True Life Stories & True Life Issues
(This beautiful picture was done by the talented artist Leah Piken Kolidas of the Blue Tree Art Gallery. In her description of the picture she writes, “The brain’s pathways often remind me of a tree’s branches, in this case it relates to my family tree, as my grandmother has Alzheimer’s Disease.”)
Signs and Symptoms to Watch For
Difficulty Following and Remembering Conversations – You might tell a story about a person for instance, and a while later if part of the conversation is mentioned, they won’t recall it or they’ve mixed up the details of the story. They may forget ever having the conversation. The short-term memory is the first to be affected. This will begin to happen as a pattern, because of course, everyone forgets things or conversations. It’s the pattern of the behavior to look for.
Lack of Hygiene – Failing to brush one’s teeth, shower or bathe, wash their clothes, or even put on clean clothes. Or, their efforts with these daily living activities are poor. They may wash their body but forget to wash their hair until reminded. If asked, they will insist they have bathed or their clothes are clean. This is a rather common sign.
Inappropriately Dressing – I think it’s mentioned in all pamphlets about how someone with dementia might put on two shirts or mix up types of clothes, like pajamas and street clothes. With both of my in-laws, we did not see this happen. However, my father-in-law would try to put on a spring raincoat when it was the dead of winter. He did not realize the difference or what was required for dressing for the weather.
Forgetting Birthdays, Anniversaries, Family Member’s Names – Very common. Yes, they both forgot these early on. They didn’t even remember their own birthdays or anniversary without reminders. My mother-in-law would often have a birthday card out on the desk close to a grandchild’s birthday for instance, but would never remember to send it, or why she had it out. It’s like there was a moment of clarity, then it was gone.
They may also forget the names of people they see everyday. They will recognize them, but not remember their name. My mother-in-law would say, “Hi ya honey” to friends or family when she couldn’t remember a name. Sometimes, later on in the visit, she would remember and would use it. However, as time went on, she even forgot her own name.
Personality Changes – This is an interesting one. Since we are all unique, then the changes in personality will be as well. The person may become fearful of things they were never afraid of, like a dog barking or getting their teeth cleaned, more prone to outbursts of anger or tears, less generous if they once were a giving person, may think people are out to take advantage of them, their time or money, may become less trusting.
My mother-in-law was always very generous with her time and gifts. She started to believe people invited them out to dinner, as one example, just so they would have to pay for it. It seems perfectly logical to them, and they’ll tell you how they know this, which in no way will make any sense.
Loss of Speech, Language Problems – Some people with Alzheimer’s lose their ability to carry on a conversation and can not speak in sentences. They can not “find” the right word to convey their thoughts. It’s so devastating. They may often forget the name of common objects or mix up words and call things by the wrong name. May begin to misspell common words and perhaps even their name. The inability to write may follow. They may retain the ability to write “hi” or “no,” or very simple words.
My father-in-law lost all ability to speak except for, “hey” when greeting you. Very sad, as he was a brilliant man. He would whistle to communicate in his own way.
He was clever at compensating. One time when I was over to help write out checks and make sure the bills were getting paid, he wanted to remind me the quarterly taxes were due. So, he came over to the table and put a quarter down and pointed to it. I told him I understood, not to worry, they would be paid. How brilliant was that! Again, everyone forgets the name of something, but it’s the pattern of forgetfulness that is of concern.
Hoarding – Collecting and hoarding trivial things and refusing to throw them away. When living at the retirement community, my mom-in-law would have an over abundance of sugar packets in her purse, or saltine crackers, or napkins, tissues, decks of cards, pens, bananas etc.
It can be anything, but whatever it is, they will amass as much as they can. We would find bananas in the bedside drawers, the cupboards, the closet, her purse, and in the fridge.
I must admit, it’s almost humorous. Sometimes the only way to survive this illness as a care giver or family member, is to look for the humor and laugh about it.
