Tips to Help You Live Alone With Early-Stage Dementia

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Early-Stage Dementia

An individual in the early stages of dementia may be able to live alone and entirely autonomously for some time, particularly with the help of family and friends. Many individuals with dementia in the early stages can continue carrying out their daily tasks.

However, they may find it more difficult to manage independently as their symptoms worsen. Therefore, it is critical to plan for a future when completing everyday activities will become more challenging.

While worries about their capacity to manage are understandable, individuals might be able to live independently for an extended period with the appropriate assistance and adaptations. Also, adopting new coping mechanisms earlier will give you more time to get used to the changes.

If you or a loved one has recently received a diagnosis of dementia and are concerned about living alone, here are some tips to help you with it. The tips in this article will assist you in managing memory and cognitive changes, planning ahead, and maintaining an active and involved lifestyle.

1. Make Everyday Tasks Easier

  • Organizing your day: Note down events, appointments, and to-do lists in a journal or calendar. Moreover, you can monitor your actions using smartphone or computer applications. You may want to employ a digital clock that shows the date and the day of the week besides the time.
  • Paying bills: You can effortlessly pay your bills on time and accurately without writing checks by setting up automated payments. Several companies and banks provide this service without charging extra. Do not forget to consult a reliable person for assistance with bill payment. After looking over your financial documents, they might ask you about anything unusual.
  • Taking medications: Many products are available to assist with drug management. Try a weekly pillbox, one that vibrates or sounds an alarm to remind you when to take your prescription, or one that has an automated drug dispenser. These products are available online or at pharmacies, but setting them up can require assistance. You might also try using an electronic reminder system, like an alarm that you set on your computer or phone or an app for smartphones.
  • Shopping for meals: Generally, various stores offer grocery delivery services for a nominal cost. You can also order fresh or frozen meals online or over the phone. Meals on Wheels America provides low-cost or free food delivery services to your home, along with the option for a brief safety inspection and visit. Senior facilities and religious communities are additional potential meal suppliers. If you cook for yourself, think about choosing easy-to-prepare foods, like those you can reheat in the microwave.
  • Utilizing transportation: If you drive, you could notice that you’re more likely to get lost, become confused, or need directions more frequently than before. Consult your physician about these changes. Take the concerns of your family and friends about your driving seriously. Some give up driving and become adept at using the bus or carpooling. Volunteers, senior ride services, and neighbors can also assist with transportation.

2. Implement Home Safety Modifications

  • Eliminate unused objects and extra furniture: Now is the moment to get rid of anything you no longer need, including furniture, appliances, clothes, and decorations. Think about distributing goods to loved ones or donating in-good condition goods to a charitable organization. Some organizations will collect goods from your home.
  • Remove anything that may cause you to trip: Look for other items you might trip over, move electrical cords, and tidy up throw rugs. Living alone may become challenging due to injuries and disabilities resulting from falls.
  • Install an automatic shut-off switch on the stove: This switch can help prevent a fire if the stove is mistakenly left on. Have your stove disabled if necessary. Consider heating meals in a microwave or cooking equipment with an automatic shut-off, such as a slow cooker or rice cooker.
  • Enhance bathroom safety: Put non-skid mats in the bathtubs and showers. Don’t forget to add grab bars to the shower or bathtub. Keep a flashlight next to your bed in case you need to use the restroom at night. Install a nightlight in the bathroom or corridor. Set the water heater to 120 °F. In addition to protecting you from burns from boiling tap water, this setting could also help save money!
  • Invest in safety gadgets to notify others in an emergency: Consider personal safety devices such as GPS tracking systems, emergency call buttons, and fall monitors. Consult your physician or social worker about setting up an alert system to inform loved ones if you fall, get sick, or lose your way.
  • Ensure that smoke and carbon monoxide detectors are installed and operational: Install these detectors in or near the kitchen and all bedrooms. Set up reminders for testing the batteries every six months.
  • Seek assistance with organizing and maintaining your home. Ask a family member or hire an expert to assist you with tasks like clutter management and home repairs. Labeling cabinets and drawers will help quickly and easily locate fire extinguishers, flashlights, and other safety supplies.

