Understanding Dementia

The entire course is based on the misconception that human brain does the thinking instead of human mind. The understanding that human mind does the thinking process which includes remembering is extremely important. Imagine a person standing on top of a tower which is a tourist spot with a telescope, and the person wishes to locate a particular object , say a railway station using the telescope, once that person has got the right angle, he or she can slowly do the focusing and eventually arrive at the image of the railway station. However, if the telescope is not placed at the right angle, it is not possible to get to the railway station no matter how much or how long is the focusing effort. Hence the right view is extremely important. Just as the right view that human mind does the thinking instead of human brain.

By having this right view, may be human and the present medical science can assist in delaying the occurrence of dementia in human being.

The mind does the thinking not the brain. While all the important components in the brains serve as the required connections to enable human to talk and to walk, they are actually the hardware while the mind is the software similar to a computer. Human brain has no thinking function. The brain serves as a controlling agent to control the eye, the ear, the nose, the tongue, the sensation on the skin and the heart. For the mind to do normal thinking or remembering, it needs the brain to be in healthy normal conditions. When a drunk driver tries to avoid compound from the traffic enforcement officer, his mind wants to walk straight but due to the intoxicated brain which could not control all the six sense organs, he fails to walk straight.

When a thought occurs, the mind receives an impression in the form of an image of the situation. The mind makes use of the sense organs, eye, ear, nose, tongue, skin and the heart to do the thinking. the mind serves as an initiator as it signals the brain on what to do. The brain which is biologically connected through the nerves to all the sense organs, has the ability to control, coordinate and operate all the sense organs. When a person experiences something or is just thinking about something, the reactions and the reflections on all the sense organs are exactly the same. However, the intensity is greater during experience as compared to just thinking or remembering. When all the similar reactions and reflections on the sense organs are brought about with the help of the normal functioning brain, memory is recalled. When we think of sour plums, our mouth secretes saliva, though the extent of the secrete is so nominal that we might not notice it, but our tongue is activated when our thoughts are on the taste of the sour plums. When we think of an object, a faint reflection of the object springs in our inner eye; when we think of a sound we have heard before, a faint reflection of the same sound springs in our inner ear; when we think of a smell we have experienced, a faint reflection of the smell springs in our nose; when we think of a taste we have had, a faint reflection of the taste springs in our tongue; when we think of a sense of touch we have felt, a faint reflection of the same sense of touch springs on our skins. We actually think in terms of colours, sound, smell, taste, hot or cold, hardness or softness. In each of these thoughts, we bring into activity its respective sense organ. Whether we visualise a situation or we actually experience it, there is an effect on the sense organs. The difference being the the degree of intensity. As mentioned, when thought occurs, the mind receives an impression in the form of an image of the situation. this impression enters the mind and remains fixed in it as a form of records. If the mind making use of the normal functioning brain, and the brain has the sufficient neurons and all the required connections in working conditions, it is possible for us to retrieve this impression retained in the mind. However, over time, with so many fresh impressions and old ones, the mind needs the brain and all the required nervous connections to be in perfect functioning conditions to do the retrieval. As we age, the overgrowth of impressions thickly formed. And as we age, the neurons population in our brain are either damaged or dead and hence the neurons population gets less and less. Other important components like the entorhinal cortex, the hippocampus. the high-order associations cortices of the temporal, frontal and parietal regions and all the other necessary nervous connections may not be in normal functioning conditions. As mentioned earlier, the brain and all the necessary components in the nervous system are the hardware of a computer which are subject to wear and tear. However, the mind which serves as the software does not. To penetrate and retrieve recent records, the normal strength remained in the brain may be sufficient. Problems starts when the normal strength of the brain deteriorates to an extent where it cannot perform the penetration and retrieval process even on recent records.

Memories are stored in the mind just as movies and video recordings are stored in videotape. A remote control is used to do the rewinding. Memories are not stored in the brain just as video recordings are not stored in the remote control. All the mechanisms in the video player are like the sense organs. Without a remote control, the video player is still able to play and function once it is switched on. However, this will be similar to brain death condition. When a person is unable to function in controlling the sense organs. Medical science cannot pronounce that person is dead becausethe heart is still functioning and the mind is still with the body. With the remote control, we can operate to rewind the video recording just as we do remembering in our daily life.

One of the main causes leading to the misconception, which the present medical science believe that the brain does the thinking is that because four out of five sense organs; the eyes, ears, nose and the tongue are all fixed around the head while the fifth sense organ, the skin, spreads to all regions of the body including the head. When we think, these five sense organs are provoked, making us feel as if our thinking occurs in the head. Actually the brain neither thinks or stores records. It merely control and coordinates all the sense organs and the nervous system.

when general anaesthetic (GA) is administered whether by inhalation agents or intravenous agents, the metabolic rate of the brain decreases tremendously. When the brain loses its normal ability to control and operate the sense organs together with the nervous system, it results in amnesia. In the case of local anaesthetic (LA), the brain is kept under normal conditions, but the area of the nerve fibres is blocked by the binding effect of local anaesthetic to the sodium channel. The impulse condition along the nerves is blocked, thus causing analgesia, loss of sensibility to pain.

