Dementia is such a vast subject; it’s a bit difficult to know where this blog should start. I guess I’ve always viewed Dementia as the heading for a majority of sub-set diagnosis’ or types of cognitive impairments. I was wondering if we all find it to be the most common diagnosis on face sheets when describing a person’s (especially Geriatric patient’s) loss of cognition over a six-month period. In a perfect world a good neurological work-up is so helpful for defining types of Dementia but as we all know not only are health care providers a bit stretched but also the Patients themselves struggle getting to yet another appointment. I do know if we can decipher as social workers patients presenting behaviors as Dementia vs Delirium it’s probably the most helpful starting point for a Patient. With that being said I am fascinated with Dementia but as a social worker feel overwhelmed by the specifics myself. There are so many characteristics of each type of Dementia as well as overlapping behaviors.
One intriguing type of Dementia I was able to work with over a period of time was Lewy Bodies. One man in particular was in his early 50’s. Being a bit younger, he still was very able-bodied presenting some uniqueness as to his care. His symptoms were profound and quite rapid in progression so everything about his behaviors and lifestyle changed drastically. The emotional toll on the family was devastating at best. Financial hardship due to lost income and the cost of care as well as behavioral changes were profound. This family advocated diligently seeking out what they hoped would be a metabolic etiology. They did share with me that they as well as the Physicians worked rather hard in confirming a diagnosis due to his atypical age. He presented pronounced visual hallucinations, which is a hallmark characteristic of Lewy Bodies, physically taking care of the “intruders” in his home. Other times he liked to wear several hats to keep his head “intact”. So things were difficult for care, for family, and for health care providers not to give up on solutions for “safe and/or appropriate” solutions. Very wisely the Spouse of this Patient did state that it wasn’t his own behavior, which impacted him but the reactions by others to his behaviors. I always thought that to be such an interesting observation.
Hope this link is a helpful resource: Lewy Body Dementia Association P.O. Box 451429 Atlanta, GA 31148 lbda@lbda.org http://www.lewybodydementia.org Tel: Telephone: 404-935-6444 Helpline: 800-LEWYSOS (539-9767) Fax: 480-422-5434
Laura, Thank You for the Link and the excellent Post. I like the angle you took with Dementia. You are right. It is vast and where do you start? Team, what you need to know about dementia is that it is slow developing and organic by nature which tells me usually when dementia presents you are going to get consistent patterns of dementia from the other "key players" etc family members that this cognitive paucity or memory loss has been consistent and you will get consistent responses from the key players in it's early detection and advanced stages. I can tell you team that with all of these big three that your information givers have to be family members, SNF's, ALFs, AFH's, Guardians, etc. Dementia is also considered to be a psychiatric diagnosis and it isn't uncommon for people c dementia to be hospitalized in an inpt psychiatric setting.
Team, Emma gave me her nice write up to post as she has been having difficulty posting. I am also having difficulty with her email, It isn't letting me copy and paste. I will print it out and bring it to group tomorrow.
In my current practice setting I don’t get to work with patients with a dementia diagnosis, but I agree that it is such a large field that it’s easy to feel overwhelmed by the various types. Thank you Laura, for the info on Lewy Bodies dementia. I had heard the name but didn’t know anything about it before.
In my past work with older adults, I have found that a key piece of supporting someone with dementia is to support their primary caregivers. Especially when I worked with several patients with end-stage dementia, the amount of caregiving required can be intense, exhausting, and socially isolating. I think this is a diagnosis where a systems/person-in-environment approach is very important. A person can live with dementia for many years, with care needs increasing over time. As social workers it is important for us to identify the key people who are supporting the person with dementia, and make sure they are getting support themselves. If we can determine who is playing what role in the patient’s life, we can do a better job of offering guidance and support to the whole system.
Dementia is such a vast subject; it’s a bit difficult to know where this blog should start. I guess I’ve always viewed Dementia as the heading for a majority of sub-set diagnosis’ or types of cognitive impairments. I was wondering if we all find it to be the most common diagnosis on face sheets when describing a person’s (especially Geriatric patient’s) loss of cognition over a six-month period. In a perfect world a good neurological work-up is so helpful for defining types of Dementia but as we all know not only are health care providers a bit stretched but also the Patients themselves struggle getting to yet another appointment. I do know if we can decipher as social workers patients presenting behaviors as Dementia vs Delirium it’s probably the most helpful starting point for a Patient. With that being said I am fascinated with Dementia but as a social worker feel overwhelmed by the specifics myself. There are so many characteristics of each type of Dementia as well as overlapping behaviors.
ReplyDeleteOne intriguing type of Dementia I was able to work with over a period of time was Lewy Bodies. One man in particular was in his early 50’s. Being a bit younger, he still was very able-bodied presenting some uniqueness as to his care. His symptoms were profound and quite rapid in progression so everything about his behaviors and lifestyle changed drastically. The emotional toll on the family was devastating at best. Financial hardship due to lost income and the cost of care as well as behavioral changes were profound. This family advocated diligently seeking out what they hoped would be a metabolic etiology. They did share with me that they as well as the Physicians worked rather hard in confirming a diagnosis due to his atypical age. He presented pronounced visual hallucinations, which is a hallmark characteristic of Lewy Bodies, physically taking care of the “intruders” in his home. Other times he liked to wear several hats to keep his head “intact”. So things were difficult for care, for family, and for health care providers not to give up on solutions for “safe and/or appropriate” solutions. Very wisely the Spouse of this Patient did state that it wasn’t his own behavior, which impacted him but the reactions by others to his behaviors. I always thought that to be such an interesting observation.
Hope this link is a helpful resource:
Lewy Body Dementia Association
P.O. Box 451429
Atlanta, GA 31148
lbda@lbda.org
http://www.lewybodydementia.org
Tel: Telephone: 404-935-6444 Helpline: 800-LEWYSOS (539-9767)
Fax: 480-422-5434
Laura, Thank You for the Link and the excellent Post. I like the angle you took with Dementia. You are right. It is vast and where do you start? Team, what you need to know about dementia is that it is slow developing and organic by nature which tells me usually when dementia presents you are going to get consistent patterns of dementia from the other "key players" etc family members that this cognitive paucity or memory loss has been consistent and you will get consistent responses from the key players in it's early detection and advanced stages. I can tell you team that with all of these big three that your information givers have to be family members, SNF's, ALFs, AFH's, Guardians, etc. Dementia is also considered to be a psychiatric diagnosis and it isn't uncommon for people c dementia to be hospitalized in an inpt psychiatric setting.
ReplyDeleteTeam, Emma gave me her nice write up to post as she has been having difficulty posting. I am also having difficulty with her email, It isn't letting me copy and paste. I will print it out and bring it to group tomorrow.
ReplyDeleteFor the test, I want you to remember that Dementia is Slow developing and Organic
ReplyDeleteIn my current practice setting I don’t get to work with patients with a dementia diagnosis, but I agree that it is such a large field that it’s easy to feel overwhelmed by the various types. Thank you Laura, for the info on Lewy Bodies dementia. I had heard the name but didn’t know anything about it before.
ReplyDeleteIn my past work with older adults, I have found that a key piece of supporting someone with dementia is to support their primary caregivers. Especially when I worked with several patients with end-stage dementia, the amount of caregiving required can be intense, exhausting, and socially isolating. I think this is a diagnosis where a systems/person-in-environment approach is very important. A person can live with dementia for many years, with care needs increasing over time. As social workers it is important for us to identify the key people who are supporting the person with dementia, and make sure they are getting support themselves. If we can determine who is playing what role in the patient’s life, we can do a better job of offering guidance and support to the whole system.