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Struggling with changes in brain function: A difficult journey

Mickie Toutant, O.T.

“Where did I put my keys?” “Why did I come into this room?”

What is dementia?

Changes in brain function, also known as dementia, can come in all shapes and sizes and is caused by many variables. Dementia is different than age-related memory loss! Age-related changes do not affect how a person functions and only the memory is affected. However, dementia is progressive (gets worse) and day-to-day function is affected. Even with cues or prompts the person may not be able to understand or identify information.

It is crucial for family members to realize the difference and not let dementia go untreated. Early intervention can have a positive impact, however, once dementia is considered moderate, it is difficult to treat.

Dementia is a disorder that is characterized by loss of memory and at least one of the following: 

· Difficulty with speaking, using words incorrectly and not understanding what an object is used for (does not know what to do with a spoon, toothbrush, etc)

· Changes in personality

· Confusion/disorientation

· Difficulty processing visual information 

Categories of dementia

There generally are five different categories of dementia. 

1. Degenerative: The most common in this category is Alzheimer’s which has a gradual progression. Lewy-Body is similar to Alzheimer’s but has a rapid progression and is characterized by increased falls and marked fluctuations in consciousness. Another condition can be associated with late-stage Parkinson’s disease.

2. Vascular: Due to the occurrence of one or more strokes, small blood vessel disease or the absence of oxygen to the brain.

3. Traumatic: Caused by a blow to the head or fall.

4. Infectious: Known as Creutzfeldt-Jacob disease; this occurs very rapidly and is fatal. Infectious dementia can also occur in late stages of AIDS.

5. Toxic: Caused by alcohol abuse or exposure to harsh compounds or chemotherapy treatments.

Other situations such as poor sleep, stress, nutritional deficiencies, anxiety, depression and chronic illnesses such as fibromyalgia, lupus or infection also can make our brain function “less efficient.” If one has difficulty concentrating and paying attention, a person will then have trouble with memory because the information does not reach the brain in the first place.

Help is available:

First, a complete physical should be done by a primary care physician. Once complete, it may be appropriate to attend Occupational Therapy to address and assist the patient and family members with any functional problems that may be occurring. The occupational therapist (OT) will do a thorough evaluation to identify the person’s abilities to complete daily living tasks, participate in activities, learn new skills, improve existing skills and so on. Treatment is based on evaluation findings. Education, memory strategies, brain stimulating tasks, “homework,” adaptive devices and recommendations regarding safety are a few examples of the skills occupational therapists can impact.

Caregiver training and support is part of the occupational therapy and intervention/education process. It is painful to watch the function of your loved one decline; and changes in their personality can be overwhelming. Often, the adult child/children must intervene, and can be forced to make difficult decisions such as removal of driving privileges, overseeing financial matters, providing 24-hour care, etc. These changes can be stressful on the relationships.

Fortunately, many insurance plans and Medicare cover occupational therapy for patients diagnosed with dementia or other brain-function conditions.

To learn more about the treatment options available for patients diagnosed with dementia or other brain-function conditions, talk with your primary care physician or contact FMC’s Therapy Services by calling 928 773-2125.

Mickie Toutant, O.T., occupational therapist in Flagstaff Medical Center’s Therapy Service, has an interest in and has received additional education in the evaluation and treatment of people with early and middle stage dementia. Is there a health topic you’d like to know more about? Please write to Mountain Medicine, c/o FMC Public Relations, 1200 N. Beaver St., Flagstaff, AZ 86001, or visit