Wednesday, August 13, 2008

Do These Behaviors Predict Dementia?

I'm often asked about examples of challenging behaviors that I noticed in my mother—behaviors that helped me to finally realize she was sinking into dementia. The list below may help you to evaluate what is happening to your loved one.

For Mom, it started slowly with just a few of these behaviors attracting my attention. I just passed them off to normal aging. Gradually, it reached the tipping point where I could no longer ignore what was happening. There was an emergency a day.

I lived 1500 miles North of Mom, trying to run a business. Every day in the middle of some crisis at work came a phone call about some calamity in Florida. Sometimes from Mom, sometimes about Mom.

Up to 30% of my time was being consumed as a long distance caregiver and decision maker—often without the facts I needed to make correct, emotion free, objective decisions. Frequent air travel to check things out became another costly requirement. Here’s some of what I had to deal with:

• NUTRITION: She was not eating well. Things in her refrigerator were scary: ie: partly eaten fruits and cheeses with lots of mold.
• CLEANLINESS: Her house was dirty (she had been a meticulous housekeeper).
• HOUSEHOLD ORGANIZATION: There was clutter everywhere. This was not my mother!
• FIRE SAFETY: She was storing plastic bags in the oven. Then, forgetting, she was turning the oven on.
• REALITY ISSUES: Hallucinations about mice were occurring with increasing frequency.
• HEALTH ISSUES: Many health issues were threatening her well-being. Hospitalizations for pneumonia, arthritis, etc., were becoming more frequent.
• DRUG COMPLIANCE: She was non-compliant with medications with the result that her blood pressure was out of control and other health conditions were not receiving prescribed therapy.
• MEDICAL CARE: She changed doctors (and HMO's) several times each year. Continuity of care suffered and I could not build a useful relationship with her physicians.
• INTERPERSONAL RELATIONSHIPS: She was isolating herself—alienating friends and family with harsh, judgmental personality changes.
• FALLING: She fell in her room, sustained a serious head injury and no one found her for 2 days
• FINANCIAL MANAGEMENT: She was messing up her finances and making other poor judgments.
• HOUSING: She became a housing hopper: In a 2 year period she went from her Florida house to a Florida condo to a furnished condo in Michigan back to her Florida condo to senior apartment to assisted living in Florida back to assisted living in Michigan. She had trouble settling in anywhere.
• DRIVING: Her driving became a daily nightmare with multiple fender benders and traffic violations.

Sound familiar? Are any or all of these things happening to your mom, dad, spouse or significant other? I hope not, but if they are, it may be time to seek a professional geriatric evaluation.

Bob Tell
Author, "Dementia-Diary, A Caregiver's Journal"