Insights
At what point do dementia patients need 24-hour care?

The decision to move a family member with dementia into a care home is not easy. Agetech World explores when it’s the right time.
Being a family member of someone with dementia, it may become difficult to decide at what point they need 24-hour care.
A person with dementia will need more care and support as their condition progresses but it can be hard to know when the time is right and who should make this decision. The main thing to think about is whether the dementia patient’s needs are met at home; is moving into a care home in their best interest?
However, moving the person into a care home is not the only option: there are other options that would enable them to live at home while being assisted.
Here are some signs that may aid in deterring the right time for 24-hour care:
Aggressive behaviours

Aggressive behaviours should not be taken personally when it comes to dementia patients. This kind of behaviour is the response of the patient to the false signals generated in their brain or sometimes simply an attempt to communicate.
Aggressive behaviours can be one of the first signs for full-time care as it can become difficult for a singular carer or family member to control these behaviours on their own.
Patient’s safety

With dementia, judgement and memory become poor and the person becomes easily exposed to domestic accidents. To prevent this, patients start needing constant monitoring and 24-hour care becomes integral for home safety to such an extent that a person cannot even identify common hazards.
Caregiver stress

Alzheimer’s caregivers frequently report experiencing high levels of stress as it can be overwhelming to take care of a loved one with Alzheimer’s or other dementia.
It is not unusual that a dementia caregiver forgets to set boundaries, creates unrealistic and impractical expectations, and ends up burnt out. In addition to this, the overwhelming needs of the loved ones can make the caregiver frustrated and stressed.
The main symptoms of caregiver stress are denial, anger, social withdrawal, anxiety, depression, exhaustion, sleeplessness, irritability, lack of concentration and health problems.
Mobility issues

Dementia patients tend to be more mobile than in many other medical conditions. The effects of dementia can cause wandering which is defined as a clinical symptom characterised by frequent, repetitive, temporally confused behaviour manifesting as random.
But, dementia is likely to have a big physical impact on the person in the later stages of the condition. They may gradually lose their ability to walk, stand or get themselves up from chair or bed. They may also be more likely to fall.
Therefore, deciding when 24-hour care is needed is not an easy task and it differs from patient to patient. The decision must be made as a consequence of the advancing symptoms of the condition, keeping in mind the best interests of the patient, of the carer and of the family.
News
Childhood loneliness linked to increased risk of dementia, study finds

Childhood loneliness increases the risk of dementia in later life, according to new research.
Adults who recalled being lonely and without a close friend in childhood faced a 41 per cent higher risk of developing dementia, even if they were no longer lonely as adults.
People who frequently felt lonely without close friends during youth showed accelerated cognitive decline — a worsening of memory and thinking — and started middle age with lower scores on these skills.
Researchers from universities in China, Australia and the US, including Harvard and Boston universities, analysed data from 13,592 Chinese adults tracked from June 2011 to December 2018.
The critical factor was the subjective feeling of loneliness itself. Those who reported often feeling lonely as children had a 51 per cent higher dementia risk, even if some had close friends.
However, those who only lacked close friends but did not feel lonely showed no significant difference in risk.
Nearly half of roughly 1,400 adults in the study reported being lonely and without close friends during childhood.
The 4.2 per cent who experienced both faced the highest risk of cognitive decline.
The link to dementia remained strong even for people who were no longer lonely in adulthood, suggesting early-life isolation can have lasting effects on brain health.
During childhood, the brain develops rapidly and is vulnerable to harm. Loneliness acts as a chronic stressor, flooding the developing brain with harmful hormones that can damage memory centres, and it reduces stimulation from social play and peer interaction that helps build robust neural networks.
A separate 2024 study of more than 10,000 older adults found that specific childhood hardships — including poverty, disruptive home environments or parental addiction — were directly linked to poorer cognitive function later in life.
Youth loneliness appears to be rising, partly linked to widespread social media use.
Among girls, 64 per cent aged five to seven, 67 per cent aged eight to 10, and 73 per cent aged 11 to 13 reported feelings of loneliness last year. More than a quarter of boys aged 11 to 17 in the US report feeling lonely.
Children face growing social isolation, with one in four Americans now eating every meal alone — a rate that has surged by over 50 per cent since 2003. Sharing meals with friends and family helps build bonds and positive memories in youth.
Fewer children are playing outside or joining team sports.
A recent study reported that one in three children do not play outside on school days, and one in five do not do so even at weekends.
The 2024 research found a direct, dose-dependent relationship between childhood adversity and cognitive problems in adults — the greater the early trauma, the greater the later risk.
For each significant increase in early trauma, individuals faced an eight per cent higher risk of daily memory issues and scored lower on objective tests of mental speed and focus.
News
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News
Snoring, silence, and the menopause taboo: The hidden health crisis affecting millions

