Dementia in Elderly Mother?

<p>Until a couple of months ago, my 88-year-old mother was mentally sharp as a tack. We've noticed since then that she's having problems with memory, initiative, following written instructions, and some behavior changes. I'm not looking for a diagnosis here, but I do have a couple of questions:</p>

<ol>
<li><p>I'd like to take Mom to see her doctor about this, but I'm not sure how to bring up this very sensitive subject. I'd appreciate ideas about how to have that conversation.</p></li>
<li><p>I've seen the ads for Alzheimer's medication. Has anyone's aging seniors had experience with these new drugs?</p></li>
</ol>

<p>Thanks.</p>

<p>Have you discussed it with her at all? There's a good chance she knows that she's having issues and is concerned about it herself. If so, she'd probably welcome having her kid help her by seeing a doc with her. </p>

<p>Don't assume she has alzheimer's. There are multitudes of other things that can cause these symptoms including being dehydrated, not taking her meds properly or taking her meds with things like sleeping aids which can throw her out of whack, she may have had a stroke, kidney issues, etc. She needs to see a doc about this, have some tests done, and see what the actual problem is.</p>

<p>Thanks. Right, I know there can be all kinds of reasons for cognitive impairment besides Alzheimers. I haven't discussed it with her; I'm scared to bring it up. :( Dad has had some kind of dementia for several years, and she really hates it. I'm sure she's noticed she has a problem, and is probably terrified that she's becoming like him. That's why I want to talk to her, but also why I feel like I want to handle it well. I don't know how to broach the subject without hurting or scaring her.</p>

<p>I am sure others have better ideas but here are my thoughts. </p>

<p>When you broach the subject, maybe frame it around how "she hasnt been herself" and ask if she notices it too. </p>

<p>And maybe you could try to look up and have in your mind other- treatable and less threatening- explanations for the changes you see. No point in worrying her needlessly and possibly jumping to the Alzheimers (or dementia) conclusion. For example, it could be related to her medications or other physical issues she already has (google them to look at side effects). Such as a change in thyroid function or blood pressure or depression (as examples, not that I'd know these would be legit explanations!). Then it would give you something more positive and specific to focus on when you bring it up and the reason to see the doctor about it. </p>

<p>Was also thinking maybe focus around the symptoms you see that are less likely to evoke the dementia possibility (again because it would be so much more scary and would be great if she didn't have to worry until you had something definitive). So maybe around her initiative, rather than say memory or following written instructions (though if she's been through this with a spouse I imagine she's pretty savvy about all that dementia involves). </p>

<p>Wishing you the best with this!</p>

<p>
[quote]
I've seen the ads for Alzheimer's medication. Has anyone's aging seniors had experience with these new drugs?

[/quote]

My mother has Alzheimer's. The drugs namenda and aricept are prescribed for this condition, but only delay the progression very minimally.</p>

<p>I don't know where you live, but my mom was diagnosed at the Alzheimer's Disease Center at NYU following several days of outpatient testing.</p>

<p>Edited to add: Here's a link for a listing of all the Alzheimer's Disease Centers sponsored by the NIH.
<a href="http://www.nia.nih.gov/alzheimers/alzheimers-disease-research-centers%5B/url%5D"&gt;http://www.nia.nih.gov/alzheimers/alzheimers-disease-research-centers&lt;/a&gt;&lt;/p>

<p>Again, as said above, this may well not be Alzheimer's but since you asked about that, thought I would provide the link.</p>

<p>There are so many things that can cause dementia like symptoms other than Alzheimers. Is she your father's primary caretaker, is he still at home with her? If so, do you think she is possibly depressed and/or anxious. Being a caregiver for someone with dementia is very stressful as I am sure you know.</p>

