So what actually causes memory loss or cognitive decline? The answer is complicated. Some things we know about. Others are speculative. Our scientists are making continuous progress in identifying potential causes, but lots more research remains to be done.
In the meantime, here are some of the more recognized ones as compiled by Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
*Medication with polypharmacy and drug interactions- if an older adult is on multiple medications and is experiencing memory issues, they should have a pharmacist or physician assess each medication.
*Infection- i.e. Urinary Tract Infection –is often a primary cause for memory decline. Urinary tract infection is the most frequent cause.
*Dehydration- not drinking enough water will cause memory decline.
*Emotional stress or depression – with the elderly a diagnosis of dementia is sometimes given when it is actually depression. If true depression is treated then memory should return.
*Pain is underreported in elderly and causes a decline in memory.
*Alcoholism can cause serious memory loss.
Bob Tell
http://www.dementia-diary.com
Sunday, July 13, 2008
Saturday, July 12, 2008
In Memorium
Some months ago, after years of slow, agonizing decline into the opaque fog of dementia, my mother died. Mercifully, she slipped away gently one evening and was buried shortly afterward next to my Dad who had been waiting patiently for their reunion for 16 years.
Oddly, Mom died the evening before Thanksgiving, while Dad passed a day before Christmas eve. His birthday was November 28th and we always celebrated it on Thanksgiving. The Thanksgiving through New Years Holiday Season will always be bittersweet from now on.
Having been through so many mini-deaths during Mom’s long decline into dementia, I sort of expected the actual event to be easier than it was when Dad suddenly died of a massive coronary event in a Florida Sears store. It wasn’t. It was like being hit in the head by a 2x4. A clergyman told me, wisely, that whenever a mother dies it’s the wrong time. You’re never ready. He was so right!
When I got “the call” I’d been expecting for years (each time one of her medium sized mini-strokes knocked her down to a new low), I was stunned. Strange how poorly human beings are able to deal with the reality and finality of death. This wasn’t just another false alarm. This was it!
Still, as they say, for Mom it was a blessing (and probably for me too, although I don’t feel that way yet). Her life quality was so low for so long that I can only believe in the goodness of her being out of pain, discomfort, total dependence, confusion, etc. For me, though, I’m still at the stage of realizing that I’ll never see her again—and that I’ve become an orphan...an adult orphan.
Humor is often the best way to deal with sadness. So, a friend told me that as an only child, caregiving Mom for 16 years was my job. Not only have I lost my mother, he said, but I’ve also lost my job.
It’s true and I’m mourning them both.
Bob Tell
http://dementia-diary.com
Oddly, Mom died the evening before Thanksgiving, while Dad passed a day before Christmas eve. His birthday was November 28th and we always celebrated it on Thanksgiving. The Thanksgiving through New Years Holiday Season will always be bittersweet from now on.
Having been through so many mini-deaths during Mom’s long decline into dementia, I sort of expected the actual event to be easier than it was when Dad suddenly died of a massive coronary event in a Florida Sears store. It wasn’t. It was like being hit in the head by a 2x4. A clergyman told me, wisely, that whenever a mother dies it’s the wrong time. You’re never ready. He was so right!
When I got “the call” I’d been expecting for years (each time one of her medium sized mini-strokes knocked her down to a new low), I was stunned. Strange how poorly human beings are able to deal with the reality and finality of death. This wasn’t just another false alarm. This was it!
Still, as they say, for Mom it was a blessing (and probably for me too, although I don’t feel that way yet). Her life quality was so low for so long that I can only believe in the goodness of her being out of pain, discomfort, total dependence, confusion, etc. For me, though, I’m still at the stage of realizing that I’ll never see her again—and that I’ve become an orphan...an adult orphan.
Humor is often the best way to deal with sadness. So, a friend told me that as an only child, caregiving Mom for 16 years was my job. Not only have I lost my mother, he said, but I’ve also lost my job.
It’s true and I’m mourning them both.
Bob Tell
http://dementia-diary.com
Friday, July 11, 2008
Signs of a decline in memory function
It's not always easy to tell when a loved one is experiencing the onset of dementia. Here are some significant signs that are provided below as a courtesy from their author, Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager," a national company that helps seniors and their families manage the complexities of older adult life.
