Dealing With Dementia: Symptoms You Should Watch Out For

Memory loss is a common problem associated with ageing. But when is memory loss and forgetfulness a cause for concern? Are there signs of Dementia you should watch out for in an elderly person? Experts and caregivers weigh in…

“My father often forgets to shut off the gas after making his morning tea. At first, I thought he was just being forgetful given his 73 years but now the frequency is making me wonder if there’s something more…”

“My mother is very forgetful and tends to forget all her grandchildren’s birthdays. I send her a separate Whatsappp message whenever there is a birthday in the family.”

“Few days back, my father went to the phone to dial his best friend’s number. They speak every morning. That morning he couldn’t remember the number, something that hasn’t changed in the last decade. It’s come back to him now but was worrisome for me and I have been asking him to go for a check up.”

Memory loss is a common problem associated with ageing. “My memory is not what it used to be,” is something we often hear from elders. While forgetfulness could be a normal sign of ageing, memory loss could also be an early sign of Dementia and Alzheimer’s Disease. Alzheimer’s is one of the most common forms of Dementia, which is an umbrella term signifying a decline in memory and other abilities that can hamper a person’s daily life. One of the greatest risk factors for Dementia is age, though memory loss is also a common fall out as people grow older. However, when is memory loss something to worry about? When should families think of approaching a doctor to figure out if there is cause for concern? We spoke to experts like Amrita Patil Pimpale of Echoing Healthy Aging and long time Dementia caregivers who shared some advice on what to watch out for.

Signs That Your Loved One May Need A Checkup

• Increased Forgetfulness: All of us have moments when we have forgotten something. Person’s with Alzheimer’s may forget events that are important and ask for information again and again. “My mother’s forgetfulness is what stood out the most. When I visited her, she would often forget which day had I come, despite having been told the date repeatedly. She would also ask us to repeat conversations, even though these had happened right in front of her,” says Sharvani, caregiver to her mother with late stage Alzheimer’s and Parkinsonism since 2014.

• Misplacing Objects: People with Alzheimer’s may often misplace things or keep things in unexpected places (e.g., house keys in the fridge) and not be able to think back to find them.

• Daily Chores Get Difficult: Difficulty in coping with daily chores or familiar tasks could be another sign. E.g., if they are finding it difficult to finish daily chores such as housework, cooking, etc, something they did at ease earlier, it could be a sign that something is not right, says Pimpale.

• Difficulty in operating familiar objects: Pimpale also adds that people with Alzheimer’smay suddenly find themselves unable to do things they have done before, such as operate a mobile. Often older people do get confused about handling gadgets and may have problems handling something new but if it is a familiar object they have handled earlier with ease, and are unable to now, it is worth looking into.

• Lack of hygiene: A disinterest in personal hygiene could be another sign. In normal ageing, a person may find taking a bath a struggle because of the risk of fall or other physical factors but they are aware of the process of taking a bath. In case of a person with Alzheimer’s, the person does not remember the process and gets confused about what to do next. Hence hygiene often suffers. Lack of poor hygiene could be an indication that there is something wrong that the family needs to address. “My mother’s reluctance to bathe or keep herself clean and well-groomed is what got me worried the most when I would meet her,” says Manisha, a caregiver who lived in another city earlier and only met her mother twice a year.

• Problem solving and calculation difficulties: Difficulty in handling personal finance and banking are often signs that something is amiss, Pimpale adds. Many people find it difficult to handle banking related work, something they may have done with great ease and interest earlier. “Forgetting where the checkbook is kept or not remembering installment dates once a while is fine but very often a person with dementia may struggle to calculate or even forget the name of the bank or branch he has his account in. That is a matter of concern,” she says. Pimpale feels family members should pay attention to such matters and cites the example of an elderly gentleman who withdrew Rs 20,000 from the bank and lost it on his way home, without any memory of how it happened. Her mother’s increasing inability and confusion with finances was also a warning sign for Manisha, who noticed that her normally alert mother suddenly wasn’t able to remember where she had spent her money or how much she had withdrawn from the bank.

