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Mental Illness and Dementia: How to Tell the Difference

By Dr. Tiney Ray Published On: March 20th, 2023

How Cognitive Decline Can Affect Mental Health
When it comes to mental illness and dementia, people commonly think dementia is a particular type of mental illness. That’s understandable, since both of these can manifest in similar ways, but there are crucial differences to understand so you can provide the best care for your elderly loved one.

Many illnesses become more prevalent as a person ages; but, according to the CDC, mental illness does not. Due to the stigma associated with mental health, seniors often delay seeking help when they’re suffering from something like depression or anxiety. Determining whether your loved one is experiencing the natural effects of aging, a decline in mental health, or early stages of dementia can prove difficult.

Sometimes, seniors suffer from both dementia and mental illness at the same time.
Gaining a better understanding of how mental illness can manifest with symptoms that mimic dementia and vise versa as well and knowing the crucial differences is key to getting proper treatments.

Mental illness with Alzheimers and other types of dementia
Mental illness with Alzheimers is not uncommon, especially in the early stages of the cognitive disorder. Depression is the most common mental illness that manifests along with various forms of dementia. The CDC states that 50% of elderly adults with Alzheimers also suffer with serious depression symptoms and that 25% of these adults experience major depressive symptoms. Depression is not a normal consequence of aging. Some research suggests a biological connection between clinical depression and Alzheimers.
It’s crucial to understand whether your loved one suffers from both a mental illness and early stage dementia, or just one of these conditions. An experienced geriatric health care provider can make an accurate diagnosis. According to Today’s Geriatric Medicine, certain treatments, based on accurate diagnosis, have been shown to improve cognitive function.

Common symptoms of dementia and other concerns
Knowing how to spot common symptoms of dementia is the first step toward getting a diagnosis and treatment plan that may decrease suffering and improve cognitive health. In addition to depression, other mental health disorders can occur jointly with conditions like Alzheimers. These include anxiety disorders and more severe psychotic conditions, such as schizophrenia.
Common symptoms of dementia sufferers:
  • Irritability
  • Restlessness (i.e. pacing, fidgeting)
  • Feeling sad and hopeless
  • Increased incidents of aggression
  • Hypersomnia or insomnia
  • Apathy toward activities previously enjoyed
  • Exhibits signs of delusions
  • Expresses unfounded suspicions or paranoia
  • Hallucinations (visual or audio)
  • Refuses to cooperate with caregiver
  • Anxiety about normal activities
  • Difficulty communicating
  • Confusion
  • Increasing issues with memory
  • Personality and emotional changes

Not only do these symptoms negatively impact the patient, they can have such consequences for the caregiver.

How to tell the difference
Knowing how to tell the difference between a mental illness and dementia is key. When thinking of dementia, people often lump it in with mental illness, since it involves brain function. But there are some important differences that a geriatric health care specialist must consider when making an accurate diagnosis.
Even though dementia does impact mental health, it is not a mental illness. It’s a brain disorder that may cause a host of symptoms, including profound memory loss and difficulty with communication. Sadly, misdiagnosis of dementia as a mental illness occurs far too often. This occurs because some behaviors associated with mental illness also manifest with dementia.

Once your elderly loved one receives the correct diagnosis, he or she can begin receiving treatment protocols that will best address the manifesting symptoms.

Lyght Bulb Moments is here to help. If you’re struggling with the changes to your everyday life and the struggles your loved one is experiencing, reach out for help from the compassionate professional staff at Lyght Bulb Moments.

Call today for a free, no obligation consultation.
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10 Possible Signs of Mental Illness in Your Elderly Loved Ones

By Dr. Tiney Ray Published On: February 15th, 2023


Undiagnosed Mental Illness In Seniors Increases Suicide Risk

Learn to spot possible signs of mental illness in elderly loved ones so you can help them receive the support they need to thrive. According to the Centers for Disease Control, 20 percent of people over 65 experience some form of mental health concerns.

The good news is that 80% of these issues respond very well to treatment.
Left untreated, mental health issues can increase suicide risk, especially in the elderly. But to get treated, a person with mental illness needs a professional diagnosis.

