Caring For People With Dementia

Photo by Andrea Piacquadio on Pexels.com

What Help Do They Need?

What kind of care do people with dementia need? Dementia can cause a range of changes in mood, including frustration as abilities decline, confusion as memory deteriorates, and other knock-on effects as such as changes in diet and interests. Read on to discover some of the key things to take into account when caring for people with dementia.

Helping with Day to Day Tasks

When a person develops dementia, it can make a big change to how they go about their day to day tasks. They’re likely to notice they’re forgetting things, for example where the teacups or plates are kept in the kitchen, people’s names, or even where the bathroom is. Other effects include decreased coordination, which can make it much harder to perform daily tasks like preparing food, washing or getting ready for bed.

How Can You Help?

As people living with dementia see how their skills are deteriorating, are unable to express themselves or forgetting things they’re sure they used to know, they can become frustrated, helpless or less self-confident. It’s important that you help them tackle these feelings of a lack of self-worth by offering them support in a sensitive manner, without criticising their efforts. This helps your loved one feel that they’re still useful and can still do the things that used to come naturally to them.

You can also help them with their memory by putting memory aids around the house. This might include putting a picture on each kitchen cupboard door of what’s inside, or photos of what’s inside each room in the house, making it easier to find what they’re looking for.

Another way to keep them engaged is to let them take part in everyday tasks, which helps your loved one feel useful. This might include involving them in preparing meals, help with the shopping, hovering or laying the table.

Food and Nutrition

It’s important that your loved one continues to eat healthily, despite their illness. A good diet is essential to boost the immune system, especially for those with dementia, as illness can cause added confusion.

Mealtimes can become more difficult in a number of ways due to the effects of dementia. Commonly, people with dementia can forget what foods they like, refuse to eat, stop recognising familiar foods, or ask for unusual food combinations.

Not all this behaviour is down to confusion, though. Dental problems can cause irritation in the mouth, leading to your loved one resisting eating, so it’s a good idea to speak to your dentist or GP if you have concerns about their oral health.

How Can You Help?

When helping your loved one to eat, it’s important that they’re involved as much as possible. Let them help you prepare food, giving them some continuity with how they used to live their life. Let them choose what they want to eat based on sight, as this can add a visual prompt to remind them about their favourite foods.

Try to keep mealtimes as calm and stress-free as possible too. For example, your loved one’s eating habits may change over time, such as wanting to eat at different times of day. Try to accommodate this, ensuring you have plenty of time for meals allowing you to deal with any problems that may arise. Above all, remember to stay calm, as this can ensure your loved one doesn’t feel overly anxious.

Don’t Neglect Your Own Wellbeing

It’s only natural to put your loved one first, but it’s also important you also pay attention to your own wellbeing. It can be very stressful and difficult to stay positive when caring for people with dementia, especially for a prolonged period of time. As a carer, it’s important to consider your own physical and mental wellbeing, and a great way of doing this is ensuring you’re able to take a break from caring.

Celebrities with disabilities

Susan Boyle

Singing sensation Susan Boyle who was discovered on the talent show ‘Britain Got Talant’ was diagnosed with Asperger’s syndrome at the age of 51.

Asperger’s is described as a ‘hidden disability’. This is because you can’t tell someone has Aspergers from their outward appearance.

Susan’s Asperger’s syndrome means she has always really struggled with social interaction and communication.

Boyle has admitted in interviews how relieved she felt when she was finally diagnosed, as she had struggled to understand throughout her life why she found communicating and social interaction so difficult.

However, Susan has not allowed her Asperger’s to take over her life. She says she still suffers from bad days, but she is learning to deal with it and getting the support she needs.

The multi-millionaire singer’s net worth amounts to £22 million, making her one of the highest paid celebrities in the world.  

She has a huge international fan base and her debut album I dreamed a dream in 2009 was the best selling UK debut album of all time.

Here is Susan’s original audition – enjoy.

NARCOLEPSY

DESCRIPTION

Narcolepsy is a neurological disorder that causes episodes of unpreventable sleep. These episodes can occur frequently and at inappropriate times, for example while a person is talking, eating or driving. Although sleep episodes can occur at any time, they may be more frequent during periods of inactivity or monotonous, repetitive activity.

