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Beats me. Did you ask her? Most kinds of dementia include both cognitive and behavioral symptoms (some kinds more than others). Was she making that distinction? For example, Lewy Body Dementia is said to have a high caregiver burden because the behavioral symptoms can be severe and also come early in the dementia, before anyone has had a chance to adjust to the new "normal."
Does that explanation fit the context of the remark?
The nurse needs to better informed about dementia. Dementia is a way to classify diseases that affect memory and functioning, including Alzheimer's,vascular dementia, dementia with Lewy bodies, Parkinsons with dementia, frontotemporal dementia are the most common. Here is a link to ALZ Association's classification for types of dementia. Quite often, the lesser known types of dementia are called by slightly different names, which is confusing to most, including me. But it is alway Dementia due to one of the major types. If someone tells you that a person has dementia, it is about as useful as telling someone that a person has hair because it does not tell you what type of dementia. All types of dementia affect the brain and the functions it performs. Thus, memory loss, inability to control one;s body, weight loss, speech and language impairment and behavioral are common symptoms of dementia. Glad you asked because the medical world needs to understand dementia more fully than it does.
This states that depression symptoms are sometimes the same as dementia, making testing difficult. Maybe that is what she has been taught, and is mixing up the difference. I don't know how you would convince her of the difference.
What was the context in which the nurse said that? It's impossible to understand what point s/he was trying to make without knowing what exactly she was talking about.
It is a new way of thinking and talking about dementia. The professionals used to spend a lot of time trying to classify and figure out what stage A person with dementia is. Because of research, and the beginning of understanding dementia as "brain failure" the new language has been simplified. Thinking about dementia in terms of behaviors empowers staff to think of strategies on how to address behaviors. When someone with dementia wanders, for example, that is a behavior that can be observed, described; when, where, how often,etc And a treatment strategy devised- behaviorally, environmentally or with medication. For example one woman would pace the halls and try to leave in the afternoon. When she told the staff she needed to meet her children at the bus stop, they put a chair opposite the nurses station with a sign over it: Bus stop and now in the afternoons she puts on her coat, holds her purse, and waits at the "bus stop". It is more humane and functional to think about dementia this way.
I would say this nurse wasn't listening in class when brain disorders were discussed. Yes, behaviors are changed when one has dementia, and cognition is one of those behaviors. Don't get mixed up with the fact dementia is a terminal illness regardless of how an individual presents with the disease. Not all patients have identical behaviors and cognition abilities.
Maybe the nurse was trying to explain that the person's cognition was out of order.Therefore, behaviors do not make sense to us. To the patient,the behavior has something to do with the past. 'The past' is often the present to the patient. My observation: Time just collapses . My personal observation over 8 years of caring for my husband withLewy Body Dementia. For example,at 11 pm he would want to go to a very important meeting at the office. (He had gone over 15 years ago to these types of meetings.) I hope this idea helps you.
Dad, age 96 and a Dementia patient had to leave AL due to aspiration pneumonia and his dementia progressed to where he needed more care than AL could provide. His demeanor at AL wasn't great. In the NH, they realize that he did "paperwork" at his job when he was employed. He also wanted to stand, but AL wouldn't allow him to stand alone. He had a behavior issue early on at AL so I had to hire a 24.hr live in aide to stay with him. Anyway, I digress.... NH has a folder of papers with his name on it. Every day they have him write his name and the date on a paper. He's treated as though he's doing work for them. It helps him feel good, improves his behavior and keeps him occupied. He fixes those papers 100 times a day. As a nurse who cares for dementia patients, I think that you have to be innovative when dealing with their issues. Behavioral, maybe, cognitive, yes, but you have to balance the 2 to do the best for each patient.
Depression can lead to dementia. Dementia can lead to depression. It's like asking which came first, the chicken or the egg. Either way, the hens don't live forever.
