Your Spouse Has Dementia: What Do You Do?
You just found out that your spouse has dementia. Here are 11 things you can do to improve your life and the lives of your spouse and family.
11 Things You Can Do When Your Spouse has Dementia
1. Accept that your marriage will change.
A spouse’s role changes several times throughout most marriages to adapt to life changes. One spouse may take on more responsibilities while the other goes to college, for example; having children can also change a marriage. The changes that come with dementia can also alter your marriage.
As your spouse’s dementia progresses, you will have to take on more responsibilities of managing your household and caring for your family. Marriage becomes less and less of an equal partnership; your role will shift from being a spouse to a caregiver. You will likely do most of the household chores and handle bill payments, for example, and you will have to make most of the decisions regarding your household and family. As the condition progresses, you will also have to provide an increasing level of supervision of your spouse.
2. Learn about dementia.
Dementia is a general term for a decline in cognitive function. In other words, dementia is any type of brain condition that causes trouble with thinking, remembering and reasoning to the extent that it interferes with a person’s daily activities. Dementia affects memory, language skills, visual perception, problem solving, self-management and self-care, and the ability to pay attention and focus. Dementia also affects a person’s behavioral abilities. Some people with dementia have trouble controlling their emotions; their personalities may even change.
The signs and symptoms of dementia can appear when nerve cells in the brain, known as neurons, stop working. Neurons help the various parts of the brain communicate, and help the brain communicate with the rest of the body. Symptoms of dementia develop as these neurons stop working, lose connection with other neurons or die. It’s normal to lose some neurons as you age, but dementia will cause your spouse to lose more neurons at a greater pace.
Dementia is more common as people grow older – about half of all people ages 85 and older have some form of dementia – but dementia is not a normal part of aging. It is often a progressive condition, which means your spouse’s symptoms will likely worsen over time.
3. Get a diagnosis.
Certain health conditions, such as an abnormal buildup of fluid in the brain, head injuries or blood clots in the brain, can cause dementia. Some medications, vitamin deficiencies and emotional problems, such as stress or anxiety, can also cause dementia. Unlike Alzheimer’s disease and other types of dementia, these problems are quite treatable.
There is no cure for Alzheimer’s disease or other types of dementia, but treatment can reduce symptoms and slow down the progression of the disease. Treatment relies on an accurate diagnosis.
The doctor will start by determining if your spouse has an underlying condition that is causing signs and symptoms of dementia; early detection is important, in that prompt treatment can optimize the results. Next, the doctor will perform a medical assessment that includes a detailed medical history, physical exam, laboratory testing and neurological tests. The clinician will perform cognitive and neurophysical tests to assess your spouse’s memory, problem solving, language skills and math skills. Brain scans, such as magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography (PET) create images of your spouse’s brain. These images help your doctor identify abnormalities in the brain, which may help the physician diagnose the type of dementia affecting your spouse.
4. Educate yourself and your family about your spouse’s dementia.
Learn as much as you can about the specific type of dementia your spouse has. There are several types of dementia. Each affects the brain in a slightly different way, so each causes different symptoms and has a different prognosis or outcome. Learning about your spouse’s dementia gives you the information you need to prepare yourself, your spouse and your family for the different stages as they occur.
There are many different types of dementia, each with their own signs and symptoms. You can start learning about dementia here and view a list of the most common types below.
Alzheimer’s disease – the Alzheimer’s Association says Alzheimer’s disease is the most common form of dementia, accounting for between 60-80% of all cases.
Vascular dementia – the second most common type of dementia; confusion and disorientation are common in the early stages, while trouble completing tasks and poor concentration can occur in the later stages.
Dementia with Lewy bodies – often causes visual hallucinations, trouble falling asleep at night, feeling faint and disorientation.
Parkinson’s disease dementia – many people with Parkinson’s disease develop dementia.
Frontotemporal dementia – also known as Pick’s disease, the term “frontotemporal dementia” describes several types of dementia that affect the front and side parts of the brain, which are the areas that control language and behavior. Frontotemporal dementia does run in families.
Creutzfeldt-Jakob disease – an extremely rare and lethal form of dementia that causes symptoms similar to other forms of dementia, in addition to possible agitation, depression, confusion and loss of memory. Creutzfeldt-Jakob disease progresses very quickly, and patients with the condition often die within a year of diagnosis.
Wernicke-Korsakoff syndrome – caused by a lack of vitamin B that leads to bleeding at the bottom of the brain, this condition can cause physical symptoms, such as double vision and loss of muscle coordination. Wernicke-Korsakoff syndrome is a memory disorder, so people with the condition may have trouble processing information, remembering things and learning new skills.
