Dementia & Cognitive Impairment | Independent Living | Independent Living (2023)

Dementia takes effect over a period of time

Dementia and cognitive impairment mean that a person’s ability to remember and to think clearly deteriorates. This happens over a period of time, sometimes quite a long period, and although there is no cure for dementia, there are some drugs that may be helpful, particularly in the early stages.

Mild Cognitive Impairment (MCI) is a condition where memory and thinking are affected, but not to such an extent that it interferes with daily life. It can be a precursor of dementia: 10 to 15% of people diagnosed with MCI will go on to develop dementia every year. However, mild cognitive impairment can be caused by other conditions, including stress, anxiety, depression, physical illness, or even side-effects of medication. So, having MCI does not inevitably mean going on to get dementia; some people recover completely, once their other health problems have been treated.

People with dementia often also experience changes in mood, becoming more anxious, irritable, or withdrawn. As the condition progresses, they may develop behaviours that are out of character, perhaps constantly pacing, questioning repetitively, being agitated and restless.

The number of people with dementia is growing rapidly, as a consequence of our ageing population. Helping people with dementia or MCI to live well is a challenge that has been taken up by many organisations, leading to development of new products and services to help support independence for those managing with diminished memory and thought processes.

The areas where dementia and MCI have most impact include:

• day-to-day memory – someone with dementia may not remember recent events

• planning and organising – they may find it more difficult to make decisions or solve problems

• language – following a conversation, or finding the right word for an object can become more difficult

(Video) Understanding Mild Cognitive impairment March 2022

• attention – someone with dementia may not be able to concentrate on a sequence of tasks, such as cooking a meal, or follow a television programme

• orientation – they may become confused about the time or date, or whereabouts they are

• visuospatial skills – problems with judging distances, and with seeing objects in three-dimensions

Click the links below to go straight to more information about providing support in these areas:

Bathroom and Personal Care
Kitchen, Eating, Food preparation
Time Management and Memory Aids
Telecare and Wander Alarms

Dementia Bathroom and Personal Care

Dementia & Cognitive Impairment | Independent Living | Independent Living (2)The bathroom is one of the most important areas of the home, when it comes to maintaining independence and dignity for someone who is cognitively impaired.

Some of the considerations are just the same as when adapting a bathroom for any type of disability or age-related frailty: ease of access; providing support where necessary; eliminating trip hazards; providing easy-to-use taps, flush levers, etc. You can read more about all aspects of an accessible bathroom here.
There are some additional points to bear in mind, when planning a dementia-friendly bathroom:

• Someone with dementia is much more likely to fall, so a completely level access wetroom is the way to go, if possible, without anything distracting about the floor covering: no colour changes or small patterns, nor high shine, which might look as if the floor is wet.

• Less ability to recognise danger is another factor, so anti-scald taps are important, and any radiator in the room should have a low surface temperature, or be covered, to prevent accidental burns.

• While short-term memory goes, longer term recall can be excellent, so a person with dementia is likely to be happier with familiar rooms and traditional-style bathroom fittings.

(Video) Mild Cognitive Impairment (MCI) - A Guide for the Public

• Overhead waterfall-style showerheads can be distressing, as the person can’t see where the water is coming from.

• Mirrors and highly reflective surfaces should be used with caution, as many people with dementia fail to recognise their own image, and believe there is someone else in the bathroom with them.

There is more detailed information about dementia-friendly bathroom design in this PDF brochure from AKW.

Dementia Kitchen, Eating and Food Preparation

Dementia & Cognitive Impairment | Independent Living | Independent Living (3)Kitchen safety is paramount – we have an extensive section on avoiding accidents when preparing and cooking food here. Consider in particular devices to guard against cookers, hob tops and taps being turned on and forgotten.

• Once again, familiarity is important, so make sure that items are always stored in the same places.

• Buying the same foods, in recognisable packets, is also helpful. Clear, see-through storage jars that let you view the contents are better than those that conceal what is inside.

• Even cupboard doors may be a barrier – you could replace them with glass doors, or remove them altogether.

• Leave items that are needed regularly where they can be seen and remembered – for example, snack foods and drinks. Keep anything hazardous out of sight and reach – ideally locked away.

• There is a wide range of easy-to-use utensils to help with preparing food – you can see more in the Independent Living kitchen section.

