Archive for March 2nd, 2010

Posted on March 2, 2010 - by Nurse Virginia

FRONTAL LOBE DEMENTIA SO DIFFERENT FROM ALZHEIMER’S DISEASE

(PART 2 OF 2)

During autopsy, in the early 1890s, a Neuropsychiatrist, Arnold Pick first saw the shrinkage of the frontal and temporal lobes of patients with dementia. (known as Pick’s disease) This was well before Dr. Alois Alzheimer first saw the plaques and tangles in the brain of his patient Auguste Deter in 1906.

See blog: January 3, 2010, Auguste Deter, Symptoms haven’t changed in 100 years

Many instructors will say the frontal lobe is what distinguishes us from the animals. The frontal lobe of the brain is where you find the ability to plan and problem solve. Impulse control as well as social skills, and manners are found there.

Gertrude was known for saying everything on her mind, no filter and no seeming awareness or concern for the observations she was making.  If Gertrude positioned herself next to the elevator, you could expect her to insult anyone and everyone coming off of that elevator. No one was safe from Gertrude’s critique.

Many times the first thing the family will notice is a change in personality, mood or thought processes.  The person might become apathetic, experience a decrease in movement, display no spontaneity and be unemotional.  While others may have increased movement, be overactive, restless, and be very uninhibited. The person who becomes apathetic will usually also sleeps for longer and longer periods than what is their norm.

Persons with frontal, temporal dementia unlike the person with Alzheimer’s will remain oriented to person, place and time, as well as be able to retain memories longer. The damage to the brain is in such different places in the early stages of each disease process that the symptoms begin quite differently. But eventually both diseases will result in total care of the individual.

Due to the major loss of impulse control, this patient can be extremely difficult to care for.  Howard suffered from frontal, temporal dementia. He came to us at a relative young age, in his mid-fifties. He was fit, very restless, walked constantly and occasionally could be seen running through the nursing community. The male nursing assistants took turns working one-on-one with Howard, because doing full-time care would have worn out the best of caregivers. Howard remained strong and on all three shifts for months, there was the changing of the guard as nursing assistants took their turn following Howard.

Because, Howard’s behavior was so radically different, from life before the diagnosis.  As with so many other patients, we got to really know Howard through his wonderful family and the memories they shared.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com