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Dementia Q&A with Geriatric Specialist Aimee Musgrove, APRN-CNP

Dementia can be a topic that people try to avoid, but learning about dementia’s symptoms and stages can help you and your loved ones prepare and find the right care. Aimee Musgrove, APRN-CNP, at Utica Park Clinic in Bixby answers a few of the big questions regarding dementia, including symptoms, testing, stages and care.

 

What are the first signs/symptoms of dementia?

Misplacing items, though it is not uncommon to misplace items, we are normally able to go back and trace our steps and recall location. People with early memory deficit are unable to retrace their steps. It can also become difficult to complete everyday tasks such as driving and getting disoriented, paying bills in timely manner, grocery shopping/meal planning. You may also notice that those with dementia can forget important dates or occasions, will start avoiding social situations which would require them to interact with other people and start to isolate themselves.

Other signs include trouble with naming familiar objects, difficulty with calculations or problem solving. Impaired decision making and judgement. Some may have behavior disturbances such as anxiety, agitation or depression.

 

Are there tests/screening for dementia? If so, when should one have these done?

First be seen by a primary care provider and have testing completed to rule out delirium and other possible etiologies such as: thyroid abnormality, vitamin B12 deficiency, stroke, brain tumor, Lyme disease, heavy metal exposure, etc.

A primary care provider can order blood tests, screening for cognitive function with tests such as: MMSE (Mini Mental Status Exam), SLUMs, MoCA (Montreal Cognitive Assessment, Geriatric depression screening, GAI (Geriatric Anxiety Inventory), and Mini-Cog. They can supply a referral to a Neuropsychiatrist or Neurologist for neuropsychological testing.

It’s recommended that these tests/screenings are done early at first signs of a cognitive deficit.

 

What are the stages of dementia?

There are 3 main stages of Dementia: Mild (early stage), Moderate (middle stage), Severe (late stage).

There is also a 7 stage model of dementia which breaks down the cognitive decline in more specific detail, and within each stage there is further breakdown in detail, most importantly used in Stage 6 & 7 for evaluation of end-stage dementia.

It is important to remember that Dementia is an umbrella term for multiple different forms of dementia such as: Alzheimer’s, Parkinson’s, Lewey Bodies, Pick’s, Vascular, Frontotemporal, and others. Each form of dementia can present itself in different stages, with different progression of disease, and different behaviors.

 

Are there certain things you should or shouldn’t say to someone with dementia?

• Use short phrases, one instruction at a time, if you need to repeat the instruction use the exact same wording.
• Speak slowly, be patient while they attempt to respond.
• Avoid saying “don’t you remember..”, or “I already told you.”
• Be mindful of your body posture, tone of voice and facial expression.
• Decrease distractions during communications.
• Arguing will typically increase agitation. Stop and revisit the topic in a few minutes.
• Avoid questions which would require decision making too complex. Offer 1-2 choices to make questions less stressful.

 

Can a dementia patient safely live at home?

People with living with dementia can live at home for a varied amount of time. As the disease progresses it is important to have access to resources to help with the increased caregiver demands. Hiring someone to for in-home care is beneficial, respite care to provide the caregiver relief, and Adult Day Care are a few options.

Eventually many people living with dementia require an environment for higher level of care. Assisted livings dedicated to memory support or long term care facilities are options to ensure safety and management of their increased physical/mental needs. Many times caregivers live with significant guilt in making this decision. There is no “right time,” the decision is typically made when the caregiver feels ready or their own personal health/well-being is in jeopardy.

 

 

If you or a loved one has been experiencing symptoms of dementia, make an appointment with a caregiver. Aimee Musgrove specializes in adult and geriatric medicine. To schedule an appointment with her, call 918-574-0150.