Confusion of Time or Place – Unable to distinguish one month from another, not recognizing familiar neighborhoods or areas they usually travel, not understanding the seasons of the year, getting lost taking a walk on their street, not knowing where they live, not knowing how they arrived somewhere.
When we brought my in-laws over to visit, they would be confused as to where they were and forget we picked them up and drove them over. The calendar became useless as they didn’t understand the passing of days. If there was a doctor’s appointment and we said, “Now remember, Wednesday you have a doctor’s appointment and we’ll be over to pick you up at 11:00 AM,” they were unable to comprehend that. We would call the night before and again in the morning to remind them.
Inability To Manage Money, Finances – Neglecting to pay bills, inability to do banking or make financial decisions, unable to do simple arithmetic needed to add or subtract money, etc. My father-in-law handled all the bills and money decisions.We had no idea, and either did my mother-in-law that the bills were not getting paid. I happen to see a notice threatening to turn their heat off if the bill wasn’t paid by such and such date! From that time forward, I made sure my mother-in-law was paying all the current bills and doing the banking.
Forgetfulness – Forgetting recent events or information, forgetting where they left things, forgetting what they were doing, etc. My father-in-law would always ask his wife where his glasses and slippers were. This was while he could still converse. He never remembered where he left them. Again, it’s the patterns you begin to observe with increased forgetfulness and questions about where things are, or who is President, or what month it is, or what day it is, etc.
Driving Errors – This one is crucial to be observant of if the person has a car and is still driving and you suspect they are having memory problems. I personally don’t believe someone suffering from dementia should still drive. My father-in-law was driving himself and his poker buddies to their poker game at a friend’s house. He was perhaps 72 years old at the time. The friends told of how he started to drive onto the expressway via an exit ramp! After learning of this, we insisted he could no longer drive, and that mom would be the driver from now on. (She did not show signs of Alzheimer’s yet at this point). He was saddened by this because he loved to drive. He would take the car keys and try to go drive. She had to hide them from him for awhile.
Paranoia and Suspicion – Although not always an early sign, I did have a friend who’s mother thought her own husband was a stranger in the house. She was terribly confused about who he was. This was the main symptom catching the family’s attention, however, I’m sure there were others before this one manifested, but they were unaware her behavior or memory problems should be a concern.
The person may become paranoid someone is going to break in during the night, or suspicious people are trying to steal money or possessions from them. My mother-in-law thought someone was coming into her apartment at night, while she was living at the retirement community, and stealing her pants and leaving different ones. In actuality, the pants no longer fit and were too small (from the weight loss mentioned above). So, she thought someone left those but took her pants with them. I must say, it’s quite funny. Again, sometimes you need to be able to laugh.
In summary, concerns are warranted if you notice a person cannot remember the date, write a sentence or does not know where he or she is, over a period of time. A primary care physician can administer or make a referral for a cognitive evaluation if the patient exhibits – or family members notice – signs of memory loss. If you suspect a loved one may be suffering from memory problems, I urge you to keep notes, make a doctor’s appointment and go with them for further evaluation.
Mediterranean diet may be brain-protective – A presentation scheduled for the American Academy of Neurology’s 62nd Annual Meeting in Toronto April 10 to April 17, 2010 will reveal the finding of Nicolaos Scarmeas, MD, MSc at Columbia University Medical Center in New York that consuming a Mediterranean diet may help preserve memory and learning ability by protecting against cerebrovascular disease.
The diet typically consumed in the Mediterranean region provides high amounts of fruits, vegetables, legumes, cereal, fish, and monounsaturated fats, low levels of saturated fats, red meat and poultry, and a moderate amount of alcohol. In previous research conducted by Scarmeas and his colleagues, an association was found between adherence to a Mediterranean diet and a lower risk of developing Alzheimer’s disease in addition to improved survival among Alzheimer’s disease patients.
The authors conclude a “Higher adherence to a Mediterranean diet is associated with reduced cerebrovascular disease suggesting the impact of a Mediterranean diet on cognition may be partially mediated by brain infarction.” ~~ from the February 12, 2010 Life Extension Update
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