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Navigating the Emotional Landscape of Dementia: Insights and Strategies for Compassionate Care

  • 18 Apr 2024
  • 3 mins

Dementia is a heartbreaking disease that affects millions of people worldwide. According to the World Health Organization, over 55 million people currently live with dementia, with nearly 10 million new cases every year. As dementia progresses, it can profoundly impact a person's behaviour, emotions, and ability to perform daily tasks – and sometimes even feel like we are slowly losing the person we love. Caring for someone with dementia is challenging, but with the proper knowledge and strategies, it does not have to be a distressing process.

We sat down with Dr. Tan Hong Yee, a psychiatrist at Farrer Park Hospital in Singapore, who has extensive experience treating patients with dementia. Dr. Tan explains that from a psychiatric perspective, "Dementia is a neurocognitive disorder characterised by a decline in cognitive function severe enough to interfere with daily functioning. The progression varies depending on the type and individual factors, but it generally follows a pattern of gradual cognitive decline."

In the early stages, individuals often experience mild short-term memory loss and difficulties with word-finding or problem-solving. As the disease progresses, symptoms worsen and significantly impact the person's ability to manage finances, perform household chores, or organise daily activities. Late-stage dementia may involve severe memory loss, loss of independence, personality changes, and round-the-clock care needs.

Famous public figures who have been open about their dementia diagnoses include Ronald Reagan, Margaret Thatcher, and Robin Williams, underscoring that dementia can affect anyone. For caregivers, dealing with psychiatric symptoms and behavioural challenges is often the most difficult aspect. Dr. Tan outlines some of the most common issues:

  • Agitation and aggression, with the patient becoming restless or verbally and/or physically aggressive
  • Psychosis, including hallucinations (seeing or hearing things that aren’t there) and delusions
  • Depression and anxiety, with low mood, tearfulness, lack of motivation, and nervousness
  • Wandering and restlessness, sometimes leading to the person getting lost or disoriented
  • Sleep disturbances like insomnia, daytime sleepiness, or wandering at night
  • Socially inappropriate behaviours like making inappropriate comments

"Managing dementia involves a combination of medication and non-medication interventions aimed at addressing cognitive, behavioural, and emotional symptoms," says Dr. Tan. "The treatment plan will be specific to each individual's presenting symptoms, and caregivers are usually taught strategies to manage behaviours, enhance communication, and provide emotional support."

Some essential tips Dr. Tan shares for dementia caregivers include:

  1. Create a calm, positive environment and avoid overstimulation that may trigger agitation. Use distraction techniques to redirect attention.
  2. Keep communication clear, concise, and simple. As the disease progresses, incorporate visual aids like pictures and gestures to enhance understanding.
  3. Foster autonomy by involving the person in decisions and activities they enjoy and are capable of. Offer choices when possible.
  4. Provide comfort and reassurance during times of confusion or distress through soothing words and actions. Always treat the person with dignity and respect.
  5. Monitor for unmet physical, social, or emotional needs contributing to behavioural issues. Address sources of discomfort or distress.
  6. Prioritise your own mental health as a caregiver. Seek professional support, join caregiver groups, practice self-care, and take breaks as needed to avoid burnout.

While medication may be necessary to manage specific symptoms, Dr. Tan emphasises that drugs cannot reverse or cure the underlying neurodegenerative process of dementia at this time. However, the future of dementia research looks promising. Scientists are investigating biomarkers that could enable early detection of conditions like Alzheimer's disease before significant cognitive decline occurs. Advanced techniques, such as MRI Volumetry, improve diagnostic accuracy, allowing for earlier interventions that may slow disease progression and help maintain mental functions for extended periods.

Researchers are also exploring several potential disease-modifying drugs that target the abnormal protein deposits believed to contribute to neurodegenerative disorders. These treatments are still experimental, with ongoing studies assessing their efficacy and safety. In the future, digital health technologies, including wearable devices, smartphone applications, and remote monitoring systems, are expected to play a pivotal role in the evolution of dementia care. The convergence of technological advancements and medical breakthroughs holds the promise of improved management and enhanced quality of life for patients living with dementia.

For caregivers seeking support, Dr. Tan recommends engaging with local resources such as the Caregiving Welfare Association, Agency for Integrated Care, Lions Befrienders, and Dementia Singapore. These organisations offer a variety of support mechanisms, from day programmes and home personal care services to caregiver support groups, activity centres and educational workshops, all designed to enhance the quality of life for dementia patients and empower caregivers in their caring journey.

Ultimately, while the dementia journey is profoundly challenging, it can also be a time of deepening love and connection. In embracing this profound journey with knowledge and compassion, caregivers can forge a meaningful connection with their loved ones, ensuring that despite the trials of dementia, the bonds of love and support remain unbroken. Remember, you are never alone in this journey – help is within reach.

Contributed by

Dr. Tan Hong Yee
Mind Care Clinic
Farrer Park Hospital