Home for the Holidays? An Opportunity to Notice Subtle Changes

October may be a bit early to be thinking about turkey and stuffing and Christmas presents. However, it’s never too early to prepare for a visit to your older loved ones. Learning what to look for that may warrant further inquiry is important. The Alzheimer’s Association advises that “an early diagnosis of Alzheimer’s provides a range of benefits for the individuals who are diagnosed, as well as their loved ones.” Although there is not yet a medication to reverse or even halt the damage done to the brain by Alzheimer’s disease and other forms of dementia, it can be beneficial to get an early diagnosis. There are lifestyle changes that are proving to be helpful in keeping someone with a dementia diagnosis functioning at a higher level for a longer period of time. Let’s look at the subtle changes that may be a clue that something is awry.

You check-in with Mom every day on the phone and she seems fine. But now that you’re with her in-person for a few days over a long holiday weekend, you notice the following:

  • During your phone calls you’ve discussed that company is coming for the holidays, yet, you’re always-meticulous mother did not clean the house. There is clutter and the spare room is not ready for overnight guests. She explains that they were not supposed to arrive until next week.
  • While preparing the Thanksgiving meal, you notice that Mom is confused about the order in which she needs to make the meal. She’s obsessed about finding “the thing for the potatoes,” and the turkey is in the oven, but the oven is not on.
  • Mom, normally full of life and chatty when family visits, is quiet during the meal, seeming to watch the conversation rather than join in.
  • You notice a stack of bills on her desk that have not been opened.
  • A few hours after everyone has gone to bed, you hear Mom wandering through the house. When you check to see if she’s ok, she says she was “just going to bed.”

Many of the early signs of Alzheimer’s disease can be rationalized. Afterall, as we grow older, our brains may slow down just like the rest of our body. In the early stages, the person with the disease can hide the symptoms by keeping to their routines and staying away from situations that have become difficult. Alzheimer’s disease becomes a disease of denial for both the person with the diagnosis and their family members. However, if we know someone well and pay close attention, we will recognize the signs, and it is to the benefit of all involved not to ignore them. It may be that your loved one has a urinary tract infection, or their blood sugar is off, and their symptoms can be reversed. If not, and it is irreversible dementia, it is better to know early rather than wait for a tragedy to occur.

To receive a dementia diagnosis, a person needs to have at least two types of impairment that significantly interfere with everyday life. Returning to your visit with Mom, consider her behavior; does it interfere with her daily life? Does it feel as if something is not quite right? Could it potentially be dangerous? One of the earliest signs is an inability to recall things that have just happened. However, as human beings with a long history of social decorum, we can answer questions convincingly, even if we make up the answer. You may not realize that what Mom told you is inaccurate because she cannot recall what really happened.

In addition to difficulty remembering, a person may also experience impairments in:

Language: A person with dementia may have difficulty explaining something or finding the right words to express themselves. Having a conversation with a person who has dementia can be difficult, and it may take longer than usual to conclude. They may substitute a word they cannot recall with a nonsensical sound.
Communication: Just as finding and using the right words becomes difficult, people with dementia sometimes forget the meanings of words they hear or struggle to follow along. They may begin to withdraw from their usual activities and avoid conversations.

Focus: A subtle shift in the ability to complete normal tasks may indicate that someone has early dementia. This usually appears as difficulty doing more complex tasks like balancing a checkbook or playing games that have a lot of rules. Along with the struggle to complete familiar tasks, they may struggle to learn how to do new things or follow new routines.

Reasoning: Someone in the early stages of dementia may often become confused. For example, they may misplace their car keys, forget what comes next in the day, or have difficulty remembering someone they’ve met before. When memory, thinking, or judgment lapses, confusion may arise as they can no longer remember faces, find the right words, or interact with people normally. These are internal symptoms that we may not be aware of until we discover our loved one has lost money to a phone scam or bought more cans of soup than they could use in a year.

Because family visits often happen during the holidays, it provides a suitable opportunity to pay attention to how your loved ones are actually doing. In addition to slips in memory, pay attention to some of the early symptoms, such as:

  • Difficulty with planning and completing familiar tasks
  • Trouble following or joining a conversation
  • Changes in vision: trouble understanding visual images and depth perception
  • Behavioral changes: depression, mood swings, irritability, anxiety, frustration
  • Wandering and inability to recognize familiar places
  • Trouble making plans and following through
  • Becoming listless, apathetic
  • Inability to adapt to change
  • Trouble with problem-solving
  • Confusion with time or place
  • Social withdrawal, not participating in usual activities
  • Misplacing things and unable to retrace steps to find them again
  • Lapses in judgment

If during your visit you do become suspicious that your loved one is having difficulty, seek help. Do not try to correct their behavior. This is humiliating for them and may cause them to become defensive. Instead, learn all you can, approach them in a matter-of-fact way, and get them to their doctor. Remember, early diagnosis is beneficial for everyone involved. There are many strategies that can help them continue to live their best quality of life.

 

For more information visit:
Alzheimer’s Association Free Course: Know the 10 Signs:
https://training.alz.org/products/4062/10-warning-signs-of-alzheimers?_ga=2.116037890.525133522.1571068385-1983113815.1563639704

Alzheimer’s & Dementia Alliance of Wisconsin: Early Diagnosis is Key:
https://alzwisc.org/Importance%20of%20an%20early%20diagnosis.htm