3. Prepare for the Future

  • Get your legal and financial affairs in order as quickly as possible: Create or amend your durable powers of attorney for financial and health care and your will. Call your attorney if you need legal counsel. Tell someone you trust where you have put the documents or give them a copy.
  • Know the in-home care choices available to you: Friends and family might be able to assist with daily tasks. Consider hiring a personal care assistant or home health care aide if you require more assistance. See how much these services will cost and if your insurance will cover any of them. Check with your insurance providers to learn more about potential benefits.
  • Plan for care when you can no longer live independently: You will probably require more daily assistance and attention at some point. Could a caregiver or family member move in with you? Or perhaps you could live with them? Other possibilities include assisted living facilities, nursing homes, and professional home care.
  • Think about your possibilities if you work: Consider sharing your diagnosis with your employer and discuss your work adjustments. According to the Americans with Disabilities Act, employers employing more than 15 workers should reasonably accommodate individuals with disabilities. It could entail dividing up big tasks, setting reminders, or adjusting your schedule.
  • Learn about possible disability benefits if you can no longer work: Individuals with dementia could be qualified for disability compensation via Social Security, veterans’ benefits, or private disability insurance (if you have previously acquired this). People with diseases such as early-onset Alzheimer’s and various other types of dementia can receive disability benefits claims reviewed quickly thanks to a Social Security program called Compassionate Allowances.

4. Strengthen Your Support System

  • Identify family and friends who can assist: Discuss your diagnosis with them and find out if they can come to see you frequently or serve as a contact in case of emergency. Jot down and store their phone numbers and other contact details somewhere visible, like your wallet, cell phone, or refrigerator door.
  • Consider telling a trusted neighbor about your diagnosis: If someone appears lost or is wandering, neighbors are frequently the first to notice and may be able to assist them.
  • Consult a healthcare provider: Your primary care physician, neurologist, or other specialist can monitor changes in your memory, thinking, and capacity to carry out daily duties. Request a care plan from the doctor and jot down any instructions. Inquire with your doctor about house visits or telemedicine appointments if traveling to the doctor’s office presents challenges. Additionally, the office might be able to suggest geriatric care managers, who assist senior citizens in finding the resources they require, or home health care providers.
  • Discover the resources and assistance available at home and in the community: Social service organizations, neighborhood charities, and Area Agencies on Aging can offer or recommend in-home assistance, transportation, and meals to support you in staying home. Call Eldercare Locator to find out about services available in your region.
  • Stay linked to technology: You can communicate with family and friends via social media, email, and video calls via smartphones, laptops, and tablets. Purchasing things that are simple to operate, like a phone that has dialing pictures, might be a good idea. Start using the technology you want to use as soon as possible so you can become accustomed to it and create a routine.
  • Talk to people who share your situation: Inquire with a social worker or your doctor’s office about local support groups or those run by nonprofits. Numerous Alzheimer’s Disease Research Centers, funded by the National Institute on Aging, provide events and programs for individuals with Alzheimer’s disease or related dementias, as well as their carers. There might be a memory café in your neighborhood where individuals with dementia and those who care for them can interact and engage in activities.

5. Look After Your Physical and Mental Health

  • Exercise: Being physically active does not require you to spend a lot of money or join a gym. Walking around the neighborhood, gardening, and even moderate housework can be beneficial. Experts advise doing strength training exercises like lifting weights and cardio exercises like walking.
  • Eat healthily: Consuming nutritious food promotes good health for all individuals. However, it is especially critical for those with dementia.
  • Get quality sleep: Dementia frequently affects a person’s sleeping habits. However, you can do some things, including sticking to a regular sleep pattern, to get a decent night’s sleep.
  • Be mindful: The mindfulness technique, which entails focusing awareness on the present moment without judgment, is one strategy for managing stress and lowering anxiety.
  • Stay social: You can enhance your quality of life and learn to deal with challenges by making meaningful connections with other people. Organize a support group, have regular conversations with loved ones, or engage in hobbies with your spouse.