Look over these 10 signs that could indicate mental or cognitive illness in your elderly loved one:
Changes in appetite. Uncharacteristic decrease or increase in appetite as well as sudden weight loss or gain could indicate the beginnings of a mental health issue.
Changes in hygiene habits. People with mental illness sometimes lose the desire or motivation to change clothes, bathe, brush their teeth, or groom their hair. Alternatively, some may unexpectedly begin to obsess about cleanliness and become obsessive about personal hygiene.
Sleep disturbances. Sudden changes in sleeping habits, such as sleeping excessively or having great difficulty getting to sleep and staying asleep may point to possible mental health struggles.
Loss of interest in favorite pastimes. When people, of any age, lose interest in hobbies or activities they typically found fun and enjoyable, this could indicate depression.
Disorientation or confusion. Confusion or disorientation may indicate onset of dementia, but it also may be a sign of psychosis.
New physical symptoms. Seniors who exhibit unexplained physical symptoms like profuse sweating, shaking, muscle tension, or changes in bowel habits should be evaluated for Parkinson’s disease and mental illness.
Social withdrawal. Seniors who suddenly withdraw from social activities may have depression or anxiety.
Substance abuse. People of all ages, including elderly, may begin consuming more alcohol than usual, abuse medications, eat unhealthy foods as a coping mechanism for mental struggles.
Express feelings of despair or worthlessness. People with serious depression or other mood disorders (i.e. bipolar) often feel overwhelmed by feelings of despair, sorrow, emptiness, or uselessness.
Personality changes. One common symptom of dementia or mental illness involves sudden personality changes. The person may become inappropriately angry, become tactless with others, or make inappropriate comments.

If you notice some of these symptoms in an elderly person you love, make arrangements for him or her to be evaluated by a mental health professional. The correct diagnosis marks the first step to getting appropriate treatment and a better quality of life.
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Celebrity Bruce Willis Receives Dementia Diagnosis
By Dr. Tiney RayPublished On: February 15th, 2023
 

Diagnosis comes less than a year after retirement due to aphasia.

The family of celebrity Bruce Willis revealed the actor received a diagnosis of dementia. Less than a year before, 67-year-old Willis announced his retirement from acting as he was suffering from aphasia. Aphasia is a disorder which affects communication, making language expression and understanding difficult. 


The Hollywood icon’s doctors say he has frontotemporal dementia

Frontotemporal dementia (FTD) affects the part of the brain located behind the forehead. Symptoms of FTD differ from the typical memory issues associated with Alzheimer’s disease and other dementia types. Some typical FTD symptoms may include things like:
  • Repetitive and compulsive movements
  • Slow speech
  • Trouble comprehending common words like ‘table’
  • New interest and obsession with timekeeping
  • Loss of everyday politeness and manners
  • Repeated use of certain word phrases
  • Personality changes
  • Diminished ability to solve everyday problems
  • Inability to show sympathy and interest in others
  • Memory loss
  • Several other possible issues with cognitive ability

Although FTD is rare, it’s one of the most common dementia-type diseases in those under 65 years of age, according to the Mayo Clinic. Like Alzheimers and other types of dementia, FTD gets progressively worse as time passes. As the disease progresses, more areas of the brain become damaged and symptoms begin to resemble those in the final stages of Alzheimer’s disease. Treatments involve therapies to ease symptoms and help elevate the affected person’s quality of life as much as possible.
Sufferers often need round-the-clock care in the later stages of FTD. Rate of progression varies from person to person, so life expectancy ranges anywhere from two to 10 years, sometimes longer. 


How families deal with a loved one with dementia

Willis’ current wife, Emma Heming and ex-wife Demi Moore have put their differences aside and joined together in an effort to rally behind the star. Willis and Moore have three daughters together, now grown, who are also involved in caring for him as well. Both of the women revealed the agonizing grief they experienced directly after the diagnosis. This is a normal reaction to this kind of life-altering news whether the loved one is a famous actor or a regular everyday person.
Learning how to deal with their loved one’s new behaviors, communication issues, difficulty with daily activities, and other complications is key to peace of mind. This is where education and coaching from experienced, compassionate professionals in dementia care helps so much.