Briefly, Alzheimer's disease is caused by progressive selective degeneration of neuron population in particular areas of the brain. In addition to the neuronal population loss, damage to ' cholinergic neurons " result in a loss of delivery of brain chemical called acetylcholine to the cerebal cortex. Alzheimer's disease is characterised as a relentless impairment in memory and decision-making that generally begins slowly and worsens over the years. Once someone gets the disease, it is always a downhill descent. Fear of getting the disease as we age, is one of the causes of the disease. It resembles the old Tetrix computer game where the task is to keep the number of lines building up. Obviously one feels anxious as the number of lines nearing game over.

As we age, the wear and tear suffered by the neurons and other components in the nervous system can resemble the analogy of a torch light. After some time, the battery is running low. A weak battery can still shine and retrieve recent records beneath if there are few opaque layers of records above it. On the other hand, if the layers and layers of records are in the form of opaque obstruction, a worn out brain similar to the wear battery in the torch light, may not be able to do the retrieval of records. Hence loss of memory.

Records in the mind are formed as an impression. When the impression is so great, it tends to stay. If someone has been traumatised or been through an experience that causes great impression on to the mind. And the reason why it stays, simply because while going through our daily life, subconsciously when we encounter some events, like watching TV or hears some conversations which is related to the greatly imprinted impressions, the records will be brought up to the recent level and represent itself as new records. Hence there are some patients can remember incidents that has taken place decades ago, but cannot remember the visit by his love one minutes ago. Partly because with the disease, impressions may have difficulty to form.

We cannot go against nature by not growing old or avoid the wear and tear. But following the analogy of the weak torch light, and if we are able to maintain a good layers and layers of transparent records, we may still be able to retrieve memories.

Some of the thoughts that could form opaque impressions on the mind are ; ego, fear, greed, jealousy, hatred, self pity, stinginess, indecision.

I am looking forward to share with others on understanding of dementia. And I can be reached at [email protected]

Thank you.

For me doing the course and its course work was a Rip Van Winkle experience. The last time I worked with people who had dementia was during the late seventies. At that time it was called Senile Dementia and Pre-senile Demetia. There were other demetias most notably Huntington's Chorea and what was termed Arteriosclerotic Demetia. It could be readily diagnosed by doctors but little could be done to halt its progress and compared to the present day, comparatively little was know about the pathology of the syndrome. Now days the terminology has changed most Dementia's are now lumped under Alzheimer's disease and the terminology for other dementias has changed to far more direct names like "Younger Onset Dementia and Vascular dementia". They have also found out that most dementias are in fact Alzheimer's disease which at one time was thought to be comparatively rare.

Concurrent with this new diagnostic typology is a far more extensive knowledge of the pathology involved. Yes they now understand the mechanism of dementia far better. Simply put they have a good idea what happens during the process of decline and deterioration of cerebral capacity that underscores dementia. But that is as far as it goes. You will find out by undertaking this course that dementia still is a downward spiral to an inevitable conclusion and ultimately little still can be done to halt or reverse this decline.

So why do this course? Well the answer is simple even though little can be done to arrest the inevitable decline a lot can be done to manage a person's dementia and this I think is where current practice is far in advance to that of 1979. These days dementia treatment and management is far more humane and it was heartening to learn this. A lot more can be done to manage the decline and I support anybody who works in this field.

Which gets to the real reason why I did this course. A dear friend died of Lewy Bodies dementia a few years back. I went to see him during the final months of his illness. Nothing could prepare me for seeing him. I thought I was tough because I had nursed in some pretty tough psycho geriatric wards but when it comes to seeing somebody that is lifelong friend and at one time saved my life, well it was a shock! Here is me big tough former nurse able to handle anything with a certain dispassion, and yes seeing him really got to me. I must admit the place where they cared for him was far more advanced than the conditions in which I nursed and the standard of care was far more advanced but I could not help thinking that God the Cosmic Vivisector had even "got" a giant of a man like my friend, too.

Yes folks, while we can do some things to stall it once dementia is diagnosed it still is an "inevitable conclusion." I know they have found a monoclonal antibody that works to reduce the formation of tau proteins in the brain and that every day they are finding new things that can be subjected to clinical trials but dementia still is a very difficult "nut to crack." That is why I appreciate every researcher that works toward better ways to treat and palliate this wretched syndrome. Who knows, maybe there will be a time when dementia is not the embuggerance that it is now. We can hope that the current dementia epidemic will one day not be as problematic as it is now.

The Understanding Dementia MOOC provides a thorough overview of the nature and range of dementias and especially useful strategies for working with people living with dementia. As a film maker and physiologist, I have worked on some very large multimedia and website projects and this one has been extremely well designed and thoughtfully implemented. The navigation system is excellent and the numerous video interviews, although limited to single camera filming, are well planned and mostly very engaging.

My only criticisms are very minor. I found the use of the term MOOC a little overdone. Calling a person 'Grandpa MOOC', or referring to 'the MOOC family' is a bit naff and actually a little distracting. Just call him 'Grandpa' or 'George' or whatever. There are probably good reasons for referring to the MOOC throughout, but I found it a little irritating after a while and would have preferred to simply call it 'the course'. These are just minor personal quibbles.

