By: Dr. Nicole Ruggiano

May is mental health awareness month! One common mental health challenge that people living with dementia face is depression. Depression is a common condition for adults and can range in severity and duration. While depression is common among all adults, older adults with dementia are at greater risk of developing depression. According to the Alzheimer's Association, up to 40% of people with Alzheimer's disease will experience significant depression. This can cause stress for caregivers, who may not understand why their loved one has become depressed, not know what to do, and may even feel guilty that their loved one is suffering. Many often ask how to assess whether their loved one is depressed and what they can do to help them. 

It is never easy for someone to receive a diagnosis of Alzheimer's disease or other type of dementia. In fact, research has shown that older adults are more afraid about dementia than they are afraid of cancer.  It is normal for those who are diagnosed with dementia to experience a number of emotions, including fear about the future, anger, depression and denial. If your loved one has recently been diagnosed with a form of dementia and is having a hard time coping with their diagnosis, there are things that family and friends can do to help them in these early stages of their condition. 

A person living with dementia can experience pain, just like anyone else.  Dementia does not cause pain, but a person living with dementia can be at risk for other things that cause pain such as falls or other injuries. Further, as with most older adults, people with dementia are more likely to have other medical conditions that might cause pain. 

​However, it might be difficult for them to understand what you are asking or what they are feeling, so they may not be able to tell you if something hurts.  Pain can come from multiple sources.  It can be temporary, like a headache or sore throat.  It can be longer lasting, like a sprained wrist or ankle. It can also be ongoing and persistent, like lower back or nerve pain.  The source can also be symptoms of a known or new disease, or the treatment of a disease such as cancer.  ​

When caregivers tell me how much their loved one's dementia symptoms upset them, they are most upset when their spouse or parent does not recognize them anymore. I understand this first hand. ​When my grandmother's dementia became severe, she would become scared and upset when I visited her. She didn't know who I was anymore. To her, I was a stranger who entered her home uninvited. There was nothing I could say to make her understand that I was her granddaughter. I even pointed to photographs of me that were hanging in her apartment to show that she did, in fact, know me. However, this didn't help and she remained agitated and scared. While this was an emotional process for me, it is a common symptom for people with dementia and is a result of the changes to the brain caused by Alzheimer's disease or other type of dementia.