FAQ

Dementia is not simply forgetting where you left your keys, being unable to recall someone’s name, or forgetting what you went into a room to retrieve. Occasional incidents like this happen to everyone and at all ages. Dementia is a general term for a decline in mental ability severe enough to interfere with normal activities of daily living, which lasts more than six months, and has not been present since birth. The loss of cognitive abilities caused by dementia leads to impairments in memory, reasoning, planning, and behavior. For a detailed list of signs, see “” in Practical Resources on this website.

No, these changes are not part of normal aging. It is normal for anyone to forget appointments, names or phone numbers and then remember them later. A person with dementia forgets things more often  and may not remember them at all.  A person with dementia will have increasing difficulty with day-to-day tasks. This may include difficulty managing finances, medications, planning meals, and forgetting where they put something with no ability to retrace their steps to find it.

Dementia is an umbrella term for a variety of diseases that cause the brain to no longer function properly. Alzheimer’s disease is the most common of these. The terms “dementia” and “Alzheimer’s” are often used interchangeably.

A diagnosis of dementia must be made by medical professionals.  The evaluation may include a physical exam, mental tests, a neurological exam, and brain imaging.  For further discussion see “” in Practical Resources on this website.

It is important to have a professional diagnosis of dementia:

-To eliminate and/or treat other medical problems–for example, a brain tumor, chemical imbalance, thyroid issues, etc.  Even a urinary tract infection or dehydration in older    people can present similar cognitive symptoms.  Brain aneurisms have also been known to affect memory.

-To enable the patient to make plans for the future, including legal and financial matters and care options.

-To benefit from available treatments.

-To allow the patient to develop a support team of family and health care professionals.

-To enable the person to live the best quality of life possible while they are able to do so.

Ask one or two close friends or family members to help you share with them the issues that you all have noticed.  This way, the person knows it is more than just one individual who is noticing these changes.  Approach the doctor’s visit from the fact that they may not think they need it, but YOU need it.  Ask them:  “What if this is a condition that, if caught early could be treated?  If I didn’t take you to the doctor until it was too late, I would have to live with that for the rest of my life and I know you wouldn’t want that.”   Tell the person they need to be evaluated to eliminate other diseases that–if caught early–can be cured.

It is important that close family and friends know so that they can understand why changes are happening and provide support.  Also, as a believers, if we are to bear one another’s burdens, we must know what those burdens are.  See the suggestions under “Telling Others” in  on this website.

Many experts believe that depression can increase the risk of dementia.  Depression can also be associated with dementia, especially immediately after diagnosis

For those over age 50 there is something called a “risk factor” gene. This gene increases your risk if you inherit it from your parents. According to the National Institute on Aging, however, some who inherit this gene never develop the disease. For that reason, a test for the gene is not recommended.

God can do anything, including divine healing of dementia. For further discussion, see “” in Christian Resources on this website.

Current medications do not cure dementia, but they delay symptoms in some people. They do not slow the progression of the disease and may have adverse side-effects.  Three medications are currently approved in the US by the FDA:

-Donepezil:  Also known as Aricept.

-Galantamine:  Also known as Razadyne.

-Rivastigmine:  Also known as Exelon.

-Memantine:  Also know and Namenda.

There are clinical trials underway for new medications.  To research this, enter “clinical trials for Alzheimer’s” on an Internet search engine.

See “” in Practical Resources on this website

Anyone who has memory problems and is able to walk is at risk for wandering because they can become disoriented.  Warning signs are forgetting how to get to familiar places, getting lost in familiar places, or returning from a regular walk later than usual.  Here are some suggestions to help.

-Identify the most likely times that wandering may occur and plan activities with others    during that time.

-In early stages, if the person can still answer a cell phone, make sure they have their phone with them and that it is on when you are in public places.

-Make sure they have an ID card with them.

-Avoid busy places and new environments that are confusing and disorienting.

-Install devices that will sound when a door is opened.  This can be part of a home security system and/or as simple as putting a bell above the door.

-Keep the car keys secured if a person no longer drives.

If a person wanders:

-Begin searching immediately.

-Contact neighbors, friends, and family.

-Call police and provide a recent photograph.

-Sometimes, local TV news stations will air alerts for at risk seniors.

-Check where the person mighty wander:  A favorite restaurant, park, store, etc.

-Enroll the person in Available at

Yes.  Usually, dementia patients function better in the morning and may get confused and agitated in the evening.  This is called “sundowning”.