By Professor Ama Johal, clinical lead and dental sleep expert at Aerox Health
During menopause, it’s very common for women to notice significant changes to their sleep patterns and experience things like restless nights, loud snoring, or simply waking up feeling exhausted.
What most don’t realise, however, is that these symptoms can signal something far more serious – obstructive sleep apnoea (OSA), one of the most impactful and consequential sleep-related breathing disorders.
Women across the world are unknowingly fighting an uphill battle. Around 90 per cent of females with moderate to severe sleep apnoea remain undiagnosed.
This collective lack of awareness is due to a plethora of factors including archaic taboos around the subject and lack of education or omission of menopause in sexual education.
Ultimately, this combination leaves women underprepared and vulnerable to the biological, social and medical realities associated with the menopause.
Now more than ever, we must confront this silence head-on and recognise the hidden sleep crisis affecting so many women globally and the opportunity to address it.
The hidden sleep crisis
Snoring that develops or worsens during menopause can progress into OSA due to a decline in estrogen and progesterone which reduces muscle tone in the throat and in turn makes the obstruction or collapse of the airways more likely during sleep.
Yet this link between menopause and sleep disorders remains largely overlooked, leaving millions of women undiagnosed, untreated, and unaware that their sleep struggles are more than just “part of getting older”.
In my practice, I see the consequences of this misunderstanding far too often.
I hear from many female patients who have been suffering in silence, without the knowledge that they could seek help. In fact, I often encounter the common misconception that snoring is a man’s issue.
This preconceived notion perpetuates a persistent gender bias in sleep-related health research.
As ENT consultant and sleep surgeon at University College London hospitals, Ryan Chin Taw Cheong recently highlighted, the development of snoring is reason enough to consult your doctor. It’s time for this pervasive issue to emerge from the dark.
So why don’t women seek help?
When considering why many women do not seek help for their symptoms, there are two overarching reasons.
Firstly, the information and knowledge is not widely available for sufferers to realise that snoring can be a medical issue which can be assessed and subsequently readily treated.
Secondly, there is a potent stigma surrounding both the menopause and snoring which is an inhibiting factor amongst sufferers, discouraging open discussion.
Perhaps unsurprisingly, menopause is not included in traditional sex education in schools. Being unaware of what is ‘normal’ and what could require medical attention is widespread amongst my patients with sleep disorders, yet this information is not freely disseminated outside of clinics.
Unfortunately, cognitive fog and irritability – symptoms of snoring and obstructive sleep apnoea – are too often written off as stress, anxiety or ‘just the menopause’.
Avoiding sharing symptoms with medical providers, combined with online misinformation, often results in individuals suffering in silence or worse, turning to unregulated miracle menopause cures that exacerbate the risks of undiagnosed OSA.
These so-called ‘cures’ reinforce the harmful notion that the menopause is a defect which needs to be fixed rather than a natural life stage.
The health costs of ignoring snoring
A breadth of research links untreated OSA to cardiovascular disease, hypertension and cognitive decline.
However, aside from the medical risks, snoring and sleep apnoea can have profound social and emotional consequences.
For women, the shame in snoring, a symptom often mischaracterised as a ‘male issue’, can significantly affect self esteem and mental health.
Partners may also suffer if the snoring is disruptive to their sleep, in some instances causing rifts in relationships and a phenomena known as ‘sleep divorces’ (sleeping in separate beds or rooms).
In fact, according to a recent study commissioned by 32Co, 47% of recently divorced Brits cite interrupted sleep linked to snoring or sleep disorders as contributing to their relationship breakdowns, with 85 per cent believing ‘sleep divorces’ contributed to ultimate separation.
Sleep specialists seek to manage and monitor the symptoms of sleep disorders and OSA to minimise disruption to an individual’s personal and public life.
Screening menopausal women for OSA is a preventative measure which leads to informed patients. It is not simply about getting better sleep but about the long-term health outcomes.
Breaking the silence: what needs to change
Drawing on the stories of those I meet in my clinic, I would like to outline five steps that we can take to address this silent epidemic.
First, the menopause and associated symptoms should be included in a comprehensive sex and health education.
This could be provided both in schools’ curricula and made readily available at health services catering to adults.
Second, throughout the course of history women’s issues have been chronically underserved.
More resources can be funnelled into conducting research to help us better understand the impact of the menopause on women’s physical and mental health.
Future research would also help to neutralise the gender bias of previous studies.
Third, launching public health campaigns and workplace initiatives to encourage employers to recognise sleep disorders as a significant element of menopause will help build awareness and reduce the impact of stigmas.
Fourth, myth-busting, shattering taboos, and normalising discussion about the menopause will be key.
We must view snoring as a gender neutral issue rather than a male stereotype and denounce harmful rhetoric and jokes that perpetuate stigma.
Fifth, we must better equip more localised healthcare providers up and down the country to both diagnose and treat OSA effectively.
Sleep disorders are not niche issues but a major public health concern with potentially severe consequences.
Quality of life amongst my patients is inextricably linked with sleep quality.
Recognising the relationship between snoring and OSA and the menopause is not simply about pathologising a natural stage of life, but providing women with the information, respect and medical care they deserve.
Only through more transparency and collaboration amongst researchers, educators and clinicians can we hope to close the gender gap in sleep medicine and bring this hidden crisis to light.
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