The Dementia Primer: 8 Things to Know About Alzheimer’s and Dementia

When her caregiver arrived, the front and back doors to “Nan’s” home were both open, and she was watching a news show on television.  The caregiver looked around and said, “Nan, your doors are propped open.”

She turned to him with her cute smile and said, “Bin Laden came in through the front door and went right out the back and left them wide open.”

In her late eighties, our client Nan had dementia, but she maintained a wonderful sense of humor about it.  She seemed to know she had memory loss and could take it all in stride.  Not everyone with dementia, however, is quite so easygoing.  In our years of providing home care services for seniors, we’ve also had clients with dementia who are easily irritated, prone to pinching, or just plain aloof.

For children taking care of elderly parents, a dementia diagnosis can be devastating.  The mother who once ensured they had a balanced diet, for example, might now need to have sweets locked up to prevent her from eating nothing but chocolate.  It’s a role reversal that many adult children aren’t prepared to tackle.

To guide families in understanding dementia, we share the following overview:

Dementia, Alzheimer's Disease, Assisted Home Care, Care for Older People, Memory Care, Care Agencies, Elder Care Provider, Home Care CompaniesWhat is Dementia?

Dementia is the progressive deterioration of cognitive function (the ability to process thought).  Depending upon the cause of the dementia, sections of the brain may literally be dying, resulting in permanent loss of the ability to think and reason.  Dementia may also be caused by a lack of oxygen circulation to the brain and other types of brain damage.  Alzheimer’s disease is just one of the medical conditions that cause dementia.


Some Effects of Dementia

Dementia affects different people in different ways, so one person’s symptoms may be entirely different from another’s.  Some people with dementia, for example, will experience visions or hallucinations, many will not.  Some will retain much of their personality and keep their bearings about them, others will not.  Here are some common effects of dementia:

1.  Nature of Memory Loss

Memory loss will happen backwards so that the person is losing newer memories first and maintaining older memories longer.

Examples:  Grandma may not recognize herself in the mirror because in her mind, she is thirty-five years old, and the person she sees in the mirror is older.  Grandpa may ask about his mother because he is remembering himself as twenty.

2.  Loss of Short-Term Memory

People with dementia will not be able to store information in short-term memory.

Example:  A caregiver was working with a client who got angry and kicked him out of the house.  He walked around to the back of the house, entered through the back door, and she was delighted to see him just minutes later.

3.  Difficulty Learning New Skills

People with dementia lose the ability to learn new skills, such as how to operate new faucets in their sink.

Example:  When one family bought their mother a new microwave, she was unable to learn how to use it.  They had to locate a functioning microwave like her old one.

4.  Language Skills Change

People with dementia may lose nouns or have difficulty finding the right word.  In giving directions, they may not understand what you say and may need you to demonstrate what you want them to do.

Examples:  Grandma may use phrases such as, “Hand me that thing you put water in” instead of saying, “Hand me that pitcher.”  When asked about her glasses, one of our clients couldn’t find them.  After looking throughout the whole house, all the caregiver found was her old pair of glasses.  When the client saw them, she said, “What would I need those for?  I have these.”  And she immediately located her newer glasses.  She knew where her glasses were; she just forgot what they were called.

5.  Change in Reasoning and Abstracting Abilities

People with dementia may lose sense of time.  Thirty minutes may seem like six hours.

Example:  Immediately after eating breakfast, one client walked up to his caregiver and asked for breakfast.

6.  Judgment Issues

People with dementia may not be able to judge situations appropriately.

Examples:  Grandpa may ask about your garden in the heart of winter.  Grandma may want to wear a nice sweater in July or may go outside without a coat or shoes in winter.

7.  Planning and Foresight Issues

People with dementia will probably only be able to do a task one step at a time.

Example:  Grandpa may be confused when you tell him to “get dressed,” or he may know to get his undershirt on and then forget what to do next.

8.  Lack of Inhibition and Impulse Control

People with dementia may share thoughts with raw honesty because they physically lack the mental filter of what is socially acceptable.

Example:  Grandma may call a baby ugly or use profanity, even if she never swore before having dementia.

Please keep in mind that the effects of dementia can change vastly from person to person.  Use this information as an overview, but continue to research in order to learn more as behaviors change.  A good book to reference is The 36-Hour Day by Nancy L. Mace and Peter V. Rabins.


Be sure to check out our follow-up primers on 6 Tips for Working with People with Alzheimer’s and Dementia, 7 Pitfalls of Caregiving for People with Dementia and Alzheimer’s, and 12 Tips on How to Get Someone with Dementia to Eat.

Read caregiver Jody’s personal journey of facing her own mother’s dementia diagnosis for additional insight.

Based on your experiences with dementia, what are some insights into the disease that you’ve learned?  We’d love to hear your experiences.

Julie Ellingson, LSW

January 4, 2012

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Comments (1)


  1. Donna Duchene says:

    Thanks, Julie for the excellent articles on Dementia. One thing that is always on my mind, having just lost my mother who had dementia is that a person need not be ‘elderly’ to show signs of onset. This can strike adults in mid age (or younger) of adulthood as well. It is wonderful that so much has been done on research thus far, but there is still a lot to learn to combat this awful disease-the brain is an extremely complicated organ.

    We do know, however, that the earlier the diagnosis the more effective the medication is to slow the progress. So it is worthwhile to have the tools in front of all of us so that we are better able to recognize what may be symtoms in those we love and care about. I see that the Alzheimers Assn of Mn/No Dak is not tagged on the article and I would encourage everyone following your blog to go to their website at The site is huge but always current and has vast amounts of information for family members and caregivers. Having done my internship with the organization, I know that the wonderful, dedicated staff and volunteers always stand at the ready to support family members and caregivers 24/7. I always have materials at my disposal to give to family members and encourage them to utilize the support and education services they offer.

    Much has been accomplished, but much more is needed.

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