their dementia, people with dementia (psychogeriatric patients) have the same health problems as other elderly people. But they are more vulnerable because, in the long run, they are less able to assess their health and to express their complaints less well. They fill "holes" in their memory with information that they find most logical (confabulation). Moreover, as their orientation skills and planning skills decrease, independent functioning becomes increasingly difficult. Doing groceries, preparing meals, making appointments and fulfilling will become a problem, although the person suffering from dementia will not experience it that way and will therefore not see it that way. In the beginning they notice that they have lost things or don't know something anymore. They will do everything in their power to continue to function, but that is becoming increasingly difficult.
Single people suffering from dementia can go astray, leave the gas or hob on, use one-sided food, no longer take care of themselves and their clothing, do not perform their oral care properly. Informal caregivers can steer that in the right direction, but that requires a lot of tact and more and more energy. The person with dementia usually thinks everything is going well. When the demented person's day-night rhythm reverses, it puts a heavy burden on the caregiver's resilience. The chance of abuse (derailed care) then increases.
Stages of Alzheimer's dementia
In the early phase of Alzheimer's disease, small changes in memory and behavior occur. First the patient and the family think that this is part of aging. When people look back later, they realize that they were the first signs of dementia. The person with dementia forgets things that have recently been said or happened, loses the thread in a story and repeats himself. He loses his interest and has difficulty making decisions. He can be anxious, restless or insecure.
In the middle phase the memory becomes worse and the character and behavior changes increase. The ability to take care of themselves is declining. The confusion increases, it becomes harder to recognize people. The person suffering from dementia can easily get angry or suspicious because he no longer sees what is happening. The sleep-wake rhythm can be disturbed. An urge to move may occur.
In the late phase of Alzheimer's disease, the patient also deteriorates physically. He will walk with small, shuffling steps. He may have difficulty chewing and swallowing and, despite a good appetite, losing weight. It can become incontinent for urine and feces. The ability to talk continues to decline. Sometimes the demented person is restless, searching. The person suffering from dementia can be sad or aggressive, especially if he does not understand what is happening. Apathy, restlessness and agitation, curses and verbal aggression are common. Depression is also common. The memory is very disturbed. The person with dementia no longer recognizes people and often objects in his environment, even though there are occasional times when he does recognize someone again. Usually the patient still responds to a calm voice, to music, smells and touch. In the period prior to admission to a nursing home, almost all demented people have behavioral problems. On average, people with Alzheimer's disease live another ten years after the symptoms have started.
Oral care problems
As dementia progresses further, there are more problems with oral care. Brushing yourself is less effective and less frequent (less attention, routines become less, motor skills are disturbed). Informal caregivers and staff in care institutions often do not provide adequate oral care. They lack the expertise, time and skill to deal with the defensive behavior of people with dementia. Insufficient brushing of teeth often leads to problems such as severe caries and exposed tooth necks for moderate to severe dementia patients.