Be Aware Of The Signs Of Dementia
Although dementia is not only about memory loss, that’s one of the main signs.
Some of the other signs of dementia include:
- increasing difficulty with tasks and activities that require concentration and planning
- changes in personality and mood
- periods of mental confusion
- difficulty finding the right words or not being able to understand conversations as easily
You may like to suggest you go with your friend or relative to see a GP so you can support them. You’ll also be able to help them recall what has been discussed.
A GP will ask how the symptoms have developed over time. They may also do a memory test and physical examination. Blood tests may be done to check if the symptoms are being caused by another condition.
If other causes can be ruled out, the GP will usually refer your friend or relative to a memory clinic, or other specialist service, where they may have more assessments to confirm whether they have dementia.
Read more about how dementia is diagnosed.
What Do Patients With Dementia Want To Know
My aim was to explore what the patients think is wrong with them, whether and what they have been told by their physicians about their condition, and what they would like to know about their illness. Thirty consecutive patients seen by me between October and December 1997 in the Old Age Psychiatry Service in Worcester participated in the study. Twenty were women. The patients ranged in age from 63 to 92 years . At the time of examination, 11 participants were inpatients, and 19 were outpatients. They had been in contact with the psychiatric service from 1 day to 17 years . All had a clinical diagnosis of dementia based on International Classification of Diseases, 10th Revision criteria,7 including Alzheimer disease , vascular dementia , and other or unspecified dementias . In addition, consensus guidelines were used to make a diagnosis of dementia with Lewy bodies in 1 of the otherwise unspecified dementias.8 Participants’ cognitive states were assessed using the Mini-Mental State Examination9 scores ranged from 7 to 29 . All participants gave verbal consent and answered a set of standard questions regarding the information they had received about their illness . The answers were recorded verbatim and will be the subject of further analysis.
Telling Someone You Are Concerned They May Have Dementia
Youve noticed that a friend or loved one is having some problems and you are worried they might have dementia. How do you voice your concerns and encourage them to seek help?
How do you tell a person if you think they might have dementia? Its not an easy conversation and its natural that the person may be defensive, angry or even in denial that anything is wrong. The most important thing is to try and see the situation from their point of view and also make sure that you dont appear to be critical or accusing them of anything. Here is the best way to let them know you have concerns:
Firstly, plan when you are going to have the conversation. Timing is key. Make sure its when youre both at your best, not when youre tired from a long day at work and not when they are most likely to be irritable. You will need to be patient and diplomatic and the person you are speaking to will need to be relaxed and feeling well.
Choose the right environment. Somewhere quiet and comfortable is key. Make sure you wont be interrupted turn off the TV and put your phone on silent. Rule out any distractions.
Decide in advance what you are going to say. Explain first that its important for you to have a conversation and why its a good thing to be able to talk to family members or loved ones when you are concerned about them.
Reassure them at every stage of the conversation. Let them know you are there to help and that you want to make sure they are OK.
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Ways To Help Dementia Parents
It is challenging for any person to admit an impairment of mental functions. In many patients, an insufficient realization of their condition is a manifesting symptom of the disease. Therefore, people often refuse to go to the doctor.
It might be challenging to convine a person with signs of dementia to visit a doctor. It can be especially heartbreaking to see the person you love change so much if it is your close relative or parent. However, when the diagnosis is evident, the crucial part will be accomplished. After that, the next step is therapy and proper care.
For a person with dementia, the safety issue is critical. Your parent may leave the house and forget to close the doors and windows or, conversely, shut the door without taking the key. The patient may not recognize faces well and could let a stranger into the house.
It is vital to ensure that your parent or loved one is in a safe environment. Here are some tips on how to prepare the house to help with dementia care:
Unfortunately, from a certain point on, these measures can no longer be sufficient: it will be necessary for someone to look after your loved one around the clock. But what if the person refuses care? Are there ways to convince a dementia patient to accept help? Read on to find out.
Focus On The Things You Can Control
Some people have said that dementia picks and chooses its battles. However, others have shared that initially, they tried to “do everything right,” but as time went on, they learned that letting go of some of these pressures and expectations saved their own sanity and reduced their frustration.
Change your focus to what’s important at the moment. You will rarely go wrong if you ask yourself if the momentary challenge will be important a month from now or not, and proceed accordingly.
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Just Do The Next Indicated Thing
Although it sounds reasonable to us to say, Its time to get ready, its likely too vague for a cognitively impaired person. Instead, focus only on the next indicated thing that needs to happen.
