After the shock and disbelief of a dementia diagnosis, it is often painfully clear to family members there had been warning signs.
Maybe mom began misplacing her keys or her purse or here eyeglasses a little more than she normally did.
Maybe dad has, for some reason, become more irritable or paranoid than usual about things going on in the world.
Maybe one of them seems to have lost interest in keeping their house meticulously neat, or cares less for their personal appearance these days.
Carla Wells is an award-winning nurse and educator whose more than 40 years experience includes dealing with older folks whose cognitive skills have begun to fail them. Speaking to the Rotary Club of Corner Brook about dementia, she said it’s these somewhat inconspicuous changes — and more — that families need to be on the lookout for as loved ones grow older.
“It kind of sneaks up on a family or a person, in terms of the changes,” she said. “You look back on subtle changes, then we realize they have been doing that for years but no one ever noticed.”
With the population aging rapidly, the issue of dementia in older people is expected to become a more pressing issue for the health care system in the near future.
While Alzheimer’s disease is perhaps the most commonly known chronic neurodegenerative condition, it is but one specific set of symptoms that falls under the syndrome of dementia. Dementia can also be caused by trauma from a head injury or stroke or from other conditions, such as Parkinson’s disease and other brain disorders.
Some forms of dementia are reversible, such as those caused by infection, drugs, brain tumours, vitamin deficiencies or even constipation, having poor vision or becoming hard of hearing.
Whatever the form of dementia, Wells said a full medical checkup is needed to find out what’s going on. If it is not a reversible form of dementia, then families need to consider taking steps to protect their loved one and others too.
Often, one of the first and most difficult things is to suspend the driving privileges of a person with progressive dementia.
“It is necessary because you don’t want it to be your child that is killed by your father or mother because you didn’t intervene and you let them drive,” she said. “Having someone’s driving licence suspended has to be the hardest thing I’ve ever had to be involved in.”
It is also crucial to make a plan for the person’s health and financial future. Preferably before the person’s condition is too advanced and they still have their wits about them, families should arrange to have power of attorney designated and an advanced health care directive worked out for the time when the person with dementia is incapable of making their own sound choices.
Wells, who currently has a family member with dementia, said she knows just how difficult it can be to deal with all of the issues associated with this diagnosis.
“It’s one thing in your professional life to know about something,” she said. “It’s another, in your personal life, to live with that something.”
Another tough decision comes after a person with dementia has died. Considering a full diagnosis, even for Alzheimer’s disease, cannot be confirmed until after death, Wells encouraged families to consider having an autopsy done to more fully determine the nature of their loved one’s dementia.
Not only would that help further the general understanding of dementia, she said it could also indicate if there were genetic factors others in the family should know about.
She said her family has already decided to have an autopsy done when their loved one dies and it’s not just out of curiosity as to what the condition was.
“We just want to be informed and know if this is something we need to be concerned about,” she said.
- Close to 600,000 Canadians live with dementia of some kind
- 25,000 new cases are diagnosed in Canada every year
- Number of those diagnosed in Canada is expected to exceed 900,000 in the next 15 years
Some warning signs of dementia:
- memory loss that affect day-to-day activities (significant forgetting and not just forgetting where keys are)
- difficulty performing familiar tasks (forgetting familiar recipes or how to knit)
- problems with language (forgetting words or using incorrect words)
- disorientation in time and space (not realizing the season)
- impaired judgment (when making big decisions, driving car)
- problems with abstract thinking (losing the ability to follow abstract concepts)
- changes in mood or behavior (changing from being quiet and mild to being angry, irritable, hyper, paranoid)
- losing initiative (stops caring about how they look, the tidiness of their house, how to do basic life skills like brushing teeth)
Maintaining brain health:
- avoid smoking, alcohol consumption
- be physically active
- track vital numbers (body weight, blood sugar, cholesterol, pressure levels)
- stay connected with regular social interaction
- eat healthy, well-balanced diet
- reduce unnecessary stress
- challenge the brain by doing puzzles, games, learning a new language
- wear protective headgear when engaging in activities that might pose risk of head injury
Source: Carla Wells