1st question: What LEVEL of "nurse" was that? Commonly, Nurses AIDS might say things like that; further, Nurses Aids, and commonly, home-health caregiver Aids, help patients stay confused about what level of caregiver they are. This level of caregiver usually lacks higher education, therefore says much, based on their own opinions, not facts. Less commonly, but still too often, even a Licensed Practical Nurse [LVN/LPN], or a Registered Nurse [RN], might make a statement like that...it still indicates they speak their opinion, not science fact. And, no matter what level of health care provider saying a statement like that, that indicates the person may have "graduated in the lower-bottom 50% of their class", thus, failed to listen in classes discussing elder care, brain disorders, some basic science classes, etc. You should ASK that "nurse", to please explain what was meant by that statement. And, politely, ask the "nurse, what their level of licensing is, for instance. You should know, Dementias of all kinds, start with physical/chemical changes in the brain; behaviors can be learned or conditioned into a person, and/or, can result from the person behaving in ways that make sense to them, based on how they now perceive things. Someone with a brain disorder, sickness or injury, SOMEtimes can control their behaviors, but most often, depending on how the brain is damaged, canNOT control their behaviors. Someone who says Dementia is behavior, also commonly thinks the person can control and/or change their behavior, if they really wanted to.. ...except they really cannot, because they do not have full access nor control over their brain, thoughts, knowledge.
I think it's amazing how many people have dementia and how many healthcare workers know little to anything about it. I discovered this when accompanying my cousin to doctor appointments.
My cousin, who as Vascular Dementia, has had quite a few visits to various medical facilities. She is in a wheelchair and has obvious signs of dementia, PLUS, they are informed of this fact. She has had her Primary visits, but also, Neurologist, radiologists, orthopedics, surgeon (had cyst removed), ER visits, etc. It's just amazing how little if anything they know. I started to give them some info. (Goodness knows they need it.) With all the dementia patients they treat, why are so many of them so ill informed? This includes MD's and nurses. It boggles the mind.
It gets tricky to balance what the patient still can process mentally, and what they cannot, to creatively problem solve, to help them keep calm, and avoid acting-out. The story of the nurses keeping a file folder for a demented businessman, and having him "work" on those papers daily, is very good! Caring for dementia'd elders, is like redirecting a child, or giving a child limited choices..it simplifies and helps keep the situation more manageable. But if someone is said to have 'behaviors, not a brain disorder', sounds like the next step is trying to coerce the ill person to willingly change their behavior, based on logic and rules....they cannot.
Lucy's Mom. What a great NH. Mom was just in rehab but part of the time was spent in long-term care till a room in rehab was available. They did nothing for people in LT that I saw. They played movies on an outdated projection TV were the coloring is off. Those poor people just sit around in wheelchairs all day. There was a blind woman that they gave her washclothes to fold and put in a basket. The woman in charge was nice and seemed to try by decorating.
My thoughts...a nurse at a hospital doesn't deal with Dementia patients all that much. Ask a nurse who works a rehab/long-term facility where they deal with it every day.
This retired RN agrees with Ferris.....your nurse, in question was not listening in class. Here is the logic: IF there was no problem in the brain, would there be any bad behaviors? NO...not without other issues we don't know about. BUT....have dementias, Alzheimers and some other types of brain disorders, you get some behaviors. Brain problem comes first....then bad behaviors. Unless you also have other medical or psychiatric issues going on and have a normal brain scan.
I would say that dementia is more of a symptom. It is a symptom of the deterioration, and ultimate death, of the brain. I like Maymsw's explanation, though. It is comforting that there is an effort to think creatively about a terrible disease. However, I do feel that thinking of dementia as a behavior is not exactly logical. To me, dementia is the cause of the behaviors. It is not the behavior. Unless you consider forgetfulness, confusion and etc. as behaviors...
My dad had a series of microstrokes that left him cognitively impaired, with the education of 2nd grader or less. Their were no behavioral changes, but now he has dementia. I would tend to agree, cognition is not a behavior, it is how we figure things out. Dementia changes behavior because they are easily confused, but the behavior change is a secondary effect.
Dementia is a slow process of information leaving one's person. However, it isn't Alzheimer's. I just to explain the difference to an uneducated family member.
