Guest column: Struggling with changes in brain function: A difficult journey

"Where did I put my keys?"

"Why did I come into this room?"

What is dementia?

Changes in brain function, also known as dementia, come in many shapes and sizes and can be caused by numerous variables.

Dementia is different than age-related memory loss. Age-related changes do not affect how a person functions; rather, only the memory is affected. However, as dementia gets worse day-to-day function is affected. Even with cues or prompts the person may not be able to understand or identify information.

It is crucial for family members to realize the difference and not let dementia go untreated. Early intervention can have a positive impact; however, once dementia is considered moderate it is difficult to treat.

Dementia is characterized by loss of memory and at least one of the following:

· Difficulty speaking, using words incorrectly and not understanding what an object is used for (does not know what to do with a spoon, toothbrush, etc.)

· Changes in personality

· Confusion/disorientation

· Difficulty processing visual information

Categories of dementia

There generally are five different categories of dementia:

1. Degenerative: The most common in this category is Alzheimer's disease, which has a gradual progression. Lewy-Body is similar to Alzheimer's but has a rapid progression and is characterized by increased falls and marked fluctuations in consciousness.

2. Vascular: Caused by the occurrence of one or more strokes, small blood vessel disease or the absence of oxygen to the brain.

3. Traumatic: Caused by a blow to the head or fall.

4. Infectious: Otherwise known as Creutzfeldt-Jacob disease, it occurs very rapidly and is fatal. Infectious dementia also can occur in late stages of AIDS.

5. Toxic: Caused by alcohol abuse or exposure to harsh compounds or chemotherapy treatments.

Other situations such as poor sleep, stress, dehydration, nutritional deficiencies, anxiety, depression and chronic illnesses such as fibromyalgia, lupus or infection also can make the brain function less efficient. If one has difficulty concentrating and paying attention, a person will then have trouble with memory because the information does not reach the brain in the first place.

Help is available

First, a complete physical should be done by a primary care physician. Following that, it may be appropriate to work with an occupational therapist to address and assist the patient and family members with any functional problems that may be occurring. The therapist will perform a thorough evaluation to identify the person's abilities to complete daily living tasks, participate in activities, learn new skills, improve existing skills and so on. Treatment is based on evaluation findings. Education, memory strategies, brain stimulating tasks, homework, adaptive devices and safety are just a few of the areas occupational therapists can impact.

Additionally, caregiver training is part of the occupational therapy and intervention/education process. It is painful to watch the function of your loved one decline and changes in their personality can be overwhelming. Adult children and other family members must intervene and often are forced to make difficult decisions such as removal of driving privileges, overseeing financial matters, providing constant care and more.

Fortunately, many insurance plans and Medicare cover occupational therapy for patients diagnosed with dementia or other brain-function conditions.

Mickie Toutant, O.T., is an occupational therapist at Flagstaff Medical Center's EntireCare Rehab and Sports Medicine. She has an interest in and has received additional education in the evaluation and treatment of people with early- and middle-stage dementia.

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