Dementia Training - Module 1 - Part 6 - Is It Always Dementia?

[Virtual Presenter] This is Part 6 of Module 1. Is It Always Dementia? It’s so important to recognise that the term "dementia" should not be used as a blanket explanation for every change, struggle, or moment of distress that someone may experience. While dementia certainly affects cognition and behaviour, it doesn't erase a person's entire health history. Individuals living with dementia can still face infections, pain, sensory loss, and side effects from medications, issues that can mimic or even worsen the symptoms of dementia. Acknowledging these possibilities reminds us of the vital role that thorough health assessments play. When we don’t take the time to investigate, we risk overlooking treatable conditions that could significantly impact someone’s well being. It's easy to lean on dementia as the explanation for all symptoms, but doing so might mean we miss out on addressing problems that could actually be reversible. As caregivers, it’s essential to approach each situation with compassion and avoid making assumptions. By valuing proper assessments, we can feel more empowered, responsible, and proactive in our roles, ultimately providing the best care possible for those we support. Here are some thoughtful approaches to consider. It’s essential to avoid making assumptions about the reasons behind certain behaviours. If someone you care for is having trouble seeing clearly, remember that the issue might be related to their eyesight rather than dementia. Encouraging them to visit an optometrist can make a significant difference. Additionally, if your loved one is struggling to walk, leg pain or joint problems might be the cause, rather than balance issues associated with dementia. Gently suggesting they see a healthcare professional can help identify the root cause of their struggles. You should also be aware that difficulties with regulating body temperature may stem from treatable illnesses, such as a urinary tract infection or a viral illness like a cold or the flu. Recognising these signs early is crucial,as they can mimic or intensify dementia symptoms but are often reversible when addressed promptly. Acting quickly can empower you to make choices that significantly enhance your loved one’s quality of life. That’s why it’s so important to rule out any physiological concerns before attributing symptoms solely to dementia, ensuring that no treatable condition goes unnoticed. Regular health checks. including vision and hearing tests, dental examinations, and blood tests, can help detect issues early. Knowing that these checks are in place can bring you peace of mind and a sense of control in your caregiving journey. By ensuring that individuals receive the care and support they need, you can truly improve their overall well being and quality of life. If you have established relationships with a general practitioner (G-P---), dentist, and optometrist, consider leaning on them to help schedule routine check ups. They may even offer gentle reminders every six months. At the very least, it’s a good idea to have these necessary health checks completed annually. Your proactive approach can make a world of difference in their care..

[Audio] Caring for someone with dementia can be both challenging and rewarding. Regularly reflecting on key questions about their well-being can help you feel more confident and attentive in your role. Remember, your efforts are meaningful and truly valued as you support your loved one through this journey. Here are some practical questions and tips to guide your thinking: It's essential to stay aware of any changes that may arise. Whether they're sudden or gradual, shifts in behaviour, mood, or abilities can be indicative of underlying issues. By recognising these changes early, you can take proactive steps to address them, helping prevent minor concerns from escalating into larger challenges. Remember, it's always okay to seek support when you notice something feels different. You're not alone in this. It's important to remember that pain is often underreported in people with dementia, as they may find it challenging to communicate their feelings. Even if they can't express their discomfort clearly, it may still affect their mood, behaviour, or actions. Taking a moment to reflect on this can help you respond with empathy, allowing you to be more attuned to their needs and ensure they feel more comfortable and cared for. It's so important to prioritise regular health checks. Reflecting on the timing of the last appointment helps ensure that any treatable conditions, such as infections, sensory loss, or medication side effects, aren't overlooked. Remember, timely assessments can genuinely make a positive difference in a person's well-being and daily life. Taking these steps shows that we care about their health and happiness. By thoughtfully considering these questions, caregivers can ensure that no treatable issues are overlooked. This approach allows us to provide the individual with compassionate, comprehensive care that is truly centred around their unique needs and preferences..

