How can we improve the quality of life for people with dementia and their families?

  Dementia is a common disease among the elderly, and with the aging of the population, the number of dementia patients will increase year by year, which will have a serious social impact on human beings, so dementia is not only a challenge for the medical community, but also a global challenge in the 21st century. 2005, the International Alzheimer’s Disease Association released: one new case of dementia appears every 7 seconds worldwide. Epidemiological surveys conducted in four cities in China, Beijing, Shanghai, Xi’an and Chengdu, suggest that the prevalence of dementia among people over 65 years of age in China is nearly 5%, according to which it is estimated that there are nearly 5-6 million people with dementia in China.  In fact, it is very important to recognize the symptoms and go to the doctor. Only a doctor can make an accurate diagnosis of the patient’s condition, and besides, sometimes some of the symptoms are reversible. On the other hand, even if a person is diagnosed with dementia, there is not nothing that can be done. In addition to prompt medication, family members and caregivers can seek help from their doctors or relevant organizations (such as the Physician-Patient Connection) to learn how to care for a person with dementia and understand how to improve the quality of care.  Alzheimer’s disease (dementia) is the most common type of dementia in old age. Patients often exhibit near-memory loss that affects their ability to work and lose things; have difficulty performing household tasks; often cannot find the right words to express themselves and cannot name even the most familiar objects; have disorientation in time and place, often get lost, do not know where they are or how they got there, and how to get home. or how to get home, or simply do not know what season it is, nor do they know the year, month, date, etc.; poor or reduced judgment; difficulty in abstract thinking and calculation; often misplace things, or even put things in particularly inappropriate places, such as putting the iron in the refrigerator or the watch in the sugar bowl; mood or behavioral changes, very rapid mood swings, quiet times will have no The mood or behavior changes, with very rapid mood swings, crying for no reason at all during quiet times, or even extreme anger; very obvious temper changes, becoming extremely sensitive and suspicious or very fearful, becoming increasingly irritable and stubborn; loss of initiative, often doing nothing all day long, wandering around at home aimlessly. These manifestations often put patients and their families in great distress.  At present, scientific and comprehensive “three-pronged” dementia treatment and health care are important measures to improve the quality of life of dementia patients and their families, including: 1. Although medication is not yet a cure for dementia, there is substantial medical evidence that medication may slow disease progression and functional decline, improve quality of life, and maintain patient dignity. Clinicians can choose which medications to initiate treatment with based on ease of use, patient preference, price, and safety. When judging treatment response, clinicians should always gather information from reliable and informed sources, consider fluctuations in dementia symptoms and physical health status, and evaluate changes in cognition, function, and behavior. It is also important to educate families to have realistic treatment expectations to improve adherence. Families should also be reminded that abrupt termination of treatment can sometimes lead to worsening of cognitive and behavioral problems.  2. Provide patients with scientific psychosocial counseling and intervention: Scientific evidence suggests that careful cognitive and life skills training during caregiving can also improve the patient’s level of functioning to some extent. Family caregivers can use self-efficacy demonstration training, reminiscence activities, memory training activities, and sensory stimulation activities as appropriate. Patients with dementia often have a number of psychobehavioral symptoms, such as depression, anxiety, agitation, aggression, delusions, and hallucinations. Once psychobehavioral symptoms are identified, it is important to actively seek out the causes of these manifestations and try non-pharmacological interventions such as cognitive interventions (redirection; cues, clues, task sequencing or prompts), environmental adjustments (modulating noise levels, providing familiar objects, reducing confusion or visual distractions, using pictures to provide cues), changes in activity requirements (completing daily activities or schedule plans, reducing activity volume and complexity), or interpersonal communication methods (simplifying language, using or avoiding touch, paying attention to the patient’s wishes, interests, and concerns). The choice of specific non-pharmacological treatments should be based on the patient’s characteristics, caregiver situation, accessibility of treatment, severity of psychobehavioral symptoms, and the likelihood that specific symptoms will respond to specific treatments.  3. Support and care for caregivers: Caring for the elderly with dementia is a difficult and sometimes distressing task that requires a great deal of patience and perseverance. Through active treatment and reasonable family care, a significant proportion of patients can remain in a stable state for a long time and share a happy life with their families. Undeniably, the mental stress of dementia caregivers can also be heavy because, it can be a very difficult job, which happens to be a very rewarding one. Therefore, it is also important to provide appropriate support for the patient’s family and caregivers during the treatment of dementia, such as caregiver education, teaching problem-solving skills, and emotional support.  The current care system for dementia patients in China is characterized by a large care load and low level; the main caregivers are mainly spouses and children; the care system is fragile and there is a large gap between supply and demand, etc. Therefore, it is important to adhere to the “three-pronged approach” and provide scientific and standardized services for dementia patients and their families. Therefore, insisting on the “three-pronged approach” and providing scientific and standardized services for dementia patients and families will be an important guarantee to improve the quality of life of dementia patients and families, and an important initiative to promote social harmony. We call for the participation of the whole society to pay attention to dementia, and it is urgent!