When an older person seems to be forgetting things frequently, how can a concerned
spouse, child, relative or friend determine whether it's just mild forgetfulness
or the onset of Alzheimer's disease or some other dementia?
In the experience
of Lynne Gallagher of the Family Service Association of Toronto, one of the first
signs is the senior making the same phone call over and over again, often to an
adult child. At workshops for caregivers, Gallagher often hears versions of this
exchange:
"What time are you picking me up?"
"At 2 p.m., Mother."
Ten minutes later: "Hello dear, what time are you picking me up?"
"Mom, what's
the matter? I just told you. Two p.m."
"Oh, 2 p.m. Okay, dear."
Twenty
minutes later: "What time?. "
To the person on the receiving end of the phone
call, the senior can come across as annoying or attention seeking. For people
close to the senior, denial is a common reaction. Or spouses and children can
be "terribly protective," says Gallagher, program co-ordinator for caregivers?
education services, at Toronto's Family Service Association. Family members might
adopt ruses to disguise the loved one's loss of memory.
Another symptom of
Alzheimer's disease, the best known and most serious of the dementias, is personality
change.
"For families, it's a real struggle if a mother who was always sweet
now wants control over everything and gets angry if she can't get it," Gallagher
says.
At her workshops, she asks caregivers to document and track such changes.
"I ask them, 'What were they like two or three years ago? And is this a change
in behaviour?'"
If a senior is experiencing difficulty in learning, thinking
or remembering or is showing changes in personality, it's essential to arrange
for a medical evaluation.
A number of other reasons might be responsible for
memory loss, including the effects of anesthesia, drug interactions or injury.
It's important to identify the reason, and whether it's treatable or even reversible.
An evaluation should also pinpoint the needs and resources of the affected person
and the caregivers.
Gallagher recommends The 36-hour Day, a book by Nancy
Mace and Peter Rabins published by Johns Hopkins University Press. It's a family
guide to caring for persons with Alzheimer's, related illnesses and memory loss
in later life.
Gallagher also points to these quick facts about Alzheimer's:
- The loss of short-term memory is one of the first indicators, although long-term
memory might persist for some time
- Alzheimer's affects men and women equally
and does not depend on personality or any social factors
- With Alzheimer's,
memory loss is permanent. The course might be slow or rapid, but progressive memory
loss that is never restored is a major sign.
New medications can prolong the early to mid stages, but a downward slide
is inevitable. If Alzheimer's is confirmed, one of the first tasks
of the caregiver is to persuade the person to give up responsibilities
now beyond him or her, such as driving a car.
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