Dealing with dementia symptoms:

Frontal lobe changes

Created date

July 24th, 2019
The frontal lobe is indicated here in red, the area closest to the front of the forehead.

The frontal lobe is indicated here in red, the area closest to the front of the forehead.

Part two of a four-part series

"With dementia-related illness, there can be several areas of the brain affected,” says Cara Skrypchuk, director of memory support services for Erickson Living. “But certain symptoms are sometimes associated with one of the four lobes, and it may take special strategies to cope with a person’s actions and/or expressions that result from the changes.” 

This is the second in a four-part series about how to deal with dementia symptoms that result from damage to particular parts of the brain. 

Last month, the temporal lobe was the focus. This month, it’s the frontal lobe.

Decision-making challenges

“The overall function of the frontal lobe is to carry out higher mental processes such as decision-making, thinking, and planning,” Skrypchuk says. “You use it every day to make small decisions, such as what to eat for breakfast, and for more complicated thinking processes, such as learning new information.”

As a caregiver for a loved one with dementia, you can help them make decisions. “To avoid frustration for both of you, follow a regular daily routine,” Skrypchuk advises. “Use memory aids such as written lists of daily tasks and schedules.”

Frame statements and questions about daily routines in a positive way. “If they want to go to the grocery store for the third day in a row, suggest a favorite alternative instead of trying to explain why there’s no need to go back to the grocery store again.”  

It also helps to converse on an adult level. “A common mistake is to treat someone with dementia as if they are a child,” Skrypchuk says. “Be inclusive, respect the fact that they are an adult, and treat them as such.” 

Communicating in tense situations

The frontal lobe controls emotions and impulse control, so changes that occur because of a stroke, Parkinson’s disease, Alzheimer’s disease, or other dementia-related illnesses may affect someone’s personality and emotional responses. 

You aren’t likely to encounter problems if someone is content and happy. But when someone’s personality traits become unfamiliar and their emotional responses seem to be angry more often than not, taking a different approach can be helpful. 

What seems like normal background noise to you may be bombarding your loved one’s senses with too much stimuli. This can set the stage for confusion and frustration. “Limit distraction and noise,” Skrypchuk says. “Turn off the radio and television. Close curtains and shut windows or doors. Consider moving to quieter surroundings if you think distractions are bothersome.”

When they become upset or angry, try changing the subject or the environment. “For example, ask for help with something or suggest going for a walk,” Skrypchuk says. “It’s important to connect on a feeling level. You might say, ‘I see you’re sad—I’m sorry you’re upset. Let’s go have dinner.’”

Even if they’re wrong about something, don’t argue. “Respond with affection and reassurance,” Skrypchuk says. “Avoid trying to convince them they are wrong. Stay focused on the feelings they are demonstrating, which are very real for them, and respond with verbal and physical expressions of comfort and support.”

Other ways to communicate

Someone with dementia may have trouble understanding the meaning or sound of words, so learn other ways to communicate. “Your overall attitude and body language can express your feelings and thoughts more strongly than words,” Skrypchuk says. “Use facial expressions and physical touch to help convey your message and show how you feel.”

Reasoning and judgment are largely controlled by the frontal lobe, so people with dementia may feel frightened in nonthreatening situations. Adjusting your body language can help with this as well.  “Do not stand or hover; it can be intimidating or scary,” Skrypchuk says. “Stay at the same level—bend or sit if you need to.”

You may also have trouble understanding what they’re saying. “Listen not only with your ears, but with your eyes and heart,” Skrypchuk says. “Wait patiently for a reply. Watch for nonverbal cues and body language, and respond appropriately. Strive to listen for the meaning and feelings that underlie the words.”

Make eye contact. “This shows trust and that you care about communicating,” Skrypchuk explains. “A face-to-face approach is best. Speaking to someone from the side or from behind can be startling.”

Memory loss

Memory loss is one symptom of dementia, and there are many reasons why someone has memory loss, so it’s important to visit your physician. Skrypchuk offers several suggestions to deal with situations that might arise when frontal lobe damage includes memory loss. 

“Having familiar objects with sentimental value visible where someone spends their time can help produce happy feelings,” Skrypchuk says. “But don’t ask your loved one if they remember something because it could be perceived as insulting and contribute to feelings of embarrassment and anger.” 

Long-term memory tends to stay intact for a period of time. “You don’t have to ask if someone remembers, but try asking some general questions about the distant past,” Skrypchuk says. “Remembering such events is often a soothing and affirming activity.”

“It may seem difficult at times, but maintain your sense of humor,” Skrypchuk advises. “People with dementia symptoms tend to retain their social skills and are usually delighted to laugh along with you.”