I think the content of the video interviews is fascinating and at times very moving. The videos would, however, be greatly enhanced by having more close-up shots of the interviewee. Two camera cover would help enormously and in fact many of the questions need not actually be included. In several interview based projects I have filmed we opted to leave the interviewer out entirely, requesting the interviewee to include the question in their answer. One consequence of this approach is to shorten the interviews without losing either content or real intimacy with these difficult subjects.

It is also important to position the camera/s at or below the subject's eye level. There's a psychological effect whereby having the camera looking down onto the subject/s - even a little bit - lessens the impact of what is being said. I do understand that the single camera option was probably dictated by budgetary constraints but I would love to see new interviews done multi camera.

Such minor points aside, I felt the intellectual level was very cleverly set at about Middle School level. This made the content accessible to almost anyone joining the course and provided an excellent overview of what is a huge and complex field.

I congratulate the course designers and participants for producing such a comprehensive and extremely valuable resource and for doing it in such a respectful way. One of the strongest points to emerge for me, especially in Part 3, was the strong and clear message to treat all dementia sufferers with care and respect for their individuality.

I recommend this course very highly to anyone dealing with friends or relatives living with dementia. I will be using all that I have learned from the course in helping our little support group as we help each other navigate this complex and difficult path we and our loved ones are following.

Understanding Dementia is a brilliant course! I initially enrolled to enable me to better understand my father, who suffers from vascular dementia, and to ensure that he has the best care possible. I found the course so engaging, that my motivation for study became an intrinsic interest in the subject matter of dementia itself, as well as a way to help my father. The lectures are presented in an easily understood format, with helpful summaries at the end of each one. You may choose to watch the videos and/or the transcripts, but as some of the videos are quite outstanding, and are a wonderful adjunct to the learning process, they are well worth watching!

Exercises and quizzes will test your comprehension of the material, but are not assessed. The discussions are a way to get to know other students and to test your knowledge of the course material. I found Body Central one of the most useful learning techniques. This programmme tests your knowledge of the structures and functions of the brain, and is a very easy and fun way to learn this material. I doubt whether I could have learnt this material so easily, without this wonderful interactive learning tool.

This was my first experience of online learning, which I found superior to learning in a classroom. The teachers are wonderful and are extremely supportive. In fact, I was so impressed by Understanding Dementia, that I completed the subsequent course, Negotiated Study in Understanding Dementia, which is equally impressive; both courses are great fun, as well as very informative. I highly recommend Understanding Dementia to anyone, who has an interest in the subject. If you aren't especially interested when you start, I can almost guarantee that you will develop an interest in the subject of dementia by the end of the course!

"Undertaking the MOOC online course provided by the UTAS - Wicking Dementia Research & Education Centre, was an incredible journey for me.
I had only worked briefly years ago in a Dementia Ward in a Nursing Care Facility in Queensland. I observed and learnt a little about the affects it has on the individual people suffering from Dementia and their families, and what the staff there had taught me.
I did this for some continuing CPE units required, but once I began this journey - I realized how little I knew, and understood about this progressive disease and how little information and education is available in the general community, that can lead to stigmas and misunderstandings of the symptoms that present, unless people are personally caring for someone in their own family circle, or are a carer in this field that have had experience.
It invoked feelings of great emotion, understanding, sadness, and finally hope and inspiration with the work, research being done, and required funding and continuing research needed, largely in Australia and globally, to ensure each of these beautiful people who are members of families and our local communities, have the quality of life, and supportive care that they richly deserve.
They have each contributed to our society and have a lifetime of skills, knowledge and have built their dreams, homes and lives in your local community for many years before any of us may have come to live there. As someone said, and it stuck with me "Don't see me for the symptoms I have, see me for the Person I Am!"
This course, has covered content to really help you see from a wholistic or global perspective, and has many experts and professors, that deliver great and valuable information, resources, and opportunities for feedback and discussion, so you gain more insight by those involved and engaged in research, and building strategies, and formulating the policies, or that are experiencing it themselves in YOD (Younger Onset Dementia), those who care for their loved ones, and who have graciously shared their thoughts, feelings and knowledge to give a wider and more informed understanding.

I was very honoured to participate and will continue studying more through the other courses here available. There are people who care and dedicate their lives to the greater needs of each of these individuals who suffer from Dementia, and their families. There are aspects and strategies, in this course that I learned that have contributed and need to continue to bring awareness, a change in the health care systems and governments for funding in developing and upgrading existing facilities as well as, continuing education.
Thank you for this extraordinary experience and I will certainly apply and adapt to, all I have learned with a new perspective and understanding and be of greater assistance to all those who may come into my care.

If you undertake and fully complete this course, it is well worth your time and can assist someone in need. Perhaps a loved one of your own, or a valued friend or community member. We can all take responsibility for our communities and loved ones, by obtaining the knowledge and the access to resources we need and making them accessible in our local communities!!
This should be mandatory in all Health Related Studies, with the increase of this type of dis-ease. There are many brave souls who I respect that endure so much, and have given me a very open window of understanding, and compassionate care - that has changed my view and has left a profound imprint on my heart and soul."
M L Rey
Natural Complementary Health Therapist

This course has been invaluable to me. My mum was diagnosed with dementia in 2017 at the age of 83.

