Dementia expert, Karen Tyrell, offers answers to www.carp.ca visitors for their situation-specific questions. Karen is a dementia consultant who can point you in the right direction, giving quick insight and personalized answers to help you with dementia care challenges.

Do you have a specific question relating to dementia that you need answered? Please submit your questions by email to: [email protected]

November, 2014 Update

1. Dementia and Dental Care – How Do I Get My Mom To Visit the Dentist?

DEAR DEMENTIA SOLUTIONS:

“My mother, who has dementia, is extremely reluctant to go anywhere near a dentist, especially since the dentist she used to visit has retired. I’m worried she is neglecting her dental care. Are there dentists who specialize in treating dementia patients? What is the best approach to get her teeth checked?”

~ Dentist Wanted

DEAR DENTIST WANTED:

Visits to the dentist are often dreaded. For those with dementia, the anxiety is often heightened. Dental care can fall by the wayside, especially for those in later stages of dementia. Some forget how to brush their teeth, others may not understand the importance of dental care or have more sensitivity in the mouth area. Your concerns are not uncommon. Try pinpointing reasons for your mother’s discomfort; this will help in finding a solution.

In locating the right dentist, a caring and patient approach is key. Also check whether the dentist has experience with dementia patients. Dentists who deal with dementia patients sometimes administer anti-anxiety medication that may also prove helpful for your mother.

Though still uncommon, over the past years there has been an increasing number of dentists who are experienced in dealing with dementia and also make house calls. Dentists do not usually make house calls to private homes because it is not economical. Instead they visit care residences and facilities where they can see several patients during one trip.

To find a dentist who does house calls, contact:

• Local nursing homes in your mother’s community and ask for the names and contact information of the dentists who visit the facilities.
• Local dentists’ offices to ask about any colleagues who make house calls.
• A local dental association.
• The nearest dental school.

In addition, do a quick online search on “Dentists who make house calls in ____ city.”

With a bit of detective work you can put your concerns at ease and find a dentist that your mother will be more comfortable with and who will give you some peace of mind.

2. Post-Sleep Confusion – A Common Effect of Dementia?

DEAR DEMENTIA SOLUTIONS:

“My spouse has dementia and whenever he awakens from a bad dream, or a restless night’s sleep, he seems very disoriented the morning after. It’s troubling to see him in such a confused state. Is this common? Is there any way to prevent these “˜post-sleep’ reactions?”

~Waking Up Confused

DEAR WAKING UP CONFUSED:

When most of us wake up from sleep, we feel bleary eyed and perhaps mildly disoriented before our head clears. For those with dementia, these feelings of confusion and disorientation are often magnified. Your spouse’s reaction is quite common among those affected by dementia. Having worked at care homes, I have seen how residents with dementia may awaken from even a brief nap and feel confused and unsettled.

Though it can be distressing for you to witness your spouse’s reaction, know that this reaction is usually short-lived. Wait for some time to pass and allow your spouse to slowly get re-adjusted to his surroundings. To ease his confusion, try distracting him by drawing his focus towards a subject or object of interest to him. For example, you can point out that the flowers have started growing in the garden, that a favourite sports team recently won a game or that his granddaughter’s birthday is fast approaching.

You may not be able to prevent his confusion, but by distracting him you can relieve some of his tension so that he doesn’t feel distraught. As a spouse it is difficult not to feel concerned for your partner, but know that his reaction in that moment is common and should pass. Knowing this will lower your own stress and ensure that you get a good night’s sleep as well!

3. Changed Behaviour- Progression of Alzheimer’s or a Different Cause?

DEAR DEMENTIA SOLUTIONS:

“I’m worried about my mom who has been acting strangely recently. She was diagnosed with Alzheimer’s earlier, but during these past few days in particular she hasn’t been her “normal” self. She has become more moody and is especially uncooperative when I assist her in the washroom. Is this due to the progression of Alzheimer’s or is there a different cause?”

~ Searching For Answers

DEAR SEARCHING FOR ANSWERS:

It’s difficult when we see a change in a loved one, but can’t understand the cause. You are not alone. The effects of Alzheimer’s can be unpredictable and difficult to recognize when they appear. A shift in behaviour or mood can be a sign of the illness’ progression, but it can also be an indication of a physical ailment, separate from Alzheimer’s, that requires medical attention and can be treated.

Your mother’s particular issue with going to the washroom may be due to a Urinary Tract Infection (UTI). (Click here for a helpful link about UTIs). UTIs are more common among seniors, because as we age the lining of our urinary track thins allowing for more bacteria to create infection. UTIs can be effectively treated but it is vital to get it attended to right away. The longer an infection grows, the more likely it is to cause further health problems and even death.

Have your mom visit a doctor to uncover the possible reasons for her changed behaviour. If a UTI is detected through urine samples and/or blood tests, treating the infection may help return her back to her “normal” self.

Putting your detective hat on to investigate the reasons for your mom’s changed behaviour will give you peace of mind. It will also help you and your mom navigate through the effects of Alzheimer’s with greater understanding and clarity.

Do you have a specific question relating to dementia that you need answered? Please submit your questions by email to: [email protected]

Karen Tyrell CDP, CPCA is a Dementia Consultant & Educator for Personalized Dementia Solutions (www.dementiasolutions.ca) and the author of the book “Cracking the Dementia Code – Creative Solutions to Cope with Changed Behaviours.” She offers her expertise on dementia care through speaking engagements, workshops and by working one-on-one with families and caregivers.