I need you to put on your shoes now, is concrete and specific. Still, depending on where your parent or partner is in the disease process, you may need to back up a step and start with, I need you to sit down now, before moving on to putting on shoes.
Most care partners are anxious at the thought of making it out the door. They worry about their parent or partners reaction to finding out a doctor appointment is on deck. I suggest a simple, Lets go for a ride. What comes after that? Ill give you several ideas in the Do what works section below.
Energy is contagious, so if youre feeling anxious, it will catch. Instead, stay focused only on whatever the next indicated thing isnot the thing after the next thing. Stay present in this moment to keep your own anxiety at bay.
Plan What You’re Going To Say
If you witness memory or behavior changes, don’t speak up in the moment. However well-meaning, blurting out, “You’ve been really forgetful lately,” or “You’re not acting like yourself whats wrong?” may cause your loved one to get defensive, upset or withdrawn.
Take the time to come up with a plan for how to have a respectful, productive conversation. Start by considering these questions:
- Has your loved one noticed the symptoms?
- Do they think their memory/behavioral issues are just a natural part of aging?
- What could be stopping them from seeing a doctor? Fear? A logistical or financial issue? Do they think there won’t be any point to seeking help?
- What approach has worked in the past to help persuade your loved one to do something they were unsure about doing?
- Who could be the best person or people to broach the subject? Is it better to have a one-on-one talk or involve others?
- Does your loved one prefer to have a lot of information to understand all possibilities, or take things one step at a time?
- Would they feel better if someone offered to go with the doctor with them? If so, who?
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Tips For Communicating With Your Parent
- Avoid power struggles. Dont push, nag or harangue your parents. Making ultimatums will only get their backs up, and yelling, arguing or slamming doors could seriously damage the relationship. Laura Ellen Christian, 15 Expert Tips for When Your Aging Parents Won’t Listen, The Arbor Company Twitter:
- Ask about your loved one’s preferences. Does your loved one have a preference about which family member or what type of service provides care? While you might not be able to meet all of your loved one’s wishes, it’s important to take them into consideration. If your loved one has trouble understanding you, simplify your explanations and the decisions you expect him or her to make.
Create A Positive Plan Of Action Together
End your talk on a positive note and, if possible, with agreed-upon next steps starting with scheduling a medical evaluation with a primary care doctor or geriatrician.
“If your loved one has anxiety or expresses doubts about seeing a doctor or any part of the plan, try to emphasize that this process will help them, not cause harm,” Bednarczyk says.
In some instances, memory loss not related to dementia is reversible. For instance, doctors can change or adjust medications, or refer a person to a therapist to address depression. And if the diagnosis is dementia, knowing early will enable your loved one and you better prepare for the future.
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How To Convince A Loved One With Alzheimer’s Symptoms To Go To The Doctor
Late one night I was deeply engrossed in writing a short story about three parakeets when the phone rang. Must be Ed I thought. But it wasn’t. It was a woman calling to tell me she’d found Ed driving on the wrong side of the road.
In my deep denial I thought it was just because he was driving after dark. I thought it was just a temporary confusion — not a sign of something more ominous. Not an early sign of Alzheimer’s.
In its 2014 report, Alzheimer’s Disease Facts and Figures, the Alzheimer’s Association states that someone in the U.S. develops Alzheimer’s every 67 seconds. The report also says that an estimated 5.2 million people in the U.S. are living with Alzheimer’s, and that 500,000 people die because they have the condition.
Overcoming Denial — The First Hurdle
As I wrote in a previous article here, Alzheimer’s and the Devil Called Denial, the disease is, above all, an insidious one. Its symptoms often begin so mildly and progress so slowly that it’s easy for friends and loved ones to deny them. There is a tendency to make excuses for the person, to push the symptoms to the back of one’s mind, or to try to explain them away.
Why to Get the Person to a Doctor
It’s critical for everyone involved to overcome their denial and take the first difficult step of consulting a physician about the symptoms. Some people think there’s no reason to seek a diagnosis because there’s no cure for the disease. Yet it’s is important for several reasons.
How To Convince Someone With Dementia They Need Help
Many people say that one of the biggest worries about growing older is the fear of losing their memory.
And yet for many people when this does start to happen they have no awareness of it. Its their family and friends who notice it most and inevitably have to pick up the pieces.
Trying to get someone with early dementia to recognise they need help is not easy, and the subject demands far more attention than in a single article like this. However, weve outlined a real case study here , and weve pulled together some tips and advice from the family concerned.
