Aged to Perfection

Humans are wired to be busy, to be productive, to be doing something.  Even when we are intentionally taking a break, we have to consciously remind ourselves to relax and not default to our busy-mode. 

This drive and desire to be productive is deeply ingrained, and for people who have heeded the productivity call their entire lives, it is a well-worn feedback loop. They feel the need to be productive, so they remain constantly busy, and the fruits of their labour are the visible reward for being constantly busy.

What happens when dementia interrupts that feedback loop?

When someone’s dementia has progressed, he has a harder time remembering how to do activities he did his entire life.  George, a gentleman who enjoyed woodworking and fixing things around the house may no longer understand how to use his tools.  He gets started on a task, and partway through forgets what he was doing, leaving a wake of unfinished projects behind him.

His desire to continually work on things around the house does not go away.  His drive for productivity and doing something meaningful and important will far outlast his ability to operate his tools. George was never one to sit and relax, instead, he was always working away on something, and that desire can carry on even as his dementia progresses.

The fact that George can no longer successfully fix broken household items will not prevent him from trying to do so. In fact, he may be inclined to ‘fix’ items that he is certain are ‘broken’ because he’s now having trouble operating household appliances.  Frustrated relatives might try to insist “just sit down and relax!” but since that was never in George’s nature, it’s unlikely he’ll be settled for long. George’s brain is sending him the signal to be productive. He has a strong sense that he should be doing something, he’s just not sure what that something is.

When George cannot easily find a task that meets his need to be productive, he will create one. Dementia has interfered with his ability to follow through with all the tasks he previously did. If the signals in his brain are scrambled, the output of his activities may also be scrambled.  He is trying his best to ‘fix’ the ‘broken’ wastebasket and has dumped its entire contents on the floor.  To an exhausted family member, this is just one more dementia behaviour that doesn’t make any sense and has now created a mess to be cleaned up.

What George needs are activities that he can manage.  Dementia has impacted his ability to do the same activities in the same way he did them 20 years ago, but it has not taken away his ability to do all activities. What George needs is someone who can customize familiar activities to match his current ability level. He needs someone else to break down an activity into individual tasks, and do only one small task at a time. George is still capable of doing many things. He needs direction and he needs cueing to successfully manage a sequence of complex activities.

George is bored. And when he is bored, his brain will create an activity to do. Even if the activity doesn’t make sense to someone else’s brain, even if the activity creates a mess or breaks something, or causes a disturbance, his brain is desperate for activity and stimulation. In the lack of meaningful stimulation, the brain will create its own entertainment.

The underlying cause of many so-called dementia behaviours is boredom.

When someone with dementia is occupied with meaningful activities that create a sense of purpose and productivity, their ‘behaviours’ are often drastically reduced. Their need to be productive is met and they feel satisfied.

Providing meaningful activities for someone with dementia is one of the most effective ways to reduce undesired behaviours.  It does not require medication changes and has no side effects.  However, it can be incredibly time-consuming and does require an enormous amount of patience.  Time and patience are two things that family caregivers often have in short supply—they’ve used up both!

Professional caregivers can fill the gap. Professional caregivers can take the abundant time and patience required to keep people like George engaged in meaningful activities. Caregivers help clients with dementia to connect to their passions and interests by making activities accessible.  Caregivers modify activities to match their client’s ability level—that might be fluctuating by the day or by the hour—to ensure that activities are never too difficult or too easy and boring.  

When people are enjoying hobbies that they love, and they are not frustrated or bored, their so-called behaviours are drastically reduced.  What passions might we re-inspire in your loved one, to spark their desire for meaningful engagement and productivity? 

Dementia is an umbrella term for various conditions that affect cognitive functioning, while Alzheimer’s disease (AD) is one specific type of dementia. In fact, Alzheimer’s is the most common form of dementia, accounting for 70-80% of all cases.

What Exactly is Alzheimer’s Disease?

Alzheimer’s disease is characterized by the development of plaques and tangles in the brain, which gradually interfere with brain function. Excess protein plaques accumulate, disrupting the function of healthy brain cells and leading to their shrinkage. These physiological changes impact different parts of the brain over time, resulting in various symptoms. AD is a progressive condition that evolves over several years through multiple stages.

The Most Distinctive Symptoms:

Short-Term Memory Loss

Short-term memory loss is often the earliest and most recognizable symptom of Alzheimer’s disease. Someone with AD may struggle to recall recent information, but their long-term memory often remains intact for a longer period. For instance, they might not remember if they had breakfast this morning, yet recall their childhood with vivid clarity.

Short term memory is critical for the development of longer term memories. Since AD impairs short term memory, it is very difficult of someone with AD to learn new information and encode it into their long term memory for recall. Learning new information becomes increasingly challenging as AD progresses.

As AD progresses, the symptoms also progress beyond short term memory loss and begin affecting other forms of memory and cognitive functioning as well. 

Memory loss manifests in various ways, and some common examples include:

• Forgetting recent events
• Asking the same questions repeatedly
• Repeating the same conversation within a short timeframe
• Not recalling names or relationships of family members
• Misplacing or losing familiar items
• Over time, memory loss typically progresses from recent memories to older ones.

Thinking & Reasoning

Alzheimer’s disease affects reasoning ability, making it harder to make decisions and follow logical thought processes. Abstract concepts, including numbers, become more difficult to grasp, which can impact financial management and tasks like balancing a chequebook. Concentration and multitasking become increasingly challenging, and detailed conversations may feel overwhelming and hard to follow.

Impact on Emotions and Mood

Alzheimer’s affects emotions and mood in two primary ways. First, physical changes to the brain can alter the regions responsible for mood regulation, leading to new emotional responses that may differ from the person’s previous personality. Second, someone with AD may experience emotional reactions to the changes in their cognitive abilities. This can manifest as apathy, withdrawal, or, conversely, heightened emotional expression.

Changes in Behavior

The changes in thinking and reasoning due to Alzheimer’s often lead to altered behaviour. If someone feels confused or frightened by their surroundings, they may react protectively, which could appear aggressive. Similarly, if they don’t understand that meals are being provided, they might start hoarding food. Understanding the perspective of a person with Alzheimer’s can help make sense of these behaviours.

Common behavioral changes include:

• Hiding valuables
• Hoarding food
• Pacing or wandering
• Strong reactions that seem out of character
• Restlessness

Physical Mobility Declines

In the later stages of Alzheimer’s, physical abilities are often affected. Gait and balance may become impaired, increasing the risk of falls. Coordination issues can make tasks like dressing difficult, and assistance with activities of daily living such as transferring, toileting, showering, and eating may become necessary.

Success Tips for Supporting Someone with Alzheimer’s Disease

Patience is Key: In the early stages, be prepared to repeat information. The person may not remember asking the same question multiple times, so answer each time as though it’s the first. For them, it truly feels like the first time they’re asking.

Understand Their Perspective: As reasoning and logic deteriorate, detailed explanations may overwhelm the person with AD. Instead, try to understand what they are perceiving and match their perspective.

Professional Caregiving Support: One of the best ways to support someone with Alzheimer’s is to enlist the help of trained professionals. At Warm Embrace, our caregivers are skilled in advanced dementia care and can provide the compassionate support needed at every stage of Alzheimer’s disease. Let us be there for your loved one on their journey with Alzheimer’s.