Unfortunately I lost my mother last year at the height of the pandemic in Victoria last year. I watched her physically and mentally deteriorate in front on me through a window for the best part of 6 months and I was unable to help her. As it turned out there were no procedures in place to combat the virus and it created havoc in her aged care facility. The State and Federal government directives ultimately failed her and many others.

I feel a strong sense of guilt that as her guardian and main carer, I was unable to look after her when she really needed me. I often think about how we all as a family cared for her in the years she lived with dementia, and if we could have done more.

After completing this course I feel content that we as a family cared for mum well; considering we had never experienced a loved one, or anyone in our lives having dementia. Mum was never an overly socially out-going person prior to her diagnosis and that didn't change once she resided in the aged care sector. The personal care staff were wonderful. They would encourage my mum to venture out of her room and join the other residents in daily activities. Mum was content to sit alone in her room most of her day. She preferred to eat her meals alone in her room. In time I understood that it wasn't so much mum was feeling anti-social but the condition of having dementia would confuse her whenever she left the security of her room. It was a definite learning curve. I would often say to the staff just to let her be alone in her room, if that's her wish. I had to explain to the registered nurse not to change her bedroom to another section of the home as her anxiety and level of confusion would be exacerbated. It was astounding to me that I needed to explain mum's symptoms with dementia when they are the staff dealing with dementia residents everyday.

I would highly recommend this course for training of personal care staff as well as allied health and all health workers, if they haven't already done so...

Since learning in this course that 30 - 40 percent is genetic in developing dementia in families, I feel better equipped to know what to expect in the journey of a person diagnosed with dementia. My aunt (my mum's sister), has recently been diagnosed with dementia and I feel very confident that I will be able to understand and assist her in the future.

I would highly recommend this course to anyone and everyone, regardless if you have experienced knowing someone with dementia. Even if it teaches you to become more aware of others in your community that have dementia and how to have the patience and take the time to be kind and assist them in their daily lives. This on line course is invaluable.

Geriatricians could inform families and loved ones of those initially diagnosed with dementia to complete this course, as a great tool in understanding dementia. I wish I had known about this course prior to mum's diagnosis. I'm certain I would have had more confidence in helping her live a more comfortable and fulfilling life living with dementia.

"Understanding Dementia" is an incredibly heartfelt and well-made course. It admirably takes on a comprehensive biopsychosocial perspective to the reality of dementia, with some content being remarkably powerful in an emotional way. Unlike most other MOOCs I have completed, the authoritative creators of this course from the Wicking Dementia Center have made it ensure that the material is never stale - at this rate, the course is bound to be an eternally-unfinished material, with the makers always looking for ways to improve and update its contents (and they listen intently to audience feedback, too) since offering it in the early 2010s. Dementia is both something that everyone has most likely encountered in the lives (primarily through aging relatives) and bound to be an increasingly-important global health issue. Thus, this course, which can be appreciated and learned from by a wide range of students, is a must-take for virtually everyone. I came for the pathological hallmarks of the disease initially, and left with so much more in being a better carer and advocate for people living with dementia.

Dementia is the leading cause of death in Australia. Since 2017 it has become the leading cause of death for women who account for 64.5% of all dementia related deaths. Currently there is an estimated 447,115 Australians living with dementia. One in ten people over 65 years have dementia. It is the single greatest cause of disability for older Australians and accounts for over half of all residents in residential aged care facilities. (Dementia Australia 2019 Key Facts and statistics).
This is alarming and shows that more likely than not, we will know or care for someone living with dementia. Yet in our society the experiences of dementia are highly stigmatised and not well understood. This Course addresses those deficits.
This course is divided into four main modules with many units or aspects of inquiry within each module. Right from the very beginning we learn that quality of life for people living with dementia throughout its trajectory is what matters most. Dementia care is person-centred care. We are given an eye-opening snapshot of how it may be experienced from the inside and learn of the basic brain pathologies that cause the changing symptoms of dementia. We learn of the modifiable and non-modifiable risk factors as well as the distinctions between normal ageing and dementia. Diagnosis is based firstly on one’s own story and its changes over time, bearing in mind that every person’s experience will have some differences.
Progressing from Orientation through to the end of Module 4 brings a rich depth of essential information. As one progresses the modules have more packed into them and take longer to achieve but I found that interest is stimulated and maintained throughout. There are many dimensions to this complex subject, some of which could be expanded into further modules. For example, towards end of Module 4 we come upon Dementia Friendly Communities, take a look at what this means and consider design and construction of positive environments. Social planning is another of those dimensions which is a field (or module) in itself. Before that however, a huge territory has been explored, from the insidious onset of dementia, how to care for the person at every stage, including most of the characteristic symptoms. We hear of carers’ experiences and discover an intriguing range of non-pharmacological interventions for both individuals and in group settings.
Given the volume of information in this Course it is no doubt hard to include everything, but I was just a little disappointed to find only one mention of cultural diversity. Culture and language shape our lives and give us meaning, so is very relevant in the care of a person with dementia. However, this may well be addressed more substantially in further education with The Wicking Centre.
The Course is structured with video interviews carefully planned in a conversation style without overloading the learner all at once. The information in each video builds upon the last, augmented with reinforcing reflections, discussion threads, quizzes and a rich set of additional resources for further learning and research. It is a remarkable effort in curriculum design and implementation. It’s easy to see why this Course has received accolades. It gives me a thirst for delving more deeply into this subject.