Best care for dementia patients and their families

Dementia patients definitely benefit from strong family support, but it’s also important to involve care services from compassionate caring professionals. This takes some of the pressure off of loved ones, helping them avoid burnout. Lyght Bulb Moments® provides consultations and services to help dementia patients, like Bruce Willis, experience important “Lyght Bulb Moments” and improve quality of everyday life.
Consulting with a dementia care specialist will provide much needed education and individualized care plans to address the family’s unique needs related to caring for a loved one with dementia.

If you have a loved one with dementia, contact Lyght Bulb Moments® today to set up a free, no-obligation consultation.
Call today!
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Tips for Communicating with Professional Care Partners
By Dr. Tiney Ray Published On: January 26th, 2023

Doctors and other healthcare professionals make up the heart of critical care for your loved one living with dementia. They work together with family, friends, and other trusted individuals to provide support during the patient’s life with the disease. It’s imperative that the dementia patient’s family develop and maintain clear channels of communication with professional care partners. Frequent and open communication will ensure your loved one receives the best care possible.

People with Alzheimer’s or other forms of dementia may experience changes in communication skills and self-care abilities, including:
  • Frustration when communication doesn’t seem to be working
  • Difficulty paying attention during conversations
  • Understanding the meaning of simple words and sentences
  • Frequent loss of train of thought
  • Remembering how to complete simple, common tasks like getting dressed, paying bills, preparing food

This means it’s up to family members to discuss concerns and changes in behavior with professional care partners on a regular basis.


Tips for communicating with professional care partners

When your loved one is first diagnosed, take the time to understand what to expect as the disease progresses and how to cope with new symptoms and behaviors. The care team will have printed and digital resources to share with you. These will be invaluable tools for educating yourself and other family members about the disease.

Some questions you may consider asking at this stage include:
  • What is my loved one’s official diagnosis?
  • What tools and tests were used to make the diagnosis?
  • What are these tests designed to measure?
  • Could my loved one’s symptoms be caused by anything else?
  • How will the disease progress?
  • Are there daily activities I can encourage the patient to carry out that may help him or her have a better quality of life with the disease?
  • How can I prepare for the future as the disease progresses?
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Think Slow

By Dr. Tiney RayPublished On: September 16th, 2022

For those who care for Persons Living With Dementia (PLWDs), you’ve seen how quickly things can get out of hand, as the person in your care faces an obstacle and becomes upset and frustrated. This is common, and it’s a challenge for the care partner—because often, an escalation with the PLWD leads to an escalation in frustration in the care partner. When that happens, think slow.

Simple situations spiral out of control frequently because the care partner’s instinctive reaction is to try to move quickly to restore calmness. Ironically, this can make things worse because the last thing you need in a situation where they’re no threat of harm is urgency. So think slow.

This is a central point of the teachings of Teepa Snow, whose “Positive Approach To Dementia Care™” is the basis for the care I teach. When a situation becomes negative, a way to bring things back to calmness is to take the time to re-frame it.

So, instead of the PLWD asking about the same thing over and over, getting more frustrated as the care partner becomes more frustrated, switch things up.

The care partner can re-frame the situation by asking the PLWD the same question. This can change the conversation, slowing it down, so the PLWD has to think about an answer.
Everyone has to think slow, so the emotion of the moment changes. And the stress level reduces, giving everything a chance to re-set.

It’s important to remember—both for professional and family care partners—that dementia takes away the ability to retain the most immediate information necessary to handle what’s happening right now. Without knowing these cues to carry on a conversation or keep to a task, a PLWD is at an extreme disadvantage.

So help out by thinking slow, and slowing the pace of life. It makes more lyght bulb moments happen.
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Food For Thought: Sundowning

By Dr. Tiney Ray Published On: August 12th, 2022

Dr. Tiney Ray discusses the common problem of sundowning.
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Sensory Overload and Dementia

By Dr. Tiney Ray Published On: August 4th, 2022

Think about what happens when you have too much going on at one time.
The TV’s blaring. Kids are asking permission to do things you’d rather they didn’t. The phone’s ringing and you’re getting a text. And you only have another 30 minutes to get dinner ready. Pretty overwhelming, isn’t it?

Now think about doing this when you’re not at the top of your game, or if you’re sick with the flu. You can see how much more difficult that can be, and how you could get overcome by the situation pretty easily. That’s what can happen with a person living with dementia in everyday situations—situations that you wouldn’t consider stressful. But to an individual whose mental capabilities have been diminished by the disease, anything unexpected or non-routine can be daunting.