Narcolepsy occurs when the part of the brain that regulates sleep and wakefulness does not function properly, causing sudden spells of Rapid-Eye-Movement (REM) sleep – the dreaming state of sleep. These “sleep attacks” last from a few seconds to 30 minutes, regardless of the amount or quality of night time sleep. These attacks result in episodes of sleep at work and social events, while eating, talking, driving, or on other similarly inappropriate occasions.

Symptoms generally begin between the ages of 15 and 30. The four classic symptoms of the disorder (although not all sufferers will have all four) are:

  • Excessive daytime sleepiness.
  • Cataplexy: a striking, sudden episode of muscle weakness triggered by high emotions. Typically, the patient’s knees buckle and may give way upon laughing, elation, fear, surprise or anger. In other typical cataplectic attacks the head may drop or the jaw may become slack. In severe cases, the patient might fall down and become completely paralysed for a few seconds to several minutes. Reflexes are abolished during the attack.
  • Sleep paralysis: the patient suddenly finds himself unable to move for a few minutes, most often upon falling asleep or waking up.
  • Hypnagogic hallucinations: dream-like auditory or visual hallucinations, while dozing or falling asleep.

Disturbed night time sleep, including tossing and turning in bed, leg jerks, nightmares, and frequent awakenings may also occur.

The development, number and severity of symptoms vary widely among individuals with the disorder but excessive sleepiness is usually the first and most prominent symptom of narcolepsy.

It is a frequent disorder, the second leading cause of excessive daytime sleepiness diagnosed by sleep centres after sleep apnea. Studies on the epidemiology of narcolepsy show an incidence of 0.2 to 1.6 per thousand in European countries, Japan and the United States.

In many cases diagnosis is not made until many years after the onset of symptoms. In one recent study, it took on average 14 years from the onset of symptoms to time of diagnosis. This is often due to the fact that patients consult a physician only after many years of excessive sleepiness, assuming that sleepiness is not indicative of a disease. Early diagnosis and treatment, however, are important to the physical and mental well-being of the sufferer, since studies have shown that even treated narcoleptic patients are often markedly psychosocially impaired in the area of work, leisure, interpersonal relations, and are more prone to accidents.

Narcolepsy can be diagnosed on the basis of a history of typical episodes and the results of an overnight sleep study with a multiple sleep latency test. The sleep study checks for other explanations that could account for daytime sleepiness, such as sleep deprivation, sleep apnoea and depression. The test is done in a sleep laboratory, where brain waves, eye movements, muscle activity, heartbeat, blood oxygen levels and respiration are monitored electronically with a device called a polysomnograph. The multiple sleep latency test is performed after an adequate night’s sleep has been demonstrated clearly. Usually, it is done after a sleep study.

The test consists of four 20-minute opportunities to nap, which are offered every two hours throughout the day. Patients with narcolepsy fall asleep in approximately five minutes or less, and transition in REM sleep during at least two of the four naps. In contrast, normal subjects take an average of 12 to 14 minutes to fall asleep, and show no REM sleep.

TREATMENT

There is at this time no cure for narcolepsy and there is no way to prevent narcolepsy but the symptoms can be controlled with behavioural and medical therapy. Excessive daytime sleepiness may be treated with stimulant drugs or with the drug modafinil. Cataplexy and other REM-sleep symptoms may be treated with antidepressant medications.

At best, medications will reduce the symptoms, but will not alleviate them entirely. Also, many currently available medications have side effects.

Lifestyle adjustments such as regulating sleep schedules, scheduled daytime naps and avoiding “over-stimulating” situations may also help to reduce the intrusion of symptoms into daytime activities.

PROGNOSIS

People with narcolepsy have a significantly increased risk of death or serious injury resulting from motor-vehicle or job-related accidents, and they must take care to avoid situations where such accidents might occur.

