Dementia is an umbrella term describing several diseases. Just as there are several kinds of pneumonia, there are a number of different types of dementia.
Alzheimer’s, the most common, accounts for approximately 65% of dementias, and is caused by abnormal proteins (no one knows why they are formed); Vascular type (about 15%), is from strokes (often a series of TIA’s, or mini-strokes); Lewy-Body type (about 15%) produces vivid hallucinations and body stiffness (similar to Parkinson’s); and then several others (Frontal-temporal Dementia, Alcoholism, Parkinson’s ) make up the remainder.
The dementia is caused by damaged brain cells (neurons), leading to progressive memory loss, which in turn naturally results in confusion, which subsequently changes a person’s personality and behavior. Taken together, these changes interfere with social and occupational life, and in the end, can leave the family with someone completely dependent for all their care.
Unfortunately, there is no cure for any dementia; all are progressive and fatal. The average life expectancy for Alzheimer’s is less than five years, although some people may live 12-15 years.
Many consider dementia to be worse than cancer because it robs the family of a personality they knew and loved so well. Families and caregivers have to remember that this is not the same person: the troublesome behaviors they try to manage are caused by a disease which has created an often completely “new” man or woman. Because of that, it’s important to diagnose early so patients can make an Advance Directive that reflects their goals so that they, and their families, may live more comfortably—and avoid unnecessary suffering and loss of dignity.
An excellent article describing dementia and the difficult decisions it may require, was written by Katy Butler in the NY Times June 20/10—My Father’s Broken Heart: how putting in a pacemaker wrecked by family’s life. [read it on-line at the NY Times archives, or find the link on my website comfortcarechoices.com].
Next time: what are reasonable goals of treatment for other problems if someone has dementia.