Episode 39

Understanding the Lost Cognitive Functions in Alzheimer's and Dementia | TLA039

Lisa explains how Alzheimer’s disease and related dementia progresses through its various stages and how that impacts the cognitive functions of people who live with it and will therefore greatly affect how they will be able to live their lives.

In this episode you will discover:

  • How and why short-term memory is altered.
  • Signs of language and communication impairments.
  • How loss of visual perception can impact their daily lives.
  • How a person living with Alzheimer’s disease and related dementia can easily put themselves in harm’s way when they lose their ability to use reasoning and sound judgement.

Join Lisa's Minding Dementia Support Group Facebook page.

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.

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Transcript
Unknown:

Welcome back to another new episode of the Truth, Lies and Alzheimer's show. I'm Lisa Skinner, your host, and I am honored to continue our exploration of the multi faceted world of Alzheimer's disease, where we will be delving into the complex and often misunderstood world of Alzheimer's disease. I'm here to help you navigate through the truth, the myth and the challenges surrounding this condition. Join me, as we explore the latest research, share personal stories, and provide valuable insights into living with Alzheimer's disease. And whether you're a caregiver, a health care professional, or someone who's been impacted by Alzheimer's disease, this show is dedicated to shedding light on the truth, dispelling those lies and offering hope in the face of this challenging disease.

Unknown:

So what I wanted to share with you today on today's episode is explaining and helping you have a better understanding of what cognitive functions people with Alzheimer's disease lose, and why they lose these functions. So one of the first parts of the brain to be damaged by brain disease, especially Alzheimer's disease, this is the hallmark of Alzheimer's disease is when these plaques and tangles formed in the brain. And they basically suffocate the neurons and do so much damage that the those parts of the brains eventually just fail. So memory is the first part of our cognitive functioning that is impacted by Alzheimer's disease. Alzheimer's often first manifests as short term memory loss, as we know, where the individuals may have difficulty remembering recent events, conversations or appointments. As the disease progresses, long term memory can also be affected, leading to challenges in record calling significant events and or personal details. However, the long term memory does stay intact for most of the disease, and sometimes all the way through the disease. So when the short term memory is failing, and as your as a person is progressing through the illness, it's working sometimes and other times, it's pretty much short circuited and it's it's not working temporarily. And that increases over time. And as that happens, that person living with Alzheimer's disease, when their short term memory has failed them will pull from their long term memories. And this is the reason why so many people so commonly talk about things from their past, like they're happening at that very given moment, the here and now, because they have gone back in time, kind of like pushing rewind. And in their minds, they're living in a past part of their life, until that short term memory comes back. And this goes off and on off and on, off and on until the end of the disease. And at that time. With many people who live with Alzheimer's disease, that short term memory shuts off completely. And then they are permanently living back in a previous timeframe of their lives. And everybody ends up in a different place. Some go back to their childhood, and they start asking, you know, where's my mommy and where's my daddy and some are in their adolescent phase of their life. So they're teenagers, summer in the prime period of their life, they're raising children and going to work and the way you know what part of their lives they've kind of got stuck in after their short term memory is completely gone or almost completely gone. Is you listen for the cues of what they're talking about. And their conversation, the things that they're talking about. Are going To give you the clues to where they are in their timeline, based on what they're asking for, it's time for me to go pick my daughter up, she'll be waiting for me, well, obviously, she's a mom raising children. So that's how you identify that they lose their reasoning and judgment.

Unknown:

So what that means is Alzheimer's can impair a person's ability to make sound decisions, to solve problems, and exhibit good judgment. This can lead to extreme difficulty in their ability to plan in their ability to organize and carry out tasks that were once routine. So from balancing a checkbook, to operating them, and a simple appliance like a toaster that they've done for decades, they lose the ability to continue to do those simple, daily tasks. As far as exhibiting good judgment, I'll give you an example. That is very life threatening and scary. But we were all taught growing up as children, when we cross the street, we need to look both ways to make sure cars not coming and that we can safely go across that street, they lose that ability to make some judgments. So all that learning leaves there the files in their brain. And it would not be uncommon for somebody living with kind of mid stage to latter stage to leave their their safe surroundings in their home or somewhere else. And just walk into a street without making sure there are not cars coming in their direction. It happens all the time. That's an example of no longer having the cognitive ability to use good judgment, safe judgment on things that we just do on a normal basis. They lose their ability to for language and communication skills. individuals with Alzheimer's may experience trouble finding the right words, we call that aphasia, following or joining in conversations, and understanding written or spoken language. So what happens is this can result in increased difficulty in expressing thoughts and emotions. And a lot of people actually lose their ability to articulate their wants and their needs. But they still trying to tell us things and communicate their wants and their needs. So they find alternative ways to do that. And this is what shows up in behaviors that we see anxiety and anger and screaming out things like that. They're trying to tell us something. And it's up to us to figure out what that something is.

