Do I… Do You… Does He… Does She…. Have Dementia?
It is a question that most of us will ask either about ourselves or those we are close to. It is not very often that I find myself speechless. During the question and answer portion of my YouTube lecture made for the Melabev organization, titled “Shh…It’s Dementia,” one of the first questions asked was “What are the signs of Dementia?” Following my hour-long presentation, I was quite taken aback by the simplicity of the question. Isn’t it obvious, I thought? But apparently it was not. The answer to such a simple question, required a very thoughtful response. Of course, there were people watching my presentation who were trying to decide whether they themselves, or perhaps a friend or loved, one was in the initial phases of dementia. I had presumed in error, that the viewers were all caring for someone with this serious condition. For one of the few times in my life, I actually could not immediately wrap my brain around the answers to the question being posed at that moment.
Still, I find myself reflecting on the answer that I should have given, but sadly did not. Sharing these experiences and indicators is indeed important, for clarification, and to get perspective.
There are times when we all forget things. The older we become; the less energy we have to file away certain information for future use. Friends are quick to remind me when I do not remember something important to them, which they shared with me. When our own lives are filled to the brim, we can also forgive ourselves for not remembering to whom we told a specific account, or placing importance on remembering someone else’s family issues.
When observing the behavior of others, there are very real indicators of the onset of dementia. From personal experience, I feel the need to share a few examples with you.
Possibly the most revealing behavior of the onset of dementia, is the repetition of phrases. When spending time with someone who repeats a concept which they find important, over and over, just minutes apart, one should pay attention to this warning sign. If we ourselves are repeating ourselves in this fashion, we will not realize we are doing this, and will need others to mention it to us. Forgetting that we told someone the same information yesterday or last week is quite different. It is the repetition of the same thought, repeatedly, over a short period of time, that is the concerning sign.
Forgetfulness has its degrees of concern. When I walk into a room to get something I need, and upon entering cannot remember what it was that I intended to retrieve, I like everyone, become concerned. When one stands in-place for a few moments, and is able to then recall the item, there is no need to worry.
A family member came to stay with me recently. I adore her. Having loaned her a set of my house keys, within minutes she could not remember where she had put them. She was sure that she must have returned them to me. Her husband helped her to find them. Later that evening she could not locate her cell phone. Her husband used his phone to locate her phone. Most of us have asked someone else to call us so that we can see in which room, we left our phone. It is all a matter of frequency. Repeatedly losing objects of importance is a sign that our memory is not as sharp as it once was.
The same lovely family member invited guests to a dinner party at a restaurant at 7 p.m. She then decided to take a quick nap. Even though she had important plans, and would need a certain amount of time to prepare for the evening, she did not consider the need to set an alarm even though she was very tired and normally would have seen the risk of leaving waking up on time to chance. The result was that her guests arrived at the celebration and she was still asleep. Her husband went to inquire why she was not answering her phone, and found her in a deep sleep. This is an indication that her planning abilities have begun to be impacted. It is all about the decline of brain function.
When you are with someone who forgets what city he/she is in, or where they are in general, this is a serious sign. When you go to an appointment with someone (doctor, lawyer, accountant, etc) and your companion forgets the purpose of that appointment, it is time to be concerned.
My own Hubby would go to a cardiologist appointment and begin discussing his hernia. I was constantly pulling him back to discussions relevant to the areas of the specific doctor’s expertise. When the doctor asks you or your loved one “How are you today?” and the response has nothing to do with one’s medical issues… oops.
People who have the beginnings of dementia, will have certain phrases that they repeat over and over. Their reactions to events may be identical each time as well. The mind begins to cubbyhole certain responses which come to mind when more creative and relevant thoughts are hard to access.
One evening a few years ago, we joined a couple visiting from out of town. The husband was a brilliant, successful lawyer in his day. Over dinner in a fine restaurant, he repeatedly asked me about housing values in the neighborhood where we both reside. Each time he asked the question; he asked with the same enthusiasm and inquisitiveness as the time before. We had already discussed this very issue just minutes before. As it repeated throughout the evening, I knew what was on his horizon. He is now at the end stages of dementia with 24-hour care.
At a meeting where a collection was taken for a charitable contribution in the memory of someone’s grandchild who had been the victim of a terror attack, one of the oldest members saw that her wallet was empty. I asked her if she would like me to loan her the sum. She was grateful. At the next meeting, I asked her if she might have the cash to reimburse me. She was shocked and angered. “I would never borrow money from you!” she responded. There was nothing to be done. It was not important to me, but her aggressive response did leave me quite stunned. It did not bother me that I had donated twice, but I was concerned about her memory.
