When Memories No Longer Exist: Understanding Dementia
Can you imagine the day when you can’t recall what you’ve had for lunch or words and alphabets don’t seem to make sense to you anymore? This was what happened to Madam Fatimah’s mother-in-law. Madam Fatimah first started noticing changes in her mother-in-law’s behaviour and decide to do a basic assessment. Despite her 20 years of experience as a nurse, nothing could have prepared her for the journey of caring for a loved one with dementia.
Through my years of experience as a nurse, I knew that we had to seek help from a doctor when she started exhibiting signs of forgetfulness and she had difficulty completing tasks she used to be able to do. The key to better understand a dementia patient’s current condition is to know which stage of dementia they are at.
The stages of dementia are determined by asking basic questions like:
Who is the Prime Minister of Singapore?
What time is it now?
Where are you currently?
Through the patient’s answers to these questions, you will have a rough understanding of how severe the dementia is.
Usually patients who are in the early to middle stages have trust issues and they do not like caregivers or nurses to touch them. I used to have a patient who has dementia who thinks that I was going to snatch her husband. The types of behaviour displayed has a wide range for dementia patients. We have seen patients who are violent and aggressive or some patients who are silent and unresponsive.
Early Stage: Your loved one will exhibit typical signs of ageing like forgetfulness. However, they are still able to perform basic activities of living (ADLs) – (e.g. bathing, walking, dressing, eating, toileting, transferring). They are still able to socialise and even drive.
There was once my mother forgot where she put her red purse. She started accusing me of stealing her purse with $800 inside. So, I calmly asked her where she last put her purse. She could not give me a concrete answer, so I helped to search for her purse. Turns out, she threw her purse in the bin.
Middle Stage: Patient might only be able to perform 3 out of 6 of the ADLs. They will exhibit behavioural changes like not knowing how to wear their clothes or how to button their shirt/blouse.
When my mother-in-law’s condition deteriorated to the middle stage of her dementia, she was not able to dress herself. And she started defecating in her pants and putting them in her wardrobe. It was extremely tiring and emotionally draining seeing my mother-in-law’s condition deteriorating,
Advance Stage: At the advanced stage, the patient might not be able to do any ADLs and he/she will have to be fully dependent on the caregiver or medical professional.
How to Manage a Dementia Loved One when he/she throws a Tantrum or Acts up:
When your loved one is diagnosed with dementia, it is never going to be easy. There will be a drastic change in both your life and your loved one. Amidst the chaos and turbulence in your loved one’s life, the key is for you (the caregiver) to remain constant and be present for your loved one.
As cliche as it sounds, the main thing is to remain patient. I know it sounds easy, but I have experienced it and we are all human, I know it is not easy to remain patient and forgiving when your loved ones repeat his/her question like the 5th or 6th time. But we always have to remain calm and patient.
When the Little Things in Life Start to Become more Complicated and Repetitive…
My mother had problems remembering when she had lunch, so she will eat her meals twice. Or she had issues remembering to take her medications. Sometimes it can get very frustrating and I really felt angry at her. But I always give myself a minute or two to calm down before engaging a conversation with her again.
For me caring for my mother in law was draining and extremely tiring. Especially when you are stressed out at work, going home was another form of stress for me. I was not able to have a good night’s sleep because she will wake me up in the middle of the night like 2 or 3 am. I had to juggle caring for my kids and my mother-in-law, it was an extremely trying time.
Feeling drained and burnt out is common among caregivers. The key is to not push yourself to the limits. Find time to give yourself a break and accept that you are only human. It is important to care for yourself because your loved one needs you.
I had to give myself an avenue to release my stress. So I attended a caregiver’s stress management workshop. It was designed for caregivers caring for dementia patients. I had the opportunity to learn and better understand what dementia is all about and why is my mother-in-law behaving like this etcetera.
One key thing I learnt from caring for my mother-in-law was not to challenge them but to accept the situation and go with the flow. I always believe that nothing is permanent is this world, so we should not take their words to heart.
We can help
If you need someone to care for your loved one while you run your errands or simply to take a break from your caregiving responsibility simply engage our respite care services. We will be there with you and your loved one on your caregiving journey.
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