Posts
Dementia staging is an inexact art, but several tools have been developed to help with ascertaining where your loved one may be in the process. The bigger problem is that no one knows definitely how long a stage will last, or for sure that every person with the disease will pass through every stage.
These tools can assist caregivers with understanding and planning. They more clearly define the disease progression and what they could face if the symptoms persist and the person continues to live with the disease. Many people with dementia have co-existing health problems, many of which may have contributed to the development of dementia in the first place.
We will set out the 7 stages offered in the Global Deterioration Scale developed by Dr. Barry Reisberg as adapted by Dr. Doug Drummond in six posts with personal observations about our own experience detailed after each stage. Stages 1 and 2 will be combined in one post. Please feel free to offer comments, tell us your own experience, and state your opinions about information offered in the posts.
Dr. Drummond's stages will be italicized for clarity of origin and personal observations will follow.
Dr. Drummond's information assesses the following:
Stage 1 Subjectively and objectively normal. Usual Care Setting-independent.
Stage 2 Subjective complaints of mild memory loss. Objectively normal on testing. No functional deficits. Usual care setting-independent.
As mentioned in previous posts, we spent a lot of time looking for hearing aids, less frequently, but still often, for glasses. My mother had a good habit of putting her purse in a certain place, and that helped as this stage moved forward. She would occasionally forget names or words during the second phase, and she expressed frustration when these eluded her.
An adaptation of the GDS by Dr. Doug Drummond and published in the American Journal of Psychiatry breaks the stages into "Deficits in cognition and function" and explains the "Usual Care Setting" for the person at that stage.
When the initial symptoms started slowly surfacing, our mother was still able to drive, manage herself and her household. In fact, one of the things we laughed about was that when we insisted that she get a physician (she honestly had not had a family physician in over 25 years-I do not suggest this as a plan to emulate), he gave her a little test of some sort to check her mental status. One of the things he asked her to do was write a paragraph. My sister, a professional writer, had taken her for the appointment, and said that Mother had written an eloquent paragraph with quite a few four syllable words written in her tiny flowing cursive. It certainly made us look like we were imagining things.
To sum up, we knew something was wrong, but we couldn't prove it. Just as well, we continued to monitor, grateful for every day that she was able to function on her own and live independently.
DEMENTIA HINT: Take your loved one for an examination by a physician if you suspect memory or cognitive issues. Early intervention or medication could help, but if not recommended, at least you have a baseline test for cognitive and functional ability.
Installed
Wednesday, January 27, 2010
Tuesday, January 19, 2010
VASCULAR DEMENTIA IN THE ELDERLY:I CAN DO THAT MYSELF; YOU DON'T HAVE TO DO IT
The following is the sixth in a series of posts based on the list of dementia symptoms published by the Agency for Health Care Policy and Research, and published in the Johns Hopkins Guide to Understanding Dementia, which is referenced on this page. Information from the Guide is in italics for clarity of origin and followed by personal observations.
BEHAVIOR Personality changes emerge. For example, the person appears more passive and less responsive than usual, or more suspicious and irritable. Visual or auditory stimuli may be misinterpreted.
Our mother's strong personality remained largely intact for many years after she began to show symptoms . When we decided to have a "meeting" and confront her about her weight loss about 4 years into the symptoms, she stood strong against us, finally striking out by telling us that we could "stand to lose a little weight" and that we were "know it alls".
It was her only way of fighting back, with her words, which she had always used to good advantage. This was the point at which we insisted on having someone come into the home to help with cooking and housecleaning. She never agreed, but her good manners took over, and she ended up enjoying the company of the caregiver very much.
The caregiving was only about two or three days a week for 4 hours each day to begin. The only other noteworthy change of behavior during this period, and it could have been due to lack of social interaction, was that she became enamored of watching a particular bird that lived in a bush in front of the house. Watching it was not what concerned us, but rather that on some days, she seemed more intent on what the bird was doing than on having a conversation. That was unusual, and for her it was uncharacteristic behavior. She always preferred people to animals.
Again, we count our blessings. She was for the most part, her old self, just unable to remember, and the less she could remember, the more dangerous it became for her. Still, we were walking a tightrope, the line held taut between the decision to leave her at home with help or move her somewhere with more oversight.