*Forgetfulness - not just forgetting names or appointments, but frequently forgetting doctor’s appointments, important anniversaries, birthdays and other special dates that would have never been forgotten in the past.
*Forgetting to the point that it causes confusion and interruption with daily activities.
*Forgetting to turn off the stove – we have all left a burner on accidentally, but if this is a frequent event or if the older adult does not remember cooking at all, then it is no longer a “normal” part of aging.
*Everyone experiences difficulties finding the right words, especially in stressful situations. It’s a bigger issue when an older adult cannot remember simple words and substitutes his or her own words making it difficult to follow what they are saying.
*Misplacing items is common for everybody, but it becomes a “memory problem” if the keys are found in the freezer or the ice tray is in the dryer.
*Finances – there is a problem if a senior has always kept an accurate checkbook in the past and now it never balances.
*Impaired judgment, such as dressing appropriately. This does not mean the senior is mixing plaids and strips, or purples and reds, but is caught wearing a bathrobe to the shopping mall or putting on several shirts instead of one.
Bob Tell
http://www.dementia-diary.com
*Forgetfulness - not just forgetting names or appointments, but frequently forgetting doctor’s appointments, important anniversaries, birthdays and other special dates that would have never been forgotten in the past.
*Forgetting to the point that it causes confusion and interruption with daily activities.
*Forgetting to turn off the stove – we have all left a burner on accidentally, but if this is a frequent event or if the older adult does not remember cooking at all, then it is no longer a “normal” part of aging.
*Everyone experiences difficulties finding the right words, especially in stressful situations. It’s a bigger issue when an older adult cannot remember simple words and substitutes his or her own words making it difficult to follow what they are saying.
*Misplacing items is common for everybody, but it becomes a “memory problem” if the keys are found in the freezer or the ice tray is in the dryer.
*Finances – there is a problem if a senior has always kept an accurate checkbook in the past and now it never balances.
*Impaired judgment, such as dressing appropriately. This does not mean the senior is mixing plaids and strips, or purples and reds, but is caught wearing a bathrobe to the shopping mall or putting on several shirts instead of one.
Bob Tell
http://www.dementia-diary.com
Wednesday, July 9, 2008
WHAT'S NORMAL AND WHAT ISN'T?
The following information is borrowed (with her permission) from Jean Bandos, MSN, RN, GCNS-BC Research Director at "My Health Care Manager." Jean is an experienced Gerontological Clinical Nurse Specialist with a vast expertise in care management of the older adult.
"My Health Care Manager" is a national company that helps seniors and their families manage the complexities of older adult life. They have a website and a free 800 number that you can call to have any of your caregiving questions answered. The number is 1-800-499-8020.
"WHAT'S NORMAL AND WHAT ISN'T?
Forgetfulness and minor memory problems are a normal part of aging. As we age, memory lapses like not remembering a name or taking more time to figure out directions to a new destination are normal. However, when these memory lapses become extreme and continuous, some action needs to be taken.
Unfortunately, there aren’t clear cut signs or determinants that an action is related to serious memory loss or if it’s common for a senior. An indicator that a behavior is normal includes minor occurrences, such as an older adult getting lost driving in a new part of town or having one fender bender. But, when the older adult can’t find his or her way home from the local grocery store or has several “I can’t remember how that happened” dents in their car, that is likely a sign of a major problem that needs to be addressed.
Dementia, or memory decline, is caused by a problem within the brain that makes it hard for a person to remember, learn and communicate. As the dementia progresses the individual may display disruptive behavior and other side effects. It’s estimated that as many as one-third of adults will experience a gradual decline in cognitive function during their lifetime. It’s important to seek medical attention right away if noticing major indications of memory decline."
I hope to be able to share more tips from Jean Bandos in future posts. Stay tuned.
Bob Tell
http://www.dementia-diary.com
"My Health Care Manager" is a national company that helps seniors and their families manage the complexities of older adult life. They have a website and a free 800 number that you can call to have any of your caregiving questions answered. The number is 1-800-499-8020.
"WHAT'S NORMAL AND WHAT ISN'T?