<p>Does your mom see her doctor on a regular basis? Do you take her to the doctor and does she allow you to know any of the information she shares with her doctor? You could call the doctor before she goes next time and tell the doctor what you are seeing. If your mother has not given the doctor permission to talk to you, he/she will not be able to respond but at least the doctor would be aware of your concerns and would hopefully try and find out what your mother is thinking regarding the problems you are seeing. Hopefully, her doctor is experienced with elderly people since many of the health problems seen in the elderly are largely unique to this age group.</p>

<p>My mother first showed signs of dementia five years ago, when she was 74.</p>

<p>Although it was apparent to all of us that she was not well, neither my father nor my mother ever said anything about it. My brother and I debated whether to directly ask my father. I finally decided against it. There were a number of reasons for this: I knew my mother was under regular medical care, my parents live in a retirement community with an Alzheimer's unit, so there was not a need to determine how to plan for my mother's care, and my father had made it clear that he wasn't interested in discussing the subject.</p>

<p>Although she stills lives at home with my father, my mother is now at the point where she no longer recognizes me. On my last visit, my father told me that my mother had never acknowledged (or perhaps noticed) that she had dementia. Now I understand why they never talked about it -- it would have meant telling my mother as well.</p>

<p>Does your mother live alone?</p>

<p>Sorry to read about it, LasMa. The other posters are correct - there are so many causes of memory impairment in seniors. If she's had a series of small strokes, the outlook and treatment are quite different than if she has developed Alzheimers. I work with seniors, including a man whose memory loss was quite noticeable. He was on Aricept, which was ineffective. Then one day his wife noticed the unmistakable symptoms of a slight stroke. When tests confirmed that he'd had several, his MD immediately changed his treatment, and the recovery was remarkable. </p>

<p>I can understand your hesitation in bringing this up. Every senior dreads the possibility of dementia, especially one who knows firsthand how devastating it can be. I really like starbright's sensitive way of raising the issue. A visit to her MD doesn't have to mean confirming a worst-case scenario. Wishing all of you luck.</p>

<p>I would open the question by asking her if she had any concerns. Then go from there. If she says no, then say I have noticed..... this depends on your read on her mood.
My MIL has this and she was recently diagnosed with Lyme disease which had progressed to affect her memory before it was incidentally found. She was on aricept but stopped taking it as it made her feel"funny, dizzy and nauseated. the substitute was no better. However they put her on a patch and she tolerates this well. dont know about the results yet as time will tell. However as many of that generation think she doesnt believe in taking anything for the mind so it gets tricky. She also gets upset when you remind her that she has already said something. so we just act like we are hearing it for the first time. I know on a smaller level, my experiences with chemo brain and being forgetful and not recalling things is really distressful. Best wishes</p>

<p>This abrupt onset as described is one that bears investigation, as you know. Small strokes can cause similar symptoms, as can medication interactions, etc. Some elders show cognitive changes with infections (including asymptomatic urinary track infections revealed only by culture) and viruses. All of that makes talking about it easier. Agree that asking her how she is perceiving things may help get the conversation going. I would be on this quickly, so that if there is something to be done, the problems can be addressed quickly. Best with this.</p>

<p>I like what others have said. Broach the issue as general concern, feel her out and try to get her to allow you to accompany her to the doctor.</p>

<p>My father has been on Aricept for years at my mother's insistence. :rolleyes: He doesn't have Alzheimer's, but they have Tricare for insurance so the meds are cheap. I have tried to explain to my mom the difference between Alzheimer's and regular old dementia, but she'll have nothing of it.</p>

<p>
[quote]
This abrupt onset as described is one that bears investigation, as you know.

