Resources - The Watermark by the Bay

At The Watermark by the Bay, we are committed to helping family members understand the approach we take to our dementia care plans, whether they are being tailored to a resident with Alzheimer’s disease or to a resident requiring vascular dementia treatment. Before we delve into caring for dementia, let’s first explore what it is.

WHAT IS DEMENTIA?

Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment and behavior. Alzheimer’s disease is the most common type of dementia, affecting 60 to 80 percent of dementia patients. While Alzheimer’s disease is the most well-known disease associated with dementia, there are other types, such as vascular dementia. These are collectively known as non-Alzheimer’s dementias (NADs). Symptoms of NADs are summarized below, along with the interventions that form the basis of caring for dementia. The Watermark by the Bay’s Memory Care services put the care and treatment interventions below into practice. We work closely with family members to determine the best dementia care plans for your loved one. For questions about our approach to caring for dementia, please don’t hesitate to contact us.

Dementia Type	Symptoms	Interventions
Lewy Body Dementias: Parkinson Disease with Dementia (PDD) & Dementia with Lewy Bodies (LBD)	Progressive dementia Visual spatial processing Attention deficit Executive dysfunction Visual hallucinations Delusions and depression/anxiety are common Confabulation Parkinsonism and fall risk: slow movement, rigidity, tremors and gait difficulties Day to day fluctuation, variable memory Autonomic dysfunction Daytime drowsiness, and difficulty staying asleep REM sleep behavior disorder: acting out of dreams Constipation Loss of smell PDD versus LBD symptoms: PDD: dementia develops after motor disorder LBD: dementia develops prior or at same time as motor disorder	Prescription medications Mindfulness-based dementia care Whole care team and family involvement Physical, occupational, and speech therapies Improve sensory impairment Structure environment (safety issues) Behavioral interventions

Dementia Type

Symptoms

Interventions

Lewy Body Dementias: Parkinson Disease with Dementia (PDD) & Dementia with Lewy Bodies (LBD)

Progressive dementia
Visual spatial processing
Attention deficit
Executive dysfunction
Visual hallucinations
Delusions and depression/anxiety are common
Confabulation
Parkinsonism and fall risk: slow movement, rigidity, tremors and gait difficulties
Day to day fluctuation, variable memory
Autonomic dysfunction
Daytime drowsiness, and difficulty staying asleep
REM sleep behavior disorder: acting out of dreams
Constipation
Loss of smell

PDD versus LBD symptoms:

PDD: dementia develops after motor disorder
LBD: dementia develops prior or at same time as motor disorder

Prescription medications
Mindfulness-based dementia care
Whole care team and family involvement
Physical, occupational, and speech therapies
Improve sensory impairment
Structure environment (safety issues)
Behavioral interventions

Dementia Type	Symptoms	Interventions
Frontotemporal Dementia	Symptoms start between 40–60 Poor planning Disinhibition Apathy Emotional blunting Euphoria Obsessions and compulsions Mental rigidity Depression Disease itself, not environment, is cause of behaviors Specific FTD variations: Behavioral variant (Pick’s Disease) disinhibition flattening of affect distractibility impulsiveness poor planning and judgment hyperorality hypersexuality memory intact Specific FTD variations: Behavioral variant (Pick’s Disease) nonfluent variant: loss of ability to produce language semantic variant: loss of word/object meaning logopenic aphasia: word finding problems, loss of language comprehension for all 3, episodic memory is intact	Prescription medications Mindfulness-based dementia care Whole care team and family involvement Replace difficult behaviors with more benign behaviors Repetitive ritualistic behaviors may have to be tolerated For apathy, structure day, help stick with task within capabilities Small rewards for completing ADLs Nutrition management, such as limiting overeating, serving limited amounts at mealtime, restricting foods or sweets, and monitoring intake

Dementia Type

Symptoms

Interventions

Frontotemporal Dementia

Symptoms start between 40–60
Poor planning
Disinhibition
Apathy
Emotional blunting
Euphoria
Obsessions and compulsions
Mental rigidity
Depression
Disease itself, not environment, is cause of behaviors

Specific FTD variations: Behavioral variant (Pick’s Disease)

disinhibition
flattening of affect
distractibility
impulsiveness
poor planning and judgment
hyperorality
hypersexuality
memory intact

Specific FTD variations: Behavioral variant (Pick’s Disease)

nonfluent variant: loss of ability to produce language
semantic variant: loss of word/object meaning
logopenic aphasia: word finding problems, loss of language comprehension
for all 3, episodic memory is intact

Prescription medications
Mindfulness-based dementia care
Whole care team and family involvement
Replace difficult behaviors with more benign behaviors
Repetitive ritualistic behaviors may have to be tolerated
For apathy, structure day, help stick with task within capabilities
Small rewards for completing ADLs
Nutrition management, such as limiting overeating, serving limited amounts at mealtime, restricting foods or sweets, and monitoring intake

Dementia Type	Symptoms	Interventions
Vascular Dementia	Similar to Alzheimer’s Memory loss Organization, problem-solving, word finding challenges Slowed thinking, distraction, absent-mindedness Depression, irritability, apathy Hallucinations, delusions Balance and movement problems	Prescription medications Vascular risk factor control Mindfulness-based dementia care Whole care team and family involvement

Dementia Type	Symptoms	Interventions
Alcohol-related Dementia (Wernicke-Korsakoff’s)	Symptoms/acute: Abnormal eye movements Gait problems Confusion Symptoms/chronic (if not treated): Severe and persistent amnesia Personality change Apathy Confabulation	Prescription medications Mindfulness-based dementia care Whole care team and family involvement Physical, occupational, and speech therapies Improve sensory impairment Structure environment (safety issues) Behavioral interventions

Dementia Type

Symptoms

Interventions

Alcohol-related Dementia (Wernicke-Korsakoff’s)

Symptoms/acute:

Abnormal eye movements
Gait problems Confusion

Symptoms/chronic (if not treated):

Severe and persistent amnesia
Personality change
Apathy
Confabulation

Prescription medications
Mindfulness-based dementia care
Whole care team and family involvement
Physical, occupational, and speech therapies
Improve sensory impairment
Structure environment (safety issues)
Behavioral interventions

The Watermark believes in connecting with the larger East Bay community by supporting local causes, learning about the culture and needs of our neighborhood and supporting local merchants. We are especially proud of our relationship with the Emeryville Center for the Arts, The Bread Project, the Emeryville Chamber of Commerce and the Alzheimer’s Services of the East Bay.

WHAT IS DEMENTIA?

Local Resources

National Resources

Articles and Research

Professional Resources