Forgetfulness and minor memory problems are a normal part of aging. As we age, memory lapses like not remembering a name or taking more time to figure out directions to a new destination are normal. However, when these memory lapses become extreme and continuous, some action needs to be taken.
Unfortunately, there aren’t clear cut signs or determinants that an action is related to serious memory loss or if it’s common for a senior. An indicator that a behavior is normal includes minor occurrences, such as an older adult getting lost driving in a new part of town or having one fender bender. But, when the older adult can’t find his or her way home from the local grocery store or has several “I can’t remember how that happened” dents in their car, that is likely a sign of a major problem that needs to be addressed.
Dementia, or memory decline, is caused by a problem within the brain that makes it hard for a person to remember, learn and communicate. As the dementia progresses the individual may display disruptive behavior and other side effects. It’s estimated that as many as one-third of adults will experience a gradual decline in cognitive function during their lifetime. It’s important to seek medical attention right away if noticing major indications of memory decline."
I hope to be able to share more tips from Jean Bandos in future posts. Stay tuned.
Bob Tell
http://www.dementia-diary.com
Friday, July 4, 2008
Keyword Glossary For Alzheimer's/Dementia Services
This article is about the best way for caregivers of parents and
spouses to use Google and other internet search engines to find
quality services for their elderly loved ones with dementia.
No matter which dementia is involved (Alzheimer’s disease, senile dementia, pick’s disease, lewy body dementia, frontal temporal lobe dementia, vascular dementia, Parkinson's disease—to name just a few of the dozens of dementias that we know about), the keywords used in the research will make all the difference.
Of course. a “keyword” is a word or phrase that is entered into the search box of Google, Yahoo, Ask, and other search engine sites to prompt them to report links to relevant websites. The following paragraphs use popular keywords (IN CAPS) that usually generate multiple links to comprehensive sources of major information for Alzheimer’s Disease caregivers and related dementia sufferers.
CARE ASSESSMENT—This phrase will be helpful to caregivers who seek professional guidance about how best to meet their loved ones’ care needs.
ASSISTED LIVING—You are a caregiver to an elderly parent or spouse and you know your loved one can no longer live independently. But how to choose a proper structured and safe assisted living home for him or her? Pundits have said that “if you’ve seen one assisted living home, you’ve seen one assisted living home.” In other words, while there are some common elements among them, they are all different. There’s the medical model, the social work model, the luxury model, the economy model, the nursing model, the NORC (Naturally Occurring Retirement Community), and many variations on these themes. This keyword (i.e. Assisted Living) will get you started on your important search for the right program for your loved one.
CAREGIVER BURNOUT: This phrase describes a common feeling of helplessness and frustration among caregivers dealing with endless demands upon their time, energy, emotions, finances and patience.
CAREGIVER SUPPORT GROUPS: Many caregivers cope with the loneliness and isolation of their situations by joining real or virtual support groups. The internet can help them find an appropriate group.
ELDERCARE: This keyword will help the researcher to identify a variety of resources available to assist with the caregiving of aging parents or spouses with dementia.
SKILLED NURSING—or skilled nursing homes—or skilled nursing care are all keyword phrases that will lead elderly parent caregivers or spouse caregivers to information about how best to access this level of care for the dementia sufferer.
NURSING HOME RATINGS—When that dreaded moment arrives that nursing home placement for a loved one is imminent, this keyword phrase will lead you to sites that provide information to help you choose the best environment for your elderly loved one. Links to several nursing home rating sites are listed on my website: www.dementia-diary.com.
MEDICAID NURSING HOMES—Medicaid is the national program for financing health care to the poor. The cost of elderly care is so high that many patients run through their savings and are nearly destitute by the time nursing home care is needed. Elderly patients needing skilled nursing care who cannot afford a private nursing home may qualify for Medicaid. While not all nursing homes accept patients on Medicaid, many do. Guidance for families in this situation can be found on the internet by using this keyword phrase.
MEDICARE NURSING HOMES—Medicare is part of our Social Security system and provides financing for medical services to most citizens over the age of 65 regardless of their ability to pay. However, not all nursing homes accept payment from Medicare because that government program is quite limited with respect to long term care benefits. These homes fear that when Medicare benefits run out, they’ll have to continue to provide care without receiving compensation for services rendered. Nevertheless, many nursing homes are open to admitting Medicare patients for at least the short term—and some will permit such patients to remain if they become Medicaid eligible. It’s important to obtain this information up front as you go about researching nursing homes for your loved one.
