Is Your Aging Parent Developing Dementia?

Dementia is a sneaky disease. You may notice your aging parent moves slower, has more wrinkles, and has lost color in their hair. But dementia can be harder to spot in the beginning stages.

My own school-teacher mom was highly organized and independent. In retirement, she continued to read and learn, even becoming adept at oil painting. We weren’t worried when at 76 she moved closer to my sister and me. That is until her canvases and brushes went unused.

I bought her a video player that Christmas, hoping that movie-watching would help shake off her malaise. But the player sat untouched unless I happened to arrive with a movie in hand. Likewise, her microwave sat idle. I didn’t realize that her disinterest in old hobbies or new technology indicated something more insidious: dementia.

However, when Mom became suspicious and paranoid about her neighbors, I realized something was up.

“They can see into my window,” she hissed as she pulled her curtains close. “I’ve seen them looking.” She then elaborated convincingly that she needed a tall fence to block the neighbor’s view.

I figured her irrational fear came from living through the Great Depression when people couldn’t trust banks and kept their money in jars buried in the ground (according to her). So, I built a fence, thinking she’d open her curtains and let sunlight in on those dreary rooms. I didn’t realize that paranoia could be a symptom of dementia.

My sister and I were worried about her increasingly dark moods. Deciding she needed more socialization we talked her into moving to a lively retirement community. Once there, she did make friends and enjoyed social outings, but within a few months, the paranoia returned.

Mom insisted that her money was being taken from her bank account and that items were missing from her safety deposit box. She developed an absurd belief that my brother-in-law was entering her apartment and moving her belongings around or stealing them. Previously adored by her, he was flummoxed and hurt.

The remarkable part of all this is that my sister and I accepted the “new normal”.  We helped her change bank accounts and door locks. Rather than suspecting dementia, we figured it was normal for people to grow strange at advanced ages.

Symptoms of dementia often start slowly. Often, they’re mixed in with periods of rational thinking and behavior. Just when we thought Mom was heading off the deep end, she’d regain clarity, asking us about our spouses and offering up the motherly advice we’d grown up with and trusted.

Relieved, we would gladly forget the odd behavior. In hindsight, I can see the progression of the disorder. But at the time, it snuck in and stole Mom from us without a clue. Well, maybe there were signs that things were amiss, but because we were busy raising our kids and working (and perhaps in a little denial), we didn’t see them until it was too late.

Even so, we took Mom to doctor after doctor, trying to find a cure. Was it low potassium? Could it be a urinary tract infection? Each doctor drew countless pints of blood. Yet none of them identified the culprit as dementia.

Identifying Dementia and Other Mental Problems

Dementia is not normal aging. It is caused by damage to brain cells and affects thinking, behavior, and feelings. The older brain compensates for the lack of memory and begins to act more on impulse. Soon, confusion, delusions, paranoia, and other mental disorders come along for the ride and make the condition even more complicated.

Currently, there is no cure for the wide range of ailments that are considered “dementia”. Medications can hold these disorders in check, but they only slow the progression of the disease. Lifestyle changes, such as dietary and physical exercise, can supplement what medications cannot and may boost your parent’s quality of life.

Dietary changes, like increasing the intake of avocados, blueberries, and turmeric, have been shown through research to slow the cognitive decline brought about by dementia. Exercise has been shown to produce a hormone (Brain-Derived Neurotrophic Factor) known to battle dementia and significantly improve cognition. A 2014 study published in JAMA showed that seniors who exercised frequently had 33% fewer cognitive defects. Magnesium L-Threonate and Lion’s Mane Mushrooms have been shown in scientific studies to raise cognitive ability.

But these aren’t complete solutions.

Dementia Warning Signs

Everyone has unique personality traits. As your parent ages, their quirky idiosyncrasies may increase. Your parent may slowly rely more on you to clean up their messes, straighten their checkbook, or get them out of contracts they’ve signed – as my mom did when she got snookered by a door-to-door salesman selling an earthquake upgrade to her foundation. “He seemed like such a nice man,” she purred. “But I’m sure sorry I signed those papers. It did seem awfully expensive.”

