Tag: dementia and memory loss

Help with Healthcare is a Great Place to Start

Staying at home has given me a lot of time for Spring Cleaning. I finally went into the last box of my parent’s papers this weekend and found this note from my Mom.

When my parent’s were still coming over for dinners on Friday and we recognized something was amiss, but were unsure what, my Mom asked if I would join her for the annual physical. She had mentioned that they were having trouble keeping up with the medicines and she was worried about my Dad … would I join? This was the note she gave me summarizing all of their medications. I attended and sat quietly and watched as concerns were raised and then mostly dismissed.

Within a year, my mom had a minor stroke and she readily accepted my rides to the doctor. However, this was the beginning of the trouble in some regards. My Mom was in disbelief that she had a stroke, and started to challenge that I was making it up. She began to debate me on the way to the appointments when I would simply report that we were going to see the neurologist. When she asked “why” and I reported it was because of her stroke, she would guffaw in disbelief. At the appointment, she argued with the neurologist. Good times. ; <

I wish I had know about Anosognosia. From the Stroke Connection: “Anosognosia (pronounced an-a-sog-NO-sia) refers to a person’s lack of awareness of their own motor, visual or cognitive deficits. It can happen in people with stroke, traumatic brain injury, multiple sclerosis, Parkinson’s disease, Huntington’s disease and Alzheimer’s disease.”

Looking back, I realize that even just stating that she has a stroke created an emotional response in my Mom that left her feeling like I did not have her best interests. She became very protective of her information and in return, insisted that she could manage her own affairs.

I learned over time that my parent’s responded with emotion to information or events. Any information citing they were unable to manage their own health and welfare pushed them into a defensive mode. If I arrived for a visit stressed, they would absorb my anxiety and we would have a terrible visit.

During this time my siblings and I watched as:

  • Their licenses were revoked and they continued to drive their cars;
  • They failed to pay their bills regularly and ran into issues with water and electricity;
  • Ultimately, their retirement community threatened to kick them out if they would not move from independent into the assisted living community.

I was ready in the wings when it was time to act, but it was more than two years before I was allowed back in to help. When I did re-enter I had learned a lot about how best to support and respond to my parent’s needs.

The current state of affairs may be a bridge that opens to invite you in to help. While many families are isolating themselves from their loved ones to protect them, others are including them in the shelter in place orders.

May you and your family find peace, joy, and common ground on which to move forward. Wished.

Making the Best Choice Medically for Mom & Dad

One of the toughest challenges I faced when caring for loved ones with dementia were the medical choices for non-dementia care issues that erupted and threatened my parent’s well-being.

A recent opinion piece in The Washington Post by an Emergency Room physician titled Doctors are torturing dementia patients at the end of their life. And it’s totally unnecessary illuminates the reality of the choices families face when caring for aging parents.

My family faced these difficult choices twice.

My father in a moderate stage of Alzheimer’s had a tumor on the back of his tongue. Knowing our parents were doing better together than they would alone, and in the hope that we would eliminate the pain my dad was feeling but could not verbalize sent us on a path to try and treat his tumor. After a week of medical visits we saw that our dad was not up for a fight with cancer. We worked to find him some relief through hospice care. Thankfully, his end came quickly.

When my Mom broke her hip in her Memory Care community and ended up in the hospital, I knew the end was near. The recommendation was to perform surgery but that required we lift the Do Not Resuscitate order. My mom no longer knew my name and I wondered if the stress of the trauma resulted in another stroke. I had to repeatedly ask that we let “nature take its course” while the hospital kept trying to certify my mom for surgery. My mom was clear that qualify of life was more important than quantity, and I knew the surgery would be painful and not provide improved quality to the rest of her life. Thankfully, the medical team agreed that she was able to survive surgery and we moved her into hospice care.

I still end up in tears recounting both of these stories, however I know it is important to make sure other families know that it could be one of the greatest acts of love you offer by taking the path of least medical intervention. I’m glad to see Dr. Geoffrey Hosta share his medical insight that reaffirms the choices my family made. At least I know we did our best to honor their end-of-life wishes. Reflected.