[Audio] Let's take a moment to recognise that, although we're exploring a complex medical condition, we are ultimately talking about a person, a person with unique feelings, dreams, a rich history, a sense of humour, and a vibrant identity. This individual deserves to be seen, understood, and honoured. At the heart of every decision regarding their care is someone who deeply needs love, connection, and dignity. I once heard a beautiful sentiment: "I may not remember their names or faces, but I will remember the emotions they made me feel." This speaks to the essence of our interactions. Allow me to share a story called "The Woman They Still Love." It beautifully illustrates why it's so vital to see the person behind the condition and to empower them in their journey. Claire was 45. A vibrant woman with a laugh that filled rooms and a heart that never ran out of space. She was a full‑time marketing manager, a devoted wife to James, and a mother to two children. Ella, 10, and Noah, 8. Her days were a whirlwind of school runs, client meetings, after‑school activities, and spontaneous kitchen dance parties. She made it all look effortless. James often said she was the glue that held their world together. But something began to shift. It started subtly, with missed appointments, sharp responses over small things, and withdrawal from family dinners. Her laughter faded. Her warm eyes grew distant. The woman who once sang loudly in the car now stared silently out of the window. After months of confusion and worry, they received the diagnosis: frontotemporal dementia. A cruel condition that doesn't just steal memories, it reshapes personality. Claire became withdrawn. Sometimes angry without reason. She struggled to express herself and often seemed lost in her own home. James learned quickly that protecting her dignity was now one of his most important roles. Ella and Noah didn't understand. "Why doesn't Mummy want to play anymore?" "Why did she shout when I asked about school?" James explained gently, "Mum's brain is changing, and it's changing what she can manage. But she still loves you both, more than anything." They sought support, specialists, a local dementia group, and friends who understood. James juggled work, caregiving, and parenting with quiet, determined strength. He cooked, cleaned, helped with homework, and sat beside Claire during her silent spells, holding her hand even when she didn't respond. And yet, there were still moments of connection. A small smile when Noah showed her a drawing. A soft laugh when Ella played her favourite song. A moment when Claire instinctively reached out and smoothed Ella's hair. A whispered "thank you" to James in the dark. They learned to cherish those moments. Weekends became slower, gentler. Walks in the park. Movie nights with cuddles. Baking sessions where Claire watched more than participated, but you could see she enjoyed being there. The children adapted in their own ways. Ella drew pictures to help her mum remember routines. Noah invented a "quiet game" so Claire wouldn't feel overwhelmed. They hugged her often, told her stories, and reminded her of who she was. James missed the woman who teased him about his cooking and danced barefoot in the garden. But he loved the woman she was now, too. Not because she was the same, but because she was still Claire. Still, the mother of his children. Still, the person he vowed to stand beside. Friends and neighbours stepped in, dropping off meals, offering lifts, and sitting with Claire so James could rest. Their support became a lifeline. And every night, as he tucked Ella and Noah into bed, James reminded them: "We're a team. We love Mummy. And we'll walk through this together." Why this story matters It shows that dementia affects everyone around the person, emotionally, practically, and deeply. It shows that resilience is not loud or heroic; it's quiet, steady, and built from love. It shows that patience is not passive; it's an act of care. And above all, it shows that even as dementia changes a person, their identity, their emotions, and their capacity for connection do not disappear; they simply change shape..

