Saturday, April 5, 2014

Can We Reconstruct or Readjust a Failing Brain?

The old saying goes "Hindsight is better than foresight" and it's never more true than with caregivers who are family or friends of men and women with Dementia.

So many current studies cite the appearance of specific behaviours as being the "keys" to attempting to diagnose Dementia -- which many forms cannot be specifically cited or identified until there's a post mortem examination of the brain.

My thought is it doesn't matter if someone has Alzheimer's, Lewy Body, Frontal Temporal or some others, they have Dementia and we need to recognize Dementia as the next big "C" disease (Cancer) because it's fatal, it's physically and emotionally draining and destructive and it stops life as we know it to tend to its needs, wants and directives.

These reports often become fixed on the decline of mental processing and even bodily functions including standing, walking and incontinence as determiners of the type and even the stage of the disease.

Are these really effective measures of Dementia's progression? Are we simply focusing on those areas we consider "more important" and therefore use these to determine the "level" of the progression and the seriousness and level for caregiving needed?

When are we going to recognize Dementia, especially Lewy Body Dementia, doesn't appear like Cancer often does with a lump you can feel or Heart Disease with a stroke? 

Lewy Body Dementia often masquarades.  As I wrote in this blog entry: Masks: Ever Changing Faces of Lewy Body Dementia , LBD is not always visible and people with LBD, to my experience, seem to be capable of adjusting and their minds are "socially conscious" enough, even far into the progression of the disease, to cover up small misstatements, laugh about "what they've just said" and even mix and match information that seems to go together to the "untrained" and "unfamiliar with the subject" ear and eye. 

Another observation I've had with Mom is how vacillating Lewy Body Dementia really is; behaviors were so unpredictable. It amazed me how caregivers at Mom's facility and especially the floor nurse, an LPN, believed we could affect her behavior or we could change it or Mom could choose to change it -- all false beliefs about a real, medical condition that like Diabetes, Heart Disease or Cancer, cannot be controlled or adjusted through "willpower" or "determination".

Sadly, the other night at the presentation I mentioned in the previous blog, the message was conveyed by the gentleman about his wife that she could somehow, if she just tried, control or affect actions like sitting up in her chair.

At one moment, perhaps she could. After a long period of time and a good day when for some reason her brain neural pathways had shifted, changed or somehow left a message "slip through", she and my Mom in the latest days, might make that movement or give that response we'd sought but not seen and desperately wanted to be there, to have the ability to "return".

Like a trained animal, we reward the Advanced Dementia patient who shows us they "can" do something, hear something correctly, respond correctly, with a smile, words of encouragement and even with statements like "I knew you could do it if you tried hard enough".  

How grateful I am now realizing that with enough advancement of the Dementia this level of self satisfaction on the part of the visitor, the family member, may not truly register with the person struggling with Dementia.

Of course, there was the other belief and one popular today about "the right medicine" controlling and eventually eliminating the disease. But can we?

It may be like eradicating Cancer. You may find the causes of some and you may be able to change behaviors (smoking) or where you live (not close to where chemicals have been dumped) and therefore not get a specific Cancer, but unless someone determines there is one specific cause for Cancer -- possibly a genetic tendency or even lack of certain configurations/compositions -- Dementia like Cancer, in my opinion, will be with us for many, many years to come.

And remember, Dementia may be most seen as being prevalent in the very elderly but each passing day we're discovering as we grow from an infant to a toddler, through adolescence and into adulthood, the vast frontier of the brain and how it is the center of the individual human universe. And, we're classifying other brain diseases, Muscular Dystrophy and Parkinson's for example, into the area of Dementias.

Let's have a movement within society to be health wary about Dementia as we're taught to do self exams for Cancer and regular checkups for Heart and other ailments. 

Let's open up the discussion, bring into the light and show the world we see, we hear and most of all we support those who are suffering with and from the disease including the individuals and their care givers whether family or other.

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