Earlier today while I was listening to a colleague (Mary Hulme of Moonstone Geriatrics) gives a talk on dementia, this question came up:
“How can someone keep Alzheimer’s from getting worse?”
Alzheimer’s disease is the most common underlying cause of dementia symptoms. It does slowly get worse no matter how. (Given enough years, it will gradually damage the brain at some point of causing a slow death, which is why Alzheimer’s called a terminal disease.)
But on the other hand, we know that some things slows the progression of brain decline, whereas other things likely to speed up the decline. In other words, the actions that we take and do not take can somehow influence a person’s dementia progress.
According to my experience, people often have heard about stuff that might slow down the decline (casino online is not the best answer). But it seems to me that exercise is a better option. However, people are often much less well informed about the stuff that can speed up Alzheimer’s decline. Too bad, because also often it's possible to take action to minimize or to avoid things that might cause dementia to get worse even faster.
So, I’m going to write about what I think is the most important thing of these potentially dementia accelerating problems, that is delirium.
Delirium: What it is? why does it matter?
Delirium is a state of worse than the usual confusion brought on by illness, some kind of stress on the body and/or mind. It is especially common thing happens during hospitalization.
The extra confusion of delirium tends to get better by time, but it is quite important to know the following facts:
Some people never recover to their previous level of thinking ability with dementia especially who experience delirium. Instead, they have settled at a new-lower-level of mental ability.
People who have experienced delirium tend to mentally decline quicker during the following years than people who have not had delirium. In this study, having had delirium had linked to thinking abilities declining twice faster in the year after a hospitalization.
Hospital delirium is common in people with dementia. This study found that delirium has affected 32% of patients with dementia during hospitalization.
saying that experiencing delirium is common, and can really speed up the decline of Alzheimer’s or another dementia.
This could be scary for patients and caregivers to realize. Hence, although it is impossible to avoid all delirium (people get sick, or need to have surgery sometimes), it is possible to take the steps that have been proven to reduce the chance of older person will experience delirium while they are hospitalized.
here to learn more about how you may help prevent delirium during an older person’s hospitalization, I would recommend this resource on the Hospital Elder Life Program website.
What caregivers can do?
When caring for someone with dementia, There are 3 things you can do to avoid mental decline due to delirium:
Educate yourself about it. You can learn more about what brings it on, how to handle it, and how to prevent it. See Things to Know About Delirium for further information.
Be careful hospitalization and surgery. If you are considering a surgery as an option for your loved one or otherwise is not completely mandatory, please be mindful of the risks factor of accelerating the decline of Alzheimer’s or dementia. For a sad reason of how a family came to regret agreeing to this (a heart valve repair for an older woman with dementia), you may read this New York magazine
Learn to spot delirium at the hospital. If your loved one with dementia has to be hospitalized and you are a caregiver, try to help hospital staff to monitor delirium. Yes, it is their job indeed, but some studies have shown that busy hospital workers often do not notice delirium in older adults. Family member can help their loved ones to get better care by watching for delirium and getting the doctors to promptly address it if it develops.