Glossary of Terms for Alzheimer's & Dementia

UNDERSTANDING DIFFERENT TYPES OF DEMENTIA

Dementia is not a single disease; it consists of various conditions that affect memory, cognition, and daily functioning.

Understanding the type of dementia you or a loved one has can help in providing better care and support.

A quick guide to some of the most common types of dementia:

ALZHEIMER’S DISEASE

The most common form of dementia, Alzheimer’s, is characterized by memory loss, confusion, and changes in behavior. It progresses gradually, affecting a person’s ability to perform daily tasks.

VASCULAR DEMENTIA

This type of dementia is caused by strokes or poor blood flow to the brain. Vascular dementia affects reasoning, judgment, and memory. Symptoms can present themselves suddenly or more slowly over time.

LEWY BODY DEMENTIA

This form of dementia is associated with elevated deposits of certain protein(s) in the brain. People with Lewy Body Dementia often experience hallucinations, movement issues, and fluctuating levels of alertness.

FRONTOTEMPORAL DEMENTIA (FTD)

FTD affects the front and side areas of the brain. It is characterized by changes in personality, behavior, and language. It often affects younger individuals and progresses more rapidly.

MIXED DEMENTIA

In some cases, individuals can have more than one type of dementia, such as a combination of Alzheimer’s and vascular dementia. Symptoms can vary depending on the areas of the brain affected.

Vocabulary words have meaning, both in life and in the law. Below I have listed the most frequent terms used in this website and what each word means. The terms are listed in alphabetical order. I am certain this glossary will be of assistance to you in your reading.

