Dementia is a term we’ve associated with aging and memory problems for the past few years.
The truth is that “dementia” is a very broad term that encompasses different causes of memory problems like Alzheimer’s disease, Lewy body dementia and vascular dementia, to name a few.
Symptoms of dementia may start as simple forgetfulness – something as uneventful as misplacing keys or a wallet.
Dementia also progresses slowly, so much so that loved ones may not realize anything is wrong until a major event happens, such as getting into car accidents, getting lost, or leaving the stove or faucet running.
But dementia is not just about forgetfulness.
Oftentimes, higher levels of brain function get affected, and the person can run into trouble doing complex tasks like cooking, doing the laundry or driving, as well as spatial ability and orientation.
Signs to Watch For
When a person has dementia, they can get lost in familiar spaces.
Finding the right words can elude them, making it difficult to carry on conversations.
They may also lose the ability to retain new information, which may irritate loved ones who find themselves repeating the same things over and over.
Their behavior may become erratic, and they may become easily frustrated or more reserved.
Their sleep-wake cycle can get affected so that they are awake the entire night and napping more during the day.
When things get worse, they might have trouble feeding themselves and taking care of their hygiene.
If your loved ones are showing signs of memory problems, it is best to bring this to the attention of their primary care physician (PCP).
Most people who have memory problems won’t even know they have this condition – in fact, a family member or friend most often brings the problem to the physician’s attention – so it is imperative to accompany them to their doctor visits.
The PCP might do some basic memory tests to gauge the patient’s baseline.
Physicians will usually try to order labs to check for reversible causes such as an undiagnosed thyroid pathology or vitamin deficiency. They might also opt to refer your parent to a neurologist or a geriatrician for further evaluation.
Reasons Why Our Memories Fail
Research is ongoing to find out how these things happen.
Is it genetic?
Is it from an early exposure to something toxic or infectious?
There are still many questions that are unanswered, but we do know that certain lifestyle choices and conditions may increase your risk for memory problems. Ask yourself the following:
- Do your parents drink alcoholic beverages? Chronic drinking of alcoholic beverages can lead to certain forms of memory problems.
- Do they smoke or have used certain illicit drugs when they were younger? These can also contribute to the problem.
- Any history of stroke or traumatic brain injury can also cause memory problems later on.
- Were they prescribed new medication before these memory problems started? Was a medication suddenly stopped? Are they taking any food supplements or weight-loss/diet pills recently? Medications can also cause memory problems.
- Patients who were recently sick or underwent hospitalization or surgery can develop delirium, which can present like dementia. Delirium can cause a person to become confused and forgetful, and may cause new behavioral problems that can last up to a year. Your loved one’s physician will evaluate them for this during the exam.
- Was your loved one diagnosed with a chronic disease like Parkinson’s in the past? Some neurologic diseases can present with dementia in the later stages.
Training Your Brain and Other Ways to Prevent Memory Problems
Unfortunately, there are not as many treatment options available as we’d like.
Among the medications on the market, most have been found to delay the progression of the disease in certain individuals.
However, no cure has yet been found.
Some things that have been found to be helpful include socialization, regular exercise and doing mental exercises.
Volunteering and participating in programs like adult daycare can provide an outlet for socialization and interaction with people their own age.
Some institutions in Europe have combined adult daycare and regular daycare to provide interaction between elderly patients and children. These programs have been found to increase a sense of well-being in the elderly patients.
Having pets has also been found to be helpful in controlling behavioral problems, encouraging nutritional intake, providing interaction opportunities, and reducing anxiety and agitation.
Pet ownership is also a great way to exercise, which has been found to improve spatial working memory and maintain physical activity in some adults with cognitive impairment.
Brain games have been shown to be protective of cognitive decline.
Music is also a great tool to promote relaxation in our kupuna with memory problems. Play something that they recall from their younger days. It might stir in them memories of their past that can be good for reminiscing.
Helpful things you as the caretaker can do is keep a regular schedule of activities to prevent confusion.
Also, provide simple instructions when presenting tasks.
Resources for Families and Loved Ones
In patients with severe presentation, caring for them might become very overwhelming. Studies have found that caregiver stress can cause worsening of memory and exacerbation of problematic behaviors.
It is recommended to take breaks to care for yourself, too, in order to provide continuous support to your love ones.
Some facilities offer respite care to give families a break.
If the condition has progressed to the point that you are having a hard time taking care of your loved one, there are institutions that can provide care for several hours during the day.
There are also foster homes, care homes and nursing homes with highly trained staff who can care for your loved ones. This will give you the chance to be the son or daughter again and enjoy their company instead of being the stressed caregiver.
Local chapters of the Alzheimer’s Association are located here in Hawaii to provide regular group teaching sessions and support groups for families.
Click here to learn more about the Aloha chapter, and for more information on resources, support groups and upcoming events.
Your local elderly affairs office is also a good resource that you can take advantage of:
- State of Hawaii Department of Health Executive Office on Aging.
- City and County of Honolulu Elderly Affairs Division.
- County of Kauai Agency on Elderly Affairs.
- Maui County Office on Aging.
- Hawaii County Office on Aging.
The book “The 36-Hour Day: Family Guide to Caring for Persons with Alzheimer’s Disease, Related Dementing Illnesses, and Memory Loss in Later Life” is a good resource for family members with loved ones affected by dementia. It has simple tips and tricks to make your day-to-day experience as a caregiver more fruitful.
If you need more help finding assistance, contact your PCP’s office to schedule an appointment.
Our mission is to create a healthier Hawaii by caring for patients and their families throughout each stage of life.
Published on: May 23, 2019
Dr. Eugene Lao is a family medicine physician at Kauai Medical Clinic who specializes in outpatient medicine and geriatrics. He is certified by the American Academy of Family Physicians and is member of the American Geriatrics Society, the American Medical Association and the Philippine Medical Association.