For me doing the course and its course work was a Rip Van Winkle experience. The last time I worked with people who had dementia was during the late seventies. At that time it was called Senile Dementia and Pre-senile Demetia. There were other demetias most notably Huntington's Chorea and what was termed Arteriosclerotic Demetia. It could be readily diagnosed by doctors but little could be done to halt its progress and compared to the present day, comparatively little was know about the pathology of the syndrome. Now days the terminology has changed most Dementia's are now lumped under Alzheimer's disease and the terminology for other dementias has changed to far more direct names like "Younger Onset Dementia and Vascular dementia". They have also found out that most dementias are in fact Alzheimer's disease which at one time was thought to be comparatively rare.

Concurrent with this new diagnostic typology is a far more extensive knowledge of the pathology involved. Yes they now understand the mechanism of dementia far better. Simply put they have a good idea what happens during the process of decline and deterioration of cerebral capacity that underscores dementia. But that is as far as it goes. You will find out by undertaking this course that dementia still is a downward spiral to an inevitable conclusion and ultimately little still can be done to halt or reverse this decline.

So why do this course? Well the answer is simple even though little can be done to arrest the inevitable decline a lot can be done to manage a person's dementia and this I think is where current practice is far in advance to that of 1979. These days dementia treatment and management is far more humane and it was heartening to learn this. A lot more can be done to manage the decline and I support anybody who works in this field.

Which gets to the real reason why I did this course. A dear friend died of Lewy Bodies dementia a few years back. I went to see him during the final months of his illness. Nothing could prepare me for seeing him. I thought I was tough because I had nursed in some pretty tough psycho geriatric wards but when it comes to seeing somebody that is lifelong friend and at one time saved my life, well it was a shock! Here is me big tough former nurse able to handle anything with a certain dispassion, and yes seeing him really got to me. I must admit the place where they cared for him was far more advanced than the conditions in which I nursed and the standard of care was far more advanced but I could not help thinking that God the Cosmic Vivisector had even "got" a giant of a man like my friend, too.

Yes folks, while we can do some things to stall it once dementia is diagnosed it still is an "inevitable conclusion." I know they have found a monoclonal antibody that works to reduce the formation of tau proteins in the brain and that every day they are finding new things that can be subjected to clinical trials but dementia still is a very difficult "nut to crack." That is why I appreciate every researcher that works toward better ways to treat and palliate this wretched syndrome. Who knows, maybe there will be a time when dementia is not the embuggerance that it is now. We can hope that the current dementia epidemic will one day not be as problematic as it is now.

**Course Review: "Dementia: Unveiling the Layers of Understanding"**

*Dementia*, an intricately designed course, offers a holistic journey into the world of cognitive decline, emphasizing the importance of a comprehensive perspective. Divided into three enlightening modules, this course delves deep into the complexities of dementia, exploring not just the medical aspects but also the profound human experience it entails.

**Module: The Brain**
*The Brain* serves as the foundation of this captivating course. It artfully unwraps the enigma of the nervous system's anatomy, ensuring students grasp the fundamentals. From neurons to synapses, this module paints a vivid picture, laying the groundwork for an in-depth comprehension of dementia's roots.

As we delve into the *Pathology of dementia*, the course masterfully navigates through the tangled web of diseases that lead to cognitive decline. It also keeps its gaze firmly fixed on the horizon, shedding light on *Future directions of dementia research*, inspiring students to envision a future where dementia is better understood and managed.

**Module: The Diseases**
*The Diseases* emerges as a beacon, guiding students through the fog that sometimes obscures the distinction between normal aging and dementia. This module doesn't stop at identification; it unfurls *Risk factors for dementia*, empowering learners to appreciate the complexity of this condition.

The course then explores the *Domains of dementia*, offering insight into the various facets of this multifaceted condition. It doesn't shy away from the challenges associated with *Diagnosis of dementia*, inviting students to confront the realities of identifying and managing this condition.

*Younger onset dementia* and *Stages of dementia* beckon students to step into the shoes of those affected, urging them to focus on providing support that truly matters. The journey through *Medical management* is a testament to the commitment of this course to leave no stone unturned.

**Module: The Person**
*The Person* module sheds light on the human side of dementia, reminding students that there are faces and stories behind every diagnosis. The *Insidious onset of dementia* is unveiled, emphasizing the importance of early recognition.

*Living with dementia* is explored with sensitivity and compassion, offering valuable insights into what it means for individuals and their families. *Dementia palliation* and *Non-pharmacological therapies* emerge as beacons of hope, suggesting that there's more to dementia care than meets the eye.

This module also delves into the intricate world of *Behavioural and psychological symptoms of dementia*, offering strategies to navigate the challenges they pose. *Pain and dementia* are addressed, acknowledging the silent suffering that often accompanies cognitive decline.

