Hallucinations, Delusions, Obsession... You Need to Understand the Symptoms to Care for 'Dementia'

 

English Translation

Hallucinations, Delusions, Obsession... You Need to Understand the Symptoms to Care for 'Dementia'

By Han Hee-jun, Health Chosun Reporter Input Date: 2021.02.02

Diverse Symptoms Beyond 'Cognitive Decline'... "Must Learn Coping Strategies"

<Image of an elderly person covering their face> Dementia manifests in a variety of symptoms. It is beneficial for the families of dementia patients to understand these symptoms and learn how to cope with them.

Dementia significantly impacts the lives of families as it involves not only cognitive decline but also a range of other symptoms. When dementia sets in, the number of neurons in the hippocampus, which is responsible for memory, decreases, leading to memory impairment. After a certain period, the frontal lobe, which controls overall brain function, deteriorates, making daily life difficult. Professor Jo Ah-rang of the Department of Psychiatry at Gangdong Kyung Hee University Hospital stated, "Survival period and quality of life change markedly depending on how well the condition is managed," adding, "It is important for families of dementia patients to learn appropriate coping strategies in advance based on the symptoms."

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<Key Psychiatric Issues>

< > Delusions About 23-50% of dementia patients experience delusions. Among the types of delusions, the most common is the belief that someone has stolen their belongings. They often single out a family member and interrogate them. Dementia patients experience these delusions because they forget where they placed the item, become flustered, and blame others. At this time, instead of pressing them about where they put the object, it's important to reassure them by suggesting, "Let's look for it together." It is even better to actively show them that you are searching for the item. It is also helpful to prepare a separate storage box for items the patient values highly.

< > Depression Many dementia patients suffer from depression, but due to difficulties in communication, families often overlook it. If the patient shows symptoms like loss of appetite or lethargy, suspect depression and engage in activities they usually enjoyed. Simply eating meals together as a family, taking a walk, or talking about pleasant past events can alleviate depression to some extent. Creating a change in environment, such as decorating the surroundings with the patient's favorite flowers, can also be helpful.

< > Hallucinations About half of the patients experience hallucinations. Most of these are visual hallucinations (<visual images that are not real>), such as seeing a deceased spouse or entities that do not exist in reality. If the family denies the patient's experience when they are hallucinating, the patient may become confused. It is helpful to acknowledge it lightly and move on, perhaps by saying, "Ah, I see."

< > Insomnia Patients often wake up in the early morning and find it difficult to fall back asleep. This is because they wake up to go to the bathroom or because they are thirsty, and then feel fear because the surroundings are dark. Professor Jo said, "Since they feel fear and anxiety even with a slight change in environment, it is important to provide psychological stability," adding, "It is good to stay next to the patient when they first fall asleep, and after they are asleep, keep low-level lighting on in the room and living room."

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<Key Behavioral Issues>

< > Obsession (Clinging/Shadowing) Because dementia patients lose their ability to recognize time and place (orientation), they become anxious if the object of their attachment is out of sight, feeling like they have been separated for a long time. When cooking in the kitchen, ensure the patient can see you from the living room. When leaving the patient alone to go to the bathroom or for a brief outing, it helps to point to a clock to indicate when you will return.

< > Questioning Due to a decline in memory and concentration, dementia patients repeatedly ask the same questions. It is important to patiently keep the patient focused and answer at their eye level. If the patient points to a cell phone and asks, "What is this?" instead of just saying, "It's a cell phone," it helps to demonstrate its use and say, "It's an item used to make calls." If the questions are incessant, redirecting the patient's attention elsewhere is also a method.

< > Sexual Behavior Many dementia patients exhibit sexual behaviors. Overreacting to this can make the patient feel intimidated. Do not panic; instead, explain who you are, for example, by saying, "I am your son." Due to the decline in cognitive ability, they may mistake the person they are attempting sexual behavior with for their spouse from a younger age. Professor Jo Ah-rang advised, "Actions like taking off pants or touching genitals are not always purely sexual acts," adding, "The cause could be a need to urinate or discomfort with a diaper, so observe carefully."