Senior Moments: Should I Be Worried?

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Although I don’t particularly like the term “senior moment,” most older people know what that means. When someone who is at middle age or beyond has difficulty remembering something such as, “Where did I put my reading glasses?” or “I can’t remember her name” he/she may find someone else responding in a joking fashion, “Are you having a ‘senior moment?'” The other person is replying with a joke about having a poor memory. I have heard people themselves make jokes about their own “senior moments” in hopes of making light of the situation. It’s true that as people age there are normally changes in memory and thinking skills. On one end of the spectrum there is normal aging that affects everyone. At the other end is dementia which is common but not normal.  In between is a condition known as mild cognitive impairment. I will touch on all three.

We all have memory lapses on occasion

It’s true we all have occasional lapses in our memory. I even see my teenage children doing it. I even remember walking into a room years ago, forgetting what I went in there for, having to go back to what I was doing in order to jog my memory. Little lapses in memory is common for everyone. We get distracted or side-tracked especially when it is something that is not really that significant. Forgetting names is a common occurrence for example.

I have been working with older adults for over 25 years now and I see all different types of memory and thinking problems. I also know many older people (including caregivers) who do not show any signs of cognitive (brain function) decline.

I often note increased anxiety in people who are struggling with the loss of cognitive abilities. It must be a scary feeling to know that they are losing their faculties.

One of the common fears people have is developing dementia. Declining memory skills are often one of the first signs of dementia. The good news is that memory problems do not always lead to dementia.

Normal aging, mild cognitive impairment and dementia

Slowed thinking and minor problems with remembering things is quite common and almost expected in our later years. There are some things we can do to help reduce our risks of further problems with our cognition such as exercising (to get the blood pumping to our organs including the brain) and doing brain exercises (such as crosswords and learning a new musical instrument). Normal aging causes us to slow down in more ways than one.

Sometimes our memory problems become more problematic and they are noticed by other people. If you are continuously forgetting someone’s name or miss appointments, this may start to interfere with your relationships and daily functioning. You may have to learn new ways of coping with the normal changes in your brain such as keeping lists handy and using your calendar more regularly. Memory and thinking problems that can be noticed by others but don’t really affect your day-to-day functioning is called Mild Cognitive Impairment (MCI).

By the way, it’s a good sign if a person is aware of or concerned about their changing memory skills as one of the skills lost in dementia is the ability to know they have problems with their memory. If you ask someone with dementia if he/she has memory problems, he/she will most likely say “No.” It’s true that long term memory may still be intact.  It’s the ability to remember recent events and learn new information that is lost.

In some cases your memory skills, thinking and cognitive functioning may be impaired to the point where you can no longer do things on your own. For example, you may need someone to give you your medication on a daily basis or else you will forget. Or you can no longer drive because your sense of direction is off. Dementia is a syndrome and can be found in a variety of conditions  that affect cognition (such as Alzheimer’s disease). In early stages of dementia you can  live on your own as long as you can enlist the support you need to keep yourself safe. Dementia can create a variety of problems. For example, sometimes people with dementia forget to eat, or think they have already eaten. In this case it’s important to have someone provide a reminder or stop by to ensure he/she eats. In the later stages of dementia, it is not possible to live alone.

Seek a memory assessment if you are concerned

If you are concerned about your memory skills or other brain-related functions (such as language, problem-solving or judgment skills), please speak to your doctor for a memory assessment. Let your doctor know if you are concerned your problems are beyond the changes seen in normal aging (such as slowed thinking, and the occasional difficulty remembering things). Only a skilled practitioner can diagnose and determine the difference between normal aging, mild cognitive impairment and dementia, and provide treatment and management solutions.

For more information, check out Aging, Memory Loss and Dementia: What’s the Difference? from the Alzheimer’s Association.

You may also like to check out Senior Moments Explained by Terry Hollenbeck, M.D.

