As you can imagine, we see many people in our law office who have a loved one suffering from dementia. Family members and spouses often find themselves needing to make decisions to keep a patient and their assets safe. Unfortunately, the nature of dementia is that the patient may not recognize the need for help, and may actively resist it, causing stress for the entire family. When people hear the word ‘dementia,” they may assume that it is the same thing as Alzheimer’s disease. But Alzheimer’s is only one of multiple forms of dementia. Understanding the different types of dementia can help family members better understand the type of support their loved one needs.
Alzheimer’s is the most common type of dementia, and is probably the best known. Alzheimer’s is a disease of the brain that causes thinking, reasoning, and memory to slowly decline. Symptoms include:
There is no one definitive test for Alzheimer’s. A patient’s family may seek the help of his or her primary doctor and a neurologist, neuropsychologist, or psychiatrist. Doctors will take a medical history, perform physical exams, mental status tests, and a neurological exam, which may include brain imaging. The cause of Alzheimer’s is not fully understood.
Vascular dementia is the next most common type of dementia, accounting for about 10% of dementia cases. Vascular dementia means that blood flow to the brain has been slowed or interrupted, causing deficits that may appear similar to those of Alzheimer’s. Unlike Alzheimer’s, vascular dementia may be caused by an acute event such as a stroke. Risk factors include diabetes, high blood pressure, high cholesterol, coronary disease, and peripheral artery disease. Vascular dementia sometimes causes hallucinations and vision problems
Many people first heard of Lewy body dementia when it was revealed that the late actor Robin Williams had suffered from it. This form of dementia is known to be caused by protein deposits in nerve cells. The deposits cause chemical messages in the brain to be interrupted; this in turn leads to disorientation and memory loss.
Other features of Lewy body dementia include visual hallucinations, sleep disturbances, physical weakness, difficulty walking, and tremors similar to those seen in Parkinson’s disease.
Parkinson’s disease is best known for the tremors associated with it, but many people in the later stages of Parkinson’s may suffer from dementia as well. Difficulties with reasoning and impaired judgment are some of the earliest signs of Parkinson’s dementia. Others include visual hallucinations, which can go hand-in-hand with paranoia and depression. Language problems may also be seen in Parkinson’s dementia.
Frontotemporal dementia, also known as Pick’s disease, is an umbrella term for multiple types of dementia that impact the front and side areas of the brain. This type of dementia may be found in people as young as their mid-forties. While the cause is not fully understood, it is known to run in families and to have a genetic component.
Because frontotemporal dementia affects the parts of the brain that control behavior and language, it may cause loss of motivation, loss of inhibitions, compulsive behavior, as well as speech and language problems.
To further complicate things, not only do many types of dementia resemble each other, it is possible to have more than one type of dementia. This is known as mixed dementia, and may be present in nearly half of all people with dementia.
Who are the professionals who will guide you and your family in diagnosing and dealing with your loved one’s dementia?
A neuropsychologist specializes in how brain conditions affect a person’s behavior and overall functioning. Your loved one’s primary care physician might refer them to a neuropsychologist for a series of tests to determine the cause of cognitive problems. A gero-neuropsychologist further specializes in the brain and behavioral health of older people.
A neurologist is a doctor who specializes in diseases of the nervous system, including the brain and spinal cord. A primary care doctor may refer an older patient who is having memory problems or difficulty thinking or speaking clearly to a neurologist for further assessment. A neurologist might order brain scans to look for physical evidence of dementia.
A psychiatrist is a doctor who treats patients with mental illness. A psychiatrist might be involved in assessing your loved one to see if depression or other mental illness is contributing to the signs of dementia your family member is showing.
Regardless of the type of dementia your loved one is ultimately diagnosed with, it is important to put legal measures in place, such as powers of attorney, to protect them as their health and functioning declines. If your family member is unwilling or legally unable to grant someone power of attorney, a guardianship may be necessary. We invite you to contact our law office to schedule a consultation to talk about keeping your loved one safe and well cared for.