• Good colour contrast, for crockery and cutlery, can make mealtimes easier. It was believed that red and white was the most effective combination for people with dementia, but it is now recognised that any clearly contrasting pair of colours is equally effective.

(Video) Dementia and Cognitive Impairment

Dementia & Cognitive Impairment | Independent Living | Independent Living (4)• Colourful, attractively arranged food will be more likely to tempt someone to eat. In particular, avoid presenting only pale and white foods. Our resident nutrition expert, Mary Farmer, has written a helpful article about diet and dementia, which you can read here

• If the person with dementia doesn’t remember to eat or drink, you can prompt them with automatic reminders – see more below.

Time Management and Memory Aids

Dementia & Cognitive Impairment | Independent Living | Independent Living (5)• Confusion over time of day or night can lead to disruption of daily living routines, with people trying to go shopping in the middle of the night, for example, or missing scheduled appointments.

• You can get clocks that show the day and date as well. One that shows whether it is day or night can also be helpful.

Dementia & Cognitive Impairment | Independent Living | Independent Living (6)• Assistive technology in the form of reminders can help maintain independence with dementia. The Memrabel shown here, above left, can be programmed with spoken reminders, pictures or video clips, to prompt activities such as eating and drinking; going to bed and getting up; taking medication; going to an appointment.

The simple voice recorder shown on the right has one side for the user, with a single big button which they press at the times they are prompted to do so, in order to listen to a pre-recorded message. For example, at 9 AM, an alarm sounds, and they press the button: “It is nine o’clock, time to take your medicine”.

Dementia & Cognitive Impairment | Independent Living | Independent Living (7)• Problems with medication management – either failing to take prescribed pills, or double dosing, is a significant issue for the individual concerned, and a cost to the NHS: in 2006-07 the cost of hospital admissions in the UK resulting from patients not taking their prescribed medication properly was estimated to be somewhere between £36m and £197m. A dedicated unit which not only provides a reminder, and dispenses the correct dose, but will also trigger an alert if dose is missed, can make a big difference to living confidently alone, even with cognitive impairment.

Telecare and Wander Alarms

Dementia & Cognitive Impairment | Independent Living | Independent Living (8)• In-home telecare systems are considerably more sophisticated than the early alarm call pendants – although this ability to summon help in an emergency is still a feature.

Additionally, systems can include a range of alerts, such as Smoke
; Floods; Falls and movement
; Temperature extreme
; Property exit sensor; Bogus callers; Carbon monoxide. In this way, an individual with dementia can be supported to live more safely in their own home, protected as far as possible from the consequences of forgetfulness. As well as the sensor to trigger an alert if they leave the property, you can also include an alert if, for example, they don’t go into the kitchen to get something to eat or drink, or the bathroom. Fall and movement sensors worn on the body can detect if somebody has a fall – far more likely with dementia – or if they are moving around more or less than normal.

(Video) Mild Cognitive Impairment & Dementia

Dementia & Cognitive Impairment | Independent Living | Independent Living (9)• Similar support is now available outside the home, with various combinations of mobile phone and GPS technologies.

A tracker device which can be programmed with a safe area, will raise an alert if the person carrying it strays too far. This could be fixed to a mobility scooter, or slipped into a pocket.

The micro tracker shown here also provides more overt support: as well as GPS tracking, the user can get help at the press of a button, make and receive voice calls, and keep records of habitual behaviour, so anything untoward can also be identified.


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Further reading and resources

This is an overview of some useful products and services to support independent living with dementia or cognitive impairment.

For the latest scientific research and insights into the condition, Mary Jordan’s book, The Essential Guide to Avoiding Dementia is interesting and instructive. You can read more about it here.

For an interesting new perspective on dementia – living with it as a society, caring for and understanding someone with the condition, read about The ‘D’ Word – Rethinking Dementia here

The Longitude Prize on Dementia is funding AI and machine learning innovations to support people with dementia to live independently at home for as long as possible

Armchair Gallery – a lovely free app brings the gallery to you when you can no longer visit. Designed particularly for people with dementia

(Video) Normal Aging, Mild Cognitive Impairment, and Dementia

Are you one of the people who avoid visiting relatives with dementia?

Scotland’s first dementia friendly park is in Stirling – more info here

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FAQs

Can someone with cognitive impairment live alone? ›

Abstract. Although most individuals experiencing cognitive impairment (CI) reside with a caregiver, an estimated 800,000 live alone. Such individuals may have an increased risk for injury to self or others through self-neglect as a result of the CI symptoms.

