Consultation & Mediation
At the blog we will regularly publish articles of general interest related to older adults and their families.
Should I Be Worried About My Memory?
By Karen Dworski, L.C.S.W.
ElderPath LLC Consultation and Mediation
As a social worker who specializes in geriatrics, I hear this question a lot: “should I worry about my memory?” This question is at the heart of one of the biggest aging issues of our time, what is normal memory change and what is a dementia such as Alzheimer's disease.
So let's start with the concept of Normal Age Related Memory Loss. Starting in their 50's, most people notice memory changes as they stand in front of the frig trying to remember what they were looking for, or searching for those car keys that aren't where they should be. Perhaps the difficulty shows up with not remembering the name of someone you know. These frustrations are common in the plus 50 years. Most people have an “ah-hah” moment and the name pops into the head moments later, or they retrace their steps from the frig and remember within minutes what they're looking for. The most important fact is that these memory changes don't interfere with functioning normally in every day life. They are just annoying and don't prevent you from socializing, working, or managing household tasks.
Many people are worried that these annoying memory lapses could be the beginnings of a dementia or Alzheimer's disease. Dementia is an umbrella term that describes changes in the brain from a variety of causes, including Alzheimer's disease, which DO affect daily functioning, social relationships, and managing tasks. The Mayo Clinic offers this description (http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/memory-loss/art-20046326):
The word "dementia" is an umbrella term used to describe a set of symptoms, including impairment in memory, reasoning, judgment, language and other thinking skills. Dementia begins gradually in most cases, worsens over time and significantly impairs a person's abilities in work, social interactions and relationships.
Often, memory loss is one of the first or more recognizable signs of dementia. Other early signs may include:
- Asking the same questions repeatedly
- Forgetting common words when speaking
- Mixing words up — saying "bed" instead of "table," for example
- Taking longer to complete familiar tasks, such as following a recipe
- Misplacing items in inappropriate places, such as putting a wallet in a kitchen drawer
- Getting lost while walking or driving around a familiar neighborhood
- Undergoing sudden changes in mood or behavior for no apparent reason
- Becoming less able to follow directions
There are many types of dementia that can cause these symptoms, with Alzheimer's disease being the most common cause. At age 85 about 50% of the population will have some degree of Alzheimer's disease. The second most common dementia is Vascular Dementia and the risk factors are high blood pressure, high cholesterol, heart disease, a history of strokes or Transient Ischemic Attacks, and Diabetes. There are many other types of dementia including Parkinson's Dementia, Pick's Disease, Frontal Lobe Dementia, Lewy Body Dementia, and others.
This information begs the question – what can be done to prevent it and what do you do if you suspect you have memory loss at the level of a dementia? Scientific research has indicated that the best thing you can do minimize the risk of Alzheimer's disease is to strengthen your cardiovascular system through exercise, the kind of exercise recommended by the American Heart Association (www.heart.org/ )– a half hour a day of aerobic exercise 5 days a week. A heart healthy diet is a good idea too.
If you suspect that you or someone you love has developed a dementia, it's important to receive treatment as early as possible. The earlier it's identified and treated, the more likely it is that an individual can remain functioning at the highest level possible over time. There are medication and non medication treatments that can be used. It's important to see a doctor, a geriatric psychiatrist, or a trained professional such as a geriatric social worker to be tested and get on the road to creating a treatment plan. Like all other chronic illness, treatment is the key, especially the non medication aspect of treatment. The non medical treatment stress the use of creativity in finding ways to have good days, to enjoy the present. My next blog will discuss treatment ideas, particularly the importance of creative approaches to daily life.
“There is a fountain of youth: it is your mind, your talents, the creativity you bring to your life and the lives of people you love. When you learn to tap this source, you will truly have defeated age.”
― Sophia Loren
De-stress the Holidays: KISS
Karen Dworski, L.C.S.W.
I hope you have enjoyed the recent Thanksgiving holiday, spending time with friends and family, eating too much, and visiting with loved ones. If you are reading this and are caring for a loved one with dementia (now called Neurocognitive Disorder), your holiday probably had some wrinkles in it that comes with being a caregiver during the holidays. For many caregivers, the holidays are a particularly stressful time, and the purpose of this article is to share some ideas about how recapture the joy and reduce the stress over the holiday season.
Over the course of working with many families and facilitating groups for caregivers, I have some thoughts to share. I’m particularly reminded of one member of my caregiver group who said that the key to enjoying the holidays is KISS - “Keep It Simple Stupid.” While the word “Stupid” seems rather harsh, it lends itself to creating this cute acronym. So how does one keep it simple?*
1. Communicate with family and friends to review the holiday plan, making sure they know the caregiver situation. Help them have realistic expectations of what you can and cannot do, which means you have to take a hard look at probably doing less or doing it on a simple level. Easy to say but hard to do. Be creative! Ask others to bring parts of the meal, serve on paper plates, see if others can host a meal, purchase prepared foods ahead of time, make it a potluck, etc. Perhaps meet for a brunch instead of a dinner especially if your loved one experiences the agitation of sundowning in the late afternoon or early evening.
2. Take into account the the pace of your loved one who has a Neurocognitive Disorder. Start preparing ahead of time so you’re not rushed, and your loved one can help with simple tasks - help set the table, work with you to wrap gifts, make cookies with you, etc. Try to keep your loved one’s routine as normal as possible.
If traveling to someone else’s home or a restaurant, plan ahead about how to enable your loved one to leave if he or she becomes overwhelmed and agitated. Perhaps you can arrange for a paid caregiver or family member who can take the person home. Perhaps you know of a quiet place at the home or restaurant where they can rest and recover from all the stimulation of having many people in one place.
3. When traveling by car, bus, or plane, make sure your loved one has identification that indicates how to contact you should he or she become separated. If traveling by plane, let the airline know that you’re traveling with a person with a Neurocognitive Disorder. Explore ways to manage the airports more easily - take advantage of riding on the transports provided by the airline. Leave more time than you’ll need and make sure to rest. Plan activity for down time in the airplane or airport. Stay by bathroom doors; don’t expect your loved one to find you at a meeting spot. Carry a photo of your loved one with you in case you become separated.
4. Thoughtful gifts for you, the caregiver, can be the gift of someone coming in to spend time with your loved one so you have some free time. Suggest a gift certificate for a cleaning service, a home delivered meal, things that reduce your stress. Gifts for your loved one with dementia could be an ID bracelet (see the Alzheimer’s Association website, Safe Return program), easy clothes to put on and take off (see Alzstore.com) and large puzzles or games. A fun family game for a loved one who retains long term memory is Life Stories which I found on Amazon.com.
I hope some of these ideas help you enjoy the holidays more. During this time of celebration, don’t forget KISS!
If you’d like more guidance, as an ElderPath Consultant, I can meet with you, your family, and your loved one with a Neurocognitive Disorder to provide an assessment, a holistic plan of care, and dementia care coaching if needed. See www.elderpath.net for more information.
Tips on Brain Health
If you were to make 2 decisions this year to maintain or improve your cognitive (brain) health, I would recommend the following:
1. Cardio exercise - walk, run, bike, dance, etc. for 30 minutes 4-5 times a week minimum. There's good research linking cardiovascular health to brain health, reducing the risk of dementia or at least postponing the onset.
2. Build up a cognitive reserve by continuing a variety of mentally stimulating activities - learn a language, play music, sing, do puzzles, play word games, take a different route to work, etc. And enjoy!