As the journey progresses into *Advanced dementia symptoms and management*, the course casts a hopeful glance toward the creation of *Dementia friendly communities* and the power of *Dementia inclusive design*, illustrating the profound impact of community support.

In conclusion, this course on dementia transcends the boundaries of traditional education. It does not just inform; it transforms perspectives, fostering empathy and understanding. It prepares students to face the challenges posed by dementia with compassion and knowledge. Enroll today and embark on a profound journey of enlightenment and empowerment.

Thank you for this opportunity ,First thank you Prof Fran Mdnerney and others for the opportunity to help us study .Mooc was initiated in 2012/2013 which has 3 modules ,a)the brain, b)the disease ,c)the person which took approximately 7weeks.

Understand the meaning of dementia which is a collection of signs and symptoms that are caused by number of diseases. Alzheimer's being most common that causes dementia (60-70%).
The early diagnosis is worthwhile because it helps us to dispel some fears and anxiety of what people are experiencing, to get trial on drug to delay symptoms,talking to loved one about value of life and what they'd like to see in health care and do important things that matter.
We get to understand the pathology of dementia which has we discussed about 1)Alzheimer's disease-see changes in brain ,i)beta amyloid plaques (tiny filaments that deposit btwn the cells brain and have toxic effects),ii)neurofibrillary tangle (occur inside the cell and thought to gum up the cell so that it do3snt work and eventually the cell dies.)2) Fronto- temporal dementia with affect under 65years of age,atrophy of the temporal and frontal lobe of the brain.there is behavioural variant symptoms and language variant symptoms. Two proteins involved are TAU and TDP -43.the largest genetic cause is C9ORF72. 3)Lewy Body dementia which involves in changes in visual spatial awareness. Symptoms are loss of attention,changes in visual spatial awareness, sleep disorder,fluctuations of cognitive change and tremors as in parkinsonism. 4)vascular dementia which is a small blood vessels disease, problem gait which is affected at suboptimal white matter under the cerebral cortex.

The disease ,risk factors include divided into three,i)early-less education .ii)midlife- alcoholism,obesity,hearing loss. iii)later life-smocking,depression ,diabetes. Different domains of dementia are a) cognitive which include orientation, planning,judgement. b)functions. c)psychiatric which affect changes of thinking,hallucinations, depressive symptoms and delusion. d)behavioural .e)physical.
We have stages of dementia, i)stage I - (mild)which include changes in judgement,planning,mood,insight,more irritability. ii)stage II -(moderate) whisky include ramping up of stage I symptoms,psychological, perception and awareness of damage is limited.,iii)stage III -(advanced) here,there's progressive physical difficulties, changes in mobility,functioned eating,swallowing,chewing.There's also progressive impairment of nerve impulses effectively working on muscle.Medical management include protecting the brain,treating the symptoms that causes dementia, providing comfort and taking the cholinestarase inhibitors.

The person,according to carers perspective we should respite,support,validate,acknowledge and show kindness to the person with dementia.in dealing with people with dementia we should get to know the person ,smile,slowdown and communicate clearly ,introduce yourself,step back,be quiet,don't argue, engage and encourage, consider safety and talk with others .Advanced dementia symptoms are incontinence, skin frailty and later constipation ,pressure ulcers if not taken care of.The management include to modify the person diet,Conservative hand feeding,support person ,and eat small amount of food.We also have palliative approach which enhance comfort,and enhance quality of life and quality of dying.Community ,persons own house,residential aged care,curative intervention ,hospices ,palliative Care units and terminal care.
Also studied non pharmacological therapies which include validation therapy,reminiscence therapy,doll therapy,pet therapy,music therapy.
Dementia enabling environment principles which include allow pole to be seen or see,support movement and engagement pathways,create familiar places,reduce unhelpful stipulations or visual stipulations,provide a home scale and should be safe(unobstructively).
Dementia friendly community (supermarket and bus stations,banks,markets) and dementia inclusive design(good environment,safe,familiarity of furniture,toilets around the garden).

The course of Understanding Dementia was extremely helpfull for me . I highly recommend it not only to people having a relative with Dementia disease, but also for every one , because by getting all this information, we could take care of our self on the domain of prevention and also we could speak in a meeting of friends about this and in this way, we could help others that have a relatives suffering this desease !
Every one that has diagnosis of Dementia should take this Course. She /he can do many things very important to ameliorate her/his life ! I learnt how many institutions and organisms and professionals are working and share information about prevention or better living with dementia !
I learnt that the life of patient of Dementia can be better ! I learnt that there is a special approach and methode that can and must be given in order to see if (and where) the patient has pain on the stage 3 , because she/he cannot express herself/himeself verbally unfortunately. I learnt and I was shocked from the videos of people in the stage 3 that they could not speak but the carer aproached them by music, singing, touching and they became alive ! People of Dementia have emotions, they have feelings , they need human company ! the need an activity that make them happy during they are awake !They need love !
I learnt that we must take care of our brain by doing or not doing speciffic things from very young age , from our twenties ! Also this could be discussed in a class of children of age 17-18 years old .
I wish also more and more people could work on the field of Medicine to develop more blood or brain test (scans) to identify the disease in early stages ! I wish the Medicine could be evolved in the domain of cure !
Even for a teacher of children in the ages between 16-18 could discuse some subjects of this course in the class and help some children to identify an interest on this domain for future study on that.
I wish patient of dementia could live as much independently in their "house" ! Please search the villages of dementia in Australlia ! There are wonderfull ! I wish we all didm practise the consult of good food , daily gymnastic , doing activities that keep our brain healthy !
Finally I wish all carers and professionals that take care of these patients could take this course.
The videos and texts and additional links provided by the University of Tasmania and specifically the department of research for Dementia through this course were amazing and will help me to continue ameliorate my knowlegde on that domain. It was not a happy course
for me ,but I am interested on that domain for myself, my parents , my friends , my community !
I would like to express my deep gratefulness, gratitude, to all Professionals , Technicians , Teachers , Researchers of Universuty of Tasmania that provided me this course ! Please continue your efforts !
Marika Deligianni