What is the difference between dementia and cognitive impairment? ›

Dementia is typically diagnosed when acquired cognitive impairment has become severe enough to compromise social and/or occupational functioning. Mild cognitive impairment (MCI) is a state intermediate between normal cognition and dementia, with essentially preserved functional abilities.

Can you live independently with mild cognitive? ›

Family members and friends who notice these problems might not express concern because the early symptoms can mimic normal, age-related changes. People suffering from MCI often recognize they are having trouble but are still able to carry on most of their usual activities and live independently.

How long can you live with cognitive impairment? ›

At age 70, Americans can expect to live 14 more years on average; of these years, 12.5 will be years without cognitive impairment and 1.5 will be years with cognitive impairment. The confidence interval for years impaired is relatively small: 1.4 years to 1.6 years.

At what stage of dementia should you not live alone? ›

In general, once a patient enters the moderate phase of dementia (the phase in which they require some help with their basic activities of daily living like dressing, bathing and grooming), it is unsafe to leave them alone for even short periods of time.

What are the dangers of living alone with dementia? ›

You may be at increased risk for harm, falls, wandering and/or malnutrition. You also may have difficulty managing personal hygiene or household tasks, which can lead to unsafe living conditions. Plan ahead for how you will address your basic needs, including housing, meals and physical care.

How long does it take to go from mild cognitive impairment to dementia? ›

For people diagnosed with mild cognitive impairment, within just one year 10 to 15% of them will go on to develop dementia, a general term for loss of memory and other mental abilities that is severe enough to interfere with daily life.

What are the four levels of cognitive impairment? ›

The four cognitive severity stages spanning normal aging to dementia are:
  • No Cognitive Impairment (NCI)
  • Subjective Cognitive Impairment (SCI)
  • Mild Cognitive Impairment (MCI)
  • Dementia.

What are the four main types of dementia that result in cognitive changes? ›

Progressive dementias
  • Alzheimer's disease. This is the most common cause of dementia. ...
  • Vascular dementia. This type of dementia is caused by damage to the vessels that supply blood to your brain. ...
  • Lewy body dementia. ...
  • Frontotemporal dementia. ...
  • Mixed dementia.
Oct 12, 2022

Do dementia patients do better at home? ›

Home care is often recommended by experts through end of life. However, every family and situation is different, so permanent home care may not always be possible. Research shows keeping a loved one with dementia at home helps them be happier and live longer; however, it is most impactful when introduced early.

How long do people live after mild cognitive impairment diagnosis? ›

Life expectancy for individuals with MCI

The life expectancy for participants with MCI ranged from 21.3 years (95% CI: 19.0–23.6) at age 60 to 2.6 years (1.6–3.6) at age 95.

What is the next stage after mild cognitive impairment? ›

Symptoms of MCI may remain stable for years. Or MCI may progress to Alzheimer's disease dementia or another type of dementia. In some cases, MCI may improve over time. MCI often involves the same types of brain changes seen in Alzheimer's disease or other forms of dementia.

How fast does cognitive impairment progress? ›

About 7.5 percent will develop dementia in the first year after diagnosis of mild cognitive impairment. About 15 percent will develop dementia in the second year. About 20 percent will develop dementia in the third year.

What is the 5 word memory test? ›

Introduction: The five-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of aging people and has previously shown its sensitivity and its specificity in identifying patients with AD.

What is the longest stage of dementia? ›

Middle-stage Alzheimer's is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer's will require a greater level of care.

What is the average age of death for someone with dementia? ›

Factors That Determine Longevity

Women lived an average of 4.6 years after diagnosis, and men lived 4.1 years. People diagnosed when under age 70 lived 10.7 years compared to 3.8 years for people over 90 when diagnosed. Patients who were frail at the time of diagnosis did not live as long, even after adjusting for age.

What are the signs dementia is getting worse? ›

increasing confusion or poor judgment. greater memory loss, including a loss of events in the more distant past. needing assistance with tasks, such as getting dressed, bathing, and grooming. significant personality and behavior changes, often caused by agitation and unfounded suspicion.

