The Many Losses of Alzheimer’s
Chantel Bishop RN
Sharing the Knowledge in Hospice Palliative
Care
October 22nd, 2011
A little bit about myself
What I hope you will learn from
today’s presentation……
• An understanding of dementia and how it
affects brain function.
• The “Silent Epidemic” it is
• The particular losses individuals and their
families experience with dementia
What is Dementia?
• Umbrella term – decline in multiple cognitive
functions
• Usually gradual onset but progressive
• Generally not reversible
• Causes damage to different areas of the brain
Types of Dementia
• Over 70 different types
• Alzheimer’s Disease most common
The Silent Epidemic
Canadian numbers....
• ~ 500 000 have Alzheimer’s or other
dementia (ADOD)
• 70 000 < 65 living with dementia
• 1 in 11 > 65 have ADOD
• 2008 – 103 700 new cases of dementia (1
new case every 5 minutes).
• 2038 – projected to be 257 800 (1 new
case every 2 minutes)
Rising Tide: The Impact of Dementia on
Canadian Society
Alzheimer’s & The Brain
The 7 A’s of Dementia
– Useful tool to
categorize and explain
losses of dementia.
– How dementia affects
the brain
– Each A will represent
damage to a particular
area of the brain
– Not likely to
experience all of them
#1 - Anosognosia
• No knowledge of
illness or disease
• Lives in present but
with past memories.
• Lack of insight.
• Often behaviour and
safety concerns.
#2 - Amnesia
• Loss of memory
• Short and long term
• Memory loss is in
reverse order – like
peeling an onion
• Their reality is not
ours.
#3 - Aphasia
• Loss of language
• Expressive aphasia
o Unable to express self
• Receptive Aphasia
o  Understanding of what is
said
• Non-verbal communication
usually very much intact.
#4 - Agnosia
• Loss of
Recognition
o people, objects,
sounds
• Perceived but not
recognized –
disconnect
between senses
and memory
• Can lead to altered
behaviors and
interactions.
#5 – Apraxia
• Loss of purposeful
movement – even
though physically able
and desire to do so.
• Results from impaired
motor planning and
sequencing.
#6 - Altered Perception
• Altered depth
perception
• Visual distortions.
• Altered tactile
perception.
#7 - Apathy
• Loss of initiation.
• Often interpreted as a
sign of depression
• Involves frontal lobes
and limbic system.
Other common losses
• Having to retire from work
• Managing finances
• Transition from independent living to care
• And one of the most difficult losses –
driving!
Driving
Family and loved ones
• They experience loss too.
• While the loved one is still alive.
• Physically present but not psychologically.
• Loss of shared history, sense of humor,
ability to communicate, role within the
family.
In summary.............
• Dementia is a chronic, progressive
disease; with no cure.
• Individuals and their families suffer
multiple losses throughout the course of
the disease.
• Think about ways you can help someone
living with dementia.