Q&A: #107

Confusion and Memory Loss
By Carol Abaya, M.A.

Question:  My husband, 71, has been diagnosed with senile dementia (not Alzheimer's) and his behavior is becoming more erratic and aggressive.  He gets very frustrated that he can’t remember how to do simple things.  My daughter and I are upset, and we don’t want to put him in a nursing home.

Answer: There is no one “right way” to care for someone with dementia.  But there are some excellent books that provide coping TIPS.

Remember that your husband cannot change his condition (unless the dementia is medicine or thyroid induced).  So you and your daughter must be flexible and try new methods of handling him.

Simplifying the home environment and daily routine can lessen his frustration.  If he can’t remember how to make a cup of coffee, for example, heat up the water and let him put the coffee into the cup.  Same technique if he can’t remember how to brush his teeth.  Put the toothpaste on the brush and then give it to him.

Your area Alzheimer’s association or a support group at your local hospital can help you.

If he is physically aggressive, talk to your doctor about medication.

In the long run, and if he becomes uncontrollable or bedridden, it may be best for everyone -- especially you and your daughter -- to find an appropriate assisted living or nursing home.

Remember that he is not going to get better and things may only get worse.  While this is very hard for you emotionally, you do need to accept reality.

Do what you can do comfortably; seek help; take time out for yourself every day.

Question:  My sister, 70, is very forgetful and recently started asking the same question over and over again.  Is this Alzheimer’s?

Answer:  Only a thorough geriatric medical exam can determine whether your sister might have Alzheimer’s.  There’s still no way of really saying, except by an autopsy.

Everyone has times when they are forgetful, have trouble finding the word they want to say, or ask the same question again.

When signs like these begin to affect every day life, and a person’s ability to care for self decreases, there might be a medical problem that needs identification and can be successfully treated.

Short term memory is usually the first to go.  So, be more patient -- and have her get a thorough examination.

Question:  Caring for my 76 year old father has increased my stress level to the breaking point.  I need something to help me, but don’t like to take drugs.  I’ve read that certain natural herbs are better than drugs, and they don’t have the bad reactions some drugs have.

Answer: While many herbs may be safe and beneficial, others may be toxic, even deadly.  Negative reactions can occur from herbs as well as prescription medicines.  You need to research the herb and its potential side effects.

Even more important, you need to get help in caring for your father -- don’t try to do it all yourself. No one is superwoman.  Make sure you find time every day for yourself.  And learn to say “no” if your father can do a task himself.

Question:   My mother’s memory is terrible.  She (79) remembers very little in relation to her daily activities.  The other day she told me that she hadn’t eaten for days and she was starving.  I know she ate because my son took her out to her favorite restaurant.  Her doctor says, “It’s just old age.”  I’m afraid it may be Alzheimer’s.  Is there anything we can do?

Answer:  First, find another doctor; one with geriatric credentials and a better understanding of the aging process.  Old age does not automatically trigger memory loss!

Second, some memory loss and certain forms of dementia can be prevented and reversed when they do occur.

Third, symptoms of senile dementia and Alzheimer’s are similar.  A person may hallucinate, be confused, have profound memory loss, may withdraw from society and be unable to cope with even simple everyday chores

But there are many conditions that can cause similar reactions but are not Alzheimer’s.

Memory loss and dementia may be the result of:

  • clinical depression
  • fluid imbalance
  • misuse of medications or adverse reactions
  • malnutrition
  • low blood sugar
  • small strokes (TIAs)
  • poor blood circulation
  • hypothyroidism
  • head injuries

Clinical depression: Can be triggered by losses, including that of a spouse, one’s independence, driving privileges or home.  Depression is the number one cause of reversible memory loss in seniors.  A combination of anti-depressant drugs and counseling help.

Fluid imbalance:  too much or little water in the body can cause confusion.  Many seniors do not drink enough and become dehydrated.

Misuse of drugs:  Seniors taking too much medication or the wrong drugs may suffer from metabolic dementia.  The drugs most often abused, intentionally or not, are sedatives such as valium,  other tranquilizers and sleeping pills.  When misused, the drugs become toxic to the body and cannot be metabolized properly, thus resulting in dementia.

Malnutrition:  Older people may have stopped cooking, and the lack of B-complex vitamins and well-balanced meals can result in mental fuzziness and memory loss.  The B vitamin closely linked to memory loss is B-12, found in meat, shell fish, eggs and dairy foods.  Seniors may avoid these due to their cost or the difficulty of chewing meat.  Others become malnourished because medication has lowered their appetite level.

Low blood sugar:  Can cause memory problems in almost anyone, regardless of age.  If a senior is diabetic and taking insulin,  malnurishment can cause a hypo-insulin state.

Small strokes (TIAs):  With physical therapy, memory loss and/or confusion can often be successfully treated.

Poor blood circulation:  anemia and lung and heart diseases, anything that interferes with the amount of oxygen going to the brain can result in memory impairment.

Hypothyroidism:  Lowered metabolic function as a result of thyroid problems can result in memory loss and is treatable with drugs

Head injury:  Head trauma, a blood clot on the brain, can cause memory loss and confusion.

Depending on the cause, such loss may be reversible.

Consult a geriatric physician and have him test for the conditions noted above.

Question:  My father, 77, moved in with us three months ago.  He keeps repeating stories about his World War II experiences and the “fish that got away.”  We’re all sick and tired of listening to them, and my children are becoming rude to him.  How can we stop him?

Answer:  Three things are happening here. First your father obviously has problems with his short term memory.  He doesn’t remember he already told you the story.

Second, he feels a need to validate himself as a human being with a purpose and needed role in life.  So he is going back to the past.

Third, he is trying to build a new relationship with you and your family.  This is his way of communicating with you.

There is little you can do to restore his memory or confusion unless it is caused by  thyroid problems and/or medications. Then the problem may be alleviated.  He should have a thorough geriatric workup.

In relation to his need to validate himself and develop new bonds there is a lot you can do.

He seems to enjoy talking and being with other people.  Look for a senior center in your area or other activities he can participate in.  Then he can share his experiences with others, who undoubtedly had similar ones.

One time I was taking pictures for an article at a nursing home that had adopted a dog and cat.  As the dog sat near one woman, who was scratching her (the dog’s) ears, others joined in exchanging stories about their pets from years past.  They had a marvelous time.

It is important  that you acknowledge  your father is talking to you.  In the case of World War II stories, you might say, “I’ve always enjoyed hearing these stories.  Next time when so-and-so comes to visit you, you should exchange experiences.”  And then divert his attention to something else.

Question:  My mother, 90, keeps repeating the same things over and over again.  I’m going crazy listening to these same statements every time I visit her.  Why is she doing this?  It has to be obvious I get upset every visit.

Answer:  Many times repeating the same thing is the result of memory loss, a physical or cognitive impairment.  Most elderly people are not repetitive deliberately.  They just get stuck in one thought.

Repeating the same thing is also a way to get attention — even if it is negative attention.  Your mother may need to feel she is still important.

Acknowledge that you heard her.  Clearly say that you understand her concerns or whatever.  By repeating what you heard, you show her you listened, understood what she said, and are respecting her thoughts.  You thereby increase her own comfort level.   Then divert her attention to something else.

Make sure medications are not causing the problem.     

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