Where is the best place for someone with dementia? ›

Where is the best place for someone with dementia?
  • In-home care. Most dementia patients prefer to stay in their own home as long as possible. ...
  • Adult day care programs. ...
  • Adult family homes. ...
  • Continuing care retirement communities. ...
  • Nursing home facilities. ...
  • Memory care units.
Apr 30, 2021

When should someone with dementia go into a care home? ›

If a person's dementia has progressed far enough that they need more care and support than you can provide, it may be time for them to go into a care home. At this point, they may need 24-hour care. Dementia is progressive, meaning the person with the condition will require more care and support as time goes on.

How hard is it to care for someone with dementia at home? ›

"Dementia can cause memory issues, impaired decision-making and behavioral changes, so caregiving for someone with dementia can be very mentally and physically challenging," says Dr. Wright. "But it's important to know that you're not alone. There are help and resources out there for you and your loved one."

Why do people with dementia isolate themselves? ›

Lack of engagement and being withdrawn

A person with dementia is much more likely to become withdrawn because they feel isolated or bored. Many people with dementia spend much of their time alone or, even if they are with others, there may not be much conversation between them.

What is considered a severe cognitive impairment? ›

Dementia or severe cognitive impairment (SCI): CI that is severe enough to limit function, usually defined as social or occupational function. In its severe forms, a person with dementia/SCI may not be able to recognize people, use language, or execute purposeful movements.

What is the shortest stage of dementia? ›

By the late stage of dementia, the symptoms of all types of dementia become very similar. This stage tends to be the shortest. On average it lasts about one to two years.

Is there medication for mild cognitive impairment? ›

There currently is no standard treatment or approved medication for MCI, but there are things a person can do that may help them stay healthy and deal with changes in their thinking. Because MCI may be an early sign of more serious memory problems, it's important to see a doctor or specialist every six to 12 months.

What is the most common cause of death in dementia patients? ›

One of the most common causes of death for people with dementia is pneumonia caused by an infection. A person in the later stages of dementia may have symptoms that suggest that they are close to death, but can sometimes live with these symptoms for many months.

When dementia suddenly gets worse? ›

Rapidly progressive dementias or RPDs are extremely rare, but can cause dementia to worsen over weeks and months. RPDs can be caused by complex medical conditions such as Autoimmune conditions, cancer, and neurodegenerative diseases – i.e diseases that damage the body's nervous systems.

What is the 7 minute screen test for dementia? ›

Background: The seven minute screen (7MS) is a compilation of the temporal orientation test, enhanced cued recall, clock drawing, and verbal fluency. It has been shown to be useful for detecting Alzheimer's disease in a population of patients with memory complaints.

What is the 3 word memory test? ›

The Mini-Cog test.

A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.

What is the second most common behavior associated with dementia? ›

Verbal aggression/threats (54%) and physical aggression/agitation (42%) constitute the 2 most frequent behavioral disturbances reported in patients with Alzheimer's disease and related disorders.

Should dementia patients watch TV? ›

For men and women with Alzheimer's disease or other forms of dementia, it can be especially beneficial. Watching movies and TV shows can help keep their brain active, which can stimulate positive memories, improve mood, and even increase socialization.

What comforts a dementia patient? ›

When an older adult with dementia sticks to a routine, they gain independence and feel comfortable because they know what to expect. According to the Alzheimer's Association, using calming phrases such as “You're safe here” and ”I'm sorry that you are upset” allow your loved to feel safe.

Why do dementia patients say they want to go home when they are home? ›

Often when a person with dementia asks to go home it refers to the sense of 'home' rather than home itself. 'Home' may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.

How to help someone with cognitive impairment? ›

Develop a Patient and Caregiver Support Plan

Suggest regular physical activity, a healthy diet, social activity, hobbies, and intellectual stimulation, which may help slow cognitive decline. Refer the person and caregiver to national and community resources, including support groups.

Does cognitive impairment get worse with age? ›

Cognitive abilities often decline with age. It is important to understand what types of changes in cognition are expected as a part of normal aging and what type of changes might suggest the onset of a brain disease.

What are symptoms of severe cognitive decline? ›

Signs of cognitive decline
  • Forgetting appointments and dates.
  • Forgetting recent conversations and events.
  • Feeling increasingly overwhelmed by making decisions and plans.
  • Having a hard time understanding directions or instructions.
  • Losing your sense of direction.
  • Losing the ability to organize tasks.
  • Becoming more impulsive.
Sep 6, 2020

What medications are used for cognitive impairment? ›

Donepezil, galantamine, rivastigmine and memantine are potentially effective interventions for cognitive impairment in dementia, but the use of these drugs has not been personalised to individual patients yet.