Meltdowns–also called “sundowning”–occur when a person finds it difficult to cope in a given situation.  Someone with dementia cannot communicate effectively what they are experiencing and/or what the problem is, so agitation results.  This syndrome often occurs late in the day–perhaps because they are tired of struggling all day to perform tasks and/or to be understood by others.  This is why it is advisable to set any business or medical appointments for them early in the day. There may be physical reasons for this condition also, so a medical exam is advisable. A person may be hungry or thirsty and unable to express it, so offer a snack and something to drink.  Remove the person to a calmer environment and/or ask visitors to leave.  Remove stress triggers like noise, bright lights, etc.  Music–especially Christian music–can often calm them.   Sit quietly with them.  Pray for them.  Read to them from the Bible or a favorite book.  If  meltdowns become frequent, there are medications that can help.  Ask your doctor.

It is a decline in cognitive ability that increases the risk of developing dementia.

There is no documented evidence of this.

These include depression, memory impairment, vitamin B12 deficiency, alcohol and drug abuse, low blood sugar, overactive or underactive thyroid, brain tumors, aneurisms and even impaired hearing and vision.  This is why a medical exam is vital.

Short-term memory is affected first by dementia and this often results in a person asking repetitive questions.  Here are some suggestions to help:

-Use memory aids.  Notes may help if the person can read.  Include things like:  “Today is Tuesday.  We have a doctor’s appointment at 2 p.m.  It is hot outside. We are having tacos for dinner”, etc.–whatever subjects their repeated questions tend to focus on to try to make sense of their day.

-Answer the person’s questions, even if you have to respond several times.

-Do not say “You already asked that”–they probably don’t remember and will most likely deny it.

-Try to divert the person to an activity to change their focus.

It takes a lot of patience to deal with repetitive questions.  This is a good point to pray about each day, that God will give you patience in dealing with this as well as other behaviors.

Some tasks a dementia patient will be able to continue to do on their own.  Other tasks you will need to assist them.  Still other tasks that they can no longer do, you will need to do for them.  This can vary depending on the stages of dementia and can change from day-to-day or even hour-to-hour on a “bad day”.    It is important to keep them active.  Examples of things you might request them to do:

-Please take the trash out to the barrel.

-Please put the plates on the table.

-Can you help me find the peanut butter?

When requesting them to do something, always give one instruction at a time, as they may not be able to process multiple instructions.

It takes two people to argue.  Drop the subject.  Let them be right.  Do not try to correct the person unless you are discussing an issue that affects their well being or yours.

Do not address the error unless it is an issue that affects their well-being or yours.  Their perception of truth is altered and it will most likely result in an argument.

In some states, doctors are legally required to submit a diagnosis of dementia to the agency responsible for issuing driver’s licenses.  Retesting is usually required and/or they pull the person’s license.  In cases where this does not occur, have someone objectively observe  the person’s driving ability.   Look at the person’s driving history–i.e., tickets or accidents.  A person may be able to continue during the early stages, but this must constantly be reevaluated.  They should not be driving if they are on medication or show any signs of disorientation.  If necessary, secure the keys and/or the vehicle.

See a doctor to check for possible medical causes such as an infection and other conditions that cause aggression.  Be aware of environments or circumstances that trigger the aggression–i.e., too much stimuli with too many visitors, changes in routine, etc.  Eliminate these.  Medication can be helpful if the person with dementia has hallucinations that are causing aggression.

Yes, it can.  For example, one patient could not have the window air-conditioner running because of the noise.  In another case, windows had to be changed out for dual pane windows because the patient was constantly agitated because of the noise outside.

First, arrange a medical exam with your doctor.  Sometimes there may be issues such as a urine infection, constipation, or other conditions causing the problem.  Be sure the person knows where the toilet is in any environment–i.e., at church, in a restaurant, in another person’s home, etc.  In later stages of dementia, you may need to have a large sign on the door of the home bathroom with a picture of a toilet on it.  Leave the bathroom door open.  Place florescent tape along the floor to show the way to the bathroom so they can find it at night.  It is better for people with incontinence and dementia to have pull-up pants with elastic waistlines to enable independence. You can also purchase covers for the bed and chairs which are washable.  You may need to remind the person frequently to go to the toilet.

See the article on “” in Practical Resources on this website.

Talk to your doctor about the type of care the person needs at any given stage of dementia.   Create a list of care needs and that will help determine the type of care required. Some in-home services provide non-medical help–such as assistance with bathing, dressing, preparing meals, shopping, errands, housekeeping, etc. In-home skilled nursing care is also offered by licensed health professionals.  If you live in the US, contact Medicare online and use their home health care comparisons.  Search “Community Resource Finder” in your area and or “Eldercare Locator Online Tool”.  Ask your doctor, friends, family, and social workers for recommendations.  Contact the local Alzheimer’s association for referrals.  Here are some important questions to ask a hoe health care provider:

-Are you trained in dementia care?

