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Course content – PFLEGE-16

2. Module 1 · What is dementia?

Fundamentals

An illness, not normal ageing

Dementia is an umbrella term for diseases of the brain that lead to a progressive decline in memory, thinking, orientation, language and everyday abilities. A clear distinction is important: dementia is not a normal part of ageing but an illness. Memory does naturally decline somewhat with age (you might forget a name now and then), but dementia goes far beyond this – it impairs the ability to cope with everyday life, and it progresses. The most common form is Alzheimer’s dementia; other forms include vascular dementia (caused by circulatory disorders), dementia with Lewy bodies, frontotemporal dementia and mixed forms.

Dementia is common and is becoming more common as society ages – many people in need of care are affected. For care, it is one of the most important topics of all. The core of this course is not just medical knowledge but above all an attitude: understanding people with dementia as valuable, feeling persons and supporting them with dignity.

What this module is about. Dementia is an illness, not normal ageing, and the person stays a feeling human being. You learn the main forms, the typical course and why emotions matter most in care.

What you will be able to do afterwards. You can tell everyday forgetting from signs of dementia, name the main forms, describe what changes at each stage and plan a first respectful encounter.

Think about it first. Mr Brandt (a fictitious name) is 78. His daughter says he has been losing his keys. On the ward he asks three times in an hour where his wife is, and each time he seems frightened. What would you want to know before you decide whether this is “just age”? And what would you do in the next five minutes, whatever the reason? You will return to this in part 3.

Learning objectives of this module

  • You understand dementia as an illness (not normal ageing).
  • You know the most important forms.
  • You know the typical course and symptoms.
  • You recognise that feelings and personhood are preserved.
  • You can sort everyday situations into “normal forgetting” and “possible sign of dementia” and explain why this needs a doctor’s clarification (apply).
  • You can plan a first encounter with a person with dementia that protects their dignity, using what you know about preserved feelings (apply, analyse).

Figure 1.1 shows how everyday forgetting differs from dementia. Read the left column as the normal range of ageing and the right column as typical warning signs. One sign alone proves nothing. What matters is the pattern, and whether it gets in the way of daily life.

Everyday forgetting compared with dementiaEveryday forgetting or a sign of dementia?Everyday forgetting with ageTypical for dementiaForgets a name, remembers it laterForgets whole events, such as a visit todayOccasionally loses the keysPuts things in odd places and cannot retrace stepsStill copes with the dayIncreasing trouble with cooking, dressing, washingKnows the date after a momentLoses track of time and place, later of peopleStays the same for yearsGets worse over months and yearsOnly a doctor can tell the two apart for an individual person.
Figure 1.1: Everyday forgetting compared with typical signs of dementia (simplified). Source: own illustration.
Key terms in plain words
  • Syndrome: a group of signs that appear together. Dementia is a syndrome, not a single disease.
  • Cause: the disease in the brain behind the syndrome, for example Alzheimer’s disease or damage from poor blood supply.
  • Cognition: thinking in the wide sense, including memory, attention, judgement, language and planning.
  • Everyday abilities: tasks such as washing, dressing, eating and managing money. Care professionals often call these activities of daily living.
  • Person-centred: the care starts from the individual person, their history, feelings and wishes, not from the task list.

Why “just age” is a risky thought

It is tempting to say “that is normal at his age”. The World Health Organization (WHO, 2026) stresses that dementia becomes more common with age but is not an unavoidable part of growing older. If everyone accepts the thought “just age”, a treatable cause may be missed. Low mood, an infection, a side effect of medicines or poor hearing can all look like dementia, and they need medical attention. Your role is not to diagnose. It is to notice, describe what you see in plain words and pass it on to the doctor and the team.

The same thought also causes harm in the other direction. If a person has been diagnosed, “just age” is no excuse for leaving them without support. Both mistakes have the same root: not looking closely at this one person.

Cause and syndrome: why the forms matter for you

You do not need to treat the forms of dementia like a medical student. You do need to know why they matter. Different causes bring different patterns. In Alzheimer’s dementia, memory problems usually come first. In vascular dementia, the course can be uneven, with sudden steps after small strokes. Dementia with Lewy bodies often brings strong day-to-day swings in alertness and sometimes vivid visions. In frontotemporal dementia, changes in personality or language may be the first signs. These are general professional descriptions, and every person is different.

For care, the practical lesson is simple: ask which abilities this person still has today, and which have changed. A person with changing alertness may manage a conversation at ten o’clock and be confused at four. Knowing this stops you from calling it “bad will”.

Remember: Dementia is an illness with many possible causes. Forgetting is only one sign. The person’s feelings and need for dignity stay, and your attitude reaches them.