Challenges of Dementia - Heart 'n Home Hospice & Palliative Care, LLC

Challenges of Dementia

Dementia affects over 50 million people in the United States today.  It is estimated that the number will rise to 75 million by the year 2030.  Dementia is not a specific disease.  It is a chronic symptom of a brain disease process or brain injury.  Brain functions such as memory loss, judgment, social abilities, personality changes, and physical declines occur.  Some symptoms of dementia can be reversed when the disease process is treated but with diseases like Alzheimer’s, Lewy Body Dementia, Frontotemporal Dementia, Creutzfeldt-Jacob Disease, Pick’s Disease, and Huntington’s Disease, treatment might only help for a limited amount of time.  Dementia caused by strokes also called vascular dementia, and traumatic brain injuries can cause nonreversible dementia too.

The effects of dementia will cause levels of severe disability requiring personal care intervention as cognitive declines occur.  The person will eventually not have the ability to properly dress.  They need assistance to pick out clothes to wear or to put clothes on.  They may layer their clothes inappropriately, have difficulty with buttons, zippers or other types of clothing closures.  They wear mismatched shoes or slippers or wear the same clothes ever day, never changing the clothes even when soiled.  They look unkept unless they have assistance with dressing. 

The person with dementia cannot bathe proper or they do not bathe at all.  They demonstrate difficulty adjusting water temperature, they forget to use soap, forget to shampoo their hair, forget to comb their hair or forget to brush their teeth.  Not only do they forget to perform these activities of daily living, they forget how to perform these activities.  For example, they forget what toothpaste is and forget how to apply it on their toothbrush or forget shampoo goes in their hair.  They do not shave their face or care for their skin any longer.  Skin infections and pressure ulcers are common.

Toileting can be a struggle.  They forget to wipe or flush the toilet.  They have urinary and bowel incontinence intermittently or have complete bladder and bowel incontinence.  Constipation may be a struggle because they are not eating or drinking normally.  It is common for the patient with dementia to have urinary tract infections because of poor hygiene and poor nutrition and fluid intake.  Unintentional weight loss also occurs.

As the level of disability increases, declines are seen with the person’s pattern of speech.  Speech is limited.  The person speaks using word salad or using stereotypical phrases.  They stop sentences mid- sentence, their sentences are non-sensical or they confabulate stories.  They cannot verbalize their own needs or thoughts.  They need to be coached or cued to speak.  Commonly, family or caregivers are accustomed to speaking for the person with dementia. 

The effect dementia has on cognitive decline will eventually take away the person’s personality.  They do not display facial expressions.  The declines can affect their ability to walk safely and falls and fractures are common.  They will not be able to sit up without lateral support, smile or lift their head.  Malnutrition, difficulty swallowing, choking become a problem and as a result, aspiration of food and fluid into their lungs occur.  Increasing anxiety, agitation, trembling, sleep disturbances and hallucinations are other changes that can happen as cognitive declines transpire.  Eventually 24/7 supervision is required and can be exhausting to family and caregivers.

The type of behaviors and symptoms displayed by patients having dementia depends on the part of the brain that has been damaged.  This is the reason why dementia can affect people differently and makes caregiving a challenge.  As many as 43.5 million adults have provided unpaid care to their loved one, neighbor or friend according to  This trend will continue as the number of people living with dementia continues to rise.

Heart ‘n Home Hospice has an experienced team of doctors, nurses, personal care assistants, care navigators and spiritual care providers who are available to support family and caregivers.  After reading about the effects of dementia, call us today if you have a loved one, or know someone who has the characteristics, behaviors or diagnosis of dementia.  We are available 24/7 and we are the agency to call for needed assistance.  Heart ‘n Home will send out an RN to introduce our care program.  We are able to help families and caregivers cope with the challenges they face every day.  Call us at Heart ‘n Home Hospice 1-800-HOSPICE or email us at

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