References

  1. Tips for Living Alone With Early-Stage Dementia. National Institute on Aging. https://www.nia.nih.gov/health/alzheimers-and-dementia/tips-living-alone-early-stage-dementia. Accessed: 13th May, 2024.
  2. Living Alone With Dementia. Dementia UK. https://www.dementiauk.org/information-and-support/living-with-dementia/living-alone-with-dementia/. Published Online: March, 2024. Accessed: 13th May, 2024.

Frontotemporal Dementia (FTD): Types, Symptoms, and Stages

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Frontotemporal Dementia (FTD)

There are various types of dementia. One of these is frontotemporal dementia, which impacts the brain regions critical for language, behavior, and personality.

Frontotemporal dementia (FTD), also known as frontotemporal degeneration, is a set of conditions characterized by progressive neuron loss in the brain’s frontal (the areas behind your forehead) or temporal (the regions behind your ears) lobes. It causes nerve cell destruction in these brain regions, resulting in loss of function, which can cause deterioration in behavior and personality and trouble producing or comprehending language.

FTD is one of the less prevalent kinds of dementia. In contrast to other forms of dementia, like Alzheimer’s disease and vascular dementia, FTD often affects persons between the ages of 45 and 65. It also tends to be identified earlier in life.

Protein accumulation in the frontal and temporal lobes of the brain leads to FTD. Since these regions of the brain control language and behavior, individuals with FTD frequently exhibit speech and behavior problems.

It is unknown what precisely causes FTD, but one in every eight people who have it has family members who have had it as well [1]. Therefore, experts assume there is a genetic element to it.

Types of Frontotemporal Dementia

There are the following two types of dementia.

Behavioral variant frontotemporal dementia (bvFTD)

It is the most common type of FTD. The symptoms of behavioral variant frontotemporal dementia (bvFTD), also known as behavior variant FTD, are notable behavioral and personality abnormalities that typically impact individuals in their 50s and 60s but can also appear in their 20s or 80s. The loss of nerve cells in the areas controlling behavior, judgment, empathy, and foresight, among other capacities, is particularly noticeable in bvFTD.

Primary progressive aphasia (PPA)

Primary progressive aphasia (PPA) is the second most common type of frontotemporal degeneration, affecting language skills like speaking, writing, and comprehension. PPA typically manifests in midlife, before the age of 65, though it can sometimes happen later in life. The two most distinct types of PPA have slightly different symptoms.

  • In the semantic variant of PPA, the person loses their capacity to understand or articulate words in a spoken sentence.
  • In the nonfluent/agrammatic variant of PPA, the individual’s speaking is hesitant or ungrammatical.

Some patients with FTD have a less frequent variation associated with mobility issues. Symptoms of this condition may resemble those of amyotrophic lateral sclerosis (ALS) or Parkinson’s disease.

Symptoms of Frontotemporal Dementia

FTD symptoms appear gradually and grow steadily, sometimes swiftly. They differ from person to person, depending on the brain regions involved. These are typical signs and symptoms [2]:

  • Behavior and/or dramatic personality changes
  • Socially inappropriate, impulsive, or repetitive behaviors
  • Impaired judgment
  • Apathy
  • Lack of empathy
  • Decreased self-awareness
  • Loss of interest in normal daily activities
  • Emotional withdrawal from others
  • Loss of energy and motivation
  • Inability to use or understand language
  • Hesitation when speaking
  • Less frequent speech
  • Distractibility
  • Trouble planning and organizing
  • Frequent mood changes
  • Agitation
  • Increasing dependence

Some individuals experience physical symptoms such as tremors, muscle spasms or weakness, stiffness, poor coordination or balance, or trouble swallowing. While they are less frequent than behavioral and linguistic alterations, psychiatric symptoms like delusions or hallucinations can also happen.

Diagnosis of Frontotemporal Dementia

An expert evaluation by a specialist experienced with these conditions should diagnose behavioral variant frontotemporal dementia and PPA. The diagnosis is based on the patient’s symptoms and the findings of neurological examinations. Brain scans, such as magnetic resonance imaging (MRI) and glucose positron emission scans, are valuable supplementary testing. However, they must be interpreted alongside the patient’s medical history and neurological exam.

