Mind and Body/Opinion

Dementia is not a disease

Alzheimer’s is only one of more than 120 different diseases that can cause dementia

Photo courtesy of Laurie Guner Mantz

Laurie Gunter Mantz is the founder and CEO of Dementia Training for Life.

By Laurie Gunter Mantz, OTR, CADDCT
Posted 10/25/21
An occupational therapist and certified dementia care trainer argues that the systems how we care for patients diagnosed with dementia need to change.
In developing new strategies for accountable entities for Medicaid patients needing long-term services and supports, how do treatments for dementia factor into the equation? What are the current protocols for residents in skilled nursing facilities with dementia? Is there an accurate census of nursing home residents in Rhode Island with a diagnosis of dementia? How can the efforts around quality improvement around the delivery of Medicare services reflect improved quality of care for patients with dementia?
As with almost every other part of the health care delivery system, the continuing contagion of the COVID pandemic has disrupted the capabilities to care for older residents of Rhode Island, increasing the likelihood of their isolation and cutting them off from the normal support their family and their community might offer.
The demographics about the future Rhode Island population do not lie – we are becoming significantly older, there is a declining birth rate, and what is known as the “minority” population will soon become the majority. The state is getting older, grayer, more diverse – and more burdened by chronic diseases.
Surprisingly, there are no specific recommendations in the newly released, “Make It Happen: Investing in Rhode Island’s Future,” that put forth any strategy for investment in supporting an aging population, one that will become increasingly plagued by peaking chronic diseases, with symptoms such as dementia becoming a predominant factor.
The proposal has been hyped as a “once in a lifetime” and “once in a generation” opportunity to positively change the direction of Rhode Island through the investment of some $1 billion in federal funds. Yet, the avoidance by the Making It Happen recommendations and the failure to invest in the urgent needs of the state’s aging population, the powers that be seem to be afflicted by symptoms of their own neurocognitive disorder about who lives in Rhode Island.

PART One

PROVIDENCE – Misinformation and stigma regarding the acquired neurocognitive disorders known as “dementia,” associated with diseases such as Alzheimer’s, often prevent individuals from receiving the early medical attention necessary for effective management and care.

Our health care system is unprepared to help the rapidly growing numbers of individuals dealing with cognitive issues that can lead to life altering impairments. Why is it so important that we wake up and correct the misinformation? Because our lives, our future economy, and the stitching that holds our social fabric together depend on it.

Every 65 seconds a new person is diagnosed with Alzheimer’s disease, according to the Alzheimer’s Association. But Alzheimer’s is only one of over 120 different diseases that can cause dementia.

You’re thinking: “Isn’t Alzheimer’s and dementia the same thing?”

The answer is no. But this misinformation can lead to poor delivery of health care – or the lack of care – that could help individuals live a more independent life. Education is the key.

An acquired disorder
Dementia is not a disease; dementia is an acquired disorder or syndrome that interferes with an individual’s ability to do the things they once did independently, due to neurocognitive disorders.

Cognitive skills develop throughout our lives so that we can communicate, problem solve, attend to tasks, be safe, understand our environment and do what we need to do.

When an individual’s cognitive skills are impaired, those individuals are at greater risk for injury, illness, isolation, hospitalization, depression, and even death. Dementia is characterized by the loss of many of these cognitive skills, not just memory.

If you have a runny nose, scratchy throat, and a cough, what do you have? These are symptoms of a cold, the flu, COVID-19 or allergies. How those symptoms are treated depend on the cause, or what is known as the disease process. For instance, you wouldn’t treat the flu with an allergy medication.

Diagnosis and treatment
The right treatments depend on an early and accurate diagnosis. Research in cognitive impairments has come a long way in the last 10 years. We now know that some treatable conditions, such as hearing loss, vitamin deficiency, malnutrition and depression can look like dementia, but aren’t. The only way to know is through early and accurate medical attention.

The diseases that impair the brain, such as Alzheimer’s disease, Lewy Body disease, and Frontotemporal Degeneration, for instance, change the brain’s structure and function. At this time, modern medicine has not found ways to stop these diseases. But we can now accurately diagnose an individual with Alzheimer’s disease early with brain scans, cerebral spinal fluid, and a blood test. An early and accurate diagnosis provides opportunity for treatment and planning.

Research has shown that dementia is not a normal part of aging. Normal aging can cause vision loss, hearing loss and changes in how we interpret and interact with our environment.

But, as we treat and adapt to those changes, we can better maintain skills and independence.

Research has also shown that what is healthy for the heart is healthy for the brain. We can improve brain function with exercise, restful sleep, a healthy diet, and social and intellectual stimulation.

Translated, dementia is not a normal part of aging. Yet ignoring the changes of
aging can speed up cognitive loss.

Can we treat dementia? Yes. Can we improve the lives and function for those living with dementia? Yes. Can we cure Alzheimer’s? No, but we can treat the symptoms.

The key to better treatment includes:

• An early, accurate diagnosis.

• Better education for health care providers – and the individuals diagnosed as well as their care partners.

• Improved community support systems and more resources.

An acquired disability
Dementia is an acquired disability. It is critical that we recognize that one can learn, adapt, and be supported well into our later years. Aging need not result in dependency.

Every individual’s primary goal is to live independently for as long as possible. That can begin with quelling the stigma of dementia, education, an accurate diagnosis, early intervention, and learning how to adapt to change.

Laurie Gunter Mantz is the founder and CEO of Dementia Training for Life, LLC. She is an occupational therapist, an international lecturer, a published author, a clinical educator, and a nationally certified dementia care trainer. Her credentials include: OTR, CDP, CADDCT, CFRDT, CMDCP, CDSGF, CDCM, These are certifications that are recognized as specialties in dementia care.

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