DEMENTIA HINT: When it is time to change the environment, moving toward greater care, have a family meeting. Be firm, but kind. You cannot reason with a person who is too far down the road of dementia, but allow them to be a part of the decision as far as they can. Ultimately, you will have to do what you deem best and hope they cooperate. Installed
Wednesday, January 13, 2010
VASCULAR DEMENTIA IN THE ELDERLY: BUT I JUST ANSWERED THAT QUESTION:DEALING WITH DEMENTIA
This is the fifth in a series of posts based on symptoms delineated in the Johns Hopkins Guide to Understanding Dementia. Information from the guide will be italicized for clarity of origination and followed by personal observations .
LANGUAGE. The ability to speak or comprehend seems impaired, and the person may have problems following or participating in conversations.
Language held a vaunted place in our mother's life. Mealtime conversation often meant that word meanings were discussed, and someone was dispatched to bring the dictionary so that the matter could be cleared up before the potatoes grew cold.
As the dementia progressed, she often searched for words, substituting a definition for the word itself, almost a classic way of responding. Since her vocabulary was large, she could often come up with a simpler word, or more often than not, we jumped in to assist her, rather than causing her embarrassment.
The most difficult language symptom to everyone was the period when she repeated herself. It might be a story told several times in one day or one hour, or it could be the same question asked over and over even when adequate answers had been given.
Our mother is in a different phase now. She doesn't talk as much most days; other days she may talk ceaselessly, but it is different than the repetition phase. Other patients in the assisted living home where she now lives are in the repetition phase. It is taxing to answer their questions over and over, and it can stretch the patience of the most saintly of caregivers.
One has to wonder if at this phase they are just at the "jumping off" point between clarity and the vagueness of mind that is dementia. Perhaps the repetition is a way of trying to hold on to their reality.
Over time, though, this phase changes too and gives way to other symptoms or an odd silence which begins to make one feel that the person is slowly leaving.
DEMENTIA HINT: The repetition phase is difficult for the caregiver. This would be just one suggestion for handling it. Answer the question as many times as you (the caregiver) are tolerant of answering it, then change the subject. Distracting the person with an activity, snack, drink or a walk may help take their mind in a new direction. For the moment, anyway. Repeat as necessary. Call in help. Give yourself a break. Installed
LANGUAGE. The ability to speak or comprehend seems impaired, and the person may have problems following or participating in conversations.
Language held a vaunted place in our mother's life. Mealtime conversation often meant that word meanings were discussed, and someone was dispatched to bring the dictionary so that the matter could be cleared up before the potatoes grew cold.
As the dementia progressed, she often searched for words, substituting a definition for the word itself, almost a classic way of responding. Since her vocabulary was large, she could often come up with a simpler word, or more often than not, we jumped in to assist her, rather than causing her embarrassment.
The most difficult language symptom to everyone was the period when she repeated herself. It might be a story told several times in one day or one hour, or it could be the same question asked over and over even when adequate answers had been given.
Our mother is in a different phase now. She doesn't talk as much most days; other days she may talk ceaselessly, but it is different than the repetition phase. Other patients in the assisted living home where she now lives are in the repetition phase. It is taxing to answer their questions over and over, and it can stretch the patience of the most saintly of caregivers.
One has to wonder if at this phase they are just at the "jumping off" point between clarity and the vagueness of mind that is dementia. Perhaps the repetition is a way of trying to hold on to their reality.
Over time, though, this phase changes too and gives way to other symptoms or an odd silence which begins to make one feel that the person is slowly leaving.
DEMENTIA HINT: The repetition phase is difficult for the caregiver. This would be just one suggestion for handling it. Answer the question as many times as you (the caregiver) are tolerant of answering it, then change the subject. Distracting the person with an activity, snack, drink or a walk may help take their mind in a new direction. For the moment, anyway. Repeat as necessary. Call in help. Give yourself a break. Installed
Sunday, January 10, 2010
VASCULAR DEMENTIA IN THE ELDERLY: THANK GOD FOR WATERMELON ANGELS
This is the fourth of a series of six posts on symptoms of dementia delineated in a Johns Hopkins special report Guide to Understanding Dementia. The information from Johns Hopkins will be in quotes for this post with personal information following.
