Reducing the Symptoms of Alzheimer's Disease and Other Dementias by Jackie Pool

Author:Jackie Pool
Language: eng
Format: epub
ISBN: 9781784509927
Publisher: Jessica Kingsley Publishers
Published: 2018-10-02T16:00:00+00:00

Prospective memory

This is the memory for what needs to be done in the future and can range from appointments to remembering to turn off the gas hob. Most of us use a range of trusted methods to hold onto prospective memories, often with the use of simple technology such as an oven timer, a calendar, post-it notes and apps. These same methods can be useful to an individual with dementia, although the use of some of these may rely initially on a new learning pattern in order to use them effectively.

Stages of dementia and levels of ability

All conditions that cause dementia are progressive and will increasingly damage the structure and chemistry of the brain over time. How quickly the symptoms of dementia progress depends on many inter-related factors including physical make-up, emotional resilience and the support available to the person. Viewing dementia as a series of stages can be a useful way to understand the illness, but it is important to realise that this only provides a rough guide to the progress of the condition. The Alzheimer’s Society in the UK describes the progression in three stages: early, middle and later.

They describe the early stages of dementia as being when a person’s symptoms will be noticeable and will affect their day-to-day life. However, someone in the early stages of dementia will be fairly independent and should be able to do most things with a little help, or perhaps a little differently. In the middle stage the person will need more support to help them to manage their day-to-day life. They are likely to become increasingly forgetful, particularly of names, and may sometimes repeat the same question or sentence over and over. They may also fail to recognise people or confuse them with others. At this stage, the person might put themselves or others at risk through their forgetfulness, for example by not lighting the gas on the cooker or forgetting to take medication.

The later stage usually describes someone who is likely to be much frailer and be reliant on others for much of their care. A person in the later stages is likely to experience severe memory loss, problems with communication and daily activities, and greater changes in behaviour and physical problems than in the earlier stages.

Whilst this delineation of dementia can be helpful for determining, for example, the level of care that a person needs, it can also be misleading as individuals can fluctuate in their abilities depending on their physical and emotional health and the physical and emotional environment that they find themselves in. The risk of viewing dementia as a progression of stages is that it creates an expectation of a downward spiral with no opportunity for maintaining abilities for longer.

I developed my PAL Instrument in 1999 with the encouragement and mentorship of Professor Tom Kitwood because I was convinced that a more helpful view of dementia is to identify the ability level of each individual. With that viewpoint, we are likely to enable rather than disable the person as we understand the physical and social environment required to sustain those abilities.

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