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Understanding Dementia

Dementia is an overall term that describes a range of symptoms associated with a decline in memory or other thinking skills. This decline would be considered severe enough to reduce a person’s ability to perform everyday activities.

Memory Problems

  • Repetitive questions
  • Memory loss that disrupts daily life
  • Challenges in planning or solving problems
  • Confusion with time and place
  • Difficulty completing familiar task and home, at work, or at leisure
  • Decreased or poor judgment
  • Changes in mood or personality
  • Withdrawal from social events
  • Misplacing items more frequently Communication Problems
  • New problems with speaking or writing words
  • Difficulty recalling conversation/names after a few minutes or even seconds

How to respond:

Validation: Show concern for the other person. Listen and agree with their concerns if they are not a danger to themselves or others. Confirm their feelings.

Reassurance:

Be patient and attempt to relate with what the person is trying to say. Reassure the person that you understand their concern. Use comforting words, eye contact and a calm reassuring voice. If you feel it is appropriate use a reassuring touch.

Redirection:

This is probably the most important lesson to learn. Many times people with dementia will fixate on one particular thing and may become agitated. Validate their concern, but at the same time redirect them away from their fixation by suggesting an alternative, perhaps a snack, a walk or music. This will allow you time to take control of the situation.

Money Handling

People with dementia may have trouble understanding their money. They may appear to struggle when trying to pay for items at the checkout counter. A little patience, a smile and compassion will help enormously. Ask if they would like some assistance. Start with giving one step directions. If that doesn’t work, you could offer to physically help them make change.

Checkout Lines

In retail stores, it is important for clerks to be aware not only of a person having trouble with money management but with bagging purchased items. Many people have difficulty with the conveyor belt. Items move faster than they can handle. Some checkout lanes can slow down the conveyor belt. Others find that offering to bag the items for the person is extremely helpful and reduces their stress and confusion. Understanding the needs of the person you are serving is critical.

Speech

Some people with dementia repeat themselves. They may ask the same question over and over again. A little patience and a helping hand to take them to what they are looking for will be valued. Usually the repetitiveness stops once they see the item they want. Sometimes people with dementia try to say something, but it comes out nonsensical. Stammering and stuttering are not always a sign of speech impediment. It can also be a symptom of dementia. At times, you will see fear or frustration in their face and body language. Please be as patient as possible. Remember, a smile and a calm voice can be very reassuring to a person with dementia.

Repetitiveness

This comes in many forms. Another common aspect is physical repetitiveness or doing the same thing over and over again. This may be putting more than one of the same item in their cart, or going back for an item they already have, but don’t realize they have it. A person known to have dementia may purchase unusual amounts of a product. This can be extremely dangerous when it comes to perishable items or hoarding. Calm and clarifying questions may help to assess the situation.

Confusion

Dementia sometimes causes a “catatonic trace.” It may look like daydreaming or like someone is very confused. This can happen when the person with dementia is having a problem focusing on what to do, or where to go. Gentle reassurance in a calm voice will be helpful and appreciated.

Spatial awareness

A person with dementia may reach out for something or be walking toward something and miss, stumble or fall. When this happens, the person is generally scared and confused. Many people mistake a person with spatial issues as being intoxicated. Common spatial issues can occur due to changes in colors, patterns, and lighting. A calm gentle comment and offer of assistance will typically help.

Talking about dementia

Some people with dementia don’t care who knows, and others feel ashamed of having the disease or are in denial themselves. Please keep in mind, it's your approach that matters. Don’t ask someone if they are suffering from dementia, but rather try to keep in mind that dementia is a debilitating disease of the brain, and it is not always age-related. There are people as young as 20 who have dementia. Note: When you recognize dementia for the disability it is, your approach is likely to be more compassionate.

If someone volunteers the information that they have dementia, ask them, “What kind of dementia do you have?” Start a conversation with them. “How long have you had it?” or “How have you managed the disease?” Showing interest in the person may reduce their feeling of being all alone. Dementia can seem like the loneliest disease in the world.

Thank you so much for your understanding. Please remember the person in front of you having these troubled times could someday be you or someone you love.