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Judson Haims: Caregiving through stages of dementia


There are many types of dementia — Alzheimer’s disease is just one. While it is common to hear people use Alzheimer’s as a general term for dementia, like using “Kleenex” in lieu of tissue, not all types of dementia are Alzheimer’s.

Dementia is not a specific disease. Rather, it is a group of symptoms that most often occur together. Dementia is a rather general term for the impaired ability to remember, make decisions and reason such that it interferes with a person’s daily life and activities.

There are many types and causes of dementia. While Alzheimer’s disease is the most common type, there are others. Parkinson’s disease dementia (PDD), Lewy body dementia (LBD), and vascular dementia are a few of the most common types.

Causes of Alzheimer’s dementia are often due to an abnormal buildup of two proteins called amyloid and tau. Deposits of amyloid cause clumps to build into plaque deposits between neurons and deposits of tau form “tangles” within brain cells — both proteins cause brain degeneration.

The cause of Parkinson’s disease dementia is unknown. However, scientists believe that it may be due to an abnormal clumping together of a protein called alpha synuclein. While alpha synuclein occurs normally in the brain, scientist do not yet understand what causes it to build up in large amounts. As more and more of this protein clump together, nerve cells die and affect functions such as memory and thinking.

Lewy body dementia is a type of progressive dementia very similar to Parkinson’s disease dementia. Like PDD, alpha-synuclein protein deposits are believed to greatly influence this disease. Deposits of alpha-synuclein protein affect chemicals in the brain called neurotransmitters that act as messengers between brain cells. As these neurotransmitters decrease, memory, learning, behavior, cognition, movement, motivation, sleep and mood are greatly affected.

Vascular dementia is a decline in thinking skills caused by an interruption or blockage of blood supply to the brain. When blood supply is impeded for a few seconds, the brain cannot get oxygen and cells can die, causing permanent damage to one’s memory, thinking and reasoning.

All of these dementia types will at one time cause behavioral changes.

Learning about the various behavioral changes associated with these diseases will help provide perspective, understanding and context. For the most part, people who have dementia will at some point behave in ways that may be vastly different from how they have acted in the past. Frequently, these new behavior types are expressively reactive; however, they may be passive, as well.

Reactive behaviors are behaviors that depend on external events that are outside of one’s influence or control. A good or bad day depends completely on what happens around someone. They often present when someone is agitated and protests (sometimes with violence), cries and/or laughs uncontrollably, or falsely accuses someone as a result of something said in conversation.

Passive behaviors are when a person hoards objects, keeping feelings to themselves, hide feelings from others, acts with suspicion, paces the floor, or acts paranoid. Often people with passive behaviors appear quiet and sometimes nonchalant giving up their own rights and (directly or indirectly) defer to the rights of another person.

These behavior changes frequently interfere with relationships and cause difficulties. Here are some suggestions I hope may help:

Do not take their behavior personally: What often drives someone’s difficult behavior is that they perceive an obstacle to what they want.

Separate the person from the behavior: Look beyond the behaviors and ask yourself what’s triggering that behavior. Someone’s behavior does not always define them as a person. Find out what their intentions are.

Provide an alternative behavior: “I want to listen to your concerns, but I need you to stop yelling.” Try explaining how you perceive the behavior and why a different behavior may be beneficial.

Those who care for someone with dementia should understand that they cannot change the disease and the resulting behaviors, but they can learn to cope with them. Understanding that changes in the brain are causing challenges to one’s ability to make sense of the world around them is important.

Here are two great websites I often refer people to learn more about managing changes in dementia: the National Institute on Aging’s managing Alzheimer’s changes and the Alzheimer’s Association page on stages and behaviors.

Judson Haims is the owner of Visiting Angels Home Care in Aspen, Basalt, and Carbondale. He is an advocate for our elderly and is available to answer questions. His contact information is http://www.visitingangels.com/comtns or 970-328-5526.

Guest commentary: Domestic Violence Awareness Month aims to shine light on pervasive problem

SEEKING HELP

If you or someone you know is struggling with domestic violence or sexual abuse call Response’s confidential crisis assistance hotline: 970.925.SAFE (7233) for an immediate response for victims any day of the week, at any hour of the day. Go to responsehelps.org for more information.

Domestic violence thrives in silence. In order to support and help victims and survivors, and to prevent domestic violence in the future, we need to end this silence and bring the topic into the light. And, in order to talk honestly about domestic violence, we need to fully understand what it is.

Domestic violence is a pervasive, life-threatening crime that affects millions of individuals across the United States.

It is a preventable and widespread public health problem that cuts across race, age, income, sexual orientation, education level, religion and gender, in terms of both victims and perpetrators.

It is a pattern of coercive, controlling behavior that can include not only physical abuse, but also emotional, psychological, sexual or financial abuse. Some abusers are able to exert complete control over their victim’s every action using mere threats of violence or none at all. All types of abuse are devastating to victims.

Abusive partners make it very difficult for victims to escape relationships. Sadly, many survivors suffer from abuse for decades without seeking help. It is important for survivors to know that the abuse is not their fault and that they are not alone. Help is available from organizations like Response here in the Roaring Fork Valley.

Every October, we draw attention to this issue through Domestic Violence Awareness Month. This year’s theme is #Every1KnowsSome1 to underscore the fact that domestic violence can happen to anyone and is so much more prevalent than most people realize.

Statistically, one in three women will experience domestic violence in their lifetime, and our valley is no exception. Our advocates at Response served 150 survivors of domestic and sexual abuse in the upper Roaring Fork Valley last year. So far in 2021, we have already helped 145 more survivors. We typically receive between 250 and 300 calls to our 24-hour crisis helpline each year, and that number is rising.

The pandemic has been especially hard on survivors who have been forced further into isolation and have faced both increased abuse and more difficulty reaching out for help.

High-profile cases of domestic violence attract local and national headlines, yet thousands more people experience domestic abuse behind closed doors every day. Individual instances of domestic violence capture public attention, particularly when they involve a celebrity or a fatality, and attention is often greater for white victims than for others. However, this coverage rarely focuses on the ubiquity of intimate partner abuse, the power dynamics driving it, and the harmful stereotypes about who victims are, how they behave, and the best ways to help them.

Dangerous stereotypes about domestic violence persist and are partly why the public and law enforcement need better education on the dynamics of abuse. Harmful myths about domestic violence include the assumption that it’s easy for victims to leave, that help is always available when sought, and that abusers are easy to spot.

The only way that we can end the crisis of domestic abuse nationally and at home is to keep shining a light on it, no matter where it happens, how it happens or to whom.

Response is available to support any victim who seeks our help. Our services are entirely confidential, bilingual and completely free thanks to our donors. We are also committed to educating the next generation about these issues and provide programming on healthy relationships and consent in middle and high schools from Basalt to Aspen.

We hope that you will join us in working toward a community free of domestic and sexual abuse.

Shannon Meyer is the executive director of Response, a Roaring Fork Valley nonprofit amid to help those experience domestic violence and sexual abuse.