"SPATIAL ABILITY AND ORIENTATION" "Driving and finding one's way in familiar surroundings become difficult or impossible, and the person may have problems recognizing known objects and landmarks."
Related to driving, this particular symptom either did not show up, or was indistinguishable because our mother had never had ANY sense of direction and NO ability to navigate anywhere but known routes. Again, we felt we were lucky.
Going out of town, she always rode with someone else. But about the time she was getting fully into the symptoms of dementia, there was a tragic circumstance in the area where an elderly woman became lost in her car and died, maybe as a result of exposure. There are numerous dangers attendant to this symptom as the person could die of exposure in cold temperatures, dehydration in hot temperatures, be at the mercy of persons with ill intentions, and a number of other dangers too difficult to contemplate and too numerous to expound on.
Later in the illness, the actual night before my sisters were coming to take her to the doctor for further assessment of her mental status, she decided to take a walk. For months before this, she had not left the porch or yard area, so we were not worried about this particular thing, focusing instead on hazards around and in the house. She left the house where she had lived for almost 50 years and walked down the road about 1/4 mile. She turned around to walk back because it was getting dark.
She became disoriented, but kept to the pasture fence that ran alongside the county road. Then she decided she needed to get out of the road and tried to climb through the fence but fell and hurt her ribs. She was very likely directly in front of my brother's house, but he of course didn't dream that she would have ventured out on the road as she had not done that in several years. So no one in the family found her.
The next morning my sisters arrived to take her to the doctor and found her under the sheets in her bed, moaning slightly, with rock and grass covering her legs. She had managed to change into her nightclothes. Unsure what had happened, they were able to piece together the story in bits.
Mother stuck to her story that a young man hauling a load of watermelons had stopped and driven her back to the house. We could never confirm this. The road is low traffic and definitely not on the way to any major market, but she stuck to this. We called him our "watermelon angel."
After a trip to the emergency room, where it was determined that she had bruised or possibly cracked several ribs, her long independent run of 87 years came to an abrupt halt. She was not left alone after this, and we realized that we were very lucky that nothing more serious happened. It was late June, about seven years into the symptoms.
Note: I want to say again that this is our personal experience. Someone may read it and say we allowed our mother to stay in her home far too long, at some personal risk. While that may be true, I can also say that other families,(and I have had occasion to deal with many families in the throes of decision-making related to an aging parent), walked this tightrope between allowing the parent independence and forcing their hand for change.
DEMENTIA HINT: If your parent is still at home, go through the house and assess the dangers. Make a list, and correct what you can. Think of the house as you would when you are childproofing.
There is a service that allows your parent to wear a necklace or bracelet that will allow them to call for help, simply by pushing a button. There are some complications in using this service with a dementia patient, so a physician would need to evaluate whether it would be useful.
Installed
Tuesday, January 5, 2010
VASCULAR DEMENTIA IN THE ELDERLY: WHEN REASONING IS IMPAIRED
This is the third in a series of six posts with information taken from the Johns Hopkins Guide to Understanding Dementia. Information from the Guide will be italicized, and the additional information is from our own personal experience with our mother's long trek through dementia territory.
ABILITY TO REASON
"The person finds it difficult to respond appropriately to everyday problems, such as a flat tire. Or, a previously responsible, well-adjusted person may display poor judgment about social or financial matters."
I believe our family was lucky in regard to the latter part of the above symptoms. Our mother's normally adequate social skills stayed intact, and she transferred her financial matters to a trusted daughter when she realized she was no longer able to competently handle them.
The idea of losing the ability to respond appropriately to everyday problems manifested itself in all sorts of ways. Each time we visited mother either weekly or in my case, monthly, the car battery was dead. We always jumped the battery, ran the car for a while, and had it in working order when we left, only to find it dead on the next trip. We realized during this time that she had almost quit driving.
A month or so prior to the car being dead on arrival each visit, she had a wreck and ended up giving a man a check for $200 rather than call the police or insurance. "He was in a hurry to go to a funeral," she reported to us, and he had pressed her for a decision. That would never have happened prior to the dementia.