Memory Loss is Normal for Older Adults (FALSE) … so WHY get tested?

First, Memory Loss is not normal as we age and is something you should discuss with your primary care physician if you notice it in yourself. There are several reasons why someone may have memory loss and many of them can be reversed. If you don’t pursue testing you will never know if your (or a loved ones) issue can be treated, slowed, reversed.

What is normal is slower processing speed. Our brain processing speed slows down generally at 50, but we should still be able to retrieve the information. If you believe you have short-term memory issues, speak with your primary care physician and request a visit to a neurologist for an evaluation if you don’t find a cause.

Understanding if you have a form of dementia can help you know if there are trials or treatments, as well as better plan for the future. It is also valuable to family members to know if and what form of dementia a relative may be diagnosed with.

I’m writing this as I am waiting for a client who is going through neuropyschological testing right now. Halfway through we shared lunch and she asked why she is bothering with this test since “memory loss is normal in someone my age.” We had a lively conversation around her believe that memory loss was a normal consequence of aging.

When she was losing her checkbook and couldn’t find it, ordering new checks and not recalling that she did it, and sending off money over and over to a friend, I asked her if she recognized she was having some issues with her memory. She said yes and she actually mentioned it to her primary care physician. He recommended she get a blood test, MRI, and neuro-psychological testing.

So here we are.

What I do know is that the testing was invaluable to me as the primary family caregiver for my parents. It helped me better understand the gaps in thinking for their different types of dementia (vascular and Alzheimer’s). I was able to attend the reporting session and what I learned help me realize that I was going to have to change because in all reality, my parent’s thinking was very different than it was previously. How they processed, and even recalled information had changed.

It also helped us understand how long they might live, and the type of care they were going to need.

For me, knowing was better than not knowing. I know everyone is different. Shared.

Use It or Lose It Applies to your Memory Too

I have three clients all with Memory issues that have shown a noticeable uptick in their engagement and activity. Unfortunately, it isn’t all of them so I started to see if there was any patterns that applied to all three.

In the past one to two months, all three of them have had more social engagement. They are all widowed, and live alone. None of them had previously had much social interaction due to giving up car keys, moving into a new community, or even just because for the last year they were giving care to a loved one.

When you visit with them, initially you may not even notice they have any short-term memory issues. However, if you try to have a longer or deeper conversation with them, you quickly recognize they have some memory issues. Due to changing circumstances, all three of them have had a lot more social interaction and I think that has helped them in a variety of ways.

I have noticed it in their activity, spending, and in my direct conversations with them.

Memory loss is not a normal consequence of aging. Our brains still produce new brain cells. However, once we hit 50, there is a slowing down of brain processing which we usually equate to memory loss. Eventually, you should be able to recall information, but it just takes longer.

However, we must remind ourselves that just like muscle-strength, we need to continue using our memory skills and engage in activities that stimulate our brains. It’s why I am afraid of the traditional concept of retirement and am often day-dreaming about how best to age, enjoy life, and stay engaged in meaningful ways that will challenge my brain.

After seeing this anecdotal result, I believe that every person needs to have some form of meaningful social engagement several times a week. For many older adults who want to age in place, managing this if they live alone can be a bigger challenge. In general our friend circle may be smaller and it might be harder to visit if we are no longer driving.

The answer on how to get more social engagement will vary for everyone but most communities have senior and community centers that offer ongoing classes and exercise programs for opportunities to make new friends. However, step one is to help us all recognize that your brain is a use it or lose it muscle we all need to work on continuing to stretch. Witnessed.

If you have a loved one in this situation, can you:
– Find local classes where they might meet a new friend (senior centers, community centers, and community colleges are easy places to start)
– Connect them with a local “village” that works to connect neighbors and offer both social engagement and help around the house
– Encourage them to look at moving to an adult community be it 55+, a condominium or apartment, as well as a Life Care Community
– Look at AARP that often offers a variety of social events in your community — if you are a member you will get mail or you can also download their app that features local events that are usually free
– Have friendly visitors come to the home to take them out or have a lively discussion at home about topics they love.