Normal pressure hydrocephalus – resulting from a buildup of excess fluid in the brain’s ventricles, which are fluid-filled spaces that rely on having just the right amount of fluid to cushion the brain.
Huntington’s disease – a genetic condition that causes the premature breakdown of the brain’s nerve cells.
Mixed dementia – a situation where a person has more than one type of dementia; up to 45% of people with dementia have mixed dementia but do not know it.
5. Recognize that your spouse’s behavior is not intentional.
The brain changes associated with dementia may cause your spouse to feel anxious, lash out and even take on a new personality. While some of the things your spouse will say and do will be hurtful, it is important to understand that his or her behavior is not intentional – broken communication lines cause your spouse’s brain to misinterpret and misunderstand events happening around them. The miscommunication within your spouse’s brain might lead him or her to think that a blowing curtain is actually a home invader, for example. Memory problems might cause him or her to momentarily forget who you are, so to them, you might really seem like a stranger who is “out to get them.”
6. Learn how to identify what your spouse needs and respond accordingly.
Dementia disrupts communication in the brain. In the early stages of dementia, your spouse might have trouble conveying what he or she needs.
As dementia progresses, your spouse’s brain has trouble identifying what the body needs. This can cause a mismatch between what your spouse needs and how he or she acts. Your husband or wife might be hungry or in pain, for example, but may act out because he or she is unable to identify what is wrong.
7. Learn how to communicate.
Set a positive mood for interaction. Keep in mind that your body language and attitude communicate your feelings, sometimes even more strongly than do words, so use facial expressions, tone of voice and physical touch.
Get your spouse’s attention and show your husband or wife that you are paying attention too. Limit distractions and noise by turning off the television or computer, closing the curtains and doors, or by moving to a quieter environment. Sit or stand at eye level and maintain eye contact throughout the entire conversation.
Establish a pleasant and respectful tone. The brain changes associated with dementia can make your spouse prone to anxiety, confusion and stress, so try to maintain a calm demeanor whenever possible. Address your spouse by his or her first name or nickname.
Ask simple, answerable questions or make actionable statements. Ask one question at a time; yes or no questions often work best. For example, instead of asking your spouse which shirt he or she would like to wear, hold up one shirt and ask if they would like to wear it.
State your question or comment clearly; use simple words, short phrases and limited, concise instructions. Speak slowly, at a normal volume and with a reassuring tone. If your spouse cannot understand you, try speaking to him or her in a lower pitch rather than speaking at a higher volume. If your husband or wife still does not understand you, wait a few minutes then rephrase the question or comment.
Listen closely to what your spouse has to say and look at the overall situation to identify other factors that might be affecting communication. Try to determine what your spouse needs and deliver it the best you can.
Break down activities into a series of small steps to make complex tasks more manageable. Encourage your spouse to do what he or she can and assist with steps your spouse can no longer do. Try using visual cues, such as picking up and placing a washcloth next to your face, which can help your spouse remember what to do without being told what to do.
When your spouse gets agitated, try changing the subject or changing the environment. Simply turning off the television can reduce distraction and confusion, for example, and going for a walk together can help you reconnect with your spouse.
8. Respond with love and kindness.
Try to respond with kindness, respect and consideration, even when your spouse cannot respond in kind. The brain changes associated with dementia can cause your spouse to feel anxious and confused, even in a calm and safe environment. The emotions and perceptions feel very real to someone with dementia, so avoid trying to convince your spouse that he or she is wrong or “just imagining it.” Stay focused on the feelings they are demonstrating and respond with physical and verbal expressions of comfort, support and reassurance.
9. Cherish the past.
Remember the good old days, as your spouse may now have trouble remembering what happened just a few minutes ago. Remember the past by looking at old pictures or by watching a favorite movie; avoid asking questions that test your spouse’s short-term memory.
10. Cherish your love.
Maintain your sense of humor and your love for your spouse. While your marriage has changed, your love for one another can continue forever.
11. Consider outside help.
If your spouse has dementia, make an appointment for both of you to meet with your spouse’s doctor. Speaking with a professional at a memory care community can also help. The memory care professionals at The Brielle at Seaview can help you understand what you and your spouse can expect during the progression of dementia. The Brielle at Seaview offers full-service assisted living and memory care in a park-like neighborhood on Staten Island, provided by a trained caring staff with on-site medical oversight. Contact us to learn more today.