She didn't want to get the very large crushed-in place on her car fixed, either, but we insisted. One day was spent searching for a hubcap to replace the one that flew off after the fender bender. She had decided that she liked the way it looked without a hubcap.
There were other problems even more pressing than the car. We often spent the night at her home. It was a long ranchstyle with three bedrooms and a bath on one end, her room being separated from this part by a small distance. One night while visiting, my college age daughter woke me to say that her eyes were burning and watering, and she thought she smelled fire. It took me only a few seconds to recognize the odor. I grew up in the country; my daughter didn't.
It was skunk scent, so strong that it made our eyes water. We got up, moved to another part of the house, took all our clothes to the car, and tried to figure out what we had to do. The next day we moved to my mother-in-law's house nearby.
We hired a pest control company to trap the skunks and remove them from under the house. I am not exaggerating when I tell you that they removed 15 skunks and one feral cat. It took several weeks, and unbelievably, the skunks returned the next spring and tried to set up housekeeping again. We phoned our best friend, the pest control guy, and he again trapped skunks for several weeks, this time getting only seven. Although we had him put wire around the whole base of the house, which was old and was pier and beam foundation, they had dug with a dogged determination to return to their birthplace, and some succeeded. It felt like being under attack, but Mother was oblivious.
She had simply been living with the odor, not realizing, since her sense of smell was compromised, that her clothes and home at times smelled like a skunk den.
Around this same time, we had an infestation of ants in the windows, not termites, but daunting still. Our much loved pest control friend helped us out again.
We had to arrange for repair of her back porch on one visit, when it was noted that the floor was "spongy". My brother ended up taking out the larger part of the back porch down to the flooring studs and replacing all the underlayment and flooring. Mother admitted it needed to be fixed, but I suppose the hot water heater would have fallen through the floor before the problem really got her attention had we not attended to it.
During this same time, she had stopped using the shower in one bathroom because it was leaking and caused the problem on the porch. She didn't resume using the shower even after she was told she could.
Just to make sure we got everyone in on the action, my brother-in-law was assigned, no, he actually volunteered, to repair the bathroom. He got all the needed supplies, spent days hammering, sawing, nailing, repairing the plumbing, and when he finished, Mother had come to the conclusion that she would not use that bathroom any more, and she didn't.
DEMENTIA HINT: Try to enlist the person's cooperation in any project, but don't get mad if all the effort seems wasted at the time. It's just part of the confusion that surrounds dementia.
Installed
ABILITY TO REASON
"The person finds it difficult to respond appropriately to everyday problems, such as a flat tire. Or, a previously responsible, well-adjusted person may display poor judgment about social or financial matters."
I believe our family was lucky in regard to the latter part of the above symptoms. Our mother's normally adequate social skills stayed intact, and she transferred her financial matters to a trusted daughter when she realized she was no longer able to competently handle them.
The idea of losing the ability to respond appropriately to everyday problems manifested itself in all sorts of ways. Each time we visited mother either weekly or in my case, monthly, the car battery was dead. We always jumped the battery, ran the car for a while, and had it in working order when we left, only to find it dead on the next trip. We realized during this time that she had almost quit driving.
A month or so prior to the car being dead on arrival each visit, she had a wreck and ended up giving a man a check for $200 rather than call the police or insurance. "He was in a hurry to go to a funeral," she reported to us, and he had pressed her for a decision. That would never have happened prior to the dementia.
She didn't want to get the very large crushed-in place on her car fixed, either, but we insisted. One day was spent searching for a hubcap to replace the one that flew off after the fender bender. She had decided that she liked the way it looked without a hubcap.
There were other problems even more pressing than the car. We often spent the night at her home. It was a long ranchstyle with three bedrooms and a bath on one end, her room being separated from this part by a small distance. One night while visiting, my college age daughter woke me to say that her eyes were burning and watering, and she thought she smelled fire. It took me only a few seconds to recognize the odor. I grew up in the country; my daughter didn't.