You may find this advice helpful if youre in a similar situation with a relative or friend with dementia
However, she was forgetting conversations, her house was deteriorating, she was losing touch with the realities of day-to-day life, she would open her post but not deal with it, junk mail was accumulating in every available space in the house, and bills and important items of mail were getting lost in all the piles of paper.
Not only was this a fire hazard, especially in the kitchen, but it soon became clear from the final demands lying around under all the paper that Alice was not paying her bills. Having her phone cut off and receiving a demand from the power company to enter her property were the final straw.
Here are some of the familys ideas about getting a relative with dementia to recognise their need for help:
If a Power of Attorney is already in place
Please share your thoughts and comments.
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Ways To Help When Someone Has Anosognosia In Dementia
1. Dont try to convince them they have dementiaUsing reason and evidence to explain or insist that someone has dementia is not going to help.
It will only upset them and will likely make them even more convinced that theyre right and youre wrongly discrediting them.
A more effective strategy is to discreetly make changes that will help them live safely.
And overall, stay calm and focused on their feelings when expressing your concerns and keep your comments as subtle and positive as possible.
2. Work with their doctors and care teamWhen your older adults dementia symptoms are interfering with their daily lives, its time to start working with their care team including doctors, relatives, friends, in-home caregivers, or assisted living staff.
Explain the problems your older adult is having and help the team understand that they arent aware of their dementia and why it wont help to try to convince them logically.
Work together to creatively provide your older adult the support they need with the activities of daily living without waiting for them to ask for help or forcing them to admit theres a problem.
3. Discreetly make their life as safe as possibleMaking your older adults everyday life simpler and safer can help prevent someone with anosognosia in dementia from hurting themselves or others.
Some people might try to drive, manage money, cook, or do other activities that could be dangerous because of their cognitive impairment.
Try these helpful resources:
How To Share The Diagnosis
Sharing the initial news of the diagnosis may come from any one of a number of people.
The doctor or specialist, assessment team or members of the family may talk to the person about the diagnosis either individually or as a group.
You might consider having someone present at the time of telling to provide extra support.
Planning ahead about the best way to share the diagnosis will make it easier.
As individual responses will be different, careful consideration must be given to every individual situation.
There are some considerations that will be generally helpful when talking with a person about their diagnosis:
- Ensure that the setting is quiet and without competing noise and distractions.
- Speak slowly and directly to the person.
- Give one message at a time.
- Allow time for the person to absorb the information and to form questions. Information may need to be added later.
- Written information about dementia can be helpful to take away and provides a helpful reference. Dementia Australia has information written specifically for people with dementia. In some instances this information is available in video or audio format. Contact the National Dementia Helpline on 1800 100 500.
- Ensure that someone is available to support the person after being told about the diagnosis.
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Use Validation Techniques To Show Empathy
People living with dementia often experience a different reality than we do. They may or insist that they have to go to work, even though they’ve been retired for many years.
Instead of being irritated and reminding your loved one that their mother passed away decades ago or that they haven’t worked in 20 years, ask them to tell you about their mother. Ask them about their job. These are examples of using validation techniques to improve comfort and reduce agitation.
The ideas behind validation therapy help us to remember to adjust our focus to see things their way, rather than try unsuccessfully to have them see it from our perspective.
What Doctors Need To Do To Diagnose Dementia
Now that we reviewed the five key features of dementia, lets talk about how I or another doctor might go about checking for these.
Basically, for each feature, the doctor needs to evaluate, and document what she finds.
1. Difficulty with mental functions. To evaluate this, its best to combine an office-based cognitive test with documentation of real-world problems, as reported by the patient and by knowledgeable observers
For cognitive testing, I generally use the Mini-Cog, or the MOCA. The MOCA provides more information but it takes more time, and many older adults are either unwilling or unable to go through the whole test.
Completing office-based tests is important because its a standardized way to document cognitive abilities. But the results dont tell the doctor much about whats going on in the persons actual life.
So I always ask patients to tell me if theyve noticed any trouble with memory or thinking. I also try to get information from family members about any of the eight behaviors that are common in Alzheimers. Lastly, I make note of whether there seem to be any problems managing activities of daily living and instrumental activities of daily living .
Driving and managing finances require a lot of mental coordination, so as dementia develops, these are often the life tasks that people struggle with first.
Checking for many of these causes of cognitive impairment requires laboratory testing, and sometimes additional evaluation.
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