Personality Changes and Dementia

A Few Early Signs of Alzheimer's

Lapse in memory that disrupts daily life
Challenges solving problems
Trouble making plans
Mixing up time and places
Problems using words in speaking and writing
Misplacing things and then not being able to retrace steps to locate
Overall decrease in judgement - trouble making decisions
Withdrawal from social activities
Change in mood or personality

What would a change in personality mean?

Personality is something that we rather take for granted. It is true that certain aspects of it are inborn, but there are other aspects of one's personality or at least of the persona that they portray, that are learned and practiced over time. We come to depend upon how well we know a person because their personality remains consistent over time. We know, for instance, whether they are generally polite or cranky. We know if they are honest or tend to lie. We know if they tend to be soft-spoken or loud. All of these things help us to feel as though we are on solid ground when describing who a person is. But once dementia or Alzheimer's enters the picture, the ground can begin to shift right under our feet.

Because different types of dementia affect different parts of the brain, the disease may affect personality and behaviors in different ways. If a person has dementia that affects the frontal areas of the brain, their personalities may seem to shift more drastically. It's an important thing to ask about at onset so that you can begin to prepare yourself mentally for how you will deal with the changes you may encounter in the coming months and years. Generally speaking, most individuals with dementia do not completely change their personality. For instance, a person who was nice and calm would not become violent, unless there were other issues such as hallucinations or drug interaction problems going on, but it can occur. Most often the changes that occur are an amplification of their former personality. A soft-spoken person may become even quieter. An angry person may become very overbearing and upset easily.

As the disease progresses into advanced stages, several of a person's learned behaviors begin to fade. If they were a voracious reader, they may lose the ability to read. If they wrote often, they will most likely lose that ability. If these were important things to them, and particularly if they were activities that you shared with them, it can seem as though you do not know who they are anymore. We often associate people and our relationships through hobbies and interests. This can also, understandingly, cause a great deal of frustration on their part. They are losing things that they consider to be important parts of themselves. During their lucid moments, if they recognize any of this, it will be frustrating and disappointing to them.

While there is not much that one can do to prevent this from occurring in the advanced stages of the disease, we can begin to prepare ourselves by knowing the likelihood that these changes may occur. We can also take time while we have it, to enjoy their true personality that we've grown to love over time. Take every opportunity to spend time with them and support them through this scary time, assuring them that whatever happens, you'll still remember their true nature. And as you speak of them to others, you'll emphasize who they are rather than the disease to others. This will do more to maintain their dignity than anything else you can do. Their life and personality is a gift to us while our love and care is our gift to them.

Home Away From Home

Assisted Living Facilities may become an alternative as we age. It isn’t easy to find a place suitable for the needs of your family or loved one when they become unable to totally care for themselves. These facilities offer many advantages for a person who feels depressed or needs help with daily activities. Several different types of homes exist, but you would want to check out the needs of the patient and the advantages of each facility before signing a contract for your loved ones. Not all are alike, so let’s examine how to find the right one. It depends on how healthy or active the person is. Are they active and over 55? It’s important to consider if you have dementia/Alzheimer’s or any other condition that might require special attention. Or, you may just be looking for an amazing place to live?

There are several different facilities, according to the needs of the resident, which offer activities to suit their needs. Activities consist of daily exercises, shopping trips, music performance, cooking demos, manicures, bowling, volley ball and golf. Activities and special events are normally planned on a week to week basis. There are movie nights and trips to the store. Their vehicles are equipped for wheel chair patients and supervised by attendants who assist with physically challenged residents.

If you are able to cook and do things for yourself, you may want an Active 55 or independent living facility. Some places offer 1 and 2 bedroom suites. These come with many amenities, and are often fully equipped with washer and dryer, granite countertops, central air, walk-in closets, and covered parking. Residents can enjoy an amenity package that includes a barbeque area, beautiful courtyard and fountain, fire place, resident lounge. Some have a café, full service hair and nail salon, library and genealogy center, game room, fitness center and more.

There are other community resources and people who volunteer to consult residents about elderly challenges and issues such as Medicare, Social Security, Wills and Insurance. Some volunteer organizations ask permission for their members to visit with residents and read to them or write letters for them. .

MEMORY UNITS – These units have Caregivers to be with the residents and watch over them. These facilities offer many advantages for a person who needs help with daily activities. Special meals are prepared and brought into the Unit. Aids (CNAs) are with the residents at all times and assist with bathing, comforting, and checking on them often to see that their daily needs are met. They even play games and help with small tasks for the mentally impaired. The nurses check vital signs and administer medication, and there is usually a doctor who comes in when needed.