Causes & Risk Factors

About one-third of cases of frontotemporal degeneration are hereditary. Individuals with a family history of frontotemporal degeneration can now seek genetic counseling and testing. A family history of frontotemporal degeneration or a related condition is the only recognized risk factor [3].

Treatment

There are no known therapies for any of the frontotemporal subtypes. Some drugs can help with agitation, irritation, or depression. These treatments help patients enhance their quality of life.

Frontotemporal dementia progressively worsens over time, and the rate of decline varies from person to person. Most patients survive for eight to ten years after diagnosis; however, some people live much longer.

People with FTD often exhibit muscle weakness and coordination issues for many years, leaving them needing a wheelchair. These muscle problems may result in difficulties with chewing, swallowing, moving, and controlling the bladder and bowels. People with FTD eventually die as a result of physical changes that can cause skin, urinary system, or lung infections.

Stages of Frontotemporal Dementia

FTD progresses through seven stages. Not everyone will reach stage seven; some people advance more quickly, while others stay at one stage for years before moving on to the next [1]. The seven core stages of FTD are listed below.

1. Mild Cognitive Changes

Early-stage frontotemporal dementia is very inconspicuous in most cases. Many people and even those close to them do not recognize any specific signs that would raise concerns. Nevertheless, people may exhibit mild cognitive abnormalities such as strange actions or antisocial behavior at this early stage. They may also exhibit speech issues or trouble putting sentences together correctly. While memory problems are uncommon with FTD, they can occur.

Nonetheless, people with early-stage FTD frequently do not link certain behaviors and situations to a neurological disorder. A person’s quality of life is not significantly affected at this point.

2. Changes in Behavior and Sharpness

The second stage of FTD may only show slight changes because it is still relatively early in the disorder’s progression. Like many disorders that impact a person’s behaviors and subtle personality traits, most people are unlikely to attribute it to a health problem. Dementia, in all its forms, might be hard to identify in the early stages because it is normal for people to get forgetful, have trouble with phrases, or stammer when they get older.

However, individuals close to someone with FTD may detect variations in their behavior and general sharpness. For instance, some people occasionally struggle to find the appropriate words to say, while others lack the cognitive ability to change one word for another. If identified early on, these difficulties may be crucial for diagnosing FTD. Unusual or antisocial behavior can also start affecting the person’s social and career life.

3. Language Issues

The symptoms of frontotemporal dementia start to intensify more quickly and become more recognizable in the middle stages of the disease. Individuals with FTD may also develop more significant language variants at this point. It usually begins with forgetting more sophisticated terminology and less often used terms, which can influence the career of individuals who use more advanced language regularly. These symptoms are usually more noticeable to people around the affected individual. The affected person does not usually notice them themselves.

Language difficulties, combined with unusual actions, a lack of inhibition, and social tact, may indicate FTD at this stage. For some people, their home and professional lives start to deteriorate in the early and middle phases of FTD.

4. Implications on Quality of Life

Stage four of FTD causes symptoms that significantly impact the person’s quality of life and the way they interact with others. A person may find it more difficult to recall and utilize basic phrases, such as common terminology and the names of everyday items, as their language impairments worsen. Forgetting simple words is far more visible to other people than forgetting more complicated words.

This is the point at which some FTD patients start to exhibit typical dementia symptoms, like forgetfulness and trouble with daily activities. Although this is not always the case, the combination of memory impairments, behavioral variations, and linguistic difficulties make life exceedingly challenging. It is typical for an individual with FTD to be incapable of identifying and addressing their own problems.

5. Mood Swings and Personality Changes

FTD at stage five is regarded as one of the mid-to-later stages and may more substantially affect an individual’s quality of life. Additionally, as memory impairments can also exacerbate cognitive impairment, including language and problem-solving difficulties, it may start to exhibit a resemblance to typical Alzheimer’s symptoms. That’s why a person with FTD could have trouble doing daily chores and making decisions—particularly ones crucial to their well-being, like healthcare.

The symptoms at this stage might be wide-ranging. A person may generally experience mood swings and personality changes, but they will usually be more severe than the subtle behaviors they previously demonstrated. It can become nearly impossible to carry on conversations and use speech to carry out regular tasks and address problems. Hence, friends or family members are frequently needed to provide help and handle different tasks for patients with late-stage FTD.