-Have you had experience in dementia care?

-Are you bonded? (This protects clients from potential losses caused by an employee.)

-Do you know first aid and CPR?

-Do you or your agency have back-up caregivers if you are sick or absent for any reason?

-Do you have references for you and/or your agency?

-What days and hours are you available?

-What is the cost?  (Costs for home care services vary depending on the services provided and whether the care is covered by medical insurance or social programs–like Medicare in the US.  The costs also depend on where you live.)

Keep a regular routine–going to bed the same time at night and getting up at the same time each day.  Discourage lengthy day-time naps.  Keep the person occupied by doing tasks which they can do such as helping with housework, walks, exercise, social activities, watching a movie, spending time with friends and family.  Spending time in natural sunlight, especially in the morning, is said to balance sleep patterns.  Avoid caffeinated drinks after 2 p.m.  As bedtime approaches, keep surroundings quiet and calm–no stimulating media or activities.

“Dementia fatigue” is a term used to describe the decreased energy level that is common in  Alzheimer’s.   Low energy can be caused by depression, sleep problems, medication side effects, poor nutrition, or hypothyroidism which is caused by an under active Thyroid.  The patient should be evaluated by a physician to determine the cause of their extreme tiredness and appropriate measures taken.  Even if none of these factors are relevant, however, dementia makes people tired because they must work really hard to do things that others without dementia do quite easily.  They must constantly try to make sense of the world and function in it.  They are tired because their brain is tired.

Often, in late stage dementia, a person will ask where someone is, even though that person may have been dead for years.  They might also say that the person came to see them.  Do not try to convince them that the person is dead. They may not believe you and/or each time you tell them this it causes new grief because they can’t remember that the person died.  Answer truthfully, but without unnecessary details. For example, if someone asks “Why didn’t Sally come today?”, answer:   “Sally was unable to be here today.”   A true statement, but one that will not cause fresh grief.  Then divert their attention to something else, i.e. “Let’s take a walk outside.”

In some idolatrous societies, dementia–as well as other illnesses–is believed to be the work of demons and the afflicted are thought to be demon-possessed.  Although it is true that  sickness entered the world through mankind’s sin, all sickness is not caused by a person’s personal sin nor is it the work of demons.  Dementia is a recognized medical condition that affects the brain.

Establish a personal hygiene routine for mornings and evenings.  Use a checklist if the person can still read. Lay out towels, soap, shampoo and other needed personal care items so that they are easily accessible.  Lay out clean clothes.  Ask if the person needs assistance and provide it as requested.

If a person is having difficulty selecting clothes appropriate for the season or event, put out  two outfits from which they can choose.  If they are having difficulty closing zippers or buttons,  obtain pants, shorts, or skirts with elastic waistbands.  Use shoes that have Velcro fasteners instead of shoe laces or buckles.

See suggestions under “” in Christian Resources on this website.

At present, there is not enough known about the disease to advocate preventative measures.

The trigger for the characteristic changes that occur in the brains of people with dementia is not known.  Although there are no specific measures recommended, a healthy lifestyle is important at any age and especially as one ages:  A nutritious diet, staying physically, mentally, and socially active. There is increasing research that suggests that having a healthy lifestyle helps to reduce an individual’s risk.

Dementia does not necessarily shorten life expectancy if other risk factors are controlled. It is  usually other health issues or accidents that will cause death.

Yes, some do, depending on which area of the brain is affected and the stage of dementia.  Eliminate stairs, throw rugs, and keep hallways and passage ways clear.

Yes.  Exercise keeps the heart healthy, improves mood and sleep patterns, and increase strength and endurance.  It can help with balance and make the brain work better also.  The type of exercise that is right for the person depends on how the disease has affected them.

There is no evidence that either one cures or slows the progression and there is some evidence that side effects of ginkgo biloba can be harmful

Since this is a Christian website, our first line of defense is our faith.  Immerse yourself in the Word. Pray about every situation.  Form a prayer support group to pray with you.  Here are some other practical suggestions:

-Educate yourself about dementia and its progression so that you will not be shocked when certain problems occur or behaviors arise.

-Join or form a Christian caregiver group.  (Information on how to do this is provided on this website).

-Be realistic:  You cannot do everything perfectly all the time, but through Christ, you can do what needs to be done.

-Take time for yourself.  Get respite care.  Stay in touch with family and friends.  Exercise.  Do things you enjoy.

-Ask others to help:  Family, friends, or a professional caregiver.

-Forgive yourself. There will be times when you respond wrong and/or lose patience. Ask God for forgiveness, then move on.  Today is a new day!