Aging, Confusion & Forgetfulness

Anyone who is more than 30 years old, and perhaps even some who are younger than that have experienced moments of confusion. When was the last time the you mixed up a day? Or how about the time... Sometimes we can contribute it to something simple, like Daylight Savings Time. Other times we have a change in our regular schedule and it jumbles things up in our heads. Women tend to experience it on a more regular basis when they’re pregnant and the hormones are taking over their bodies, or when menopause kicks in. Everyone experiences it if they are suffering from lack of sleep due to a newborn or from taking care of a loved one during an extended illness. If you have gone through prolonged times like this, you understand on a deeper level what it is like to feel confused. It is unsettling for the person that it is happening to. It always makes me feel insecure when it happens & I’m very grateful if there is someone around to reassure me that I’m not losing my mind.

As we watch those around us age, it is important to take note of several things in their lives that can contribute to confusion and forgetfulness so that we can help to reassure them & make them feel more at ease. Sometimes what they’re experiencing is a natural occurrence, which we’ll talk about below. Sometimes it is pointing to a more serious illness that they’ll need to combat. In either case, compassion, grace & reassurance are the best ways to handle the situation.

Confusion and forgetfulness can also be exhibited when days, months & years no longer hold much meaning. We’ve all had the feelings of confusion when we’ve mistaken which day it is. It often happens to us when our routine is upset. With older people, though, it can happen for a variety of reasons. If their days are so similar to one another & there is not much of importance happening, there is really no reason to keep track of the days of the week. Think about if you didn’t have a job or other activities of interest to you. Would you pay close attention to the passage of the days? What would make one day different from the others? Even months and years pass with less activities and less to look forward to. After all, when you’ve lived 80 or 90 years, what is one week?!

The people you are helping to care for are many decades older than you are. They’ve seen more in their lifetimes than most people can dream of. They’ve catalogued huge amounts of change into their brain during that time, some of it interesting to them, & other data that is on the periphery, there- but of little importance in their immediate life. Aging people who have been living on their own in an isolated manner often have a narrower scope of life as they are at ease to only pay attention to what interests them. If they get to the point where they need to have in home care or go into assisted living, it changes this, as their interactions become broader & it may be temporarily troubling to them that they seem to know less about the world outside of the one of their own making. They may exhibit periods of confusion & seeming forgetfulness. This may not mean that anything is wrong with them, but simply that it will take some time to re-adjust to life that involves more people in diverse settings.

It can also occur when there is a change in routine or situation. Moving from one’s own home into an apartment or another arrangement can be a common time for confusion and forgetfulness to surface. Having to change everything from the route you take to reach the bathroom, to memorizing a new home telephone number after you’ve had the same one for 40 plus years can be very taxing on an aging brain. If you add in any kind of emotional anxiety or disappointment from the move, or any injury that predicated the move, you can see why confusion might ensue. In your dealing with people going through these things, show patience and compassion. They are far more frustrated with their confusion and forgetfulness than you could ever be.

If you start to notice forgetfulness on a broader scale and for prolonged time periods, talk to their doctor. There might be some indications for dementia or Alzheimer’s disease that they’d like you to keep an eye on. But even if they do have one of these diseases, remember to be reassuring as often as possible. That feeling of confusion that you have when it feels as if the rug has been pulled out from beneath you and perhaps the whole world is playing a joke on you because you’ve lost your place in time is not a fun feeling to have. Orientation in time is an important part of keeping our equilibrium in life. When if feels as if it’s slipping, it is scary. People act differently when they feel scared or insecure. Some will cry more, others will want someone around all the time, and still others will be cantankerous and angry. Deal with each situation as it comes, but do it as kindly as you can muster. One day you will be in a similar position, facing the challenges of aging, and you’ll want others to treat you kindly too.

Reading, Cognitive Abilities & Dementia

According to several different studies of dementia patients, there is promising evidence that a number of activities performed by patients can actually slow down the progression of this disease. You've probably heard that doing crossword puzzles will help keep your memory strong, and that may be true, but in general, there are a whole host of things that one can do to keep your brain functioning at its best for the longest period of time, even after a diagnosis of dementia or Alzheimer's disease. Reading is one of them.

