World Mental Health Day: Dementia and Physiotherapy

Dementia is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is a disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, and judgment.

There are many kinds of dementia, with Alzheimer’s and vascular dementia among the most common. Memory, thinking, comprehension, mood and judgement can be affected.

Stages of Dementia

• Stage 1 -No impairment- The person does not experience memory, movement or cognitive difficulties.
• Stage 2 -Very Mild Cognitive Decline
• Stage 3 -Mild Cognitive Decline- Family and friends begin noticing cognitive difficulties at this stage, there are common difficulties including; difficulties finidng names, difficulties retaining new information, social and work interactions are challenging, losing and misplacing valuable items and difficulty planning or organising.
• Stage 4 -Moderate Cognitive Decline- At this stage clear symptoms are evident in several areas; forgetful of recent events, difficulty with challenging mental arithmetic, complex planning tasks are nearly impossible, forgetful of the persons own history, mood swings, withdrawn and frustration set in.
• Stage 5 -Moderately Severe Cognitive Decline- Day-to-day activites become a challenge, recaling addresses, phone number, orientation to place, choosing clothing and remembering significant details about themselves all decline into almost impossible tasks however eating and toileting are still independent.
• Stage 6 -Severe Cognitive Decline- Memory and personality changes worsen and individuals need help with daily activites. Individuals may; lose awareness of recent experiences, difficulty remembering their own name, unable to remember familiar faces, need help dressing, making mistakes with buttons, major changes in sleep patters, need help with toiletig including incontinence, major personality changes and wandering becomes commonplace with a subsequent increase in falls. Hallucinations and delusions may also become troubling for the person with dementia.
• Stage 7 -Very Severe Cognitive Decline- In this final stage of the disease process individuals lose the ability to respond to their environments, all daily activites need to be assisted, muscles grow rigid and swallowing becomes impaired.

Most people who develop Alzheimer’s Disease are over the age of 65 but younger people can develop the disease.

How can physiotherapy help?

Physiotherapists use movement of the body to help bring about physical, psychological and social well-being. Physiotherapy plays an important role in promoting and maintaining mobility in people with dementia as well as improving their quality of life and reducing the burden of care.

Physios can assess problems that restrict a person’s physical activities as well as how able they are to join in with everyday life. The physio can work with the person with dementia and their carers to encourage and promote physical activity and maintain their mobility and independence for as long as possible.

They can show carers how to support independence. This can help to ease the carer’s role and promote the best quality of life for the person with dementia.

Exercise can help to improve the thinking and mood of people with dementia, which in turn can reduce the need for medication and encourage social interaction. Exercise may in some patients have a positive impact on the behavioural and psychological symptoms of the condition.

Physios may lead exercise, music or recall classes. Seated exercise groups are an effective way of providing physical activity, along with walking and the use of technology such as the Wii. Strength and balance exercises are key for people with dementia to reduce the risk of falls and fractures.

People with dementia often have difficulty with reporting any pain they may be in; physios can assess and advise on identifying and treating pain with supporting seating and positioning advice to make the person as comfortable as possible.

People with dementia are at higher risks of falls. A physio can help reduce the risk of falls through advice, strength and balance exercises and postural assessments. They can also advise carers and other health professionals on preventing falls.

Physiotherapists are the third largest health profession after doctors and nurses. They work in a number of settings including the NHS, in private practice and in community settings. Physiotherapy has been shown to work through studies and and is a treatment you can trust.