Besides cognitive problems, FTD can lead to motor impairment, including stiffness and the inability to use specific body parts. An example is the capacity to swallow and drink fluids. Behavior and memory problems can sometimes lead to people acting strangely and doing things they are unaware of.

6. Memory Deterioration

People with FTD may resemble those suffering from Alzheimer’s dementia when they reach stage six of the illness. There is a prominent impact on behavior and language, and memory loss adds to the acute mental decline. Individuals may exhibit little emotional, physical, or verbal output.

Motor problems, such as imbalance and reflexes, can potentially be a symptom of late-stage frontotemporal dementia. Thus, falls and accidents are common, exacerbated by a decrease in aspiration and strange reactions to everyday situations. It can be difficult for a person with FTD to recover psychologically from a fall injury, which may require them to use wheelchairs and other devices permanently.

A person with late-stage FTD experiences a significant mental and physical decrease in day-to-day functioning. Daily duties, including eating, cleaning, dressing, and moving, often require assistance from another person. Later-stage dementia necessitates continuous care at home or placement in a specialized care facility for this reason.

7. Severe Cognitive Deterioration and Health Decline

Stage seven is the most advanced and final stage of FTD. Living alone is nearly impossible at this time, and patients suffer from severe cognitive deterioration. Since there is no cure for FTD, the person will continue to decline in a variety of ways. While this typically results in a continuous deterioration of the symptoms they have experienced throughout the seven stages of the condition, others may experience additional and more severe symptoms later on. For instance, if a person has always had problems with their speech and movement skills, later stages may now affect their memory and other mental aspects.

FTD by itself is not lethal; however, it can raise the chance of developing a very severe condition at stage seven. Pneumonia, the most frequent cause of death in patients with FTD, is a typical example. Additionally, FTD increases a person’s susceptibility to falls and accidents, which can result in fall-related injuries and fatalities, from which recovery is far more challenging.

References

  1. What are the 7 stages of Frontotemporal Dementia? Dementech Neurosciences. https://dementech.com/2022/11/10/what-are-the-7-stages-of-frontotemporal-dementia/. Published Online: 10th November, 2022. Accessed: 7th May, 2024.
  2. Frontotemporal Dementia. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/dementia/frontotemporal-dementia. Accessed: 7th May, 2024.
  3. Frontotemporal Dementia. Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/frontotemporal-dementia. Accessed: 7th May, 2024.
  4. Understanding the Stages of Frontotemporal Dementia. Healthline. https://www.healthline.com/health/stages-of-frontotemporal-dementia. Published Online: 18th November, 2022. Accessed: 7th May, 2024.

Everything You Should Know About Chronic Traumatic Encephalopathy (CTE)

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Chronic Traumatic Encephalopathy (CTE)

Chronic traumatic encephalopathy (CTE) is a degenerative and fatal brain disorder caused by repeated traumatic brain injuries (TBIs), such as concussions and head blows. It is also linked to the onset of dementia.

This disorder has an impact on how different parts of your brain function, communicate, and work with one another. CTE may have severe effects, depending on the level of damage and the affected parts of the brain.

CTE is well known to affect professional players in contact sports, including boxing, American football, and ice hockey. However, this syndrome can occur in those who have had recurrent head traumas, regardless of whether they play sports or not. Medical professionals also recognize it in veterans of the armed forces who have had several explosion- or blast-related incidents.

Who is affected by chronic traumatic encephalopathy?

A history of repetitive head trauma can cause chronic traumatic encephalopathy in any person. However, CTE does not emerge immediately. For most persons with this disorder, it might take years or decades before symptoms become severe enough to warrant attention.

Individuals who have repeated head injuries over an extended period are more likely to acquire CTE; this is especially true for professional athletes. A large percentage of people who play high school sports do not develop CTE. The typical age of patients with confirmed CTE falls between 42 and 43 years.

People with the highest risk include:

  • Individuals engaged in combat sports and competitions. It especially applies to traditional martial arts like judo, tae kwon do, aikido, boxing, and mixed martial arts (MMA).
  • People who participate in contact sports, such as ice hockey, football, and rugby.
  • People who participate in activities centered around roads and concrete, such as rollerblading, skateboarding, and cycling.
  • Military soldiers who are subjected to blasts and other concussive incidents.