Reading is an amazing thing. It is a technical function, requiring the use of your eyes and brain to work together. It is a learned function, generally requiring a bit of effort at the onset for the student to grasp the symbols and what they each mean, then stringing them together into sentences to make an idea come to life on a blank sheet of paper. It's also a feat of the imagination, in order to “see” before you what the author is speaking of.

Most of us who have been literate for years think nothing of the ability to read, or of all of the mental functions that have to be operating in order for us to be able to engage in this activity. Reading is active, whereas television viewing, is for the most part, passive. This is why it's often more difficult to talk oneself into reading in the evening when you are sleepy than talking yourself into watching a program. One requires of those activities requires something from you mentally, one does not.

For all of us, this is good news, but especially for dementia patients who are trying to fight back against the brain's process to shut down their memory. Activities that exercise active cognitive functioning are perfect for keeping mental capacity at it's sharpest. This does not mean that it will reverse a diagnosis. It simply means that the patient will be trying to maintain the mental powers that they do have for as long as possible.

But, what should the patient read? The simplest answer to this question is to start where there is interest. If they are interested in gardening, get all manner of books, magazines & newspaper articles about gardening. If they love fiction, get fiction. Beginning with subjects that interest them will help to encourage even those who do not enjoy reading to begin to engage with written material again.

How about a challenge? Many libraries also offer challenges to help people broaden their reading enjoyment. Read 1 mystery, 1 non-fiction, 1 book of poems and read aloud 1 book to a child. If your library does not offer these challenges, they are simple enough to make up yourself. Just post them on the wall & check them off as they are completed.

What about libraries? Some people begin to shy away from public locations once a diagnosis has been obtained, but a library is a wonderful place to visit for as long as is possible. They are often very quiet, do not change much, and are full of areas to challenge cognitive abilities. Looking up books and finding them in the aisles can be quite challenging, but there is always librarian help if it gets too frustrating. Oftentimes, there are puzzles laid out on tables to be worked on and walked away from, at will. Every type of reading material is available through your library or through inter-library loan to anyone who has an address and would like a library card.

If you happen to be working with someone who never learned to read, does not read well, or has perhaps lost the ability to read, books are not out of the question. Most libraries have an enormous section of audio books to check out. Start with some that you know to be enjoyable and work out from there. There are also a number of online resources available, such as audible and librivox where you can subscribe and listen to a nearly limitless supply of books without having to actually read them in print. This process will still stimulate the brain, though perhaps not as much as an actual print copy.

Encourage reading whenever you can. Model it whenever you can. You'll not only be doing a service to those around you, you'll be doing a service for your own mind.

Nature and Dementia

All of us have probably experienced the benefits of nature at one time in our lives or another. The calming sound of waves on the beach, the gentle rain on a roof or the canopy of the forest, or even the calm breeze through the pines can knock our anxiety levels down a few notches. What few people realize, however, is that there is genuine scientific evidence that reveals that which we’ve all experienced…nature is good for us! It’s even better for those suffering from dementia or Alzheimer’s.

It is so good for us, in fact, that in Finland regular doses of nature incorporated in their governmental health policy. They may prescribe a walk in a natural area as treatment for anxiety, alcoholism, attention problems or depression. But Finland is not alone as a country finding ways to combat the ailments of our century. South Korea, Canada & the US are all studying nature’s effects on the human psyche. Many questions are being answered as scientists delve into these areas of study, but it is mostly confirming what we all seem to know intuitively. Nature is good for us. It calms us down & helps us become more thoughtful.

Because Dementia & Alzheimer’s can be diseases that have some social stigmas attached to them, the diseases themselves are often accompanied with extreme depression or anxiety. Regular outings into nature are incredibly helpful for those suffering from any of these diagnoses. When you’re in nature, none of those things matter so much. You can find a beautiful caterpillar, for instance, and be allowed time to pay attention to the exquisite detail of something that is currently in front of you without needing to remember its relationship to everything else in your world. You can watch it for a long period of time without needing to rush. You can remain calm & it will not judge your actions. You are given time to think, to wonder & to be amazed. You are given the freedom to be you.

Of course, it is prudent to have someone along with you on your trips into nature. We are not advocating that patients with dementia or Alzheimer’s wander in the woods alone as treatment. But, as often as possible help those you care about to experience nature in meaningful ways. Perhaps they’d like to bring along drawing supplies, or a camera for the outings. Meaningful occupations that will bring attention & mindfulness are never amiss with patients & loved ones that struggle with these diseases. It will likely improve their (and your) quality of life for years to come!