It was skunk scent, so strong that it made our eyes water. We got up, moved to another part of the house, took all our clothes to the car, and tried to figure out what we had to do. The next day we moved to my mother-in-law's house nearby.
We hired a pest control company to trap the skunks and remove them from under the house. I am not exaggerating when I tell you that they removed 15 skunks and one feral cat. It took several weeks, and unbelievably, the skunks returned the next spring and tried to set up housekeeping again. We phoned our best friend, the pest control guy, and he again trapped skunks for several weeks, this time getting only seven. Although we had him put wire around the whole base of the house, which was old and was pier and beam foundation, they had dug with a dogged determination to return to their birthplace, and some succeeded. It felt like being under attack, but Mother was oblivious.
She had simply been living with the odor, not realizing, since her sense of smell was compromised, that her clothes and home at times smelled like a skunk den.
Around this same time, we had an infestation of ants in the windows, not termites, but daunting still. Our much loved pest control friend helped us out again.
We had to arrange for repair of her back porch on one visit, when it was noted that the floor was "spongy". My brother ended up taking out the larger part of the back porch down to the flooring studs and replacing all the underlayment and flooring. Mother admitted it needed to be fixed, but I suppose the hot water heater would have fallen through the floor before the problem really got her attention had we not attended to it.
During this same time, she had stopped using the shower in one bathroom because it was leaking and caused the problem on the porch. She didn't resume using the shower even after she was told she could.
Just to make sure we got everyone in on the action, my brother-in-law was assigned, no, he actually volunteered, to repair the bathroom. He got all the needed supplies, spent days hammering, sawing, nailing, repairing the plumbing, and when he finished, Mother had come to the conclusion that she would not use that bathroom any more, and she didn't.
DEMENTIA HINT: Try to enlist the person's cooperation in any project, but don't get mad if all the effort seems wasted at the time. It's just part of the confusion that surrounds dementia.
Installed
Monday, December 28, 2009
VASCULAR DEMENTIA IN THE ELDERLY: MORE SIGNS THAT YOU MAY BE DEALING WITH DEMENTIA
This is the second in a series of six dealing with the symptoms that may signal the start of the process known as dementia. The symptoms are taken from the Johns Hopkins free Guide to Understanding Dementia, and will be taken in parts and related to personal events experienced by the family of Lib, who is the subject of this blog. All symptoms taken from The Guide will be italicized for clarity of origin.
HANDLING COMPLEX TASKS
has trouble with previously familiar activities, like balancing a checkbook, cooking a meal, or other tasks that require a complex train of thought.
Our mother was a bookkeeper by profession. She loved keeping orderly books for a large highway construction company and did this for twenty-two years. Prior to that, she kept books for the gins our parents operated. Not only did she keep books as her vocation, but she seemed to enjoy it as an avocation too. She kept meticulous books of all personal expenditures and her small cattle operation. She was active in other ways, but spent a good deal of time inputting all information by hand, using a small adding machine, a ledger, and a pencil to perfect results. Finding a penny error could consume a day at work, and she couldn't understand a child of hers who could never balance a checkbook.
The change we noted was subtle at first. But she must have noticed it before we were aware of it as she asked her youngest daughter, who also kept books for their business, to take over her taxes, and later, her checkbook. During the investigative phase by her daughter, magazine subscriptions were found to have been paid over and over, five or six years in advance, because they kept sending bills.
Fortunately, because her financial health was so important to her, she let go of that control sooner than she did in other areas. Her daughter Jan would go to the house and pay her bills, work on taxes and get her to sign checks. That was in the early phases.
Eventually she could not even sign her name.
The other more baffling symptom was in the area of food preparation. My sisters had come for a visit once to find her panting on the couch, fanning her face. She had just put out a grease fire in a skillet on the gas stove. The phone distracted her, and she simply forgot she was cooking.
We had noted that she had begun to leave her foodstuffs out on the counter, but mistakenly thought it was just too much trouble to put it all up. The truth was that it took too much effort to find it.
We engaged a friend to bring meals about two to three times a week at this point, and my sister paid her. However, mother thought she was doing too much, not knowing that she was being paid, and we couldn't tell her because she wouldn't think it was necessary for meals to be brought to her. So that help eventually had to be discontinued.
