Dementia And Autonomy

Operating a vehicle involves cognitive and motor skills, and although it becomes automatic for many drivers, giving up driving can be challenging for someone with dementia. When the loss of abilities jeopardizes safety, ceasing to drive becomes crucial. Some individuals recognize the need to do so themselves, but others may resist. Communicating the necessity of giving up driving becomes a challenge for family members, as some affected individuals may show resistance or denial.

At what point should a person with Alzheimer’s stop driving? Although the diagnosis of cognitive impairment doesn’t require an immediate cessation of driving, the gradual decline in skills will make relinquishing it inevitable at some point. It is advised to watch for warning signs such as disorientation, confusion while driving, or slow decision-making. Giving up driving can be difficult, but addressing the issue with empathy and proposing alternative transportation can make it more manageable. Safety should prevail, and in extreme cases, measures like hiding the car keys or selling the vehicle may be necessary.

In the early stages of dementia, many people can continue living at home and enjoy life much like before their diagnosis. After receiving a diagnosis of cognitive impairmente, professionals provide advice on how to continue doing what is important for the person for as long as possible. They also offer information about resources and services that could be helpful.

As the disease progresses, it may become more challenging for individuals to take care of themselves and their homes. At that point, they may need additional help with daily activities such as household chores, shopping, etc. They may also require home adaptations.

The importance of making progressive adaptations in the home of a person with Alzheimer’s lies in preventing accidents, mitigating cognitive difficulties, and reducing physical limitations. These changes not only serve the purpose of maintaining a safe environment but also contribute to preserving a familiar and cozy space. By adapting the living space, a friendlier and more accessible environment is created, allowing the person with dementia to maintain a sense of familiarity and comfort in their daily surroundings. This approach not only helps reduce the anxiety and stress associated with the disease but also enhances the quality of life for the affected individual and facilitates the work of caregivers.

Keeping the home organized and comfortable, with spatiotemporal references, benefits both the patient and the caregiver. These adjustments will be implemented gradually as specific issues arise. Measures to reduce risks include removing carpets, getting rid of lightweight furniture, being cautious with slippery floors, and securing doors and windows. It’s also important to ensure good lighting, and mark stairs.

In the kitchen, it’s suggested to label cabinets and use safe utensils. In the bathroom, replacing the bathtub with a shower, using non-slip mats, and installing support bars are recommended. In the bedroom, organizing commonly used items, securing items that can fall, and using appropriate lighting are essential. As the disease progresses, railings can be incorporated into the bed.

Ensuring a safe environment in the home of a person with dementia involves careful adjustments.

In Spain, there are various social services and resources available for people with dementia and their families. Some of these resources include:

Organizations such as the Spanish Confederation of Associations of Family Members of People with Alzheimer’s and other Dementias or the Alzheimer Spain Foundation provide information, support, and resources for people with dementia and their families.

It is important to consider that access to measures, rights, benefits, resources, aids, adaptations, and other benefits for people with dementia and their family caregivers is subject to compliance with certain «access requirements.» These requirements may cover aspects such as age, gender, income level, years of previous contributions, among others, depending on the scope and type of provision or resource.

The red teleassistance button is not limited to being a simple emergency device; it serves as the assistant for older people, playing a crucial role in promoting autonomy and preventing dependence.

Many localities have day centers specialized in caring for people with dementia. These centers offer activities and care during the day, allowing families to balance care with other responsibilities.

Some Day Centers and Care Homes offer respite programs for caregiver family members, providing temporary relief through professional caregivers.

There are nursing homes specialized in the care of people with dementia. These homes offer 24-hour care, medical services, and adapted activities.

It is important to consult with local social services and specialized associations for specific information on available aids in each region. Additionally, social workers can provide guidance on resources available to meet individual needs.

Dementia challenges autonomy in various aspects, such as driving and daily life at home. It is necessary to find the right balance between safety and autonomy. Home adaptation becomes essential to create a safe and familiar environment, allowing the person to maintain their functioning. The use of aids for daily life, such as adapted clocks and teleassistance devices, stands out as support to maintain independence. Finding support through associations and local services is essential to provide guidance and support to both patients and their families. This support emerges as an essential pillar to address the disease with greater support and understanding, while simultaneously promoting the patient’s autonomy.

María Isabel Zamora is a physician with a double specialty in Psychiatry and Neurology. She has experience in the care of patients in general psychiatry consultations, and in a more specialized way, in the care of patients who combine psychiatric and neurological symptoms. She has worked with psychogeriatric patients and patients with functional diversity. She has experience in cognitive impairment, psychological and behavioral symptoms of dementia, psychiatric symptoms related to neurological disorders or chronic pain, autism, ADHD, adaptive disorders, depression, anxiety, addictions, bipolar disorder, obsessive-compulsive disorder, sleep disorders, eating disorders, etc.