What is the 6 item cognitive impairment test? ›

The Six Item Cognitive Impairment Test (6CIT) is a brief cognitive function test which takes less than five minutes and is widely used in primary care settings. It involves three orientation items – counting backwards from 20, stating the months of the year in reverse and learning an address.

What do dementia patients think about? ›

People with dementia think about the same things that any human thinks about — emotions, relationships, daily life, tasks to accomplish, and more. Receiving a life-changing diagnosis of dementia does not strip a person of their humanity and personhood.

What are the three D's of cognitive impairment? ›

Understanding the Three D's: Dementia, Delirium and Depression - For Health Care Professionals.

What triggers cognitive decline? ›

While age is the primary risk factor for cognitive impairment, other risk factors include family history, education level, brain injury, exposure to pesticides or toxins, physical inactivity, and chronic conditions such as Parkinson's disease, heart disease and stroke, and diabetes.

What is the new dementia drug? ›

Today, the U.S. Food and Drug Administration approved Leqembi (lecanemab-irmb) via the Accelerated Approval pathway for the treatment of Alzheimer's disease. Leqembi is the second of a new category of medications approved for Alzheimer's disease that target the fundamental pathophysiology of the disease.

What does the Bible say about dementia? ›

Scripture assures us that nothing can separate us from the love of God, not even a dementia that may strip a person of her awareness of God's presence (Romans 8:38-29).

What questions do they ask in a dementia test? ›

The MMSE includes questions that measure:
  • Sense of date and time.
  • Sense of location.
  • Ability to remember a short list of common objects and later, repeat it back.
  • Attention and ability to do basic math, like counting backward from 100 by increments of 7.
  • Ability to name a couple of common objects.

When should you call hospice for dementia? ›

Patients with dementia or Alzheimer's are eligible for hospice care when they show all of the following characteristics: Unable to ambulate without assistance. Unable to dress without assistance. Unable to bathe properly.

What stage of dementia is wandering? ›

During the middle stages, people may experience depression, anxiety, irritability and repetitive behaviors. As the disease progresses, other changes may occur, including sleep changes, physical and verbal outbursts, and wandering.

What stage of dementia is sleeping all the time? ›

Sleeping more and more is a common feature of later-stage dementia. As the disease progresses, the damage to a person's brain becomes more extensive and they gradually become weaker and frailer over time.

How do you live with a cognitive impairment? ›

Studies have shown that playing games, playing an instrument, reading books and other activities may help preserve brain function. Being social may make life more satisfying, help preserve mental function and slow mental decline. Memory training and other cognitive training may help improve your function.

Can people live independently during early stage of dementia? ›

In the early stages of dementia, many people are able to live at home and enjoy life in the same way as before their diagnosis.

Can person with mild dementia be left alone? ›

Many people live alone. Living in a place that is safe, familiar and comfortable is important to everyone, including people with dementia. A diagnosis of dementia does not automatically mean that a person is incapable of living alone. Some people may be capable of living on their own for some time after the diagnosis.

Is it better for someone with dementia to be in a home? ›

However, every family and situation is different, so permanent home care may not always be possible. Research shows keeping a loved one with dementia at home helps them be happier and live longer; however, it is most impactful when introduced early.

What is the expected lifespan of a person with dementia? ›

On average, a person with Alzheimer's lives four to eight years after diagnosis, but can live as long as 20 years, depending on other factors. Changes in the brain related to Alzheimer's begin years before any signs of the disease.

What is one of the first signs of cognitive decline? ›

Symptoms
  • You forget things more often.
  • You miss appointments or social events.
  • You lose your train of thought. ...
  • You have trouble following a conversation.
  • You find it hard to make decisions, finish a task or follow instructions.
  • You start to have trouble finding your way around places you know well.

Videos

1. What's the difference between mild cognitive impairment and dementia
(Dementia Careblazers)
2. MCI v. dementia: How can you tell?
(GoCogno.com)
3. Ethical Dilemmas in the Care of Older People with Cognitive Impairment
(NW GWEC)
4. Predictive factors of progression from mild cognitive impairment to dementia
(VJDementia)
5. Mild Cognitive Impairment - What is it and what to do about it
(The Wrinkle)
6. Healthy Living with Mild Cognitive Impairment: Cognitive and Social Engagement
(Wisconsin Alzheimer's Disease Research Center)
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