Thus began weekly trips by my sisters and brothers-in-law to buy groceries and take food.they had prepared. As often as I could, I would go and cook a lot of food and freeze it for her to eat. She could still at that time barely manage the microwave. Never having been technologically savvy, it was difficult to maintain that ability as her symptoms progressed.
We were still in the early phases of the dementia, in approximately years 3 and 4. She was, unbelievably, still driving and still managing in many areas, but the damage was beginning to be apparent. We saw her life change, watched the slow melting of the candle, and hoped we'd realize when the hot wax spilled out, and we had to act. quickly.
DEMENTIA HINT: Labeling cabinets might help at this stage.
Writing out directions for using coffee pot, microwave, etc. helped.
Contact your local Meals on Wheels and/or local meal service which are sometimes operated in your community
*Let me make one note. We were trying to honor our mother's wishes to stay in her own home. I want to be clear in this. She was extremely independent and was in one sense difficult to help because in her estimation she needed no help.
Families who have a parent who reasonably makes a plan to go into assisted living or independent living before they become so mentally and/or physically disabled are fortunate. This blog will probably make more sense to families who are walking a tightrope with an extremely strong and independent parent.
HANDLING COMPLEX TASKS
has trouble with previously familiar activities, like balancing a checkbook, cooking a meal, or other tasks that require a complex train of thought.
Our mother was a bookkeeper by profession. She loved keeping orderly books for a large highway construction company and did this for twenty-two years. Prior to that, she kept books for the gins our parents operated. Not only did she keep books as her vocation, but she seemed to enjoy it as an avocation too. She kept meticulous books of all personal expenditures and her small cattle operation. She was active in other ways, but spent a good deal of time inputting all information by hand, using a small adding machine, a ledger, and a pencil to perfect results. Finding a penny error could consume a day at work, and she couldn't understand a child of hers who could never balance a checkbook.
The change we noted was subtle at first. But she must have noticed it before we were aware of it as she asked her youngest daughter, who also kept books for their business, to take over her taxes, and later, her checkbook. During the investigative phase by her daughter, magazine subscriptions were found to have been paid over and over, five or six years in advance, because they kept sending bills.
Fortunately, because her financial health was so important to her, she let go of that control sooner than she did in other areas. Her daughter Jan would go to the house and pay her bills, work on taxes and get her to sign checks. That was in the early phases.
Eventually she could not even sign her name.
The other more baffling symptom was in the area of food preparation. My sisters had come for a visit once to find her panting on the couch, fanning her face. She had just put out a grease fire in a skillet on the gas stove. The phone distracted her, and she simply forgot she was cooking.
We had noted that she had begun to leave her foodstuffs out on the counter, but mistakenly thought it was just too much trouble to put it all up. The truth was that it took too much effort to find it.
We engaged a friend to bring meals about two to three times a week at this point, and my sister paid her. However, mother thought she was doing too much, not knowing that she was being paid, and we couldn't tell her because she wouldn't think it was necessary for meals to be brought to her. So that help eventually had to be discontinued.
Thus began weekly trips by my sisters and brothers-in-law to buy groceries and take food.they had prepared. As often as I could, I would go and cook a lot of food and freeze it for her to eat. She could still at that time barely manage the microwave. Never having been technologically savvy, it was difficult to maintain that ability as her symptoms progressed.
We were still in the early phases of the dementia, in approximately years 3 and 4. She was, unbelievably, still driving and still managing in many areas, but the damage was beginning to be apparent. We saw her life change, watched the slow melting of the candle, and hoped we'd realize when the hot wax spilled out, and we had to act. quickly.
DEMENTIA HINT: Labeling cabinets might help at this stage.
Writing out directions for using coffee pot, microwave, etc. helped.
Contact your local Meals on Wheels and/or local meal service which are sometimes operated in your community
*Let me make one note. We were trying to honor our mother's wishes to stay in her own home. I want to be clear in this. She was extremely independent and was in one sense difficult to help because in her estimation she needed no help.
Families who have a parent who reasonably makes a plan to go into assisted living or independent living before they become so mentally and/or physically disabled are fortunate. This blog will probably make more sense to families who are walking a tightrope with an extremely strong and independent parent.