This course inspired me to write a little poem about Dementia. It is called One Day at a Time.

One Day at a Time

I drive the only taxi in a little country town,

So I get to know a lot of folks who need to get around.

Each Friday Uncle Reg likes to walk down to the shop,

But sadly Aunty Susie said he’s kind of lost the plot.

Now what she really means is he forgets a lot of things,

Like where he left his glasses or put the baking tins.

Today Reg did the shopping. His son Pete owns the General Store.

So when Reg wandered in Pete met him at the door.

“Hello Dad.” Pete greeted him and escorted Reg inside.

But Reg looked very worried, a look he couldn’t hide.

Who was this man who had the hide to call him names like Dad?

His son was quite a bright young man, a rather handsome lad.

Reg didn’t want to dwell on this and got a trolley to lean on.

The shopping gets so heavy now he isn’t quite so strong.

Then he thought he’d fancy buying Susie something yummy.

So he stocked up on some bags of chips, some crumpets and some honey.

A hot chook would be nice for tea but now was time to go,

But he couldn’t find his wallet and his stress began to show.

The check out chick called that man who thought he was his son.

What a mess, what should he do, maybe it was time to run.

That man called Pete fixed up the bill and told Reg not to worry.

All was good, he made a joke, “Don’t leave town in a hurry.”

I wasn’t very busy so was waiting for Pete’s call.

He always rang when Uncle Reg had finished shopping in the Mall.

We packed the cab and then I took my Uncle to the park,

Where we stopped and bought an ice cream and reminisced till it was dark.

I call this our weekly trip so Reg can find his way,

And maybe he‘ll remember Pete and even me one day.

We talk about when Pete and I would play there in the park,

And buy Bob, our dog, an ice cream so he wouldn’t bark.

Reg would have an ice cream, rum and raisin he liked best,

Then we’d talk about the good times and then he’d have a rest.

And when I’d take Reg home again, Susie’d rush down to the car,

To help Reg carry all the bags as if it was too far.

So take the time to stop and chat to old folks that you see.

They’ve seen a lot and done a lot and could be quite lonely.

There is so much that we could learn from tales that they might share,

And one day you might be old and slow so show them that you care.

Judy Renner

1/9/2020

This is a very easy to understand course for anyone interested in learning about and understanding the lives of people living with a dementia disease.

It is presented in a recorded video conversation/interview style. There are scripts to read if required and closed captions for those requiring them.

There are activities and quizzes at the end of each module to assess your understanding of the module just completed.

The modules are spaced out so you have time in between to go over anything you didn't understand at first.

I found the whole experience to be very satisfying and extremely informative.

I would recommend this MOOC to anyone who is just beginning their journey down the path of dementia study, care, or even if you are maybe concerned about yourself or a loved one or friend. It will help you to understand what they are about to go through or are already going through.

153 words....

I am 74 years old and have a family member with mild alzheimer's disease. I wanted to learn as much as I could about the disease.
A friend who works in providing care, completed the course in 2017. She sent me information on the course as she knew I was concerned about changes in my family member's short term memory. I contacted the University last year and was able to enrol in this course at the appropriate time.
For me personally, the course was somewhat of a lifeline. I needed to get a better understanding of alzheimer's disease in particular but in Dementia generally. The course has done this and I am not as apprehensive and fearful about the future for our family member and the rest of our family including myself as carer.
I have enrolled in the Preventing Dementia course which begins in May to gain more knowledge. I am looking forward to this opportunity also.
I have been able to pass information about the course on to a close friend whose husband has Parkinson's disease. I believe she will gain as much benefit from the course as I have done.
I now attend some carers' activities and find I am able to pass on some of what I have learnt from the course to other carers.
The course is so well designed that while I am not very good at IT, I was able to complete the course without much difficulty.
I am hopeful that I will be able to do further online course as a result of completing and thoroughly enjoying this course.
Throughout the course, I have been so appreciate to have the opportunity to learn about alzheimer's disease/dementia and to get correct answers to some of my questions and concerns.
I would like to say a very sincere thanks to all involved. Well done and much appreciated.