HOSPICE CARE—Most folks are now familiar with this wonderful care concept for dying patients and their families. It was pioneered in England in the 1960’s, promoted by Elizabeth Kubler-Ross’s work on death and dying, and is now widely available throughout the United States. Medicare currently pays for most elderly patients requiring hospice care.
BILL PAYING SERVICES—Sloppy bill paying behavior is one of the first things caregivers notice when they see decline in their elderly parents or significant others. This often leads to a search for a commercial bill paying service. Many banks offer this service too. While not exclusively for dementia patients, these services can make it much easier to assist a loved one with dementia to pay his or her bills and eventually, if necessary, to take it over completely.
Do you know of other important keywords? If so, let me know at bobtell@mac.com
Bob Tell
http://www.dementia-diary.com
spouses to use Google and other internet search engines to find
quality services for their elderly loved ones with dementia.
No matter which dementia is involved (Alzheimer’s disease, senile dementia, pick’s disease, lewy body dementia, frontal temporal lobe dementia, vascular dementia, Parkinson's disease—to name just a few of the dozens of dementias that we know about), the keywords used in the research will make all the difference.
Of course. a “keyword” is a word or phrase that is entered into the search box of Google, Yahoo, Ask, and other search engine sites to prompt them to report links to relevant websites. The following paragraphs use popular keywords (IN CAPS) that usually generate multiple links to comprehensive sources of major information for Alzheimer’s Disease caregivers and related dementia sufferers.
CARE ASSESSMENT—This phrase will be helpful to caregivers who seek professional guidance about how best to meet their loved ones’ care needs.
ASSISTED LIVING—You are a caregiver to an elderly parent or spouse and you know your loved one can no longer live independently. But how to choose a proper structured and safe assisted living home for him or her? Pundits have said that “if you’ve seen one assisted living home, you’ve seen one assisted living home.” In other words, while there are some common elements among them, they are all different. There’s the medical model, the social work model, the luxury model, the economy model, the nursing model, the NORC (Naturally Occurring Retirement Community), and many variations on these themes. This keyword (i.e. Assisted Living) will get you started on your important search for the right program for your loved one.
CAREGIVER BURNOUT: This phrase describes a common feeling of helplessness and frustration among caregivers dealing with endless demands upon their time, energy, emotions, finances and patience.
CAREGIVER SUPPORT GROUPS: Many caregivers cope with the loneliness and isolation of their situations by joining real or virtual support groups. The internet can help them find an appropriate group.
ELDERCARE: This keyword will help the researcher to identify a variety of resources available to assist with the caregiving of aging parents or spouses with dementia.
SKILLED NURSING—or skilled nursing homes—or skilled nursing care are all keyword phrases that will lead elderly parent caregivers or spouse caregivers to information about how best to access this level of care for the dementia sufferer.
NURSING HOME RATINGS—When that dreaded moment arrives that nursing home placement for a loved one is imminent, this keyword phrase will lead you to sites that provide information to help you choose the best environment for your elderly loved one. Links to several nursing home rating sites are listed on my website: www.dementia-diary.com.
MEDICAID NURSING HOMES—Medicaid is the national program for financing health care to the poor. The cost of elderly care is so high that many patients run through their savings and are nearly destitute by the time nursing home care is needed. Elderly patients needing skilled nursing care who cannot afford a private nursing home may qualify for Medicaid. While not all nursing homes accept patients on Medicaid, many do. Guidance for families in this situation can be found on the internet by using this keyword phrase.
MEDICARE NURSING HOMES—Medicare is part of our Social Security system and provides financing for medical services to most citizens over the age of 65 regardless of their ability to pay. However, not all nursing homes accept payment from Medicare because that government program is quite limited with respect to long term care benefits. These homes fear that when Medicare benefits run out, they’ll have to continue to provide care without receiving compensation for services rendered. Nevertheless, many nursing homes are open to admitting Medicare patients for at least the short term—and some will permit such patients to remain if they become Medicaid eligible. It’s important to obtain this information up front as you go about researching nursing homes for your loved one.
