By Shannon Martin
Shannon Martin has a Master’s in Social Work and a Gerontology Graduate Certification. She has worked for over 20 years with older people and their families, in care homes, hospices, and with a care management company. In recent years, Shannon has moved more into an educational and communications role and started her own company, Style & Substance Communications. After falling in love with Spain on some short stays, Shannon and her husband always dreamed of retiring to Spain. After many years in Shanghai, China, their dream came true in October 2020. Shannon is enjoying all that Valencia has to offer and continuing to work through the challenge of improving her Spanish. Shannon enjoys traveling, food, books, podcasts, and volunteering with the Friendline.
The first thing to understand on this topic is a little bit about terminology. What do we mean by dementia? Is it different from Alzheimer’s Disease?
Dementia is a broad term used to describe symptoms such as memory loss, impaired cognitive functioning and changes in thinking and functioning. Dementia is not a specific disease but more of an umbrella term, which can be caused by several different diseases (such as Alzheimer’s).
Types of Dementia
Alzheimer’s disease is the most common type of dementia. Many other types affect smaller numbers of people, with an overview shown below. The various types of dementia share many similar symptoms but tend to have slightly different patterns or presentation.
*Image courtesy of The Alzheimer’s Association (www.alz.org)
Many people have a blend of types of dementia. There is currently no cure for these progressive forms of dementia. The treatment plan will be based on the person’s symptoms and condition and will often change over time, as will their care and safety needs.
However, there are occasionally cases where dementia is caused by something reversible. Therefore, it is important to get a thorough health checkup if you spot the symptoms. First, you want to be sure it is not something that could be treated and reversed. Second, knowing what is happening allows for better planning and can prevent unnecessary crises and stress.
Some potentially reversible causes of these symptoms include Vitamin B12 deficiency, thyroid problems, infections, brain tumor or brain injuries, medications, alcohol and substance misuse, and even depression.
Is it Dementia or Just Part of Getting Older? Questions to Ask:
1. Is the person experiencing more frequent memory problems, especially difficulty with forgetting recently learned information?
It is normal to forget names or appointments occasionally. However, a person with dementia begins to forget more often and cannot recall the information later. They will often forget entire experiences and repeat questions or stories often in a short timeframe. Their memory issues become disruptive to daily living.
2. Is my loved one having difficulty performing familiar tasks? People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, making an appointment, playing a game or even getting bathed and dressed.
It’s normal to forget why you came into a room or what you planned to say from time to time.
3. Do I notice the person is having problems with language, forgetting words and/or becoming withdrawn in conversations? People with Alzheimer’s disease and other dementias often forget simple words or substitute unusual words. They may be unable to think of the word for toothbrush, for example, and refer to it as “that mouth stick” or otherwise oddly describe it. You’ll often start to notice when this happens more than once in a conversation. You may just notice the person talks much less than usual and looks to others to speak on their behalf.
It’s completely normal to occasionally have trouble finding the right word in the moment.
4. Are they sometimes disoriented? People with dementia can become lost easily, forget where they are and how they got there, and not know how to get back home. They may yearn to “go home” when they are at home, perhaps thinking of where they grew up or simply sensing their own disorientation. They often experience confusion about time also, not knowing the day, time of day, or even month or year.
We all may forget what day it is on occasion, but it would be unusual not to know the season or year. Anyone can take a wrong turn occasionally, but most of us can find our way back on our own or can ask for and follow directions. However, getting lost and being unable to find your way back (or use tools to do so), especially from routine places, is a cause for concern. For people with a dementia diagnosis, this typically gets progressively worse. Therefore, they may seem to be doing fine driving to familiar places, but at some point, that will be more than they can handle.
5. Is my loved one showing poor judgment? Those with dementia may lose their normal sense of judgment, from how to dress or act appropriately in regular situations to giving money away or doing things that are unsafe.
One lapse of judgment or debatable decision does not necessarily indicate a problem. And, of course, we don’t all have the same sense of judgment as a baseline. However, with dementia, you will likely notice a significant departure from the person’s typical behaviors.
6. Are they having trouble with abstract thinking or mental tasks that require several steps? People with Alzheimer’s disease and other dementias will start to experience difficulty with complex mental tasks. This is why many people with dementia have trouble managing their finances and paying bills or can no longer manage a household, where they were once competent and fastidious. Dementia makes it difficult to follow the steps involved in many tasks or to solve problems.
7. Have they been losing things lately? A person with dementia may put things in unusual places and will have difficulty retracing their steps to find things they have misplaced.
Don’t worry if you or your loved one occasionally misplaces your keys or wallet. The concern comes when it becomes a consistent problem and when one cannot track things down. A person with dementia has difficulty remembering the usual places to put things so this often starts to affect functioning. For example, they may put frozen food in a drawer or leave their groceries outside and completely forget.
8. Is the person’s mood or behaviour significantly different? Someone with dementia may show rapid mood swings and not seem to be in control of their emotions.
It’s normal to occasionally feel sad or moody. And, since the symptoms of depression and dementia can be hard to distinguish in elders, the diagnostic process if quite important. In fact, many elders experience confusion, pain, and other less known symptoms of depression. Therefore, depression is underdiagnosed.
9. Does your loved one seem to almost have a different personality? Because of all the changes in the brain and the accompanying emotions this brings, someone suffering from dementia can come across as extremely agitated, suspicious, fearful or dependent.
We all go through changes at different points in life, but personality is relatively stable. When you know someone well, you will notice something is amiss.
10. Has the person lost initiative and become apathetic? A person with Alzheimer’s or other dementias may become quite passive, sleeping more than usual and losing interest in normal activities or even basic routines.
It’s normal to occasionally feel weary of work or social obligations. This is another symptom which might indicate either dementia or depression.
So, what should you do now? If you’re just noticing some problems, observe and take notes on what you see. It is important to seek professional help. Early diagnosis of Alzheimer’s disease or other disorders causing dementia is an important step to getting appropriate treatment, care and support.
Many healthy people are less able to remember certain kinds of information as they get older. The symptoms of progressive dementias are much more severe than simple memory lapses.
Age in Spain Dementia Awareness Week: If you are currently facing urgent issues relating to dementia we urge you to seek help through your doctor, local social services or local voluntary organisations.