How to know when it’s time to seek counsel from a professional
One Sunday afternoon, a daughter notices her mom can’t remember a close family member’s name. That evening, her mom left her purse in the restaurant. Does mom need Memory Care or is she just a bit forgetful?
As people age, it’s common to assume memory lapses mean either Alzheimer’s disease or some other type of dementia. However, dementia-like symptoms can result from a medication side effect, a byproduct of certain health conditions, or as part of the normal aging process.
Tina Wells, senior program director for Alzheimer’s Association, says keeping a journal is the first step in determining whether a loved one’s forgetfulness is a sign of dementia. Write down your observations, the date they occurred, and other notable details. “If you notice an increase in frequency or the incidents become more serious, it might be time to talk to their doctor,” she says.
Does Mom Need Memory Care or is it Something Else?
Our brains change as we get older. Over time, it may take aging parents longer to learn new things or they may become more absent-minded. If you find yourself asking the question: “Does mom need memory care?”, it’s time to pay attention.
“It’s pretty normal to forget where you parked your car at the grocery store,” says Wells. “What would be more concerning is if someone didn’t remember driving to the store in the first place.”
The American Society on Aging lists seven ways to tell the difference between normal, age-related memory changes and signs of dementia. A few signs include:
Forgetting your reminders. People of all ages use post-it notes and calendars to remember appointments and to make to-do lists. If your parent doesn’t remember a fact when reminded, it may be a flag.
Forgetting the same thing repeatedly. Your mom met Sally last week but can’t remember her name. When she bumps into her again, she will likely remember. If she can’t remember Sally’s name no matter how many times she meets her, it can be a sign of impairment.
Personality changes. If dad has always been calm as a cucumber, he’ll likely stay that way. If he starts acting irritable or anxious, take note.
Alzheimer’s disease, the most common form of dementia, is a degenerative brain disease caused by changes due to cell damage. It leads to cognitive impairment that gets worse over time. Currently, Alzheimer’s has no cure, but there are medications to manage symptoms. Certain lifestyle behaviors, such as regular exercise, a healthy diet, and not smoking, can lower risk factors.
Alzheimer’s disease early warning signs mirror that of other dementias, including forgetting recently learned information and personality changes. If you notice your loved one acting more confused, anxious, suspicious, or depressed, it may be cause for concern.
Other flags include:
Planning or problem-solving challenges. You notice changes in your loved one’s ability to work with numbers, complete a task, or follow a plan.
Confusion with time or place. This means not simply forgetting the date but losing track of seasons or forgetting where they are or how they got there.
Trouble understanding visual images and spatial relationships. If your loved one has a hard time judging distance or determining color or contrast, it can be a sign of Alzheimer’s disease. For instance, a dark carpet color pattern might look like a change in the level of the floor.
New problems with words in speaking or writing. Your parent has trouble having or following a conversation. He or she calls things (or people) by the wrong name.
Withdrawal from work or social activities. Mom stops attending her exercise class and hasn’t seen her friends. Some people avoid social activities due to cognitive changes.
Delirium, Which is Reversible
When you visit with aging parents and loved ones, pay attention to physical health as well as cognitive health. Certain medications, medical conditions, and nutritional deficiencies can cause memory loss. Fortunately, when these conditions are treated, the delirium may reverse. “Just as it’s important to get an accurate diagnosis, it’s also important to rule out what it’s not,” says Wells.
- Urinary tract infections
- Medication or changes in medication
- Alcohol and drug abuse
- Sleep deprivation
- B12 deficiency
- Thyroid conditions
The Importance of Cognitive Assessments
If mom experiences more than one of the above warning signs, and you’re wondering, “Does mom need memory care?”, ask her primary care doctor to give a cognitive assessment. Tell the doc about your “memory journal” entries as well as any changes in your parent’s physical health. Not all tests are created equal. The Mini-Mental State Examination (MMSE) is commonly used as a screening tool to detect dementia. However, it performs poorly in identifying persons with mild neurocognitive disorder.
The Saint Louis University Mental Status (SLUMS) examination is a 30-point screening questionnaire that tests for orientation, memory, attention, and executive functions, and it’s the test Spectrum Retirement relies on for determining whether a resident should be in Assisted Living or a Memory Care neighborhood.
“Families can add to that exam by sharing what they’re seeing,” says Meghan Donahue, director of family services for Alzheimer’s Association. “Share all the symptoms your loved one has been experiencing: medication, alcohol use, previous illnesses … all this information will help lead the doctor to the right diagnosis.”
Note: Medicare beneficiaries are entitled to a cognitive screening as part of their annual wellness visit. Wells and Donahue recommend all adults request a cognitive screening at age 65, if only to establish a baseline, and then repeat the exam annually. “Sometimes the patient will have to ask,” Wells says. “That’s okay. We want our families to feel empowered and to know this test is available.”
How to Have the Talk About Memory Care
Not all parents respond well during conversations about memory, dementia, and doctor visits. At the same time, adult children worry they’ll upset their parent and don’t want to start an argument.
First, take a deep breath. Second, no matter how you broach the subject, make sure your parent knows you’re coming from a place of support, concern, and love. Third, know you can ask for backup.
“Often bringing in a third party, such as a primary care doctor, is most effective,” says Wells. “This generation tends to listen to the doctor, so involving someone they’ve built a relationship and trust with is a good place to start.”
Donahue agrees, adding that the initial conversations can be light and informal. For example, adult children can build on a passing comment. “If they say, ‘I’m not thinking the way I used to,’ respond with ‘that must be so scary. Maybe at the next doctor’s appointment, we can talk about it.’”
If your loved one’s cognitive abilities have declined to the point where they may not be safe living at home, extend the conversation to discuss Memory Care. Memory Care communities can offer all the benefits of Assisted Living combined with a secure environment and programming tailored to residents with dementia.