How prevalent is chronic traumatic encephalopathy?

Experts are unsure how common CTE is, partly because there is no way to diagnose it while a person is still alive. Medical professionals may assume someone has it, but an autopsy is the only way to be sure. Also, many other degenerative brain disorders, including Alzheimer’s disease and frontotemporal dementia, have strong similarities and shared symptoms with CTE.

What are the symptoms of chronic traumatic encephalopathy?

The signs and symptoms of CTE typically appear gradually and worsen with time.

Typical signs and symptoms of CTE include:

Other signs that may manifest are:

  • Depression
  • Executive dysfunction
  • Difficulty speaking clearly
  • Tremors and other types of uncontrollable muscle movements (parkinsonism)
  • Balance issues and unsteady walking
  • Coordination loss (ataxia)
  • Increasingly aggressive behavior
  • Self-harming thoughts and actions (including suicidal thoughts and attempts)

What causes chronic traumatic encephalopathy?

CTE is the result of a combination of causes, which include:

  • A history of repeated head traumas: One of the most well-known risk factors for CTE is a history of repetitive head trauma. These impacts don’t necessarily cause someone to lose consciousness or be “knocked out.” Rather, repetitive head impacts have cumulative effects over time. That may result in the development of the condition.
  • Accumulation of fatty proteins in the brain: Another crucial factor in the development of CTE is the tau protein. Protein function depends on their structure. Similar to how a lock requires a key with the proper shape, your cells can only use a protein if it has the right shape. However, if a protein undergoes modifications, it will malfunction and may spread and impact other parts of the brain. Currently, the diagnosis of CTE involves locating a modified type of tau protein in a particular pattern within the brain.

How is chronic traumatic encephalopathy diagnosed?

There is no definitive way to diagnose CTE while an individual is alive. The only way to do so is to analyze brain samples under a microscope, which is only possible during a post-mortem examination.

Although a physician can make a tentative diagnosis of CTE based on your symptoms and a physical and neurological test, they may not be able to confirm the condition before death. In addition, they will go over your past head traumas and suggest particular laboratory and imaging testing. The most commonly used tests do not detect CTE. Instead, they rule out other possibilities. The tests include computed tomography (CT) scans, positron emission tomography (PET) scans, magnetic resonance imaging (MRI) scans, and cerebrospinal fluid (CSF) testing.

How is chronic traumatic encephalopathy treated?

CTE has no known treatment. Various factors, including your medical history, symptoms, and other conditions, may influence the treatments available for some symptoms. Furthermore, there are some practices that you can integrate into your lifestyle to promote overall brain health. Your healthcare professional is the best person to inform you of the treatments.

How can I prevent chronic traumatic encephalopathy?

Reducing the amount of head blows you might experience is the most effective method to lower your risk of CTE. Furthermore, there are easy methods that can lower your likelihood of experiencing a concussion, where impacts to the brain can produce significant symptoms:

  • Play safely: When participating in contact sports like ice hockey or American football, wear the proper protective gear. Helmets and other forms of protective gear can lower the risk of a concussion. Playing carefully and avoiding scenarios where you could experience a dangerous collision or put yourself in danger is also crucial.
  • Avoid playing while injured: If you receive a hit but retain your consciousness, it is easy to ignore it and consider yourself alright. A concussion can happen without unconsciousness, albeit it can be hazardous to take another blow after one has already occurred.
  • Wear your helmet: A helmet is essential for everyone who enjoys sports like skating, rollerblading, cycling, and related activities. They can significantly lower the incidence of concussions.
  • Wear your seatbelt: Nonathletes frequently sustain concussions as a result of traffic accidents. Wearing your seatbelt can lower your risks of getting a concussion or lessen the severity if you already have one.

References

  1. Chronic Traumatic Encephalopathy (CTE). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17686-chronic-traumatic-encephalopathy-cte. Accessed: 30th April, 2024.
  2. Chronic Traumatic Encephalopathy (CTE). Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/chronic-traumatic-encephalopathy. Accessed: 30th April, 2024.