A very fine gentleman I know showed up over time with dementia. His mother, aunt, grandmother, two of three sisters, and a brother have had mental illness near the ends of their lives.
It begins slowly, then progresses in fits and starts. Big strokes and TIAs can be the beginning or the middle of the disease, or not occur at all. Dementia does not follow any pattern except that it doesn't get better. It has one direction. Non-functioning of the mind. The mind becomes like Swiss cheese...not holes but dysfunctions here and there. Putting shoes on the wrong feet. Loud noises and TV mix up brains. Boredom can set in, too! Then a person might follow a caregiver around or try to be a manager of all events around them. Fear can set in big time. Calming words and music help.
Driving may be the first privilege to be taken away. Honor Health has a slick driver test which can eliminate family feuds about the issue. Aphasia often comes with dementia...the inability to voice thoughts and understand what people are saying. Calendar issues, inability to draw a clock, not remembering words, spelling mistakes, inability to balance a checkbook, and tunnel vision are clues. Spatial concepts are lost and people feel unsafe and slow down. The ability to type and write leave. A person may continue to garden, do dishes, cook (but with close oversight), and care for pets.
Stairs, step stools and ladders, curbs, escalators, and elevators become dangers because of balance issues. Dressing is a puzzle. A person might not know where they are at times. Toileting issues arise suddenly. Afternoon sundowner's syndrome can set in. This is when a person with dementia becomes uncomfortable in their own skin. Anxiety sets in and drives the person almost mad at about 4 p.m. It continues until bedtime. Appropriate drugs can help, but then balance can become a problem and falling is an issue. Keeping the body strong and moving is important. It will not, however, cure dementia's progress. Dementia affects every area of a person's life.
No one knows what dementia is and why it progresses steadily. It is not Alzheimer's. It is not buildup of any chemical that we know in the brain. We do know that it is tragic and a challenge to manage a person's life for them when they no longer can carry out life's complex survival tasks. So, bully for caregivers who take on these responsibilities and bring joy and order to people with this affliction. Caregivers are golden and my thanks go out to them. It is not a job to handle alone. Heroes are called for!
~ Frosty Kroening