Alzheimer’s & Dementia Glossary

ADLs: Activities of Daily Living: The basic personal care tasks that must be performed to maintain some degree of independence, such as eating, transferring (e.g. moving from bed to chair) walking inside and outdoors, dressing, grooming, bathing and toileting.
Advance Directive (AD): Also called LIVING WILLS. An AD is a written document(s) completed and signed when a person has the cognitive ability (legally) to explain their medical wishes in advance of a medical need or life/death decision. Advanced directives allow someone else to make treatment and end-of-life decisions on behalf of the person with Alzheimer’s and/or dementia as they become more disabled by their condition.
Alzheimer’s Disease: A disability characterized by impaired memory & ability to learn new material, accompanied by a high level of stress, anxiety, impaired judgment, confusion, behavior change(s) and other bodily/physical changes.
Anomia: The inability to recall or recognize the names of objects. As dementia progresses this problem intensifies, and word substitutions are common. e.g., all 4-legged animals may be called a ‘dog’.
Apathy: Lack of interest, concern, or emotion, sometimes confused as depression.
Apraxia: The loss of the ability to carry out both complex, learned, familiar and purposeful movements (e.g., a dressing apraxia). Difficulty remembering the sequence associated with putting on clothes. e.g., putting a sweater on over a shirt.
Assessment: An evaluation of a person’s physical and cognitive condition or personal needs to enable them to live as independently as is possible. An assessment is a process that is ongoing and is vital to therapeutic care & support of people with dementia.
Brain: The center of thought & emotion, responsible for the coordination & control of bodily activities & the interpretation of information from the senses. The brain has several lobes. Frontal, Temporal, Parietal, Oribito-Basal, are related to different behavioral functions.
Care Plan: A document specifying long-term care goals for residents/patients and the time frame within which the goals should be achieved. Goals are determined through careful assessment of the person’s physical and psychosocial abilities and difficulties. Care planning should involve the person with dementia, their family and if in a medical setting, the multi-disciplinary team. Plans should be regularly reviewed to take account of changing abilities.
Challenging Behavior: Any type of behavior deemed difficult to manage, harmful, potentially harmful, or disturbing to the person performing the action or to others. Such behavior should be viewed as an attempt to communicate by the person with dementia.
Cueing: The provision of prompts or hints, often verbal and/or visual to assist the person with dementia with orientation, to initiate or complete a task or stage of a task. The objective is to maintain the independence of the person with dementia.
Delusion: A persistent belief that an event or situation is true even though it may be illogical and is untrue in reality. It is often based on a perceived fact or a distortion of perceived or actual facts.
Dementia: An umbrella term for a range of symptoms that manifest a decline in intellectual functioning caused by disease or other injuries to the brain. The most common symptom involves loss of memory. From a psychosocial perspective dementia is a disability characterized by impaired memory & ability to remember, learn new material, a high level of stress, and loss of sensitivity to the social environment.
Depression: An abnormal emotional state characterized by feelings of worthlessness, sadness, emptiness, and hopelessness. When the primary diagnosis of the mental disorder is depression, it is potentially reversible, but it may be extremely difficult to treat. It may be so severe that physical symptoms and symptoms of mental impairment (including short-term and long-term memory loss, confusion, delusions, and hallucinations) occur. When the symptoms of dementia appear but do not have an organic base, it is pseudo-dementia. Depression is the most common pseudo-dementia. Alzheimer’s disease and related disabilities, therapeutic drug use, illegal drug use, and excessive alcohol use may all cause depression as a symptom of the primary condition.
Diagnosis: The identification of a disease or condition by a scientific examination of physical signs and symptoms, history, laboratory tests, and other procedures.
Drugs: Aricept & Exelon are on the market since 1998 for use by people who have a mild/moderate level of dementia. Both work in a similar fashion, influencing one of the chemical pathways in the brain that is involved in storing memories. As dementia progresses, other pathways in the brain become involved so the effectiveness of the drugs becomes limited. The limitations of the drugs also relate to the fact that they do not directly affect the disease process; they are expensive and are not appropriate for everyone.
Durable Power of Attorney (POA): Unlike the more general power of attorney, a Durable Power of Attorney remains in place should the person become mentally incapacitated. A Durable Power of Attorney (POA) must meet certain legal requirements. It is advisable to contact an elder law attorney for more information.
Dysphasia: The person has difficulty understanding what is being said.
EEG: Electroencephalography. Study of electrical currents in the brain.
Frontal Lobe: Located behind the forehead in several hemispheres of the brain. It controls cognition, personality, and emotions.
FTD: Frontotemporal dementia is a rare degenerative condition caused by damage to the frontal lobe and/or the temporal parts of the brain. In the early stages of the disease, it differs from Alzheimer’s as memory may not be badly affected.
GAIT: Person’s manner of walking. People with Parkinson’s disease or Lewy Body dementia may have a “shuffling” gait. While people with Alzheimer’s disease have a reduced gait because as they become more disabled, they lose the ability to lift their feet.
Hallucination: A persistent belief that something is seen, heard, or smelled when nothing is there. It is not based on fact, or even misinterpretation of fact. Visual hallucinations are more common in Alzheimer’s Disease.
History: A document recording all relevant medical (the medical history), psycho-social (the social history) information about a person or resident to enable the caregiver to care for & support the person with dementia.
Huntington’s Disease: A rare, abnormal hereditary condition characterized by involuntary, purposeless movements and progressive dementia. Those with the condition usually begin to have symptoms between ages 30-45 years and have a life expectancy thereafter of approximately fifteen more years.
IADLs (Instrumental Activities of Daily Living): The tasks of home management (such as money management, shopping, housekeeping, preparing meals, and answering the telephone) that are necessary but not as crucial to independent living as the ADLs.