In the 'good old days" there was no such thing as dementia. People just became "senile" and some were more difficult than others to manage. Anyone over the age of 65 was classified as generiatric and not placed in an acute setting more suited to their current condition and therefor did not always receive the treatment needed. Those placed in a geriatric ward even if cognitively sound on admission frequently sank to the "norm" of the population they found themselves in. they exhibited signs of dementia or simply with drew probably due to depression. Few had anyone to advocate for them because if they did families were more able to care for them at home as most families stayed intact and the wife did not have to work. She was a "housewife" and had the time to care for the elder. Because dementia has only recently been recognized there was zero teaching about it in nursing schools. Those who could not be managed in a conventional hospital ended up in mental hospitals. Education and knowledge in this area has been slow to evolve and still may be playing "catch up" as far as education is concerned and interest by the medical professionals. Nursing school and acute care for me is over 50 years ago so I don't know how much is taught to current dy nurses. I did however take the RN NYCLEX (and passed) 18 years ago and do not remember any questions related to dementia but maybe there were because the exam is based on a pool of 250 questions and your level of expertise determines the type of questions you are asked. The minimum pass level makes you answer 75 questions and I got through with 85 mainly I believe because I had had a lot of supervisory experience and the exam is aimed at new graduates. Fifty years ago in the UK the only experience offered was 6 weeks in a mental hospital and of 60 in my class only 6 who were judged suitable were selected. I did apply but was not deemed suitable. I am sure training is very different these days as nurse education is now college based and not an apprentice style experience with only had a few weeks each year in the classroom. Just my 2 cents. The nurse who made that comment was either not educated or simply had no interest in that area terest in the area and clearly believed patients had the ability to control their "bad" behavior
Venn diagrams can come in handy for that kind of situation - let Dementia be the set, with Alzheimers (and the rest) being subsets. Even true that sometimes the subsets will intersect, sigh...
Both my DIL and SIL are physicians. They don't know squat all about dementia. Well, maybe my SIL who is currently finishing his residency and has had more contact with "mental patients"...but still. My mother is showing obvious signs of age related dementia. She only sees my SIL once a year, if that. He saw her last month and said "She's not nearly as bad as you say she is". Well, talking to her for 10 minutes at church hardly constitutes a dx. He doesn't deal with her on a day to day, as I do. My DIL is completely off board and since it's not her grandma, she doesn't care one bit about my mother. Her one and only comment about mom's increasing decline is that she wouldn't take her as a patient for surgery. (DIL is an anesthesiologist). Pam is right, depression can lead to dementia. Most people will develop some level of it, if they live long enough. That's just my experience. And kudos to the sweet caregivers who find ways to incorporate "dignified" methods of dealing with their patients' dementia.
My Italian mom is 93 years old and has some sort of dementia. After reading all these posts, i'm really not sure which she has but i think it is vascular...However, she remembers/recognizes me and knows she is living in a facility (memory care). We can even have very cognitive conversations. Of course, she doesn't remember them the next day; but in that very moment, when we are talking she talks to me like her daughter. THIS is what makes the disease so confusing and tears at me heart strings every night. The facility wants to lump her into a group of less cognitive people but i have to keep reminding them that she understands what they are saying. She wants fresh air, but they don't let her out as much as she would like. They think she will escape. She only wants some freedom, some independence. She can't live at an assisted living place because they really don't know how to handle people with dementia AT ALL. The system is broken and it's so freaking sad.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Does that explanation fit the context of the remark?
All types of dementia affect the brain and the functions it performs. Thus, memory loss, inability to control one;s body, weight loss, speech and language impairment and behavioral are common symptoms of dementia.
Glad you asked because the medical world needs to understand dementia more fully than it does.
A person with dementia is. Because of research, and the beginning of understanding dementia as "brain failure" the new language has been simplified. Thinking about dementia in terms of behaviors empowers staff to think of strategies on how to address behaviors. When someone with dementia wanders, for example, that is a behavior that can be observed, described; when, where, how often,etc
And a treatment strategy devised- behaviorally, environmentally or with medication. For example one woman would pace the halls and try to leave in the afternoon. When she told the staff she needed to meet her children at the bus stop, they put a chair opposite the nurses station with a sign over it: Bus stop and now in the afternoons she puts on her coat, holds her purse, and waits at the "bus stop". It is more humane and functional to think about dementia this way.
long does it take on average, barring the exceptions, for alziehmers to
kill people
My observation: Time just collapses . My personal observation over 8 years of caring for my husband withLewy Body Dementia. For example,at 11 pm he would want to go to a very important meeting at the office. (He had gone over 15 years ago to these types of meetings.) I hope this idea helps you.
