Dementia, the Immune System, and COVID-19
by Melanie Bunn, MSN, GNP,
PAC Certified Trainer, Coach, and Consultant
Amygdala reaction, and not the pleasure seeker kind. The danger kind. If you’ve spent any time in public, read a paper, watched a news program, interacted at all on social media, answered your phone, looked at a text or email, the word COVID-19/Corona virus brings a new level of understanding to the term amygdala or stress reaction. What’s really going on? What do you really need to know? To do? Here is some information to get you started and some resources to keep you going.
How does the brain and the endocrine system impact the immune system?
The brain controls hormones and hormones interact with the immune system. When the body is exposed to a virus (bacteria, fungus, or something else), the immune system detects the proteins as not me or dangerous and the white blood cells respond to get rid of it. More white blood cells are released and the body gets rid of the waste through the lymph system.
How does aging impact the immune system?
While not all people living with dementia are older, most of them are, and aging can have a significant impact on the immune system. Generally speaking, the immune system doesn’t respond as quickly or as vigorously. This allows a virus, for example, more time to grow and have more intense impact. It also means that older people may not show symptoms, like a fever or cough, so they might not be identified as sick until they have been exposed for longer.
How does dementia impact the immune system?
Dementia impacts all parts of the brain. That includes the parts that connect with the immune system. So, there may be a slower response to communication from the brain that there is an exposure. Also, late in the disease when the brain stem, the part of the brain that controls the basic body functions like heart and breathing rates and temperature is impacted, the body may not be able to respond.
What should we do if someone we know has dementia and we’re worried about COVID-19?
Don’t panic! Follow PAC guidelines to respond, not react.
This will include following the CDC guidelines for high-risk populations and looking to teepasnow.com and other reputable sources for dementia specific recommendations. There will be some additional resources linked for additional information on the topics below.
Mainly, reduce exposure by social distancing, handwashing, and other prevention strategies to reduce transmission, promote health, and well-being through nutrition and hydration, exercise and activity, sleep and rest, and stress management. Respond quickly for any early signs or symptoms, remembering in people living with dementia this might not be fever and cough but instead change in thinking or doing (confusion, communication, mobility, daily routine).
If the person does become infected, reach out to the health care community for support and assistance with managing symptoms.
Finally, what if the person becomes infected and doesn’t seem to be recovering?
One of the hardest things we have to do is learn how to and when to let go when it’s time. For some people, the impact of COVID-19 is not something their bodies can overcome. Reach out for help understanding what’s going on, meditate on what the person would say to you if that opportunity were available, and find a safe place to find guidance from people who get you and get dementia.
Lastly remember, reach out for resources, information, and support.
Melanie Bunn is a PAC Certified Trainer, Coach, and Consultant with Positive Approach® to Care, Dementia Training Specialist for Dementia Alliance of North Carolina, and Consulting Associate at the Duke University School of Nursing. Melanie also leads her consulting company, Bunn Consulting. She received her undergraduate degree in nursing from the University of North Carolina-Chapel Hill, her Master’s Degree in Family Health Nursing from Clemson University, and a Post-Master’s Gerontological Nurse Practitioner Certificate from Duke University.
She is a skilled and experienced advanced practice nurse and nurse educator, conducting over 200 presentations and trainings annually to health professionals, community organizations, first responders, families, and other groups focused on the care and needs of people living with dementia and their families, throughout North Carolina, the United States, and internationally. Her research efforts have focused on improving care of older people, especially those with cognitive impairment, through improving the education of inter-professional teams and families. She has volunteered as an Alzheimers Support Group Facilitator for over 25 years.