Incontinence: Loss of bowel (fecal) and/or bladder (urinary) control due to physical problems or to an inability to perceive signals correctly, which is common in Alzheimer’s disease. Some people may become doubly incontinent. When incontinence first becomes obvious a medical examination should be carried out to exclude a treatable physical problem.
Level of Care: The amount of physical care, psycho-social stimulation, support, and supervision a person with dementia requires; measured by the staff-to-patient/resident ratio and type of care needed to provide good quality care for that person.
Lewy Body Dementia: A type of dementia, with a range of features including symptoms like Parkinson’s Disease such as tremor, shuffling gait & rigidity & hallucinations both visual & auditory. Of note people with this type of dementia are sensitive to neuroleptics (anti-psychotic medications)
Living Will: Also called an Advanced Directive, is a written document completed and signed, when a person has the cognitive ability (legally) to explain their medical wishes in advance. Advanced directives allow someone else to make treatment decisions on behalf of the person with Alzheimer’s/dementia as they become more disabled by their condition.
Long Term Memory: A permanent storage place for memory and information.
MCI Mini-Mental State of Examination: A mental status exam used to measure a person’s basic cognitive abilities, such as short-term memory, long-term memory, orientation, writing, and language. Marked out of 30 points. A score of less than 24 is usually suggestive of some form of cognitive impairment.
MRI Magnetic Resonance Imaging: A special radiology technique that is designed to image internal structures of the body using magnetism, and a computer to produce the images of body structures. MRIs are very clear and are particularly good for imaging the brain and soft tissues.
Neurodegenerative: Disease characterized by a progressive decline in the structure, activity, and function of brain tissue. These diseases include AD, Parkinson’s disease, and dementia with Lewy bodies. These are usually more common in older people.
Neurology: The field of medicine deals with the nervous system composed of the brain and spinal cord with their cranial and spinal nerves.
Paranoia: Suspicion of others not based on fact.
Parkinson’s Disease: A slowly progressive neurological disorder usually occurring in the early sixties characterized by tremor, impassive facial features, shuffling gait, and other muscular disturbances. Symptoms of dementia can occur or occur as a result of medication for other symptoms of the disease.
Pathology: The study of the characteristics, causes, and effects of the disease by examining the structural and functional changes in the body.
Perception: The conscious recognition and interpretation of external stimuli using any of the senses. The correct interpretation is based on unconscious association with memory and is the basis for correct understanding and learning of new information.
Person Centered Care: An approach to dementia care that takes a holistic view of the person & their needs based on knowledge of the person & their story. The person with dementia is placed at the center of every intervention.
Pick’s Disease: A disease affecting the frontal and temporal lobes of the brain. Onset is usually between 40 and 65 years of age. There is a gradual dissolution of language in the first 2 years. People are usually aware of this deficit and are adept at covering it up. Later memory deficits, personality change, and disinhibited behaviors become evident. Neglect of personal hygiene, loss of insight, apathy, or obsessional traits may also develop.
Plaques & Tangles: With Alzheimer’s Disease, plaques and tangles develop which interfere with the transmission of the signal from one neuron to another or from neuron to brain, muscle, etc. These plaques & tangles are visible only on autopsy following death.
Power of Attorney: A power of attorney is a document whereby one person (the donor) authorizes another (the attorney) to act for them in certain matters on their behalf and in their name, e.g., power to sell a property. It may be limited or general. It is always written.
Praxis: The performance of an action or task.
Progressive: Increasing in severity.
Psychosocial: Relates to the psychological-emotional and social aspect of a person’s history in relation to their needs and abilities.
Psychotropic Drugs: are drugs primarily designed to affect the brain. They control emotions and behavior. Psychotropic drugs are not only tranquilizers, some act as antidepressants, others may reduce anxiety.
Sundowning Syndrome: Confusion and irritation that may occur in people with dementia at the end of the day. The cause of sundowning is not really known, but it may be due to general tiredness and an inability to process any more information or to interpret the environment correctly. A reduced level of activity consisting of familiar, undemanding tasks is best at this time.
Vascular Dementia: Multi Infarct Dementia. Dementia caused by small or mini-strokes that may be so small that they go undetected, but eventually results in a stepwise deterioration of cognitive functioning. Similarly, risk factors to those of cardia disease are more common in men than in women and less common after age 75 years. May co-exist with Alzheimer’s disease.
Wandering: A tendency to keep on the move, either in an aimless or confused fashion or in pursuit of an indefinable or unattainable goal (Stokes ’86). It may be indicative of a person’s need for exercise or their feeling of boredom. Two associated risks (1) possibility person may become exhausted or (2) their safety and security in some environments may be threatened if they wander. The capacity of a person with dementia to wander underlines the need to have an appropriate space or an area such as a garden to allow them to wander/pace safely.
Ward of Court: If a person becomes incapable of managing his/her affairs due to having significant cognitive impairment caused by i.e., dementia, one or more persons are appointed by the court to manage their affairs. The person then becomes a ward of the court. A guardianship application is made with notice to the alleged person incapacitated who is allowed by law to participate in the court’s determination concerning their future. All applications are processed through the Surrogate’s Office as Clerk to the NJ Supreme Court. The Office publishes an explanatory booklet and approximately 30% of all applications involve people with dementia.

Fredrick P. Niemann Esq.

Have questions about a Last Will? If so, call our office today. Ask for Mr. Niemann to personally discuss your questions and individual situation toll-free at (855) 376-5291 or e-mail him at fniemann@hnlawfirm.com.

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