Luckily, I was able to cancel the contract. I knew Mom had a small nest egg for her retirement but how long would it last if she could get so easily duped? Would she bury her money in a jar and forget where?

Dementia – Immediate Action You’ll Need to Take

If you’ve noticed a parent’s strange behavior and they have assets over $35,000, hopefully you’ve already helped them set up a Power of Attorney for Health Care, Durable Power of Attorney, Life and Death Directives, and a good Living Trust. If they have few assets, you may be able to get away with setting up a joint bank account and joint titles, along with a Power of Attorney for Health Care Form so you can be their advocate for healthcare decisions. All these legal actions must be completed while your parent is still competent.

If you haven’t already, get your parent to a doctor for a thorough physical examination. Make sure the doctor checks the potassium level in their blood. Sometimes low potassium can alter memory and cognitive ability. So can low vitamin D.

Bring a list of your parent’s prescription drugs too. Sometimes a combination of two prescription drugs can also lead to cognitive problems.

Memory Field Test for Dementia

Tell the doctor about any memory issues. A memory field test will likely be performed. Your parent may be asked to draw a clock with the hands frozen at specific times. Or comprehension will be determined by mentioning three items your parent will be asked about later. In Mom’s case, the doctor presented three simple items: Elvis, a red Cadillac, and a birthday cake.

Then he went on about what activities he did that weekend. Suddenly, he looked at Mom, changed his tone, and asked, “Who’s the current President?” Mom looked flummoxed but managed to spit out the answer after a few minutes. Then he asked kindly, tilting his head slightly, “What year is it?” Mom couldn’t recall. He then looked concerned and asked, “Who is the Vice President?” She couldn’t answer that one either. Then he delivered the key question: “Now about those three key items that I asked you to remember? What were they?” After a few hints, the doctor spoke like Elvis, “One was a person’s name, thank you very much,” he growled. Thankfully, Mom remembered Elvis but completely forgot the red Cadillac and the birthday cake. My sister and I were shaken that she’d failed such a simple memory test.

The doctor wasn’t surprised but suggested that Mom was just getting old and maybe a little forgetful. My sister persisted, “Can we at least get a CAT scan or an MRI to see if she’s had a stroke?” I’m glad she suggested this because the test revealed that mini-strokes had occurred in Mom’s brain. At this point, we moved forward and asked for a geriatric assessment evaluation.

Geriatric Assessment Evaluation

The geriatric assessment is multidisciplinary and designed to evaluate an older person’s functional ability, physical health, cognition, and mental health. It examines nutrition, vision, hearing, and balance. The geriatric assessment is comprehensive and aids in diagnosing medical conditions, treatments, follow-up plans, and an evaluation of long-term care needs. Best of all, if your parent is on Medicare, as of this writing, the test is free.

The evaluation takes place in a hospital where your parent stays for several days while undergoing physical and psychiatric tests. A team of doctors assesses your parent’s condition, prescribes drugs, and helps you plan for your parent’s future care.  

If your parent is diagnosed with dementia, you’ll no longer have doubts about what is causing their strange behavior. You may still have trouble accepting this new reality and feel an innate sense of loss. It’s hard to accept that the wise one who once took care of you is now completely in your care.

Support Groups for Caregivers and Family Members

Support groups bring together people who are coping with the same situation to share in the laughter and the tears of their experiences. I felt pretty low until I met up with an old friend who shared his experience with his mom, who developed full-blown Alzheimer’s.

He actually laughed when he related how his mom had met a guy at her nursing home and immediately fell in love. The man played piano and when she heard him, she put on her bathing suit and began dancing around to get his attention. She wanted to marry him. At the time, my friend said he was aghast. The potential groom was indigent. My friend’s mom still had assets the family was desperately trying to preserve.

The peacekeeping solution was to plan a pretend wedding. All his siblings gathered and arranged this play-act in the assisted-living home rec room, right down to the decorations and even a wedding cake. Hearing his story made me identify with his pain and laugh at his solution, which felt really good when Mom’s diagnosis seemed so hopeless. We can often find humor and humility in other people’s struggles, especially when dealing with something as complex and confusing as dementia.