Wednesday, June 25, 2008

Comparing Alzheimer's With Other Dementias

Here’s a popular article I wrote that is appearing on eldercare blogs, zines and sites throughout the web. It first appeared on my former website on September 17, 2006. I hope you agree that it is as relevant today as it was then. Feel free to continue a conversation on this theme, caregiver burnout, caregiver support, or on any other related topic:

In 1906, Dr. Alois Alzheimer presented a key paper to the meeting of the South West German Society of Alienists. In it he described the disease syndrome that now bears his name. Today, Alzheimer’s Disease has become the common term most people use whenever they talk about any kind of dementia. In fact, the very term “Alzheimer’s” has become a catchall for any syndrome in which progressive cognitive dysfunction is the major manifestation.

However, there are dozens of other dementias including, to name just a few: Multi-Infarct Dementia, Frontotemporal Dementia (FTD), Pick's Disease, Progressive Aphasia, Corticobasal Degeneration, Lewy Body Dementia, Senile Dementia, Binswanger’s Disease, Vascular Dementia, Parkinsonian, etc.

From a caregiver’s point of view, it almost doesn’t matter which dementia is at hand. The perpetual grief and mourning felt by the caregiver will be the same regardless of the specific process affecting his or her loved one.

My special interest is in Multi-Infarct Dementia because that is the one that affected my mother and the one I write about in: “DEMENTIA DIARY: A Care Giver’s Journal.” (Another name for this syndrome is Vascular Dementia.)

I should say that I am not a physician or a professional expert in this disease. I am, by profession, a hospital administrator, so I do feel equipped to at least understand the language of the clinicians. What I know comes from 16 years of watching my mother sink into her opaque world, plus 16 years of discussions with physicians providing her medical care.

Here is the way one physician described Multi-Infarct Dementia to me. It is caused by multiple strokes, some call them mini-strokes. The “victim” of this condition may not be, indeed usually is not, aware that anything out of the ordinary has occurred. Neither are his or her significant others.

Perhaps there is momentary weakness, headache, or dizziness, but nothing major. Over time, however, enough damage is done to the brain that symptoms begin to appear such as: confusion, impaired judgment, aphasia, irritability, depression, mood swings, inertia, significant memory loss, and a host of possible others.

Not all symptoms are experienced by every sufferer, but sooner or later most of them may appear. And the symptoms of Multi-Infarct Dementia are not really all that different from Alzheimer’s or other dementias. I’ve been given to understand that these differences are subtle, hard to tell apart for a layman.

Health care professionals have explained that if one were to line up sufferers of each of the various dementias next to one another you could probably differentiate them—but that’s what it would take.

If you are dealing with a dementia in a loved one, good luck and best wishes in your search for help and understanding.


Anonymous said...

My husband was recently diagnosed with vascular Dementia. He has had small strokes over the years which no one could identify...diagnosing them as all sorts of different problems. He has had test after test over the years with no certain diagnosis. He is 79. I am quite a bit younger with no health problems so I will be able to care for him. The main thing he does lately is accuse me or my son of stealing his Scope mouthwash. He carefully wraps the bottle in a towel and hides it;then forgets where it is. I have read about this and instead of getting mad at him as I used to do, I just tell him we'll find it. It's so hard to go along with the idea that we're stealing his Scope. I bought him a heavy plastic box with a key; he make sure it's locked when we leave, and there's nothing inside. This is all new to me; and I guess this is normal for his problem. Pattilu

Bob Tell said...

I describe similar behavior in my mother in my book, "Dementia Diary." It started when she was the same age as your husband. She also had a vascular dementia. My father was deceased and I'm an only child. So care give responsibilities fell on me. I wrote the book to show folks like you that you are not alone and the behavior problems you face are normal. My heart goes out to you as you are most likely in for a long process. Good luck!

Bob Tell, Author,
Dementia Diary, A Caregivers Journal

Anonymous said...

My father also has vascular dementia (or so the doctors have said). He is in a nursing home as he cannot walk but he is physically healthy with a totally demented mind. Every time myself or my mother visit all he says is 'OK, lets go I have lots of work to do and I can't sit here all day'. We explain for the next five minutes that he is there to be looked after and as soon as we stop talking he says 'OK, lets go I have lots of work to do and I can't sit here all day'. He has the presence of mind to tell us off because we wont take him home to work. He knows who we are and we really cop it when we visit. He seems to have a lot of 'nouse' to give us a piece of his mind but none to comprehend his situation that he is 75 and doesn't work anymore and can't walk and needs care. He used to love watching sport on TV now all he does is play with a piece of cord on his chair. He looks like he could live for 10 years and it will kill my mother watching him like this before it kills him. I am quite 'beside myself'. It is a shame there is not some medication that can clear the mind. Best wishes to all in the same situation. Sandra

Robert Tell said...

Hi Sandra

I can definitely relate to your comments having lived through a similar experience myself. If it's not too self-serving, may I recommend that your mother read "Dementia Diary." Other caregivers tell me that it helps them to relieve some of the stress of caring for a loved one with dementia. Best wishes to you as you try to deal with this difficult situation.