HOSPICE CARE—Most folks are now familiar with this wonderful care concept for dying patients and their families. It was pioneered in England in the 1960’s, promoted by Elizabeth Kubler-Ross’s work on death and dying, and is now widely available throughout the United States. Medicare currently pays for most elderly patients requiring hospice care.
BILL PAYING SERVICES—Sloppy bill paying behavior is one of the first things caregivers notice when they see decline in their elderly parents or significant others. This often leads to a search for a commercial bill paying service. Many banks offer this service too. While not exclusively for dementia patients, these services can make it much easier to assist a loved one with dementia to pay his or her bills and eventually, if necessary, to take it over completely.
Do you know of other important keywords? If so, let me know at bobtell@mac.com
Bob Tell
http://www.dementia-diary.com
Wednesday, June 25, 2008
Comparing Alzheimer's With Other Dementias
Here’s a popular article I wrote that is appearing on eldercare blogs, zines and sites throughout the web. It first appeared on my former website on September 17, 2006. I hope you agree that it is as relevant today as it was then. Feel free to continue a conversation on this theme, caregiver burnout, caregiver support, or on any other related topic:
In 1906, Dr. Alois Alzheimer presented a key paper to the meeting of the South West German Society of Alienists. In it he described the disease syndrome that now bears his name. Today, Alzheimer’s Disease has become the common term most people use whenever they talk about any kind of dementia. In fact, the very term “Alzheimer’s” has become a catchall for any syndrome in which progressive cognitive dysfunction is the major manifestation.
However, there are dozens of other dementias including, to name just a few: Multi-Infarct Dementia, Frontotemporal Dementia (FTD), Pick's Disease, Progressive Aphasia, Corticobasal Degeneration, Lewy Body Dementia, Senile Dementia, Binswanger’s Disease, Vascular Dementia, Parkinsonian, etc.
From a caregiver’s point of view, it almost doesn’t matter which dementia is at hand. The perpetual grief and mourning felt by the caregiver will be the same regardless of the specific process affecting his or her loved one.
My special interest is in Multi-Infarct Dementia because that is the one that affected my mother and the one I write about in: “DEMENTIA DIARY: A Care Giver’s Journal.” (Another name for this syndrome is Vascular Dementia.)
I should say that I am not a physician or a professional expert in this disease. I am, by profession, a hospital administrator, so I do feel equipped to at least understand the language of the clinicians. What I know comes from 16 years of watching my mother sink into her opaque world, plus 16 years of discussions with physicians providing her medical care.
Here is the way one physician described Multi-Infarct Dementia to me. It is caused by multiple strokes, some call them mini-strokes. The “victim” of this condition may not be, indeed usually is not, aware that anything out of the ordinary has occurred. Neither are his or her significant others.
Perhaps there is momentary weakness, headache, or dizziness, but nothing major. Over time, however, enough damage is done to the brain that symptoms begin to appear such as: confusion, impaired judgment, aphasia, irritability, depression, mood swings, inertia, significant memory loss, and a host of possible others.
Not all symptoms are experienced by every sufferer, but sooner or later most of them may appear. And the symptoms of Multi-Infarct Dementia are not really all that different from Alzheimer’s or other dementias. I’ve been given to understand that these differences are subtle, hard to tell apart for a layman.
Health care professionals have explained that if one were to line up sufferers of each of the various dementias next to one another you could probably differentiate them—but that’s what it would take.
If you are dealing with a dementia in a loved one, good luck and best wishes in your search for help and understanding.
In 1906, Dr. Alois Alzheimer presented a key paper to the meeting of the South West German Society of Alienists. In it he described the disease syndrome that now bears his name. Today, Alzheimer’s Disease has become the common term most people use whenever they talk about any kind of dementia. In fact, the very term “Alzheimer’s” has become a catchall for any syndrome in which progressive cognitive dysfunction is the major manifestation.
However, there are dozens of other dementias including, to name just a few: Multi-Infarct Dementia, Frontotemporal Dementia (FTD), Pick's Disease, Progressive Aphasia, Corticobasal Degeneration, Lewy Body Dementia, Senile Dementia, Binswanger’s Disease, Vascular Dementia, Parkinsonian, etc.