Friday, December 18, 2009
VASCULAR DEMENTIA IN THE ELDERLY: IS IT DEMENTIA?
While dementia today is not considered a disease by itself, it is rather a set of symptoms resulting from different sources.
These next six posts will explore individually 6 problem areas in functioning that suggest that a person should be evaluated for dementia, along with examples from our own experience. Part of the post will delineate the intellectual component of the symptom; the second part will explore the practical and emotional aspect of the symptom.
The symptoms are taken from the Johns Hopkins Guide for Understanding Dementia, and in their booklet, they list these as guidelines published by the Agency for Health Care Policy and Research.
I. LEARNING AND RETAINING NEW INFORMATION:
REGULARLY MISPLACES OBJECTS-did I mention my mother's hearing aid? For about a year, we had something to do about the hearing aid every two months or so. It would be that the battery had gone down and thus she was not using it. The battery had been jammed in the wrong way, so we had to take it to the audiology office for repair. She couldn't remember if it went in the right or left ear, so would have it in the wrong ear. Sometimes, she forgot which way it fit into her ear (and we were little help in that regard-some sort of familial mechanical deficiency)
And during the time we were not working on these issues, we were looking for the tiny thing. My older sister could often find it when no one else could. We found it in her purse, in the closet, in the pocket of clothes she had worn, in the car, under the bed, under magazines on the bedside table, and behind a bookshelf in the kitchen---for starters.
HAS TROUBLE REMEMBERING APPOINTMENTS-remember that we noted in an earlier post that at the very beginning, when symptoms were first appearing,our mother forgot birthdays for the first time in her life. It was one of the earliest signs that something was wrong.
HAS TROUBLE REMEMBERING RECENT CONVERSATIONS-at the beginning of the emergence of the symptoms, we noted that she couldn't remember which of her four children had told her things. She would repeat something to one of us as though we didn't know, when we were the one who told her. (I know, I know, many of you are saying "I do that", and I am saying "I do that"), but it is not as often, and it is not consistenly so, and probably when you are tired, overworked or stressed. For the person with dementia, this trouble remembering occurs regardless of external factors.
On a lighter note, I decided one day on a two hour car trip that I could make the trip pleasant by using the fact that my mother couldn't remember our conversation. She still was able to "get" jokes, so I told the same joke about six times during the trip, and she laughed and thoroughly enjoyed it each time. We had a pleasant trip, and I only had to know one joke. Minimized frustration.
Another comical day was the summer of 2004, and the repetition was fairly pronounced by this time. I noted she had stopped talking as much overall which was sad, but she still liked to tell stories. Our future son-in-law made himself a card carrying member of the family on this day.
Mother wanted to tell him about his soon-to-be wife, her granddaughter, and had a particular story in mind from when our daughter was three years old. She told it at dinner on Tuesday night, again during the morning on Wednesday, and when we were seated for lunch, she said "Oh, I can tell you a story about K", and started out again.
Four of us at the table either laughed or giggled; our very kind future son-in-law turned to the side, leaned slightly down and put his head down. His face became so red he looked like he might explode. But he did not laugh. What kindness. Meanwhile, Mother happily joined in the laughter. Every day was a good day for her, as always. We were fortunate.
REPETITIVE IN CONVERSATION-several notes here. We noted this in her conversation, and on good days, I would listen to stories over and over. On my bad days, I tried to change the subject, as did we all.
There seemed to be a marked increase in this after the death of her younger brother in 2000.
She felt a great love for him, and he was twelve years younger than she. At his death, she became the only remaining sibling of her original family. At his memorial service, it seemed that she repeated to each new person that she met that she had loved him as a baby and that she had pushed him in a baby carriage when he was tiny. That was all. She pushed him in a baby carriage.
That day was key for us in realizing the change in her. Not a word of his chidhood, adulthood, how she adored him. Just pushing him in a baby carriage. It seemed odd. to us. But it was her new way of coping.
AND WE WOULD ALL JUST HAVE TO ADJUST!
