The Global Deterioration Scale for Assessment of Degenerative Dementia, also known as the Reisberg Scale, is used to determine the levels of cognitive decline.
Those who are considered not to have dementia are in this classification. They have normal function and no memory loss.
At this level of decline, the person will experience mild memory loss, such as forgetting names or where they've placed everyday objects. The symptoms are not yet noticeable to loved ones or caregivers, and the duration of this level is also unknown.
During this stage, the person will start forgetting tasks and even have some trouble remembering words. Their work performance is impacted as they experience mild drops in their ability to concentrate. As a caregiver, you'll start noticing these changes. The average duration for this stage is around 2 to 7 years and it's not classified as dementia, just mild cognitive decline.
This is the first level of dementia and is referred to as early-stage dementia. At this point, physicians can detect cognitive issues and diagnose dementia. The person might be in denial and have trouble interacting socially. They're no longer able to go to new places by themselves, and getting lost happens more frequently. They experience difficulty concentrating and forget recent events. Loved ones need to take over financial decisions at this point. This stage is expected to last around 2 years.
The mid-stage of dementia is when you as a caregiver become actively involved in the person's daily routine. They may find it difficult to perform tasks such as self-care, hygiene and eating. They may also experience some mobility issues. The person may have difficulty remembering you as their caregiver and will struggle to remember where they are. This stage is expected to last around 1.5 years.
During this stage, caregivers are required to help with all personal and hygiene care. The person may also experience episodes of delusions and anxiety. It's also at this stage that they start forgetting their family members and major life events.
During late dementia, the person's mobility is impacted, and they can't walk or use their fine motor skills. They're no longer able to communicate and rely fully on their caregiver. This stage typically lasts 1.5-2.5 years.
When you're able to communicate with a person who has dementia, you instantly reduce the stress and anxiety of the situation. As the disease progresses, communication becomes harder. Here are some methods known to facilitate communication.
The tone of the conversation determines whether you'll successfully communicate with the person. Always keep your tone polite and respectful to maintain rapport, even when the situation escalates. If you notice that the escalation increases, divert the person's attention and distract them from the current discomfort. For instance, you can say, "I can tell this situation is causing you distress. How about we go water the flowers instead?"
The more dementia progresses, the harder it becomes for the person to concentrate on specific tasks. For instance, if the TV is on and the sounds, images and colors are distracting, they're going to find it hard to listen to your instructions. Ensure you're the focus of their attention when you try to communicate with them.
Laughter and humor can be a great antidote to the stresses caused by dementia. As a caregiver, you can improve a person's social interactions through humorous interactions, but these should never be at their expense.
When you're communicating an instruction, be concise and clear. If the instruction is to perform an activity, you want to make the steps of the activity clear.
One of the most important components of effective communication is effective listening. When you're dealing with someone who's already overwhelmed by the anxiety of cognitive decline, it's important to listen to their concerns or objections with understanding and compassion. It can help defuse tough situations and reduce the stress experienced by the person.
Reminiscing can be a therapeutic experience for those with dementia. It helps form a bond between the person and their caregiver and increases the cognitive function and quality of life of those with dementia.