Learn How to Advocate for your Medical Needs – Healthy Habit #20

iwantanswers

The days of the family doctor are gone. Most doctors are crushed for time as they try to address your needs in what feels like a shrinking time window. The average time physicians are spending with patients is less than 24 minutes. According to The Medscape Physician Compensation Report 2017. Thirty percent of physicians spend 17 – 24 minutes with their patients. That is followed by 29 percent of physicians who are spending between 13 – 16 minutes with patients.

Here is a quick primer on 6 Ways to Be Your Own Health Advocate by Elizabeth Renter. In short, you need to arrive prepared and refuse to leave until you have a diagnosis or next step toward one. You may need to repeat this cycle if your condition persists. 

You have probably noticed that no one seems to do more than glance at the 4 (plus) pages you diligently completed before your appointment. After caring for my parents and navigating a host of doctors with them, I learned to come prepared for each appointment. I could quickly cite their health issues, medicines, and stated the reason for our visit. I learned that if the doctor in front of me could not resolve the issue, I would find a secondary resource to help.

It is now the requirement of every adult to be their own advocate. The healthcare system is unable to do that for you.

When it comes to short-term memory issues (remember this is not a normal consequence of aging) it is important to push to get diagnosed. It could be a side-effect from a medicine — and it can happen with medicines you have taken for years. If you notice a change, bring it up with your primary care physician. Some will do a screening for it, but I recommend you request a referral to a neurologist. Memory issues are not really a primary care physician’s expertise. The earlier you know you have an issue, the earlier YOU can decide how you want to live should it be permanent and should you decline.

This ideal applies to any medical issue that is impacting your quality of life. Push to find a reason and understand how it may impact the rest of your life.

If you know this is not your skillset, or are overwhelmed by other matters, consider a consultation with an Aging Life Care Manager. In minutes they would resolve issues that I failed to unravel in days when it came to caring for my parents. Visit this website to find one located near you.

Can you eventually figure it out? Most likely. I know because before I knew about Aging Life Care Managers, I was working to handle a lot of the issues as the primary family caregiver for my parents. However, I would do anything to have a mulligan and spend that time enjoying my parents’ company instead of fretting over the next medical hurdle to traverse. Wished.

Know Short-Term Memory Loss is NOT a Normal Consequence of Aging – Health Habit 12

totalmemoryworkout

There are many conditions that can cause memory loss and an early diagnosis can make a huge difference for you and your loved ones.

When you dig into the science, short-term memory loss is not a normal consequence of aging. You should consider your brain like you do a muscle and it needs exercise to stay strong.

Our brain processing speed slows down generally at 50, but we should still be able to retrieve the information. If you believe you have short-term memory issues, speak with your primary care physician and request a visit to a neurologist for an evaluation if you don’t find a cause.

In general, we can store from 5-9 pieces of information in our short-term memory. If you want something to stick you need to pay attention and attach meaning to it. Where you distracted when someone was talking to you so you didn’t really hear what they were saying to you?

I’m thankful I still have a child at home so I can see that even she seems to forget things. However, the reality is that she never received the information in the first place, which our modern and distracted lifestyles seem to encourage.

Just know that memory loss is NOT a normal consequence of aging. To learn more about this and find out how to boost your memory and recall get a copy of Dr. Cynthia Green’s Total Memory Workout.

Please don’t believe that memory loss is a consequence of getting older and take the time to learn more about how you can rev up recall. Encouraged.

Break a Habit of Drinking Alcohol #6

drinkinganddementiaOne of my big fears after caring for my parents is that should I lose my short-term memory, I will also lose the ability to know that I have had more than one, or even two drinks.

I have yet to see alcohol on any healthy diet without an asterisk next to it. I’m always intrigued to read interviews with octogenarians (and older) to learn what they chalk up to their healthy aging habits. I swear that a snifter of whiskey or brandy has been in the largest majority of those I have read.

What I do know is that the habit of “quiet hour” honed over 5 decades of marriage became a problem for my parents when they lost their short-term memory. Instead of stopping at one or two drinks, they started to drink more. It was one of the most obvious signs to their adult children that something was different with our parents.