Although it is a life-long condition, most individuals with the narcolepsy enjoy a near-normal lifestyle with adequate medication and support from teachers, employers, and families. If not properly diagnosed and treated, narcolepsy may have a devastating impact on the life of the affected individual, causing social, educational, psychological, and financial difficulties

Lonliness and the disabled

Loneliness and social isolation can affect anyone, but some people are more vulnerable to it than others – like disabled people.

Anyone can experience the life transitions that our research has shown can trigger loneliness, like retirement or bereavement. But disabled people often face barriers in daily life that can make them more likely to be chronically lonely than non-disabled people.

new report by the Jo Cox Commission on Loneliness explores why loneliness affects so many people with disabilities, from the perspective of disabled people. It claims over half of disabled people report feeling lonely.

While each disabled person is unique in terms of the impairments and personal circumstances they face, loneliness is an experience that many disabled people will have in common. Getting the right support is so important.

Matt’s story

Matt Delaney now works for the British Red Cross

“It was a hideous time. Loneliness is very destructive,” said Matt Delaney.

The ex-serviceman spent years dealing with the effects of loneliness and social isolation after a severe injury left him immobile and housebound.

“The injury happened when I was 19 years old and serving with the Grenadier Guards,” Matt said.

“We were on an operation and I was carrying a very heavy load. I jumped over a wall and completely shattered my left leg. It was broken in about 20 places.

“I was in and out of hospital for about 18 months undergoing numerous operations and rehabilitation.”

Matt left the army a few years later and took a job working with people with learning difficulties, which he thoroughly enjoyed. But his ankle continued to cause him extreme discomfort.

“Eventually in 2012 I retired on ill health and I was told I’d need a below-the-knee amputation,” he said.

Matt spent four years out of work with limited mobility. He was unable to do the things he had always enjoyed, such as walking and DIY. Both his mental and physical health began to suffer.

“It affected my relationship with my wife, Michaela, and I didn’t see my friends. It changed how I felt about myself. I felt like my life was eroding away.”

Turning things around

Luckily for Matt, his wife supported him, changing her job to allow her to be at home with him more. She also encouraged him to make small, positive changes to his life.

Matt was fitted with a carbon fibre exoskeleton orthotic, which saved him from undergoing an amputation and allowed him to get mobile again. He also started taking evening classes to refresh his skills.

Recently, Matt joined the British Red Cross’ Connecting Communities service in Plymouth to help others experiencing loneliness and social isolation.

“I’m very passionate about this service and my personal experience has given me a great insight into how we can try to solve the problem of loneliness.”

Barriers: both physical and human

Living with a disability can create barriers to building social connections, particularly practical issues such as difficulty accessing mobility aids, like a wheelchair, the need for accessible transport and buildings, and appropriate social care.

But a poor level of public understanding and awareness of disability is most often the biggest barrier to making friends and finding common interests with others.

Shockingly, one in two non-disabled people don’t believe they have anything in common with disabled people and a quarter admit they have avoided engaging in conversation with a disabled person. They fear appearing patronising or saying the wrong thing, and many struggle to look past the disability and focus on the individual.

Wendy’s story

Wendy* has a long-term condition. Despite spending years being there for others as a nurse, eventually her condition left her in too much pain to work. Even sorting out her energy bills became a huge challenge.

“I was in a lot of pain for many years and becoming less and less social,” said Wendy.

Eventually she contacted the Red Cross to ask for support. She felt that time was passing her by and that she was stuck in a situation she did not have the strength to get out of alone.

From helping people home from hospital to loaning wheelchairs, the Red Cross does a lot to promote health and wellbeing in the UK. This includes supporting those experiencing loneliness.

Red Cross support worker Roz Bates paid Wendy a visit. In Wendy’s own words, she helped her “put the world to rights”.

Roz reminded Wendy of all the people she had helped as a nurse and encouraged her to focus her thoughts on them and how grateful they were for her support.

She also persuaded her to pick up old hobbies such as sewing and making things for her home.

“She re-arranged her room and took pride in how it looked and it became a pleasant, cosy and happy place to be,” Roz said.

With Roz’s support, Wendy had the confidence to do much more – such as phoning the energy company to sort out her bills and attending a weekly exercise class where she has since made new friends.

