Elders can be adept at covering memory problems
by Carol Bradley Bursack, Editor-in-Chief
"They finish each other's sentences." How often have you heard that said about a happily married couple? This is generally considered a tribute to their harmony. However, when long married couples do this automatically, it can gradually expand into filling in for memory gaps and even doing tasks the other spouse forgets or can no longer successfully complete.
Often, this is not a conscious effort on the part of the spouse filling in the gaps. It's just a gradual process of caregiving that comes naturally. Many times, it takes a catastrophe of some sort, such as a stove fire because the wife forgot to turn off the stove yet again, and the husband didn't think to check the stove before bed. After such a potential disaster occurs, one or both spouses generally open their eyes to what has been going on.
However, even such a serious circumstance as a fire or accident doesn't always sound an alarm. Adult children lead their own lives, and often are used to their parents working as a unit. If the elders don't report an incident to the adult children, discovering Mom or Dad's problem (or sometimes both of them having problems at once) will probably take time or some particularly bad accident that demands attention. This delay takes precious time away from an early diagnosis of dementia, or even--in a happier circumstance--find out the problem isn't dementia at all, but is being caused by a medication reaction or an infection.
Not all memory problems are related to dementia
Even if Dad has become aware of Mom's slipping memory, he may not be willing to mention the problem to Mom or to the kids. His attitude is probably, "There's nothing we can do. We'll get through this together." This attitude can be even more pronounced in the pre-boomer generation, because many elders still believe strongly in self-reliance. There is also, in general, less acceptance of mental disorders with that generation.
This thought process can be tragic for two reasons:
- Dementia may not be the cause. Often, memory issues, and even bizarre behavior, can be traced to dietary deficiencies, medication reactions or interactions, or even an infection such as a urinary tract infection. Once these situations are addressed, the person is generally back to normal, with no signs of dementia.
- Medical tests are available. If a good physical doesn't uncover a hidden medical problem such as those listed above, more tests can be ordered to see if any of a number of types of dementia is the problem. There are now medications, as well as general life-style changes, that can make early diagnosis very helpful. Once on the right medications, some people maintain their cognitive levels for months or years longer than they would have without medical intervention.
A dementia diagnosis is scary
While accepting a dementia diagnosis is very difficult, knowing that something can be done to help stave off the worst symptoms is helpful. Also, when people know the name of the monster they are facing, they can better prepare to fight it, and also to plan for a time when they know they will lose that fight. They can better help themselves and their families if they find out the truth early on.
Some studies have indicated that people who have a high intellect and more education can cover up the signs of dementia for a longer period of time. They can even deny it to themselves longer. These people simply start at such a high level of knowledge that others don't notice a slight slip. This isn't, of course, always true. Many who have not had higher education are very clever and can cover up memory slips with ease. No two people are the same, thus adult children should be on the lookout for signs of deterioration in their parents--to a point.
Dementia isn't about age
As a person who is no longer young, by the numbers anyway, I notice ageism all over. Just because a person hits 55, 60, 65 or more doesn't mean they suddenly become doddering fools. We who have racked up a number of decades can resent the fact that if we forget a name it's a major worry for those who love us, but when our 30-something kids do the same, it's simply stress or they state that they weren't concentrating.
Yes, we need to monitor our elders for signs that they need help. We need to watch for subtle signs that indicate they may be covering up their own health concerns or covering for their mate. But don't hover and indicate that every slip of the tongue could be a sign of Alzheimer's. Give them a break even while you are alert. We are all human.
If your elders can still learn new things, which they should be making a priority of anyway, if they can carry on a conversation as they always have, if they can pay their bills (assuming they could in the past), and drive just fine, then don't leap to any conclusions because they have a bit slower recall of information than they once had, or they forget a name for a time. Just keep an awareness of how they normally function, so you can spot it when there is some reason for concern. And watch for spouses covering for spouses. After all, it's still cute if they can finish each other's sentences. The problem becomes apparent when one spouse must finish sentences for the other.