What is dementia?

We all forget things as we get older. Many older people have a slight loss of memory that does not affect their daily lives. But memory loss that gets worse may mean that you have dementia.

Dementia is a loss of mental skills that affects your daily life. It can cause problems with memory, problem-solving, and learning. It also can cause problems with thinking and planning.

Dementia usually gets worse over time. But how quickly it gets worse is different for each person. Some people stay the same for years. Others lose skills quickly.

Your chances of having dementia rise as you get older. But this doesn't mean that everyone will get it.

Usually the first symptom of dementia is memory loss. Often the person who has the memory problem doesn't notice it, but family and friends do.

People who have dementia may have increasing trouble with:

• Recalling recent events. They may forget appointments or lose objects.
• Recognizing people and places.
• Keeping up with conversations and activity.
• Finding their way around familiar places, or driving to and from places they know well.
• Keeping up personal care such as grooming or bathing.
• Planning and carrying out routine tasks. They may have trouble following a recipe or writing a letter or email.

To diagnose dementia, your doctor will:

• Do a physical exam.
• Ask questions about recent and past illnesses and life events. The doctor will want to talk to a close family member to check details.
• Ask you to do some simple things that test your memory and other mental skills. Your doctor may ask you to tell what day and year it is, repeat a series of words, or draw a clock face.

The doctor may do tests to look for a cause that can be treated. For example, you might have blood tests to check your thyroid or to look for an infection. You might also have a test that shows a picture of your brain, like an MRI or a CT scan. These tests can help your doctor find a tumor or brain injury.

Knowing the type of dementia a person has can help the doctor prescribe medicines or other treatments.

Medicines for dementia can slow it down for a while and make it easier to live with. Medicines can't cure it. But they may help improve mental function, mood, or behavior.

If a stroke caused the dementia, doing things to reduce the chance of another stroke may help. They include eating healthy foods, being active, staying at a healthy weight, and not smoking.

As dementia gets worse, a person may get depressed or angry and upset. An active social life, counseling, and sometimes medicine may help with changing emotions.

The goals of ongoing treatment are to keep the person safely at home as long as possible and to provide support and guidance to the caregivers.

The person will need routine follow-up visits. The doctor will monitor medicines and the person's level of functioning.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Eat healthy foods. Eat lots of whole grains, fruits, and vegetables every day. If you are not hungry, try snacks or nutritional drinks such as Boost, Ensure, or Sustacal.
• If you have problems sleeping:
  • Try not to nap too close to your bedtime.
  • Exercise regularly. Walking is a good choice.
  • Try a glass of warm milk or caffeine-free herbal tea before bed.
• Do tasks and activities during the time of day when you feel your best. It may help to develop a daily routine.
• Post labels, lists, and sticky notes to help you remember things. Write your activities on a calendar you can easily find. Put your clock where you can easily see it.
• Stay active. Take walks in familiar places, or with friends or loved ones. Try to stay active mentally too. Read and work crossword puzzles if you enjoy these activities.
• Do not drive unless you can pass an on-road driving test. If you are not sure if you are safe to drive, your state driver's license bureau can test you.
• Keep a cordless phone and a flashlight with new batteries by your bed. If possible, put a phone in each of the main rooms of your house, or carry a cell phone in case you fall and cannot reach a phone. Or, you can wear a device around your neck or wrist. You push a button that sends a signal for help.

Acknowledge your emotions and plan for the future

• Talk openly and honestly with your doctor.
• Let yourself grieve. It is common to feel angry, scared, frustrated, anxious, or depressed.
• Get emotional support from family, friends, a support group, or a counselor experienced in working with people who have dementia.
• Ask for help if you need it.
• Tell your doctor how you feel. You may feel upset, angry, or worried at times. Many things can cause this, including poor sleep, medicine side effects, confusion, and pain. Your doctor may be able to help you.
• Plan for the future.
  • Talk to your family and doctor about preparing a living will and other important papers while you can make decisions. These papers tell your doctors how to care for you at the end of your life.
  • Consider naming a person to make decisions about your care if you are not able to.