From a caregiver’s point of view, it almost doesn’t matter which dementia is at hand. The perpetual grief and mourning felt by the caregiver will be the same regardless of the specific process affecting his or her loved one.
My special interest is in Multi-Infarct Dementia because that is the one that affected my mother and the one I write about in: “DEMENTIA DIARY: A Care Giver’s Journal.” (Another name for this syndrome is Vascular Dementia.)
I should say that I am not a physician or a professional expert in this disease. I am, by profession, a hospital administrator, so I do feel equipped to at least understand the language of the clinicians. What I know comes from 16 years of watching my mother sink into her opaque world, plus 16 years of discussions with physicians providing her medical care.
Here is the way one physician described Multi-Infarct Dementia to me. It is caused by multiple strokes, some call them mini-strokes. The “victim” of this condition may not be, indeed usually is not, aware that anything out of the ordinary has occurred. Neither are his or her significant others.
Perhaps there is momentary weakness, headache, or dizziness, but nothing major. Over time, however, enough damage is done to the brain that symptoms begin to appear such as: confusion, impaired judgment, aphasia, irritability, depression, mood swings, inertia, significant memory loss, and a host of possible others.
Not all symptoms are experienced by every sufferer, but sooner or later most of them may appear. And the symptoms of Multi-Infarct Dementia are not really all that different from Alzheimer’s or other dementias. I’ve been given to understand that these differences are subtle, hard to tell apart for a layman.
Health care professionals have explained that if one were to line up sufferers of each of the various dementias next to one another you could probably differentiate them—but that’s what it would take.
If you are dealing with a dementia in a loved one, good luck and best wishes in your search for help and understanding.
Longevity and its hazards
Sadly, the interest in Alzheimer's and other Dementias is universal. So is caregiver burnout. The good news is that modern medical technology has enabled millions to experience longer life. The bad news is that many of these aging millions live longer but don’t really experience it—at least not in the way you and I do (or as they themselves did when they were younger). Their memories are gone or going and their loved ones are grieving for who they were. But caregiver support is available.
This blog is dedicated to all caregivers of aging parents or other loved one’s whose identities have been lost to this terrible process. To encourage discussion and exploration of this timely topic, I have made myself available to community, library, academic and religious groups primarily in, but not limited to, Michigan and Florida. A complete calendar of my scheduled eldercare talks is available on request. If you are interested in scheduling a presentation, please let me know with a comment on this blog or else contact me at: bobtell@mac.com.
Here are just a few of my past presentations:
Warren Arsenal, Warren MI: Civilian Employee Group
Selfridge Air National Guard Base: Civilian Employee Group
Northbrook Presbyterian Church, Beverly Hills MI: Adult Education Group
Madonna University Library, Livonia MI
Temple Beth El, Bloomfield Hills MI: Community Library Program
Birmingham Rotary
Madonna Magazine—Catholic Television Network—TV Interview
Metro Detroit JCC Book Fair
Washtenaw (Ann Arbor) JCC Book Festival
Wayne State University, Detroit: Writing & Publishing Workshop
This blog is dedicated to all caregivers of aging parents or other loved one’s whose identities have been lost to this terrible process. To encourage discussion and exploration of this timely topic, I have made myself available to community, library, academic and religious groups primarily in, but not limited to, Michigan and Florida. A complete calendar of my scheduled eldercare talks is available on request. If you are interested in scheduling a presentation, please let me know with a comment on this blog or else contact me at: bobtell@mac.com.
Here are just a few of my past presentations:
Warren Arsenal, Warren MI: Civilian Employee Group
Selfridge Air National Guard Base: Civilian Employee Group
Northbrook Presbyterian Church, Beverly Hills MI: Adult Education Group
Madonna University Library, Livonia MI
Temple Beth El, Bloomfield Hills MI: Community Library Program
Birmingham Rotary
Madonna Magazine—Catholic Television Network—TV Interview
Metro Detroit JCC Book Fair
Washtenaw (Ann Arbor) JCC Book Festival
Wayne State University, Detroit: Writing & Publishing Workshop
Subscribe to:
Posts (Atom)