Unknown:

They lose visual perception. This surprises a lot of people, Alzheimer's can actually impact a person's ability to interpret visual information, leading to difficulties with spatial awareness, recognizing objects and navigating their surroundings. So let me give you a quick example of that. So as far as visual perception, when people are suffering from Alzheimer's disease, they eventually lose their depth perception. So it is known that if you put their food on a white plate, and the tablecloth is white, they would have a very difficult time or could not at all, separate the plate from the table and just see it as one big thing. So a remedy for that is to color contrast, the color of the plate with the color of the table or the tablecloth. So if you have a white tablecloth, maybe you want to put the food on a red plate, and then they can stink distinguish the plate from the actual table. And so that's, that's a good example of how they lose visual perception, recognizing objects, things like that. I'll just give you another quick example of recognizing objects. A lot of people men especially have a very difficult time being able to To differentiate toilets from the rest of the, from the floor, and they and that causes them to basically miss their aim. So again, if you have a toilet seat that is a different color from the floor, the tile, they would be able to make that out much easier than if everything is the same same color, and it just all blends in through their, through their perception. They lose attention and concentration abilities. People with Alzheimer's, they struggle to maintain focus on things to stay attentive to process information, which can hinder their ability to engage in conversation and follow instructions and complete tasks, they also lose their ability to do what we call task sequence. And eventually we'll need help with that. Now in the beginning, you can help them by prompting or cueing them. But eventually, that's not going to work for them either. So they'll have to be taken over by a caregiver. Brushing your teeth is a good example. We've been doing it all our lives, we know that we could probably do it in our sleep, you could walk into the bathroom, the first thing you do as you turn on the water, you pull your toothbrush out of it holder, you put the toothpaste and then you start brushing and it's all that whole entire task is done in a learned sequence a person, once they get to about the mid stage of Alzheimer's disease, they can no longer perform tasks in their correct order or sequence. So you might have to say okay, now you put the toothpaste on the toothbrush, and then maybe even demonstrate, and then eventually they probably will need to have somebody do that for them.

Unknown:

These cognitive functions are affected by the Hallmark brain changes associated with Alzheimer's disease. And as I mentioned, these include the accumulation of abnormal protein deposits called amyloid plaques, and tau tangles, as well as the loss of connections between the nerve cells. These changes what happens is, and this is why we see the things we see with this disease. These changes disrupt the communication and functioning of our brain cells, leading to the cognitive decline observed with Alzheimer's disease, this is all part of the disease. Additionally, as the disease progresses, these cognitive deficits can significantly impact an individual's independence and quality of life, highlighting the need for ongoing research, improved care strategies, and effective treatments for Alzheimer's disease. Now, I've been doing this for professionally for 30 years, I've had eight of my own family members live with one of the brain diseases that causes dementia. My very first experience dates back about 50 years when my grandmother started telling me that birds were living in her mattress, and coming out at night and pecking her face telling me that rats were invading her home and she points to the wolves and said, See they're running along the walls, and insisting that men were stealing her jewelry, which is part of the changing brain, we see a lot of paranoia and suspicious behavior with this disease. So these are all very, very common things that accompany Alzheimer's disease and some of the other brain diseases that cause dementia. And if we are aware of these things, we will know what to expect. And when they do happen, we'll recognize them as being part of the disease and then to just take that one step farther.

Unknown:

There are best practices and effective responses that we as loved ones and caregivers can learn that can minimize a situation from escalating into a really serious situation. We call those serious situations catastrophic reactions. So to minimize catastrophic reactions, which are like meltdowns that you will see in people suffering from Alzheimer's disease, there are things that you can learn. We've talked about them before, but I'll continue to bring them up. So they'll eventually become second nature to you. And what that's going to do for everybody is provide a better quality life for the person living with the dementia, it's going to provide a better quality of life for the caregiver and the family members. And really then focus on what's most important, and that is obvious. It's spending quality time with the person you care for, or your loved one without all the added stress and anxiety that comes from all the expect unexpected things that show up and not being prepared to know how to properly handle them. So that's what I have to share with you on today's episode, and I look forward to seeing you back next week for another new episode of The Truth lives and Alzheimer's show. Thanks

About the Podcast

Show artwork for Truth, Lies & Alzheimer's
Truth, Lies & Alzheimer's

About your host

Profile picture for Lisa Skinner, CDP, CDT

Lisa Skinner, CDP, CDT

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.
Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Skinner’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle they can have a better-quality relationship with their loved ones through education and offering workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.