“Roz has really pulled my confidence and self-esteem up,” Wendy said.

“She has aided me with collecting food from the food bank. She has been a star. I feel I have now reached a place where I can go out more. I am so happy I met her.”

Tackling loneliness and social isolation

The Red Cross is part of the Jo Cox Commission on Loneliness where MPs, policy makers and 13 leading organisations have come together to expose the growing crisis of loneliness and find ways to overcome it.

The late Jo Cox MP strongly believed that, “we have far more in common than that which divides us.” We could all benefit from seeking to create connections with others by focusing on our similarities and shared interests rather than our differences.

Why Mental health nurse?

Real-life story – Cherie Lawrence

Cherie became a mental health nurse after suffering post-natal depression as a teenager. Her career took off from there and she isn’t looking back. 

Cherie LawrenceMental health nurseEmployer or universityNottinghamshire Healthcare NHS TrustSalary range£20k-£30k

What made you decide to become a mental health nurse?

I became a mother unexpectedly at 17 and suffered from (post-natal) depression both during and after my pregnancy. Unfortunately at the time there wasn’t really that much information out there and neither me or my family really understood the condition. My doctor couldn’t offer much help either.

To try and understand it better I did a community mental health course and discovered a passion for the subject – I found it really fascinating.

At school, like many teenagers I didn’t really know what I wanted to do, but I had from quite a young age always admired nurses, after all we trust our lives with them don’t we – they’re the backbone of the NHS. So when I discovered a passion for the subject of mental health, becoming a mental health nurse seemed like the obvious thing to do. I also felt like becoming a mental health nurse would help me be a really positive role model for my daughter.

How did you become a mental health nurse?

I studied for my degree in mental health nursing at Nottingham University – I was actually the first person in my family to go to university, which was a little scary but I needn’t have worried as there’s so much support out there for nursing students.

I really enjoyed my degree and particularly the variety of placements I was given – I was able to get really valuable experience of working in hospital and community settings, with young people and old, including placements in forensics and working with people with functional dementia.

Nurses and particularly mental health nurses are really in demand so I was contacted about job opportunities all the way through my degree and was offered a choice of four jobs when I graduated! Being a nurse means that unlike quite a lot of other professions, you have a guaranteed job for life, which means I’m never going to have to worry about getting a job and providing for my daughter.

I’m so glad I chose to work for Nottinghamshire Healthcare, as they offer so much support and help for newly qualified nurses. I think some people worry about the responsibility they’ll have once they’re doing the job for real but Nottingham, like other Trusts runs an amazing preceptorship programme which helps bridge the gap between being a student nurse and a qualified nurse. They make sure you’re really supported, with regular group meetings and one to ones where you can discuss anything you need to and they make sure you have access to further training, such as safeguarding training.

I also love that I have a guaranteed job for life, which I enjoy – a lot of my friends are jealous!

What I do

I get to work with a variety of people and importantly, no two days are the same, I go to work each day never knowing what to expect, which keeps things really interesting.

I work with a range of patients on the ward, some of whom are very vulnerable and I work as part of a multi-disciplinary team, who are really supportive of each other. I think some people have a view that mental health nursing must be really tough and whilst there are challenging times there are also lots of lovely things that we get to do with patients as well, on a 1 to 1 basis, like taking them out for a walk or shopping in town. This helps give them some normality and experience of life outside the ward and I really enjoy this aspect of the job.

The best bits

I love my job so it’s difficult to know where to start – I love the variety and how rewarding it is to see the difference we make to the lives of our patients. I also love that I have a guaranteed job for life, which I enjoy – a lot of my friends are jealous!

What’s next and top tips for others

Nottingham is a fantastic pace to work, not only is there lots of ongoing training to take part in but other opportunities as well, so I’ll definitely be here for the foreseeable future. I’ll be becoming a mentor in the next six months and hope to complete a Master’s in the next three years.

I think it’s really important for students to understand how much support and help there is out there for student and newly qualified nurses, how varied the job is and the opportunities that are out there for developing your career in the direction you want to and continuing to learn new skills.