Make No Assumptions

At one time or another, everyone forgets where they left the car keys, blanks-out on a word or name, or cannot remember why they went to the kitchen. Is our forgetfulness simply the result preoccupation, a “senior moment,” or is it something much worse? 

It’s easy to leap to conclusions. It’s considerably more difficult to take the next step and talk to your family, a close friend, a religious or spiritual advisor, or your doctor about your deepest and darkest worries.

Your family and friends will probably say something non-committal and suggest that you make an appointment to see your doctor. A religious or spiritual advisor will probably have some comforting words and encourage you to speak with your doctor. Your doctor will recommend that you undergo a complete medical exam.

Your medical history comprises the first portion of your exam. Your doctor will ask if you smoke, drink, or have ever had a head injury or a concussion. He or she will want a list of the medications you take and the daily dosage. Your doctor will want to know your surgical history--dates, type and if you experienced complications. 

The doctor will also give you a check-list of various diseases and conditions that you or a close relative may have or have had. Some of these include: diabetes, psychiatric disorders, high blood pressure, migraine headaches, thyroid disease, epilepsy, strokes or heart disease. In other words – come to your appointment prepared with a list of the important information that most people do not remember in sufficient detail.

Next, your doctor will listen to your heart and lungs and then begin the usual prods and pokes. One aspect of your physical exam may be different from the ones you have experienced before. Because you are concerned about memory difficulties, your doctor may administer a series of simple tests to evaluate: your cognitive functions--the ability to think, learn, and remember as well as your executive functions--the ability to plan, organize, strategize, and pay attention to detail. Together the medical history and the physical exam provide the clues your doctor needs to take the most appropriate next steps.

Based on the results of your complete medical exam, your doctor may say “everything looks good.” However, don’t jump to conclusions if your doctor suggests that you undergo further tests. Just try to remember that ruling out Alzheimer Disease or any other of the dozen or so kinds of commonly encountered dementia is difficult. Yes, “it’s easier said than done.”

Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

Having the Conversation

The doctor told me that, “Dementia is the cause for the changes we have all noticed.”

These are sobering words are ones that elicit conversation between loved-ones. The location could be an office where a counselor facilitates productive discussion. Or perhaps the best place is an informal one where coffee and cake creates an atmosphere of comfort and connectedness. 

It’s hard to know where to begin. Some find it easiest let the conversation gradually drift from the weather to the emotional and practical aspects of dementia. Others prefer having the help of counselor to guide productive exchange. 

People in the early stages of dementia may be the one who initiates discussion. He or she may start by addressing their fears of what they face as well as their distress of becoming a burden. He or she may have words to say about choosing the person who they hope will oversee their care as well as express the desire that dementia does not create ill-will between family members. 

His or her thoughts about end-of-life care are another important topic. Here listening maybe more important than discussion. Listen to what he or she has to say about advance directives, comfort (palliative) care and hospice--the last stage of palliative care. 

Conversation among-loved-ones will undoubtedly include more immediate wishes such as enjoying time together, taking bucket-list adventures, and the challenge of the “things I have always wanted to do” list. This is the time to create memories. 

Sometimes families and same-sex couple and their families do not have the luxury of beginning conversation with a diagnosis of early-stage dementia. When this is the case, your loved-one may still have the capability to listen and perhaps make comments. Be sure to acknowledge his or her presence and, as much as is possible, engage them in the discussion.

Speaking with and among loved-ones is an ongoing process. Events occur that require reassessment. Family dynamics may have deteriorated and should be addressed before they worsen. It may be time to talk about the conflicts between personal views about death and dying and your loved-one’s advance directives. Or perhaps reassessment involves orchestrating a family gathering or a final adventure.

Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org