Nanette Taylor - University of Canberra Hospital The course was an excellent 'learning platform' to outline the 'normal person with some challenges' versus those persons that have possible signs of dementia and those that have been conclusively diagnosed as having dementia and the significant signs plus variances that the disease can display. I have worked in a hospital setting in senior management and also had a mother that had dementia following an accident where a tree branch fell on her head in a storm. In the course, I have been able to follow the steps of her illness and suddenly it all made sense. Whilst I was learning and bedding down knowledge - I started to wonder - how did she feel? An intelligent lady who was always the carer to everybody else, losing her memory day by day. The presentations by 'every day' people who had been diagnosed with various types of this dreadful disease added the 'real meaning' for me. Meal Presentation, Flavour and Old Fashioned Meals One of the areas that I would have liked addressed is the provision of food from a home based scenario and also from a care facility perspective. I have made this area a project over the past 10 years and implemented effective initiatives in ward based care plus options can be addressed as per overseas facilities where someone will sit with the person - alone or in a group and eat with them where the patient will 'mimic' the carer picking up of the spoon and putting food it in their mouth. The lack of concentration is often described as the 'patient wasn't hungry', not the fact that we didn't try and keep their attention on the meal. One of our patients was described as 'non verbal' until we started to talk about 'bread and butter' pudding and she proceeded to tell me about both her and her grandmothers recipe - a real breakthrough for someone that had not spoken in over a year - a similar scenario to the video with the gentlemen that was listening to music via an IPad - it was as though a light turned on. I could not recommend the course more highly- content, videos and professionalism of the presentation were exceptional.

Understanding Dementia.

This review describes the brain science on dementia, the risk factors for dementia, the behavioural & psychological symptoms of dementia and therapy.

Dementia is a collection of syndromes. Alzheimer's disease is known to be the main course of dementia among other causes. The nervous system allows us to sense and respond to our environment, control what happens inside us, and do "higher order" functions. The cerebral cortex is involved with functions of feelings, emotion, experience and memories while the hippocampus is involved in formation of new memories. Alzheimer's disease results from the damage of the hippocampus. Changes in the brain that result in Alzheimer's disease are beta-amyloid where tiny filaments between the brain have toxic effects on neurones and the neurofibrillary tangle which occurs inside nerve cells and "gum up" the cell not to work properly. The loss of synapses lead to cognitive symptoms.The effects of dementia are change in behaviour & personality, language, impaired planning & judgement, apathy, loss of empathy and disinhibition.

The major cause of dementia is ageing. Dementia has modifiable and non- modifiable risk factor. The modifiable risk factors like hypertension, type 2 diabetes, obesity and high cholesterol can be modified. They can be controlled through healthy balanced diet, cognitive training, high blood pressure management, weight management, alcohol use and diabetes management. The domains of dementia are cognitive, functional, psychiatric, behavioural and physical.From the video on risk factors of dementia, it has been shown that progressive decline in certain cognitive functions goes with "normal ageing". It has been shown that the more educated have less likelihood to get dementia when ageing. This is known as cognitive reserve. It is therefore advised that one should keep the mind active, get body active, get appropriate support and manage health conditions and nutrition.

The behavioural & psychological symptoms of dementia are aggression, sleep disturbances, being withdrawn, resistant to people and being anxious. Dementia patient receive less analgesia because of belief that they don't experience pain. Dementia patients need person- centred care at all times. Alternative therapy can be used get positive response from dementia patients. Such as reminiscence therapy and multi- sensory therapy.
In conclusion, a patient with dementia can be given palliative care to improve quality of life and make the symptoms more manageable since there is no cure to the disease.

I am writing to express my sincere gratitude for the opportunity to participate in and successfully complete the "Understanding Dementia" course offered through your MOOC platform. This learning journey has been enlightening, enriching, and incredibly valuable in expanding my understanding of dementia and its impact on individuals and their families.

I would like to take this opportunity to provide feedback on my experience throughout the course:

Course Content: The course content was well-structured, comprehensive, and presented in a clear and organized manner. The modules covered a wide range of topics related to dementia, including its various forms, causes, symptoms, caregiving strategies, and the psychological and emotional aspects involved.

Engaging Format: The combination of video lectures, reading materials, interactive quizzes, and supplementary resources kept me engaged throughout the course. The inclusion of real-life case studies and scenarios provided practical insights and helped me apply theoretical knowledge to practical situations.

Expert Instructors: The instructors demonstrated a deep understanding of the subject matter, and their passion for educating learners about dementia was evident in their teaching approach. Their ability to simplify complex concepts and address learners' questions effectively was commendable.

Community Interaction: The discussion forums and peer interactions allowed me to engage with fellow learners, share perspectives, and learn from others' experiences. This sense of community enhanced my learning journey and made the course feel more collaborative.

Flexibility: The self-paced nature of the course allowed me to balance my learning with other commitments. This flexibility was crucial in ensuring that I could delve into the course content thoroughly while managing my personal and professional responsibilities.

Assessment and Feedback: The quizzes and assignments were thought-provoking and provided a means to gauge my understanding of the material. The prompt feedback from instructors on assignments was greatly appreciated as it helped me track my progress and make necessary improvements.

Certificate of Completion: The certificate I will receive upon successful completion of the course holds immense value to me. It signifies not only the knowledge gained but also the effort invested in deepening my understanding of dementia.