During this period we learned that there is a form of dementia that is a result of alcohol abuse. Drinking and drug use is proven to kill brain cells faster than aging alone. You can learn more about these impacts on this page at the American Addiction Center.

At first we thought my Dad’s quietness and forgetfulness were because of the increased drinking. We later learned that he had Alzheimer’s. Had there been no habit of drinking, we may have gotten to an answer sooner.

During this time, I was able to encourage my parents to purchase Umbrella insurance. I was terrified that their actions could hurt someone and they could lose all of their savings.

If you have a study that shows that alcohol does lead to healthy aging … please share! My belief is that like many things, moderation is the key. My goal is to age without a habit of drinking alcohol. Aspired. 

Follow the Science on How Brains Age – Healthy Habit #2

followthescience

I wanted to understand how I could perhaps better recognize, prepare, and hopefully avoid the fate of my parent’s who both were diagnosed with different forms of dementia. One of the best things I did was to go through the Total Brain Health Certification. I met the founder Dr. Cynthia Green when we both appeared on The Dr. Oz Show.  Her book Total Memory Workout is a great primer on simple ways to maintain brain health and boost your memory.

The reality is that the common belief that “forgetfulness” is a normal sign of aging is false. Our brain processing slows down usually starting in our 50’s but the inability to recall information or short-term memory loss are signs of disease, not a typical reality of aging. But A LOT of people believe it and tell themselves it is normal.

If you understand how your brain ages, as well as how some of the changes in our brains actually make us MORE trusting (and why older adults are easier targets for fraud), you will be better able to plan and put systems in place to safely live well.

If you start to notice changes, you can then talk with your doctor. There are many things you can do if you catch issues early and some of them are entirely reversible.

If you have a loved one who is showing signs of memory loss, I hope you will raise the issue with them. I certainly tried with my parents. My Dad was open to pursue testing and investigate while my Mom shut down the idea that something was amiss. It took several years and many doctors before we found someone who would help us understand what was happening to our parents. Unfortunately, it was too late to do anything … and maybe there was nothing to be done. However, it would have helped if we could have talked through their wishes knowing a diagnosis of memory loss was made.

In the case of your brain health, knowing will afford you a lot more options. Recommended.

Here are a few articles to get you started:

Age-Associated Financial Vulnerability: An Emerging Public Health Issue Annals of Internal Medicine Annals of Internal Medicine – December 1, 2015

Supplements for Brain Health Show No Benefit – a Neurologist Explains a New Study The National Interest – June 28, 2019

Why It’s Easier to Scam the Elderly NPR – December 6, 2012

When our memories fail us.

As I was caring for two parents who had different types of dementia, I started to second guess my own memories. I started to worry that I was already failing cognitively and then I started to notice how often within my own household we would have conflicting memories of an event we had shared. It made me feel better … and worse.

Apparently, many emotional memories we are convinced we remember, turn out to change over time. In a story that ran in The New Yorker titled You Have No Idea What Happened by Maria Konnikova, it’s interesting to learn how our memories fail us … yet how sure we are that our memories are vividly correct.

simpsonchase

As I write this on the 25th anniversary of O.J. Simpson’s famous drive in a white Bronco, my husband asks me if I remember where I was eating. I immediately know where I was. It is a major restaurant chain that I haven’t entered since this night … but it had nothing to do with that car chase.  I’m looking forward to finding out how different my memory is from my hubby’s.

The research shows that “the strength of the central memory seems to make us confident of all of the details when we should only be confident of a few.”  In one study, they actually ask the participants how confident they were of their recall of memories they had recorded two years previously. Five was the highest level and they averaged a 4.17. However, “their memories were vivid, clear—and wrong. There was no relationship at all between confidence and accuracy.” Worse was that when they were told they were mistaken — they just didn’t buy it.

Knowing how fragile memory can be has made me much more sensitive to how it feels to have your ability to remember challenged. No one wants to hear their memory is bad, but we all need to recognize that sometimes our recall may fail us.

As a reminder, memory loss is not a normal consequence of aging. And apparently we all have problems remembering “flashbulb” emotional events in our lives. Humbled.