There was a Time….
By Debbie Hommel, ACC/MC/EDU, CTRS
There was a time when older adults living with memory loss were simply labeled senile or confused.
There was a time when someone asked for their parents, they were told their parents had died.
There was a time when they tried to leave the building, they were placed in a chair and restrained so they could not go anywhere.
There was a time when they called out repeatedly, they were given a pill to keep them quiet.
Those practices reflected a time when little was understood about memory loss and the experiences of those living with it. Thankfully, care has evolved. Today we recognize that memory loss can stem from many different conditions, each with its own progression, symptoms, and support needs. Rather than labeling people as confused, we now strive to understand the individual—honoring their history, abilities, and preferences. Person-centered approaches guide how we respond, emphasizing dignity, meaningful engagement, and compassionate support that adapts to each person.
Understanding the clinical aspects of dementia and the various types of dementia is the first step to providing better care. Dementia itself is not a single diagnosis, but an umbrella term used to describe a group of conditions that affect memory, thinking, behavior, and the ability to perform everyday activities. These conditions—including different forms of dementia—have distinct symptoms and patterns of progression. Recognizing these differences can help the activity professional respond more effectively, tailoring communication and programming to the unique needs and abilities of each person.
Alzheimer’s Disease is the most common form of dementia, accounting for the majority of dementia cases in older adults. It is a progressive brain disorder that gradually damages memory, thinking, and the ability to carry out everyday tasks. The disease is caused by changes in the brain, including the buildup of abnormal proteins that interfere with communication between brain cells and eventually lead to cell death. Symptoms typically begin with mild memory loss and confusion but progress over time to affect language, reasoning, orientation, and the ability to recognize familiar people or places.
Frontotemporal Dementia (FTD) is a form of dementia caused by damage to the frontal and temporal lobes of the brain. These areas are responsible for personality, behavior, judgment, language, and emotional regulation. The earliest signs often involve changes in personality or language abilities. A person may demonstrate impulsive behavior, reduced empathy, poor judgment, or difficulty finding and using words. Frontotemporal dementia often occurs at a younger age than many other dementias, sometimes appearing in people in their 50s or 60s.
Lewy Body Dementia is a type of dementia caused by abnormal protein deposits, called Lewy bodies, that develop in brain cells. These deposits interfere with brain function, affecting thinking, movement, behavior, and mood. One of the distinguishing features of Lewy body dementia is fluctuating cognition. A person may appear alert and engaged at one moment and significantly confused or withdrawn at another. Visual hallucinations are also common, and individuals may see people, animals, or objects that are not present. Lewy body dementia often includes movement symptoms similar to Parkinson’s disease, such as stiffness, slowed movement, balance problems, or tremors.
From an activity professional’s perspective, understanding dementia and its many forms provides the foundation for meaningful engagement. When we recognize how different types of dementia affect thinking, communication, behavior, and abilities, we can design programs and interactions that match the person’s strengths and needs. This knowledge allows activity professionals to move beyond simply offering activities, focusing instead on creating purposeful experiences that support dignity, connection, and quality of life.
“Do the best you can until you know better. Then when you know better, do better.”
– Maya Angelou
Check out three NCCAP Approved programs detailing clinical aspects of dementia.
Dementia Basics – 3 CE Hours
Frontotemporal Dementia Basics – 2 CE Hours
Lewy Body Dementia Basics – 2 CE Hours