If your mother forgets to serve the apple pie she just baked, that's forgetfulness. If she forgets she already baked it, she may have a more serious problem.
One or two lapses shouldn't worry you. But a pattern of changes might be alarming.
It's difficult to acknowledge someone you care about is having trouble remembering, communicating or making judgments. But if you suspect dementia, early evaluation, information and support can make life easier for you and your family member.
Dementia is a medical condition feared by most older adults. Yet, it affects less than 15 percent of people older than age 65.
Dementia is a progressive loss of memory and other mental skills. Eventually, it may lead to inability to handle daily activities.
In many cases, a specific event or crisis makes you begin to suspect a family member has dementia. An older relative gets lost walking in his own familiar neighborhood. A parent usually concerned with proper appearances loses interest in her clothes or home. The family bookkeeper neglects bills.
Often, a discussion with others who have contact with your family member helps create a complete picture of behavior changes. As you work together, you may recall past events that may be related to dementia. But, like most people, you may have easily rationalized the changes or credited them to some other cause.
Someone with early dementia may be unaware of problems or minimize them. Sometimes, the person may be struggling to hide problems and be relieved when you bring up the subject.
When you talk, suggest you see your doctor together about a memory problem. Your primary care physician can begin the evaluation or refer you to a specialist in dementia.
In a few cases, the examination may detect a reversible dementia. But more importantly, early diagnosis allows you to plan ahead. You have time to work together to adjust daily activities to keep your relative functioning as fully as possible.
A complete evaluation may include a history of work and hobbies, diet and use of medications, followed by a physical examination and laboratory tests. A neurological examination focuses on alertness, reflexes, senses, coordination and strength. Computed tomography (CT) or magnetic resonance imaging (MRI) may be used to identify changes in brain structure.
Specialists may evaluate mental and intellectual abilities.
The work-up can be daunting. Don't hesitate to schedule a follow-up appointment or phone call if more questions come to mind later.
If your family member is diagnosed with dementia, you'll probably feel overwhelmed. You may wish for more information and worry about the future.
To be a better caregiver:
-- Many people with dementia can participate in social activities with little problem. You may find regularly scheduled outings provide a structure your family member needs.
-- Choose specific tasks that allow involvement but fit your family member's current abilities. You might reassign the banking duties to someone else and focus on your relative's gardening hobby.
-- Join an organized support group for caregivers or find support among your family and friends. Because of earlier diagnosis of dementia, some communities also have support groups for people with dementia.
-- Look into respite care. After a few hours to yourself, you can return to caregiving re-energized.
-- You may have to give up some activities as you take on the role of caregiver. Hang on to hobbies that renew your mental or physical strength.
Right now, your biggest need might be reliable information or an understanding friend. Later, you may need more practical help. And you may eventually need full-time alternative care for your family member.
As dementias are diagnosed earlier, adult day programs, foster or group homes and long-term care facilities are catering specifically to people with dementia. Many times, services for people with dementia have waiting lists. Thinking ahead allows you to be prepared if the time for full-time care arrives.
When you become immersed in caregiving, keeping a clear perspective may be difficult. Ask other family members or health-care providers to help you evaluate when you need more help.