Tuesday, December 10, 2019

That Sinking Feeling

When I left my job of 12 years, a few of the ladies who had retired wanted to do a"ladies lunch" a time or two a year.  We kept it up for a few years consistently and then it got more inconsistent for the larger group of us as time has passed.  Last year, we finally scheduled one and I told them the only way I would cancel was if my grandma passed away on that day.  We buried her two days before.  I wasn't going to cancel it because I needed something to keep my mind off of the culmination of seven years of suffering our family endured at dementia's hands.

Two of the ladies are in their 70's and one in her 60's now.  It's like lunch with your mom or grandma and nice to have ladies of different ages to commiserate with.  When they asked what I'd been up to and how my grandma was, I told them we'd just buried her two days prior.  They were so empathetic and I didn't think to tell them because it wasn't on the top of my list since I had a eulogy to write.  As we continued with the lunch, something became very apparent to me...one of the women in her 70's was in the early stages of dementia.  I fought back the tears and looked skyward and said "really?  I can't even get an escape at lunch from it for ONE day?  Thanks."  I was so sad when I left.  I know that confusion like she was experiencing can also be the sign of other medical issues so I didn't want to jump to conclusions.  That was 18 months ago and I forgot about it because out of sight out of mind.  Then I got my Christmas card from her and it all flooded back.  We get an email with what we'll be getting from the USPS that day and I saw a scan of the envelope.  There was the telltale slanted scrawl that my grandma got in the beginning.  It's still hard to see those birthday or Christmas cards from her knowing what we know now.

When I opened the card from my friend, instead of having the side of the card filled out with a long recap of her year and her love for the dog, it was a shaky signature of her, her husband's and her dog's name.  It was slanted which is an early sign of cognitive decline.  My heart broke.  I know that dementia is taking her even if she has not formally been diagnosed.  (I don't know that she has or hasn't and how would you begin to bring that up to someone you're not exactly close with?)

How can you tell if someone you know and love may be going through the beginning stages of cognitive decline?  Here are some of the signs to watch for and be ready to have a serious talk.

1)  Memory Loss

Obviously, memory loss is the main symptom most people think of with dementia.  It's more than walking into a room and not remembering why you went in there, which is typical as you age.  This memory loss is more, they can't recall things newly learned.  Say they've moved, they may not be able to remember their new address or how to get to their newer favorite restaurant.  They may rely on planners or post it's to aid their memory much more than before.

2)  Difficulty doing tasks they are familiar with

With my grandma, it was her noodle recipe she made for 60 years or serving an almost raw inside turkey because she didn't turn the oven to the right temperature.  It can be forgetting how to make coffee when they've made it every morning their whole adult lives or forgetting how to get to the hairdresser they've been going to for 25 years.

3)  Not being able to tell time

One of the first tests a neurologist will run on someone suspected to have dementia is the clock face test.  They will have them tell them the time on a clock face.  (IE;  It's 3:40 so draw that on a clock face.)  They will also have them draw a clock face.  Often someone with dementia will put all of the numbers on one side of the clock, skip some or bunch them up very small.  It is imperative you know how to tell time on a clock face and not digitally since this is used as a diagnostic tool!

4)  Misplacing things in odd places

We all lose our keys or that piece of mail on occasion but when you find them in the freezer or fridge or the linen closet, then it's time to consider a doctor's visit.  If you can't find the missing object right away, you could be accused of stealing which leads to...

5)  Paranoia

Many in the early-ish stages misplace things and accuse family or friends of stealing.  They can also get paranoid thinking you are trying to take their money, put them in a home or want what is theirs.  If this happens, they need doctors care immediately.

6)  Isolate themselves

If you have someone who was always on the go, in all kinds of clubs or traveled a lot, you may notice them pulling back from activities they once loved.  If they had a scare with getting lost or not remembering something, they could no longer trust their judgment and be scared to bring it up for fear of the disease or being put in a home.  It's up to their family and friends to keep an eye on those things and talk to them calmly about your concerns.

7)  Personality changes

A person can go from very outgoing or funny to agitated, belligerent, paranoid, and/or fearful.  This can change not only day to day but minute to minute depending on the kind of day they're having.

8)  Can't find the words

My grandma always said "whatchamacallit" but when that and thingamajig became her main forms of communication, the family noticed. We all search for our words from time to time but when you look at an everyday object like a skillet or car and don't know the name for it or can't write the name for it, it's time to see a doctor.

As the holiday season approaches, you may see some of these signs in family or friends you don't see all of the time.  How do you bring this up without ruffling feathers?  If they have children, consider pulling them aside (or emailing/texting them) and ask if everything is okay with their parent.  Note some of the things of concern and you just wanted to make sure they are okay.  It is because two people did this with our family that they went from "wait and see" to "we need to make an appointment."   Your observation could be just the push the family needs to make a decision.  If there are no kids, you could pull them aside and ask if they've been feeling okay, they seemed a little off today.  Don't bring something up in front of other people where they may feel embarrassed or ashamed and get defensive.  Just express your concern in a kind, compassionate way and you could say you just made your doctor's appointments for the year and you want to make sure they're taking care of their health too.

It's never easy to come to terms that someone you love may be suffering from cognitive decline but putting your head in the sand delays treatment which allows them to slip away quickly.  Knowing the signs could give you more time with the people you know and love.
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  1. This is good information for anyone to have. You don't always have to be a family member to notice these things in someone else. As much as it can be a dilemma to be in a situation where you might need to say something, I personally would prefer someone point it out to me knowing it could lead to catching something earlier.

  2. I see this every day in my work life and it's incredibly hard to watch certain declines, while still trying to celebrate "the good days." My uncle had Alzheimer's and it was devastating to see what he and his family suffered through for over ten years. We found tremendous help utilizing our local Alzheimer's Association, that was extremely helpful for caregivers, the "do's and don'ts,", etc. My friend is in the worst of it right now with her husband and we talk constantly because she's incredibly overwhelmed. She fully admits she's buried her head in the sand for years about a lot of things, and now is thrown into having to learn it all, from house stuff, to bills, to pumping her gas for the first time in her life, to 24/7 care of her husband. He couldn't find her in the house the other day, so he literally ripped the baby gate out of the wall by the stairs to go search for her. I've known this man since I was a little girl, so it's heartbreaking to see where he is at now. It's an insidious disease that affects every single person, be it family, friend, co-worker, etc. Just awful.


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