So it’s important for care partners to be aware that even though the person living with dementia is seeming to function fine one moment, he or she may be stressed and overwhelmed the next. A classic example of this is “sundowner’s” syndrome, where the person living with dementia becomes more agitated and confused late in the day, as the sun goes down and the light around them changes.

So what should you do when this happens? Here are some possible responses:
  • Cut back on the stimuli around the person. If there’s a lot going on with other people, animals, or electronics, see about reducing or eliminating some of these distractions.
  • Remain calm yourself. If the person living with dementia sees the care partner getting upset, it only compounds the situation. Keep your cool.
  • Refocus attention on an activity that the person living with dementia enjoys, one that tends to be calming. This redirection can help settle the person and allow a “recharge” so the rest of the day is easier.

Remind yourself that what’s manageable for you may be way too much for the person under your care. When you look at the world from that perspective, you can see paths forward that can help both of you.
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Dehydration and Persons Living With Dementia

By Dr. Tiney Ray Published On: July 19th, 2022
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Food For Thought: Support Groups

By Dr. Tiney Ray Published On: July 6th, 2022

Dr. Tiney Ray discusses the value of support groups for caregivers of people living with dementia.
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Grief Is A Thing

By Dr. Tiney Ray Published On: June 23rd, 2022

One typically doesn’t associated grief with someone who’s still living, and caregivers of persons living with dementia my find themselves surprised at how they experience sudden feelings of grief. It’s a common occurrence. Because even though you may not have physically lost a loved one or a patient, you do see the loss of who that person used to be before dementia.

That’s a significant human loss. And in some ways, it can be more devastating than a death, because even though you’re being a caregiver, you feel helpless as the personality of the PLWD slips away.

So if you find yourself experiencing feelings of grief, understand that it’s perfectly normal. And that you can do something about them. Face up to your grief. Realize that it’s OK to have these feelings. Think about the things that will help you cope with them. Realize that you will experience feelings of grief more than once.

Psychologists have identified five stages of grief: Denial, Anger, Bargaining, Sadness, and Acceptance. These don’t always occur in order, so if you find yourself in the midst of being upset without a clear reason, or thinking that the PLWD isn’t going through the disease, realize that it could be attributed to the grieving process. Don’t go through it alone.

Talk to others—friends, family, or support groups, for example. In the counseling I do for families and professionals, we encourage dialogue so that feelings don’t get bottled up, and so others can tell you how they managed their feelings. Realize that some people may not understand. That’s OK; these people may not have direct experience with dementia, and don’t realize the emotional impact. Don’t second guess yourself—concentrate on the things that allow you to manage and still provide care for your PLWD. And yourself.
Like many aspects of dementia care, you will find yourself from time to time in uncharted territory with your own feelings. Realize that’s, for better or worse, part of the process. When you do, managing gets easier.
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Video: Caregiver Stress

By Dr. Tiney Ray Published On: June 13th, 2022

Caregiver stress is common among people who care for People Living With Dementia. Dr. Tiney Ray counsels families and professional caregivers on how to manage the stress. In this video, she shares some key ideas.
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Comorbidities And Dementia

By Dr. Tiney Ray Published On: June 13th, 2022

During the pandemic, we often heard about how comorbidities (other diseases or conditions) could have an impact on a person’s ability to recover from COVID-19. Public service information on comorbidities opened many people’s eyes to how a long-term condition could directly affect others.

Comorbidities are definitely something that must be taken into consideration with Persons Living With Dementia. More than 90% of people living with dementia have another health condition. In persons over the age of 65, the average person without dementia has two comorbidity conditions, while persons over 65 with dementia have an average of four comorbidities.

Common comorbidities for PLWDs include hypertension, arthritis, diabetes, depression, and cerebrovascular disease. These conditions obviously can complicate a dementia diagnosis, and complicate how to care for a PLWD. If you’re a caregiver working with someone who has comorbidities, then it’s important to understand these additional conditions and their effects.

Because it is often difficult for a PLWD to communicate if something is bothering them, you have to train yourself to look for signals that may tip off another health problem that affects your care.

