Are you gathering with families this holiday season? Maybe it’s been a long time since you’ve seen your parents or relatives in person. If you’ve noticed some changes in your mother or father, or anyone you love, you might have more than just a festive reunion on your mind. You may be wondering if the differences you’ve noticed are significant, like early Alzheimer’s or if it’s just normal aging. And if there is something more, how do you approach the conversation?
The first goal is to tell the difference between normal forgetfulness that comes with aging and early signs of dementia. Teepa Snow of Positive Approach to Care offers a helpful rule of thumb: forgetfulness due to aging progresses at a rate of about 1% per year. If the changes you’ve noticed seem to be moving faster than that, Alzheimer’s or some other form of dementia needs to be considered. This brochure lists early signs of Alzheimer’s.
There are also some similar signs that could simply be due to aging. The common theme that distinguishes normal forgetfulness from the first signs of dementia is this: a person who has normal forgetfulness associated with aging is able to course correct eventually. For example, they might make a mistake in their checkbook but be able to find and fix it later. They might think briefly that it’s Wednesday when it’s actually Thursday but then realize their error. Or they might have trouble thinking of the right word or the name of an acquaintance—but then remember it later. They might skip a social occasion out of fatigue here and there but not withdraw permanently from activities they used to enjoy. Or you might see they’ve made a questionable decision, but you still have the sense that their judgment in general is sound. A person with normal age-related forgetfulness will misplace items but usually be able to find them by retracing their steps.
Dementia, on the other hand, is forgetfulness that disrupts daily life. A good indicator to look out for is simple tasks that your loved one used to be able to do easily and sometimes can’t do at all now. For example, normal aging might take the edge off your father’s magical ability to find his way to places he’s never been before, but if he is getting lost on his way to his favorite grocery store—or finding himself somewhere with no memory of how he arrived—that is a sign of something more than age-related forgetfulness. Similarly, it is normal for an older person to become irritable when their routine is disrupted, but a change in their whole personality, and not just a temporary mood, is a matter of concern.
If you think your parent or a loved one might have dementia, there are two things to consider: your own reaction and theirs. This will surely be an emotional time for you, but try not to jump to conclusions. Understand that there are many kinds of dementia, and some of them are quite treatable. Also know that the progression rate of dementia can vary widely. Don’t try to form a whole picture of the future in your mind all at once.
If you are sure that the changes you’re seeing are a matter of concern, your next objective is to have a talk with your loved one. Here are some tips for this important conversation:
The next step is to come up with an action plan together: probably a visit to the doctor. Remember that even if you’re sure you’re seeing signs of dementia, you don’t know the cause—the doctor will begin by ruling out conditions with relatively simple assessment and treatments like vitamin deficiencies, medication side effects, or thyroid imbalances. If you remember not to jump to conclusions yourself, you’ll be able to speak more reassuringly to your parent.
Coming home for the holidays can be emotional under the best of circumstances because it brings up so many memories, good and bad. If you have worries about your parents’ memory, you may find these emotions overwhelming. Having a simple plan of action is a good way to reassure yourself—so that you can pass on that “we’ve got this!” attitude to the ones you love.