The Many Losses of Alzheimer’s

Chantel Bishop RN

Sharing the Knowledge in Hospice Palliative Care

October 22nd, 2011

A little bit about myself

What I hope you will learn from today’s presentation……

• An understanding of dementia and how it affects brain function.

• The “Silent Epidemic” it is

• The particular losses individuals and their families experience with dementia

What is Dementia?

• Umbrella term – decline in multiple cognitive functions

• Usually gradual onset but progressive

• Generally not reversible

• Causes damage to different areas of the brain

Types of Dementia

• Over 70 different types

• Alzheimer’s Disease most common

The Silent EpidemicCanadian numbers....

• ~ 500 000 have Alzheimer’s or other dementia (ADOD)

• 70 000 < 65 living with dementia

• 1 in 11 > 65 have ADOD

• 2008 – 103 700 new cases of dementia (1 new case every 5 minutes).

• 2038 – projected to be 257 800 (1 new case every 2 minutes)

Rising Tide: The Impact of Dementia on Canadian Society

Alzheimer’s & The Brain

The 7 A’s of Dementia

– Useful tool to categorize and explain losses of dementia.

– How dementia affects the brain

– Each A will represent damage to a particular area of the brain

– Not likely to experience all of them

#1 - Anosognosia

• No knowledge of illness or disease

• Lives in present but with past memories.

• Lack of insight.• Often behaviour and

safety concerns.

#2 - Amnesia

• Loss of memory

• Short and long term

• Memory loss is in reverse order – like peeling an onion

• Their reality is not ours.

#3 - Aphasia

• Loss of language

• Expressive aphasiao Unable to express self

• Receptive Aphasiao Understanding of what is

said

• Non-verbal communication usually very much intact.

#4 - Agnosia

• Loss of Recognitiono people, objects,

sounds

• Perceived but not recognized – disconnect between senses and memory

• Can lead to altered behaviors and interactions.

#5 – Apraxia

• Loss of purposeful movement – even though physically able and desire to do so.

• Results from impaired motor planning and sequencing.

#6 - Altered Perception

• Altered depth perception

• Visual distortions.

• Altered tactile perception.

#7 - Apathy

• Loss of initiation.

• Often interpreted as a sign of depression

• Involves frontal lobes and limbic system.

Other common losses

• Having to retire from work

• Managing finances

• Transition from independent living to care

• And one of the most difficult losses – driving!

Driving

Family and loved ones

• They experience loss too.

• While the loved one is still alive.

• Physically present but not psychologically.

• Loss of shared history, sense of humor, ability to communicate, role within the family.

In summary.............

• Dementia is a chronic, progressive disease; with no cure.

• Individuals and their families suffer multiple losses throughout the course of the disease.

• Think about ways you can help someone living with dementia.