What is dementia? We think we know (but we don't).



Teepa Snow


This is part two of my series on dementia. This was published in MidWeek on June 19, 2019.

Say you’ve noticed a parent has been different lately. Mom forgets things almost as soon as they happen. She asks the same questions over and over again. Dad has trouble finding the right words to express what he’s thinking. He forgets to take his medication, or takes it twice because he’s forgotten he already did. She gets hostile and angry if you question her. He loses interest in things that used to give him pleasure.

Everybody is constantly on edge.

Is it dementia, you wonder? Is it (heaven forbid) Alzheimer’s?

Teepa Snow is an educator in dementia care. She’s an occupational therapist with 40 years in clinical practice, and founder and CEO of Positive Approach to Care (PAC). Snow travels around the world training professional caregivers, family members and medical professionals in the most effective ways to support and care for their patients and loved ones with dementia. Snow has just wrapped up a visit to Hawaii, sponsored by the Healthcare Association of Hawaii. She took some time to share a bit of her knowledge with me.

Think of dementia as a big umbrella, she says. A great big umbrella.

“The world of dementia is changing,” she explains, “week by week. What we thought was all Alzheimer’s we now know there are 120—at least—forms, causes and types of dementia, and Alzheimer’s is not the big boy in the box anymore.”

Now researchers know there may be mixed causes, or a couple of them, or different forms such as Lewy Body or frontal temporal or vascular dementias. Some are byproducts of a health condition such as Parkinson’s disease.

Snow says dementia isn’t a diagnosis, it’s more of a syndrome—a collection of symptoms.

In one of her excellent videos, Snow presents four facts: If you have dementia, at least two parts of your brain are dying. Second, you can’t bring back what’s lost, stop it or cure it.

“When someone is living with a brain change like dementia, it means the brain is gone,” she says. “And I can’t fix that.”


Third, the symptoms are constantly changing, because dementia is progressive.

And finally, and this is true of all dementias—they’re terminal.

“But frankly,” she concludes, “so is life. My goal is to keep working with what’s there.”

Before concluding a person has dementia it’s important to rule out other conditions that actually are treatable:

*Mental health issues, like depression;

*Physical health issues, such as hypothyroidism;

*Complications from medications;

*Sensory changes, such as a loss of hearing or vision;

*A new chronic condition, such as diabetes.

Once treatable conditions are ruled out, Snow says every person needs to be screened “to figure out what are they able to do, and what aren’t they able to do.”

And then work out how best to deal with what’s going on.

I’ll go into that in part three. Snow gave me too much information for one column. I’ll have more on what she shared about strategies for living and caring with a person with dementia, and also touch on some caregiver resources that are available for families in Hawaii.

In the meantime, if you need more information, go to the PAC website at https://teepasnow.com/resources/about-dementia/.










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