Is it OK telling fibs to a person with dementia? The answer is: ‘yes and no’ or ‘it depends’. This is discussed in my book on pages 78-79 and 341-345. Rigid, dogmatic, blanket and insensitive application of ‘Reality Orientation’ or ‘Therapeutic Fibbing’ can be damaging to a person with dementia. But the account of therapeutic fibbing in the link below is helpful and not dogmatic in considering situations where this approach is necessary, indeed essential. Therapeutic Fibbing: Why Experts Recommend…..
COLLABORATION WORKING IN OLDER PERSONS MENTAL HEALTH, AGED AND DEMENTIA CARE. “Raise Your Voice’ – A thought provoking and stimulating conference from the PGNA on Friday, 13th September in Wollongong. A great line-up of speakers from diverse backgrounds includes Dr Sue Packer, 2019 Senior Australian of the year, and 9 others. www.pgna.org.au/conference Dr Sid will be speaking on: ‘Mental illness: mind, body, brain, family and culture’. He will present some information on: anxiety, depression, hallucinations, delusions and confabulations associated with…..
The fibres/tracts/connections shown in the beautiful pictures in the link below are often affected in older people by damage to microscopic arteries (arterioles) in the brain. This can contribute to depression and to neurocognitive problems, including dementia. (page 275 and pages 455-458 in my book). The ABC Science article provides a nice account of the way these pictures are produced, indirectly, via mathematical analysis from MRI imaging. Knowing about these connections can help us to understand how brain systems (rather…..
Judgment depends on memory. New research appears to show that remembering task and decision-making sequences involves a later replay of those processes directed by a structure in the brain called the hippocampus. Replay in the hippocampus is critical to forming memories but also to learning which of our behaviours and decisions are most effective at accomplishing a particular or perhaps related goal. The hippocampus is damaged in Alzheimer’s disease and usually in Alcohol Related Brain Disease. This process of ‘replay’…..
The link below is to an article which nicely outlines three important presentations of Frontotemporal Dementia (FTD) – a common form of early onset dementia – dementia which affects people in their 50s and 60s: Behavioural variant FTD; Language variant FTD; Amyotrophic Lateral Sclerosis (motor neurone disease) with FTD. Or read about it in Your Brain in Sickness and in Health: page 66 and descriptions/explanations elsewhere in the book of particular issues with this disorder such as deterioration in social…..
A person experiencing dementia may easily become overwhelmed and flustered. They may then have even greater difficulty than usual with remembering, with managing tasks and with functioning independently. They may become very anxious, angry, ashamed or distressed in other ways. The heightened emotion can then further interfere with their ability to ‘think straight’, to function well, and a ‘vicious cycle or circle’ may set in. This has been called a ‘catastrophic reaction’ and is discussed in Chapter 4 of my…..
Another cause of severe memory loss, particularly affecting people over 80 years of age, has been found. So the known causes of the disorders called dementia are now believed to be: Alzheimer’s disease, Vascular dementia, Dementia with Lewy bodies, ‘LATE’ (the newly understood cause) and, importantly various mixtures of these brain disorders. You can read about it in a CNN post: https://edition.cnn.com/2019/04/30/health/dementia-late-alzheimers-study/index.html or in detail in an article in the journal Brain.
The drug ‘aducanumab’ showed great promise in removing amyloid from the brains of people with Alzheimer’s disease. Amyloid deposits (‘plaques’) have been thought, perhaps incorrectly, to be the cause of brain deterioration in Alzheimer’s disease. But preliminary analysis of results from an incomplete very large trial did not show enough improvement to justify continuing the trial. Read more in the Time article: http://time.com/5557060/alzheimers-drug-aducanumab-trial-patient/
If you are interested in buying ‘Your Brain in Sickness and in Health’ by Dr Sid Williams you have many options. It is available in soft cover, hard cover and e-book. You can press the ‘order now’ button which will take you to ‘Lulu.com‘ – the publishers. They are in the US but the book is printed ‘on demand’ in a number of other countries. You can ask your bookshop to order the book. Because the book is printed ‘on…..
Korsakoff syndrome, usually associated with alcohol abuse can occur without alcohol intake at all. It is due to a deficiency of thiamine (Vitamin B1). Other conditions where it can be a problem include: anorexia-bulimia nervosa; severe and persistent vomiting (pregnancy, chemotherapy); after gastric banding; associated with Cancer or other causes of malnutrition or subnutrition. It is discussed (as Wernicke-Korsakoff state) on pages 94, 104, 353-4 in Dr Sid’s book. http://www.jneuropsychiatry.org/abstract/a-case-of-nonalcoholic-korsakoff-syndrome-resulting-from-malnutrition-due-to-selfneglect-and-severe-depression-12799.html