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This Policy is designed to summarise information about the definition, causes and symptoms of Dementia in older people, and how these contribute to the concept of Person-Centred Care:


1.1 Dementia is a general term used to describe a group of illnesses which affect the brain. Dementia essentially damages the brain tissue, leading to a progressive loss of this tissue. As brain tissue cannot be replaced, the condition will worsen with time.

1.2 Most forms of Dementia cannot be cured, although there are now some drugs available (acetylcholinesterase inhibitors) which can temporarily alleviate some of the symptoms of some types of Dementia.


The immediate cause is disease in the brain causing loss of neurones (nerve cells). There are several diseases and conditions that can cause Dementia, the most common of which include the following:

2.1 Alzheimer’s disease - the most common cause of Dementia and accounts for more than half of Dementia cases. It destroys cells, disrupting transmitters that carry messages to the brain, particularly those responsible for storing memories.

2.2 Vascular disease - arteries which supply blood to the brain become blocked. The brain relies upon a network of vessels to bring it oxygen-bearing blood and if this supply is blocked or interrupted in any way brain cells will die. These symptoms can also occur following a stroke.

2.3 Dementia with Lewy Bodies - Lewy bodies are tiny spherical structures that develop inside nerve cells, and their presence in the brain leads to the degeneration of brain tissue, leading to a deterioration in language skills, concentration and memory.

2.4 Fronto-temporal Dementia - in this type of Dementia the damage is usually focused in the front part of the brain. This can adversely affect behaviour and personality.


Dementia has 3 stages - mild, moderate and severe. The table on page 2 of this Policy shows the common effects of each stage of Dementia, but on a more general basis, the symptoms of Dementia can be summarised as follows:

  • Loss of memory, with inability to concentrate and poor sense of time and place; e.g. forgetting the way home

  • from the shops, being unable to remember names and places, or what happened earlier in the day.

  • Difficulty in finding the right words, or understanding what people are saying.

  • Difficulty in completing simple tasks (e.g. self-care or domestic tasks) and solving minor problems.

  • Increasing problems with basic communication skills; e.g. a deterioration in the ability to talk, read and write.

  • Mood changes and emotional upsets, sometimes being angry, frightened or depressed.

3.1 Specific Symptoms - MILD DEMENTIA:

  • Problems with memory

  • Problems finding the right words for people, objects etc

  • Repeated speech (e.g. asking the same question over and over again)

  • Problems making choices

  • Trouble understanding ideas

  • Trouble with busy / cluttered environments

  • Becoming lost in unknown places

  • Mood / personality changes

3.2 Specific Symptoms - MODERATE DEMENTIA:

  • Greater trouble with memory

  • Problems learning new tasks

  • Repeated speech (e.g. asking the same question over and over again)

  • Speech which is jumbled and confused

  • Problems thinking clearly

  • Trouble recognising known objects, friends and family

  • Poor judgement

  • Restlessness (finding it hard to settle)

  • Becoming lost in known as well as unknown places

  • Tendency to wander away or become lost

  • Limited skills in daily living tasks

  • Confusion about time and place

3.3 Specific Symptoms - SEVERE DEMENTIA:

  • Little or no speech

  • Little or no memory

  • Trouble understanding what has been said to them

  • Problems recognising known objects, people or places

  • Acting on impulse

  • Seeing or hearing things that are not real

  • No understanding of time

  • Need for full support with all daily tasks

  • Incontinence

  • Limited movement skills

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