Myth 1. People with dementia are like children.
This is not true. Although people with dementia often require assistance with daily tasks and have barriers to participation in certain activities, they are still adults with many of the same needs and desires as other adults. Some of the symptoms of dementia do overlap with behaviours that young children and teenagers often exhibit such as mood swings, difficulty with vocabulary, and a decreased attention span. However, the causes of these behaviours and the internal experiences are different between an adult with dementia and a child or teenager.
It is important that individuals with dementia are treated with dignity and respect. Continuing to treat people with dementia like adults after diagnosis is a part of this! Few adults, if any, would want every decision made for them. This is still true if those adults happen to be living with dementia. Ensuring the individual is involved in care decisions and activities are of interest to them are two ways that autonomy can be maintained. Activities may need to be modified, and care decisions may not always be exactly in line with their desired outcome. However, involvement in the process maintains a level of dignity and can improve outcomes.
Our word choices are vital. I certainly don't know an adult who wants to be spoken to with childish language or a parental tone. Although simplifying language and maintaining space for responses and comprehension are great tools for communication with both children and adults with dementia, these should look different between the two groups. A care activity that both young children and adults with late-stage dementia may need assistance with is toileting. A parent might say to a child "Use the potty before we go" to reduce accidents while out. Instead of this type of language "Let's use the bathroom first." is a simple way of saying the same thing in a more appropriate way.
Finally, unlike children who will continually progress the opposite is true of people with dementia. There will of course be good days and bad days, but it is an overall progressive disease that at present can only be managed and not reversed. Managing expectations can be important for both caregivers and people with dementia due to this. Important decisions are best made early on, to maintain as much dignity and involvement as possible. Typically mistakes are made from a well-meaning place, but keeping in mind that this is still an adult is important and can limit difficulties.
Myth 2. People with dementia are at an increased risk of elder abuse.
Unfortunately, this one is true. It is difficult to assess exact rates of any type of abuse, due to a lack of reporting, legal definitions of abuse, and other factors. However, it is estimated that 4-8% of seniors living in Canada experience elder abuse. For those diagnosed with dementia, the estimates range from 5-12%. However, these are both likely underestimates. Symptoms of dementia create additional vulnerabilities through increased reliance on caregivers, communication difficulties, lowered cognitive capacity, and personality changes. These vulnerabilities can increase the risk of experiencing abuse.
Elder abuse is not only physical abuse, but can also include neglect, psychological abuse, financial abuse, sexual abuse, or other forms. Watching for signs of abuse and neglect can lead to quick interventions that may be lifesaving or quality of life-saving. Abuse has negative impacts on both physical and mental health, and it takes a community to prevent elder abuse, and react when it does occur.
If you suspect that you or someone you know may be experiencing abuse a list of available resources is available here. Locally, you can also reach out to Camrose District Support Services, a trusted health care professional, or the Camrose Primary Care network.
For more information
For more information on dementia and cognitive capacity visit: https://www.lchaimretirement.ca/dementia-care-reverting-back-to-childhood.html
For more information on dementia and elder abuse visit: https://alzheimer.ca/en/help-support/im-caring-person-living-dementia/ensuring-safety-security/elder-abuse
Sources Consulted
https://www.brainsparks.com.au/dispelling-dementia-myths-people-with-dementia-become-like-children/
https://www.alz.org/help-support/caregiving/safety/abuse
https://www.edmontonpolice.ca/communitypolicing/familyprotection/elderabuse.aspx
https://www.alberta.ca/elder-abuse-prevention-engagement.aspx