It is common knowledge that dementia is a slow-progressing, chronic illness today. Five million Americans suffer from its impact, and it is estimated that this number will triple as baby boomers reach 70. (Those who live to 85 have a 50 percent chance of having dementia.)

There is no cure for this devastating illness. But, thanks to the brave families who have "pioneered" care for their loved ones and those who have experienced the illness, we can all deal with dementia much more successfully and happily.

About 2.5 million people are in the early stage of dementia. Each person’s illness progresses differently, but the common early symptoms are: asking questions repeatedly, being unable to follow directions, losing their way in familiar places, getting disoriented to time and place, neglecting personal care and safety. Some people are all aware of cognitive changes and frequently are the first to ask for assistance. Others are fearful of change and try to "hide" these early warning. For years, families and doctors contributed to patients’ anxieties by telling them not to worry, it’s just aging. This well-meaning response is no longer appropriate or kind.

People in early stages have taught us what is appropriate support for them. Through their support group networks, their presentations, and books they write, they share the following "How To" Points to Improve Dementia Care:

Doctors must make early diagnoses. A good diagnosis includes a thorough physical, urine and blood test, a brain scan, neurological tests and other performance batteries. The symptoms of early dementia are common to other, reversible medical conditions such as: medication reactions, vitamin deficiency, malnutrition and dehydration. These must be ruled out first.

Medicines are available that have proven to slow the progression of the illness and to alleviate symptoms. They can improve the person’s quality of life and extend their abilities across time.

Medicines are sometimes given when the progression of the illness causes anxiety and fear and interferes with sleep. They help with emotions that cause difficult, unmanageable behaviors. Careful use of prescriptions across the stages of the illness can ease the patient and the caregivers.

Family members and friends can provide invaluable help to them by letting them express their fears and worries while they can. Accepting the illness and planning for care as the illness progresses brings great comfort to the person.

Family caregivers, neighbors and professionals who provide daily care for people with dementia now know what quality of care includes. In books they are writing and by their sharing of "what helps" in support groups, focus groups, blogs and online "help" lines, the following are key strategies for caregiving:

Quality daily life must include staying independent as long as possible by simplifying the tasks of dressing, grooming, using the bathroom, eating.

Communicate directly with the person and simplify the way you communicate as their ability to process language changes. Straightforward, simple sentences are the best. Learn that "therapeutic fibbing" is often kind.

Take action by rearranging the environment, making safety-protection modifications (ie. disconnecting the stove burners, preventing wandering, replacing clocks and phones with simplified ones, etc.) You cannot discuss most of these changes with the person with dementia. He or she cannot remember what you’ve discussed. You have to minimize "talk" and maximize "doing the task." The person will adjust if possible.

A continuum of care includes social times, cognitive stimulation, physical fitness, good nutrition and a feeling of safety and security.

Social contacts are crucial to all humans. The person with dementia is no different. Loss of friends, neighbors who don’t come by and fewer visits with grandkids can cause the person increased depression. Family and friends must learn how to connect; how to be with the person comfortably. Their interactions may be different, but feelings remain strong for years.

Doctors need to be "helped" by caregivers. As the illness progresses, the caregiver is the one who knows if a person is fearful, is eating, is pacing. If the doctor does not listen or take time, demand it or find another who will.

One message that is common from early-stage patients and from long-dealing caregivers is: Enjoy the moments you have together. People with dementia frequently have "moments of lucidity" even when the illness has progressed. Treasure those moments.

From grandchildren we hear, "Grandpa is different. I can still watch the Yankees games with him." Just being together and holding hands is priceless time for both. One teen shares, "What we do for grandma is the best, even though she doesn’t think so sometimes."

Dementia is to be learned about, not just feared. Our new understanding of the illness will bring better care. New research and increased government funding will, we hope, bring a cure. (The Alzheimer’s Breakthrough Act has just emerged from the Senate Committee on Health, Education, Labor, & Pensions. It would double the funding for research and provide needed support for families.)

For information and assistance call your Office for the Aging (Otsego County, 547-4232) or your local Alzheimer’s Association Chapter (for Otsego, Delaware and Schoharie, 547-1650). Or visit the websites

www.alz.org and www.alzfdn.org. A free quarterly publication is available from Alzheimer’s Foundation of America and the Brookdale Respite Reporter.

Sue King Elkan is assistant director of the Otsego County Office for the Aging.