[/quote]
</p>

<p>I agree. My understanding and experience with relatives with dementia (including Alzheimers) is it generally comes on slowly...so slowly that it often goes unrecognized by loved ones for a very long time. Going from sharp as a tack to the types of problems you are describing in a few months may suggest something other than dementia although there are a number of forms of dementia.</p>

<p>I like the 'you don't seem like yourself' statement and then add 'so I've made us an appointment with your doctor for Monday.'</p>

<p>My husband and I are beginning to see signs of something in my MIL (she's 75). It's very subtle but real. Not just your run of the mill forgetfulness. It's more along the lines of forgetting major pieces of information and then acting as if she had never heard it before. For example, my husband has been a licensed stockbroker for about 15 years. He does a lot of her investment work. My husband was having a conversation with her the other day about investing and when my husband said 'Mom, you know I'm a stockbroker, also' she replied, 'Oh, I didn't know that. How nice for you." My husband was quite disturbed. We're seeing more and more of this but in between she seems quite normal.</p>

<p>
[quote]
I have tried to explain to my mom the difference between Alzheimer's and regular old dementia.

[/quote]
</p>

<p>Actually it is impossible to know for sure if a person has Alzheimer's until after an autopsy.</p>

<p>^ Wow, is this true Fenrock? My mom had such a battery of tests when she was first diagnosed and they seemed so confident that she had a particular type of dementia that was not Alzheimers. We were assured by this as they said her dementia would not have the same decline as one would expect with Alzheimers (and consistent with that, her functioning is about the same as five years ago when she was diagnosed). But I just accepted it at face value at the time and it never occurred to me until now that it could be otherwise.</p>

<p>I think that other forms of dementia can be diagnosed (for example, vascular dementia) but not Alzheimer's.</p>

<p>Generally they rule out other possible causes, and consider it Alzheimer's if the symptoms fit.</p>

<p>My MIL has short term memory issues and FIL is quite worried, all the time, about this worsening. He had their doctor administer a baseline test for each of them, in the way athletes do it pre-concussion. That was there is something to compare to in terms of the conditions progress. You might consider contacting her Doc and asking him to suggest a baseline test in a routine manner?</p>

<p>I think the medical and well-being concerns for her have to override any delicacy is raising the issue with her - not any different than if she was suddenly unable to walk or was bleeding from somewhere - it's a medical question. You can emphasize that when you discuss it with her. </p>

<p>If she has a chemical imbalance in her blood, which can have a number of causes, it can easily cause the symptoms she's experiencing and if it's not taken care of readily can have much more dire consequences. The chemical imbalance can be caused by kidney issues, liver issues, certain cancers, and even dehydration. An imbalance can be detected through a blood test and urinalysis and many of these issues can be treated. </p>

<p>If she had a stroke that's causing it that can be treated as well including going on meds to attempt to prevent future strokes. She may also have a blockage reducing blood flow to the brain. Again, this needs to be treated right away.</p>

<p>Once you raise this with her and offer to help her get in to see a doc you may find that she's actually relieved that it's being addressed.</p>

<p>One important note - docs regularly see elderly patients who do have Alzheimer's and various degrees of dementia and sometimes all too readily dismiss the symptoms to that and can skip considering other causes. They only see the patient for a couple minutes at a time but you know far more about her state. Other posters indicated instances of this and I've seen it as well. This is where you need to be assertive with the doc and explain that this is something that was a rapid decline in a very short time frame and that you think there may be some other cause to this. Make sure they do a blood test and urinalysis test.</p>

<p>I just remembered an article I saw in the NY Times a few weeks ago. Not trying to diagnose your mom but it does bring up the point that dementia like symptoms can be caused by a variety of things:</p>

<p>"It Could Be Old Age, or It Could Be Low B12"</p>

<p><a href="http://www.nytimes.com/2011/11/29/health/vitamin-b12-deficiency-can-cause-symptoms-that-mimic-aging.html?_r=1&scp=1&sq=b12%20aging&st=cse%5B/url%5D"&gt;http://www.nytimes.com/2011/11/29/health/vitamin-b12-deficiency-can-cause-symptoms-that-mimic-aging.html?_r=1&scp=1&sq=b12%20aging&st=cse&lt;/a&gt;&lt;/p>

<p>^^I was just going to mention that very article!!
Start her on 2000 mg of B 12- taken with food, and see if that starts to make a difference!</p>