 

Angela G. Gentile, MSW RSW

www.AngelaGGentile.com

 

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Drinking and Dementia Don’t Mix: How Families Can Help

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Angela G. Gentile, MSW, RSW

People with dementia who are also experiencing alcoholism or alcohol abuse is a very challenging situation for family members to manage. Alcoholism speeds the decline in the skills needed for independent living, worsens behavioural problems, and raises concerns of safety for the affected family member and those living with/caring for them. This is in addition to the known health risks of alcoholism (e.g., cirrhosis of the liver, alcohol withdrawal syndrome and death).

Statistics reveal that 40% of adults 65 and over drink alcohol. We also know that almost 15% of older adults have Alzheimer’s disease or another form of dementia. The issues surrounding dementia and alcohol are becoming more prevalent as our society ages. We need to work together to find solutions to manage this difficult situation.

For families who are caring for a loved one with dementia such as Alzheimer’s, alcohol use becomes extremely challenging. The person is already impaired cognitively (in thinking, memory and processing information) and adding alcohol to the situation makes it much worse. A person with memory impairment may not appreciate how much s/he is drinking and will often neglect nourishment and basic hydration. It is even harder for family members to keep on top of things when the loved one lives independently. I have seen this problem in many settings such as when the person lives alone, or with family members, or in long-term care.

Family members ask what can be done. There are a few things that can be tried; however, there is not a clear-cut answer. I would like to share with you some of the common problems and solutions related to drinking and dementia.

Problems:

• A person who consumes a lot of alcohol on a regular basis may start to neglect his or her own hygiene and health care. Self-neglect is often the first sign that alerts family members that something is not right.

• Certain medications and alcohol do not mix. For example, a sleeping pill taken with alcohol can cause increased confusion. Be aware of over-the-counter sleep aides that often contain diphenhydramine (e.g., Benadryl).

• The person with dementia is already impaired — becoming intoxicated makes matters worse. Increased confusion, risky behaviour and falls can cause complications. Falling can cause bruises, cuts, sprains and fractures and can lead to hospitalization.

• Against his or her better judgement, an intoxicated person may decide to go for a drive. Remove the keys or disable the car if this poses a potential risk.

• If the person lives in a rental suite, s/he may face risk of eviction. If the person neglects to care for the home environment and/or him or herself, co-tenants may complain of fruit flies, rodents or odours (like urine due to mismanaged incontinence). Other tenants may not like the fact there are risks associated with the person smoking (fire hazard). The person with alcohol dependence may not pay the utility bills, or fail to pay rent. These are all grounds for eviction if the situation is not rectified.

• Some people develop life-threatening illnesses related to drinking, such as cirrhosis of the liver. They are told they should stop drinking, but forget that they were told. They may need to be in a 24-hour secured facility to keep them healthy and alcohol-free. This is only when deemed incompetent or incapable of understanding the risks.

• People with dementia and/or alcoholism may confabulate. This is when a person unintentionally lies about the facts. They appear to be telling the truth, but in fact, it is all made up. This makes it difficult for family members to trust their loved one and get a true sense of what is going on.

• Nutritional deficiencies can occur in people who have alcoholism. They tend to drink a lot of alcohol, but usually don’t eat enough foods containing thiamine, or vitamin B1. Thiamine is naturally found in fruits and vegetables. This continues to cause damage to the brain and body (Wernicke-Korsakoff Syndrome) which may be irreversible.

Practical Tips for Helping a Loved One with Dementia Stay Safe:

• Remove all alcohol from the home. If necessary, replace it with non-alcoholic beverages such as low-alcohol or non-alcoholic beer or wine.

• Put the person’s address on the “Do Not Deliver” bottle delivery list. Some bottle delivery programs will accept a letter from a doctor or another person in authority, such as the person assigned Durable Power of Attorney. Call your local liquor commission to inquire about this option.

• Let all other family members and friends know that you would like them to refrain from bringing alcohol to the person.

• Keep the person busy with other activities.