For example, a PLWD who isn’t interested in a walk or a physical activity that they normally enjoy is a flag that something else might be wrong. It may be that arthritic pain is too much and the person is avoiding movement because of it. It might also signal a wave of depression. It’s a good idea to keep a record of times when the person under your care doesn’t respond normally, along with the reason if you can determine it. This can help you quickly address the comorbidity that may be interfering.

It’s also important to follow any monitoring regimens that physicians my have recommended, such as checking blood sugar levels for diabetic patients. A comorbidity can be a trigger that leads to more serious health issues. And when you’re caring for a PLWD, even seemingly minor health concerns can trigger a snowball effect that creates big problems.

Interesting fact:  Over 80% of the reasons PLWD are admitted to the hospital are from comorbidities that are preventable:  falls, fractures, urinary infections, and chest infections.
So if you’re caring for a PLWD, don’t think you’re being over-reactive if you notice something that might be a comorbidity or a complication from a comorbidity. Fast action can stop bigger problems from happening.
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Dementia Care: The Power (and Profitability) Of Teamwork

By Dr. Tiney Ray Published On: May 9th, 2022

I work with numerous nursing homes, assisted living, and other health care facilities to help professionals better understand how to be better care partners to persons living with dementia (PLWD).

I use the Positive Approach to Care™ (PAC) developed by renowned Occupational Therapist Teepa Snow, which has proven to be the cutting-edge methodology for optimum dementia care training in professional settings. There are six key elements of the PAC process, and I like to stress one in particular:  Collective Effort, or the power of teamwork.

We conduct workshops on this, in conjunction with the care facility. Since much of the care required for a PLWD is individual, it’s easy to fall into a mindset that one or two people should take primary responsibility for that person’s care. And while most of care may be assigned to one or two people, there are advantages to working together in a cooperative effort.

The workshop gives real-world examples of how a cooperative effort can better manage the work and stress that professional care partners experience. We emphasize how to derive fulfillment from the care process. This can lead to better care, as staff members feel more personally connected to each PLWD’s care and to their fellow care partners. Staff members become cheerleaders for each other and more responsive should one care partner need assistance. This has a significant impact on workplace contentment, which translates into less turnover, fewer extreme situations in care, and ultimately, greater profitability for the care facility.

The results can be a significant “win-win” situation for both resident care and the facility bottom line.
To learn more about our workshop and the PAC process, start a conversation with me here. I’m happy to answer questions, learn more about your facility, and focus on areas where instruction can make an impact.
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Being A Care Partner Is Tough. It’s Also A Gift.

By Dr. Tiney Ray Published On: May 9th, 2022

When I counsel families and the family members who will provide care for the Person Living With Dementia (PLWD), we talk about a lot of serious topics—how to handle inappropriate behaviors, sudden changes in behavior, and practical day-to-day issues.

Caring for a person living with dementia can be daunting, and our process gives family members the tools needed to keep everyone safe and to provide the PLWD with the best possible quality of life.

And that’s something very important to remember. Even though the PLWD has many challenges in negotiating everyday things that used to be simple, he or she also has many moments where there can be comfort, or joy, or fun. And if you’re the person’s care partner, you get to experience those, too. That’s why I stress this to everyone providing care: It’s a gift for you, too.

There are few things more noble than helping care for another human who needs help. As parents, we’re rewarded over and over again when children accomplish new things or have experiences where family members bond. That same sense of reward can be felt when helping a PLWD accomplish something that seemed difficult, or when the person experiences a moment of lucidity and can recall joy from past experiences.

You’ve done something important and meaningful for someone else.
We’ve been conditioned (particularly as Americans) that we’re supposed to be independent and self-sufficient, and overcoming this perception is a key to being a good care partner. Sometimes, for a PWLD to maintain independence, it takes a little help. And if you can give that as a care partner, you should feel you’ve accomplished something—and celebrate that opportunity.

I’ve talked with many family care partners who understand that by helping a parent or spouse or other loved one, they’re giving back care that was administered to them, either as a child or as part of the family dynamic. As you understand this, the burden of care is lifted a bit.

You’re giving back. You’re creating an even stronger bond with someone dear to you. And even if the person living with dementia can’t always acknowledge this, it still is an important experience. As a care partner, it can be easy to get bogged down with the day-to-day annoyances or challenges. But when you can keep the “big picture” perspective in mind, these take a back seat to what’s really important.

