I am in the age group where many of my friends are now
dealing with aging parents. Many of the latter have some form of dementia which
complicates not only their health issues but also our ability to help and
support them. “Dementia” does not only refer to memory loss. It also includes
defects in reasoning, decision making, judgment, and language. Keep all of
those factors in mind since there is an interplay between them and the affected
person’s own personality.
One difficulty we face is that our parents often refuse to
acknowledge that they have a problem. They can be very good at covering-up
memory lapses such as joking about them (“if my head wasn't screwed on I swear
I’d forget where I put it”) or even denying they have a problem. Sometimes the
problem can be evident to us and sometimes they’re good at covering up. This is
where I want to take you in this series of blogs: how can you identify dementia
using the other symptoms? What does early, untreated dementia mean to you and
your relationship with your parent? And what can we do about it?
Dementia is not a disease per se but rather a set of symptoms that cause difficulties in any
or all of the following mental capabilities:
1.
Memory
2.
Reasoning
3.
Judgment
4.
Decision Making
5.
Language (not only expressive but importantly,
receptive)
Developing these five areas is what growing up is all about.
Becoming proficient in them is what being an adult is all about. We gain better
judgment because of what we remember that works and does not work. Because of
that judgment, based on our experiences, we become better at reasoning and
decision making, and “decision making” is the active result of reasoning
whether it is in what we say or what we do. In this first part of the series, I
want to focus on language or what we say (“expressive”) and what we understand
others say to us (“receptive”).
Perhaps a better word than language is communication because
only a percentage of what we communicate is auditory while a large part is body
language, voice pitch and rate, and facial expression. For a more detailed explanation, check into
Neuro-Linguistic Programming (see “Recommended Reading” at the bottom of this
page). In a nutshell, what a person hears is not necessarily what we believe we
speak. Older people automatically have a disadvantage since the sense of
hearing naturally worsens as we get older. Secondly, people with dementia have
poorer memories so what they REMEMBER hearing is often not what was said.
Thirdly, there becomes a disconnect between the communication received and that
person’s reasoning, judgment, and decision making. As a result, how they respond (say or do) can
be totally unexpected based on what we spoke to them.
Some people naturally have difficulties with this processing
and it becomes worse with dementia. We have to be careful: is the unexpected
result because of that personality defect, the dementia, or the dementia making
the defect worse? One true example: I have a friend whose mother is naturally
stubborn about going to seek medical attention. As she gets older, she also
needs more help but refuses to believe she has any problems that warrant going
to her physician. She also has early dementia and has become lost several
times. Still refuses help. When he phoned me last he was actually in town from California and the
stress in his voice was undeniable. After helping arrange his mother’s affairs
he suggested that he take her to get medical help the next day. She understood
this to mean that he considered her weak and unable to take care of herself. She
blew up at him and kicked him out of the house.
I think about scenarios like this a lot. Does anyone have
any suggestions on how to handle mom or dad in a situation like this? My own advice
is if there is more than one sibling involved, that they all stick together and
not encourage or enable the demented parent to act on irrational judgments,
reasoning, and decision making. Gently correct, be supportive of reasonable
actions and words, and try not to blame each other or the parent for bubbles in
the road.
Early stage dementia is the best time for medicinal and
nutritional intervention. Get the parent’s doc involved. Consider
gingkobiloba, Omega-3’s, and Vitamin E, all of which have been shown to help dementia
but not necessarily prevent it. Mind exercises are good, too as is exercise and
sleep. Consider getting help with anxiety and depression which often accompany
aging and dementia itself.