• Find out what is motivating the person to drink. Could it be loneliness, stress, anxiety, depression or grieving? Find solutions to these underlying causes.

• If possible, limit access to funds they use to pay for the alcohol.

• Contact your local addictions organization for more support. Join an Al-Anon Peer or Family Group.

• Know your limits as a family member/caregiver. Look after yourself first. The overuse of alcohol likely predated the dementia and will likely be a difficult behaviour to change. A loved one with dementia is unable to appreciate (or remember appreciating) that there is a problem.

• Get your loved one assessed by a specialist. Geriatric Psychiatrists are experienced in this area. It is difficult to determine the level of cognitive impairment when someone is under the influence.

• Enlist the help and support from other family members and friends.

• Consider Family Counselling to work on the issues together.

• Pursue individual psychotherapy if you are feeling guilty, struggling with the change in roles, or grieving the loss of your loved one.

• Contact your local Alzheimer’s organization for more support and tips.

Solutions:

• Detoxification and rehabilitation are difficult and usually impossible for persons who have irreversible brain damage from chronic alcoholism. I have seen situations where the person is hospitalized, detoxed (removing toxins and abstaining from alcohol), then move to a secured facility for older adults which offers either no access to, or controlled access to alcohol. Voluntary recovery is almost impossible in persons with dementia. A person needs certain mental abilities to benefit from rehabilitation (restoring to optimal health and functioning). Most programs are based on cognitive-behavioural changes, which is not possible for someone with mid to late-stage dementia. A person with mild or early stages of dementia may be able to benefit.

• I have seen success in persons who have dementia and whose lives were derailed by alcoholism when they are detoxed in hospital, then moved to a supportive environment where there is no access to alcohol. They benefit from living in a secured environment where they have stimulation, supervision and activities. They thrive with regularly scheduled meals, medications, and personal care assistance. In my community, these facilities are called Supportive Housing or Personal Care Homes (also known as Nursing Homes.) One unfortunate (or fortunate?) side-effect of this is that the person thrives and does so well that he or she may get to the point where it appears that s/he will be safe and capable of living independently. We fear that once the person moves out and lives independently, they will start drinking again. With proper supports and increased diligence (although the person may not see a need for it) it is possible for them to move home.

Preventative Measures:

Families can encourage older adults to ensure that Power of Attorney, Wills and a Living Will/Advanced Health Care Directive is prepared well ahead of time. This will help prevent any major problems down the road — for example, when it comes time to sell property.

If you or someone you know has an addiction to alcohol, seek medical advice or call your local addictions organization. Education and support are key to aid in prevention and treatment of this challenging situation.

 

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Angela G. Gentile, M.S.W., R.S.W. is an author and specialist in aging with more than 25 years of experience working with older adults and their families in a variety of capacities. She has written a book called “Caring for a Husband with Dementia: The Ultimate Survival Guide” and a mobile app for iOS called “Dementia Caregivers Solutions.” When she’s not working, she enjoys writing, traveling, photography and exploring what it means to age well. She is a realistic optimist who lives in Winnipeg, Manitoba with her husband and two children. Find her online at angelaggentile.com.

Photo credit: “Dandelion Wine” by Sattva @ FreeDigitalPhotos.net

What is Alzheimer’s Anyways?

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As I was perusing through the Alzheimer’s Reading Room, I came across this video on YouTube. It is a well-done video called, “What is Alzheimer’s Disease?”. It comes from the AboutAlzOrg YouTube channel. Check out this three minute video and come away with a greater understanding of this incurable and fatal disease: What is Alzheimer’s Disease?

The more we understand, the more we can help.

Warm regards,

Angela G. Gentile

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Angela G. Gentile, M.S.W., R.S.W. is a clinical social worker who specializes in aging. She has helped hundreds of people who are struggling with the challenges aging can bring. Angela is passionate about challenging ageist myths and stereotypes and exploring what it means to age well. She considers herself a realistic optimist but she still can’t tell her left from her right.