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!