• Change in habit & lack of involvement: In some cases, the person may gradually stop doing things they’ve done their entire life. “My mother stopped exercising and listening to music, two things that were extremely important to her,” says Sharvani, who noticed these changes over time and was worried. She also felt her mother was distracted and not as involved in things as she used to be. For instance, her mother was an avid news watcher but as she came closer to the disease, she would just sit and watch, without really being involved in it.

• Communication impairment: In some cases, the person could find it difficult to explain things or communicate what they need. “My mother would start a conversation and get distracted midway or somehow be unable to explain things to us, which added to our worries,” Manisha adds.

Wait For The Right Diagnosis

While these are some possible red flags families could watch out for, Pimpale warns people not to jump to conclusions before thorough tests and check-ups.“Becoming a bit more forgetful does not necessarily mean that you have dementia. Many people notice that their thinking gets a bit slower or their memory becomes a bit less reliable as they get older,” she says, adding that, Depression, Delirium, certain vitamin deficiencies and UTI could have similar symptoms like Dementia. All these conditions are treatable or get better over time whereas dementia is incurable and progressive.

One of the reasons for certain changes could also be attributed to Mild Cognitive Impairment (MCI), which causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer’s or another dementia.

A family’s best bet, according to Pimpale, is to visit a doctor. “Your doctor will evaluate your overall health and identify any conditions that could affect how well your mind is working.” She further adds that, your doctor may refer you to a specialist such as a:

• Neurologist – specializes in diseases of the brain and nervous system

• Psychiatrist – specializes in disorders that affect mood or the way the mind works

• Psychologist – has special training in testing memory and other mental functions

• Geriatrician – specializes in the care of older adults and Alzheimer’s disease

Screening Tests That May Be Needed

There is no single test for dementia. A diagnosis is based on a combination of things:

• Taking a ‘history’ – the doctor talking to the person and someone who knows them well about how their problems developed and how they are now affecting their daily life

• Physical examination and tests (for example, blood tests) to exclude other possible causes of the person’s symptoms.

• Tests of mental abilities (for example, memory, thinking) – simpler tests will be carried out by a nurse or doctor, more specialist tests by a psychologist

• A scan of the brain, if this is needed to make the diagnosis.

In case the family gets a diagnosis of Dementia after following this process, Pimpale wants to mention that it is only just the beginning of the process. “Once the family has found out their loved one has Dementia, they need to seek help from counselors to understand the disease and family members need to seek help and focus on the safety of the person with dementia as well as focus on maintaining their quality of life.” She also feels that it’s important for families to involve more people and let them know that a loved one has dementia. It will not only provide them with much needed support but also help put an end to the stigma.

Experts and Caregivers Spoken To:

Amrita Patil-Pimpale: Amrita Patil Pimpale is a Dementia Care Consultant based in Mumbai. She is founder, lead consultant in Echoing Healthy Ageing, a social enterprise working in Dementia care sector, focusing on home based therapies, counselling & Dementia care training for family carers and professionals. She’s the Winner of Social Entrepreneur ‘Unltd India Award’ for 2012 and 2013. She’s a Certified Trainer of Person centred dementia care from University of Bradford, UK and a Dementia care mapping advance practitioner. She has designed and delivered training for care staff (dementia care), NHS nurses in England and has internationally published research papers on dementia care.

Sharvani Basu: Sharvani is a caregiver to her mother and a communications consultant based in Mumbai. She has been looking after her mother since 2014 and has made significant changes to her personal an professional life to become her parent’s primary caregiver.

Manisha: Manisha is a former banker who moved cities to help and support her family as her mother battles Alzheimer’s Disease. She feels creating a circle of support around you by informing everyone you come in regular contact with about the ailment can take a lot of the load off the primary caregiver.