Commonly, Nurses AIDS might say things like that; further, Nurses Aids, and commonly, home-health caregiver Aids, help patients stay confused about what level of caregiver they are. This level of caregiver usually lacks higher education, therefore says much, based on their own opinions, not facts.
Less commonly, but still too often, even a Licensed Practical Nurse [LVN/LPN], or a Registered Nurse [RN], might make a statement like that...it still indicates they speak their opinion, not science fact.
And, no matter what level of health care provider saying a statement like that, that indicates the person may have "graduated in the lower-bottom 50% of their class", thus, failed to listen in classes discussing elder care, brain disorders, some basic science classes, etc.
You should ASK that "nurse", to please explain what was meant by that statement. And, politely, ask the "nurse, what their level of licensing is, for instance.
You should know, Dementias of all kinds, start with physical/chemical changes in the brain; behaviors can be learned or conditioned into a person, and/or, can result from the person behaving in ways that make sense to them, based on how they now perceive things.
Someone with a brain disorder, sickness or injury, SOMEtimes can control their behaviors, but most often, depending on how the brain is damaged, canNOT control their behaviors.
Someone who says Dementia is behavior, also commonly thinks the person can control and/or change their behavior, if they really wanted to..
...except they really cannot, because they do not have full access nor control over their brain, thoughts, knowledge.
My cousin, who as Vascular Dementia, has had quite a few visits to various medical facilities. She is in a wheelchair and has obvious signs of dementia, PLUS, they are informed of this fact. She has had her Primary visits, but also, Neurologist, radiologists, orthopedics, surgeon (had cyst removed), ER visits, etc. It's just amazing how little if anything they know. I started to give them some info. (Goodness knows they need it.) With all the dementia patients they treat, why are so many of them so ill informed? This includes MD's and nurses. It boggles the mind.
But if someone is said to have 'behaviors, not a brain disorder', sounds like the next step is trying to coerce the ill person to willingly change their behavior, based on logic and rules....they cannot.
Those placed in a geriatric ward even if cognitively sound on admission frequently sank to the "norm" of the population they found themselves in. they exhibited signs of dementia or simply with drew probably due to depression. Few had anyone to advocate for them because if they did families were more able to care for them at home as most families stayed intact and the wife did not have to work. She was a "housewife" and had the time to care for the elder.
Because dementia has only recently been recognized there was zero teaching about it in nursing schools. Those who could not be managed in a conventional hospital ended up in mental hospitals. Education and knowledge in this area has been slow to evolve and still may be playing "catch up" as far as education is concerned and interest by the medical professionals. Nursing school and acute care for me is over 50 years ago so I don't know how much is taught to current dy nurses. I did however take the RN NYCLEX (and passed) 18 years ago and do not remember any questions related to dementia but maybe there were because the exam is based on a pool of 250 questions and your level of expertise determines the type of questions you are asked. The minimum pass level makes you answer 75 questions and I got through with 85 mainly I believe because I had had a lot of supervisory experience and the exam is aimed at new graduates.
Fifty years ago in the UK the only experience offered was 6 weeks in a mental hospital and of 60 in my class only 6 who were judged suitable were selected. I did apply but was not deemed suitable.
I am sure training is very different these days as nurse education is now college based and not an apprentice style experience with only had a few weeks each year in the classroom. Just my 2 cents.
The nurse who made that comment was either not educated or simply had no
interest in that area
terest in the area and clearly believed patients had the ability to control their "bad" behavior
Pam is right, depression can lead to dementia. Most people will develop some level of it, if they live long enough. That's just my experience.
And kudos to the sweet caregivers who find ways to incorporate "dignified" methods of dealing with their patients' dementia.