Looking after someone very important in your life.
If you’d like to know more about how Dr. Tiney Ray and Lyght Bulb Moments can help your family with a care partner plan and counseling, click here.
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Healthy Living for Your Brain

By Dr. Tiney Ray Published On: April 5th, 2022

Dr. Tiney discusses the importance of brain health and manageable solutions to decrease your risk of dementia.
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Tips for Communication with Someone Living with Dementia

By Dr. Tiney Ray Published On: April 5th, 2022

Dr. Tiney discusses communicating with someone living with dementia. She provides simple techniques to help guide care partners so they can maintain a meaningful connection with the person living with dementia.
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Care Partner Care:
You Can’t Help If You’re Not Looking Out For Yourself

By Dr. Tiney RayPublished On: March 7th, 2022

“I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou

One of the first things I stress to the care partners of people with dementia is that being a care partner can be a true gift. You are being of service to another human being who needs your help. There are fewer things that could be considered more important.

But caregiving is difficult. Even if you have accepted the task (that can take time), and even if you find it rewarding, it still can be exhausting, both mentally and physically. So you have to take care of yourself, too. You can’t help someone else if you’re not making time to rest and recharge. This isn’t easy, either. But if you don’t acknowledge the need for self care, the results can be disastrous—to yourself and your person with dementia.

Here are some suggestions that can help with your self care, and help you cope when things become difficult. Look for “escapes,” even if you have to stay in one location. These can be things as simple as reading a book or magazine, watching a TV show, or working on a craft. Work some of your pleasures into routines. That might include listening to music or trying a new recipe when preparing a meal.

Don’t sweat the small stuff. It’s almost a paradox to stress the need for routine for persons with dementia, and then say “don’t worry if little things go wrong.” But they will go wrong, and it’s important to know that. Things not going to plan isn’t a sign of failure, particularly if the person you care for is doing well overall. Give yourself credit for the things that go right. Think about gratitude. We’re not suggesting you be grateful for having to deal with a cruel disease, but it can be very valuable to acknowledge gratitude for caring for someone in need, and to give yourself credit for it. This is a reminder of why you are doing this, either as a professional who is devoting time to others, or as a family member taking responsibility for another.

Our training programs for both professional and family care partners focus on a proven Positive Approach To Care curriculum developed by Teepa Snow, which includes detailed information on self care.
To learn more, click here.
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Happiness and Dementia: The Joy Of The Moment

By Dr. Tiney Ray Published On: March 7th, 2022

“When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.”- Alexander Heifer.

Let’s start with the obvious: Dementia is a tragic disease, one that typically takes years to play out. But we strongly caution people who have been diagnosed or the people who care for them that it’s a mistake to let the disease take the joy from life. It’s not that powerful.

A dementia diagnosis, however, will require you to re-think how you may approach your relationship with that person or the people around them. Surprisingly, many people discover something very valuable when they do this. The power—and the joy—of living in the moment.

Persons with dementia have bad days, but also many good ones. It is important to take advantage of the good ones, and not let them go unappreciated. This is important to both the person and the care partner.
And it can deliver much happiness for all.

When you let yourself appreciate the good times, it becomes easier to handle the many challenging issues of dementia. The good times can sustain and restore you. Here are some simple techniques you can use to make the most of the joyous moments: Slow down. Acknowledge the day and the activity at hand, whether it be something special like a family event or something simple like a relaxed conversation. Build routines that encourage the person with dementia to relax. Routine is very important; it’s the out-of-the-norm situations that can lead to confusion and stress.

So with routines in place, triggers can be removed and individual happiness improved. Address immediate needs. Even with routines in place, care partners will discover that if something stands out—personal care or housekeeping—it can be important to take care of those things right away, removing a stress point and getting the person with dementia re-focused on what can be joyful. Encourage and acknowledge the person’s contributions to the activity or event. One of the most frightening elements of dementia is loss of control. So the more the person is able to contribute to an activity (even something as simple as grocery shopping), it can help alleviate these fears and boost happiness.

Even small moments and small things matter, and can make a huge difference. When you realize that, you discover joy in small places. Which is more than worthwhile.