[Audio] Delirium and dementia can often be confusing for both patients and their loved ones, as they share symptoms like confusion, memory challenges, and difficulties with concentration. Understandably, distinguishing between the two can be daunting, but careful differentiation is vital for proper care. Recognising the unique features of delirium, such as its rapid onset, fluctuating levels of consciousness, and attentional difficulties, is crucial. In contrast, dementia typically involves a gradual decline in cognitive abilities. Utilising assessment tools can provide much-needed clarity during this challenging time. The Confusion Assessment Method (CAM) is specifically designed to identify delirium, while cognitive testing can assist in diagnosing dementia. Together, these tools can empower clinicians to make informed decisions and help guide both patients and families toward the appropriate path forward. How can we quickly understand whether someone is experiencing a decline in dementia or the onset of delirium? It's essential to recognise that delirium can lead to a sudden and significant change in mental status, which can be pretty distressing. Unlike the gradual progression of dementia, delirium typically develops within hours or days. An acute medical issue, such as an infection, a medication reaction, dehydration, or physical stress, often triggers it. The symptoms can be quite pronounced and may come on unexpectedly, making it crucial to identify this condition promptly. Understanding these differences can help provide the care and support needed during such challenging times. It's important to understand that delirium is treatable, and with timely intervention, many individuals can make a full recovery. This fact can be comforting to both patients and their families, underscoring the importance of acting quickly. When the underlying cause of delirium is identified and addressed, individuals often return to their usual level of functioning. That's why it's vital to seek medical help as soon as there are signs of delirium. For clinicians, keeping delirium in mind when assessing sudden cognitive changes is essential. By doing so, they can provide the support and care that patients need during such a challenging time. Dementia is a chronic and progressive condition that affects many individuals and their families. It develops gradually over months or even years, leading to a steady decline in cognitive abilities that can profoundly impact daily life and the sense of independence. It's important to remember that symptoms of dementia tend to emerge slowly and persistently, which can be challenging for both the individual experiencing these changes and their loved ones. However, it's crucial not to rush to conclusions about cognitive changes. Sudden confusion can often stem from other causes, such as delirium, which may be reversible. Misdiagnosing delirium as dementia can mean missing out on valuable opportunities for recovery and support. This is why having an accurate diagnosis is so vital. If there's any uncertainty, seeking medical advice is a key step. Tests, like urine and blood assessments, can help identify other potential causes and ensure that individuals receive the appropriate treatment and care they deserve. In summary, while delirium and dementia may share some outward symptoms, they are distinct conditions with different causes and management strategies. By recognising these differences and seeking guidance when in doubt, we can ensure that individuals and their families receive the compassionate care they truly need. Next, we'll explore these critical points through the story: "The Shift in the Garden Room.".

[Audio] The Shift in the Garden Room A story about love, illness, and attentive care. The soft morning light filtered through the garden room as Margaret sat beside her husband, Harold. His gaze drifted somewhere beyond the hydrangeas they had planted together years ago. His dementia had always been a slow tide, gentle lapses, occasional confusion, moments of clarity. But over the past two days, something had changed. He was restless, barely sleeping, and now barely speaking. He kept trying to stand, then forgetting why. His eyes, once warm with recognition, seemed clouded in a way Margaret hadn't seen before. Clutching a cup of untouched tea, she whispered, "Is this the dementia worsening… or something else?" Trusting her instincts, Margaret called Nurse Anna, a calm presence with keen clinical intuition. Anna knelt beside Harold, speaking softly as she checked his temperature, observed his attention, and asked questions Margaret hadn't thought to ask. "He's not tracking my voice," Anna murmured gently. "His attention is patchy, and his temperature's elevated. These are classic signs of delirium." Margaret's breath caught. "Delirium?" Anna nodded. "Yes. And his urine test suggests an infection. This isn't the dementia progressing. It's an acute episode, and we can treat it." Relief washed over Margaret, warm and overwhelming. She hadn't been imagining it. Something had shifted, but not in the way she feared. Harold wasn't slipping away faster than expected. He was still there, just temporarily lost in a fog that could be lifted. As antibiotics were started and fluids given, Harold's agitation eased. By late afternoon, he was calmer, his eyes clearer. And by evening, he looked at Margaret and smiled faintly. "Hydrangeas," he murmured. "You planted those." She nodded, gripping his hand. "Yes, love. And you helped me dig the holes." The next morning, Harold reached for his tea, the first time in days, and asked, "Did the birds sing today?" Margaret smiled. "They did. And you asked about them yesterday, too." Anna had returned to check up on Harold, standing nearby. She nodded with quiet satisfaction. "That's the fog lifting." This powerful story gives us a real-life example of how delirium can be confused with symptoms of dementia. In Part 7, we will explore how dementia affects daily activities such as making a cup of coffee..