Dementia is defined as a decline in cognitive functioning which is serious enough to interfere with daily life. The term dementia covers a number of symptoms accompanying certain diseases or disorders, resulting in deterioration of intellectual functioning, for example in memory, perception and routine. There are many different causes of dementia and they vary in progression and complexity.
This definition categorises dementia as a syndrome that is not one particular type of condition but a variety of conditions with similar or common features. The word ‘dementia’ alone cannot describe the whole story; a more precise diagnosis is required to inform practice and instigate timely and appropriate care. Some of the most common causes of dementia are described below:
As there are several different causes of dementia, symptoms can vary from person to person, and could be affected by lifestyle, personality, history, co-morbidity, quality of life, relationships and health. Some of the more common symptoms include:
A range of tests and procedures can be used to diagnose dementia, which includes the following:
Questionnaires are often used to help test the mental abilities of the person with symptoms of dementia to understand how severe they are.
These tests may look at:
Blood tests for dementia
A person with suspected dementia may have blood tests to check their overall level of health and to rule out other conditions that may be responsible for their symptoms, such as thyroid hormones and vitamin B12 levels.
Dementia brain scans
Brain scans are usually used for diagnosing dementia. They are needed to check for evidence of other possible problems that could explain a person’s symptoms, such as a major stroke or a brain tumour. Several types of brain scans can be used to help diagnose dementia.
Treatment options for Alzheimer’s disease are medication based on the ‘cholinergic hypotheses’ which maintains that as a result of underlying pathological processes, neurons that use acetylcholine, critical to memory and learning are affected. Recent advances have seen the production and prescribed use of acetylcholinesterase inhibitors. These drugs increase the amount of neurotransmitter available by inhibiting the action of the enzyme responsible for its deterioration.
Examining the psychosocial approach to dementia reminds us that a person with dementia is no less a person than anyone else and efforts should be made to maintain and improve quality of life by respecting and preserving the individual’s personhood. To develop this further means that we take the perspective of how the person with dementia views their life rather than our perspective of how they should lead their life. As Kitwood argued the ‘dementia’ is not the problem; the problem is ‘our’ (individual, carer, professional, society) inability to accommodate ‘their’ view of the world (Kitwood 1997).
At the heart of Kitwood’s (1997) conception of person-centred care is ‘personhood’:
‘Personhood: it is a standing or status that is bestowed upon one human being, by others, in the context of relationships and social being. It implies recognition, respect and trust.’