DEMENTIA HINT: This is for family and friends. If you don't have patience and a sense of humor, you probably ought to get some and find one or this phase could be harder on you than it has to be. And it will be hard enough-guaranteed!
These next six posts will explore individually 6 problem areas in functioning that suggest that a person should be evaluated for dementia, along with examples from our own experience. Part of the post will delineate the intellectual component of the symptom; the second part will explore the practical and emotional aspect of the symptom.
The symptoms are taken from the Johns Hopkins Guide for Understanding Dementia, and in their booklet, they list these as guidelines published by the Agency for Health Care Policy and Research.
I. LEARNING AND RETAINING NEW INFORMATION:
REGULARLY MISPLACES OBJECTS-did I mention my mother's hearing aid? For about a year, we had something to do about the hearing aid every two months or so. It would be that the battery had gone down and thus she was not using it. The battery had been jammed in the wrong way, so we had to take it to the audiology office for repair. She couldn't remember if it went in the right or left ear, so would have it in the wrong ear. Sometimes, she forgot which way it fit into her ear (and we were little help in that regard-some sort of familial mechanical deficiency)
And during the time we were not working on these issues, we were looking for the tiny thing. My older sister could often find it when no one else could. We found it in her purse, in the closet, in the pocket of clothes she had worn, in the car, under the bed, under magazines on the bedside table, and behind a bookshelf in the kitchen---for starters.
HAS TROUBLE REMEMBERING APPOINTMENTS-remember that we noted in an earlier post that at the very beginning, when symptoms were first appearing,our mother forgot birthdays for the first time in her life. It was one of the earliest signs that something was wrong.
HAS TROUBLE REMEMBERING RECENT CONVERSATIONS-at the beginning of the emergence of the symptoms, we noted that she couldn't remember which of her four children had told her things. She would repeat something to one of us as though we didn't know, when we were the one who told her. (I know, I know, many of you are saying "I do that", and I am saying "I do that"), but it is not as often, and it is not consistenly so, and probably when you are tired, overworked or stressed. For the person with dementia, this trouble remembering occurs regardless of external factors.
On a lighter note, I decided one day on a two hour car trip that I could make the trip pleasant by using the fact that my mother couldn't remember our conversation. She still was able to "get" jokes, so I told the same joke about six times during the trip, and she laughed and thoroughly enjoyed it each time. We had a pleasant trip, and I only had to know one joke. Minimized frustration.
Another comical day was the summer of 2004, and the repetition was fairly pronounced by this time. I noted she had stopped talking as much overall which was sad, but she still liked to tell stories. Our future son-in-law made himself a card carrying member of the family on this day.
Mother wanted to tell him about his soon-to-be wife, her granddaughter, and had a particular story in mind from when our daughter was three years old. She told it at dinner on Tuesday night, again during the morning on Wednesday, and when we were seated for lunch, she said "Oh, I can tell you a story about K", and started out again.
Four of us at the table either laughed or giggled; our very kind future son-in-law turned to the side, leaned slightly down and put his head down. His face became so red he looked like he might explode. But he did not laugh. What kindness. Meanwhile, Mother happily joined in the laughter. Every day was a good day for her, as always. We were fortunate.
REPETITIVE IN CONVERSATION-several notes here. We noted this in her conversation, and on good days, I would listen to stories over and over. On my bad days, I tried to change the subject, as did we all.
There seemed to be a marked increase in this after the death of her younger brother in 2000.
She felt a great love for him, and he was twelve years younger than she. At his death, she became the only remaining sibling of her original family. At his memorial service, it seemed that she repeated to each new person that she met that she had loved him as a baby and that she had pushed him in a baby carriage when he was tiny. That was all. She pushed him in a baby carriage.
That day was key for us in realizing the change in her. Not a word of his chidhood, adulthood, how she adored him. Just pushing him in a baby carriage. It seemed odd. to us. But it was her new way of coping.
AND WE WOULD ALL JUST HAVE TO ADJUST!
DEMENTIA HINT: This is for family and friends. If you don't have patience and a sense of humor, you probably ought to get some and find one or this phase could be harder on you than it has to be. And it will be hard enough-guaranteed!
Subscribe to:
Posts (Atom)