Another close elderly friend had a habit of agreeing to share the expenses of hosting events with others. She NEVER paid her share. Those with whom she had made the plans, were too embarrassed or kind to force the issue, even though sometimes hundreds of dollars were involved. I often asked those who had been slighted why they did not broach the subject of the reimbursement. They were embarrassed and uncomfortable. The behavior persisted and others were willing to gossip about the repetition, but not address it with her. In truth, they probably should have discussed it with her adult children, but what is done, is done.
A very special friend was the head of a major organization which she had created and funded. She advised me that she wished to make a major contribution to a particular cause, and asked that I introduce her to those who could accept her funds and do good work with them. Meetings were arranged at her home, and many people were invited to participate. She required that written proposals be created. She never concluded anything. For her it was an exercise in hosting, enjoying the guests, with no sense of obligation on her part. Everyone involved was dumbfounded. This same woman had once moved mountains to achieve her goals, was now unable to realize that she had abused the energies and time of others. It happened more than once and I became aware that there was a pattern evolving. It was important to recognize that it was not her intention to use others, but also that we could not allow ourselves to be involved, as she would likely repeat the behavior. From that experience two years ago, she progressed to serious dementia. She now calls me and invites me to her home. She says she will call back to make a plan, but she never does. She calls me an hour later not remembering that we have talked before.
One friend repeated her political wisdom in identical paragraphs each time we were on the telephone. Slick phrases, remembered in their entirety, repeated frequently, each time as if they have never been spoken before, is a classic indicator of approaching dementia. The person making these statements, indeed does not remember saying them before. The listener cannot help but recognize the repetition and the behavior.
Depending on the scope of our social encounters, we may all forget with whom we have shared certain experiences or concerns. Mea culpa! It would be foolish of me to preclude that even my behavior might be indicative of something in the future. But that is not the point of this chapter. Let me elucidate.
We all have a tendency to judge others (whether we admit it or not). Some behaviors that we witness in others are totally unacceptable. In many of the examples mentioned thus far, it was uncomfortable for others to remain in the same close relationships after they felt as if they had been abused. With time and perspective however, when one can look back objectively, we can often see that the actions we abhorred were not really the fault of the individual who we felt was taking advantage of our friendship. Some of those behaviors were not of their own choosing, and not intended to be disrespectful of others.
When awkward situations occur, which make no sense whatsoever, based on the relationships of the past, it is a good time to reflect on what has transpired. It may be possible to see a new pattern of behavior which indicates that dementia or cognitive decline is impinging on the decisions of those we once trusted implicitly. It is in these situations, if we are to be fair, that our forgiveness is in order. How can one be angry with someone whose thought processes are no longer as they once were? Understanding will reap more benefits than our fury.
Once having recognized irrational or unpredictable behavior in others, there are many avenues from which one can select. It is reasonable to remove one’s self from a casual relationship which is upsetting or insulting. It is even more beneficial to speak kindly with a family member about your concerns. They may confirm that their loved one is going through a difficult decline, or they may deny that there is a problem. You will have done your best. They will, in the future, look back on your concern and recognize their own error. It is much more complicated when the behavior is that of a close friend or family member from whom we must not disconnect.
Many of the chapters which I have written for The Dementia Diary address specific situations where my husband could not remember where to meet me, when to meet me, what he had promised to do, where he was, or where I had gone that morning. Cognition decline is multi-faceted. You will find these chapters available at: https://thedementiadiary.com/index.
Most important of all: After having recognized the beginning signs of memory loss and/or cognitive decline in another, there is a need to forgive the behaviors which would normally upset you. It is only after understanding the context of the behavior, and allowing our own selves not to be affected by them, that we can deal with the new reality without damaging ourselves. Our anger at others, injures only ourselves. Our anger at someone with the beginnings of dementia, harms all within earshot.
It is indeed possible that we may see some of the signs I have mentioned in our own behavior. One friend shared with me that her husband would get angry when he had to repeat himself, or when she forgot what he had asked of her. I spoke gently with the husband who acknowledged that he is impatient when his wife isn’t doing as she had promised, even though, intellectually he knows it is not her choice to forget.
A personal confession which I must share with you: This morning I awakened with a terrific idea for a chapter about recognizing the signs of “memory loss and dementia.” I arrived at my computer filled with ideas to share, only to discover I had already written most of this chapter four months ago, and had titled it: “Recognizing and forgiving dementia.” We all forget things, and we all are hopeful that it is just a “glitch!”
Understanding and forgiveness for that which others cannot control is the core imperative in this battle which will save our own mental health, and allow us to be there for those who deeply need us by their side.
