by Cheryl Blanchard

During the holidays, you may have seen family members for the first time in months. Families often notice changes in their loved one’s cognitive abilities and wonder if it is normal or something to be concerned about. Alzheimer’s Tennessee is here to help answer your questions and guide you to local resources as needed.

First of all, let’s discuss dementia. Dementia is defined as a loss of cognitive function over time. Dementia itself is not a disease but a syndrome or collection of symptoms including memory loss, trouble with activities of daily living, difficulty with communication, increased confusion and changes to personality and behavior. The term is often used interchangeably with Alzheimer’s disease but that is not accurate. Alzheimer’s disease is the leading cause of dementia, but other forms include Lewy body dementia, frontotemporal dementia and vascular dementia. Many conditions that cause the symptoms of dementia are reversible, so if you have concerns, it is important to get an evaluation as soon as possible.

We all experience memory struggles from time to time. Sickness, stress, sleep deprivation and being overtasked all make it difficult for us to recall information. Given enough time, however, we will likely have an “aha!” moment. We can retrace our steps, look for cues and recall the information. The person with dementia cannot. The cognitive loss associated with dementia starts to have a noticeable impact on daily living. Although we may slow down as we age, memory loss that impacts daily living is not normal.

Perhaps you sometimes forget where you park your car at a large store. This is likely because you are thinking of several other things at once, the phone rings, you get text messages, or other distractions occur. The brain can only deal with so many pieces of information at one time, so you may lose the memory of where you parked. However, as you replay parking in your mind, you can problem-solve and may recall that you walked in by the bakery and realize your car is on the other side of the lot. You find your car in a few minutes, but the person with dementia cannot retrace their steps, so they will likely not find the car without help. They truly have no recollection of where they parked the car.

In its early stages, Alzheimer’s disease impacts the storage of short-term memories. This is why people with Alzheimer’s can recall details of something that happened years ago but not recall what happened three hours ago, like what they had for lunch. Families often get very confused by this and think their loved one is being difficult. The fact is that they cannot access a memory that was never stored. You may have noticed mom putting water on to boil and forgetting about it or going to let the dog out when she just did that a few minutes ago.

Misplacing items becomes more common. We all do this from time to time. We are often so busy that we set something down and don’t remember where we placed it but, again, we are typically able to retrace our steps and find the item. People with dementia will put things in unusual places like putting the phone in the freezer or their watch in the cookie jar. They know an item needs to be put away but lack the understanding that things may belong in a certain place.

If your loved one has misplaced items and cannot find them, this could be a sign of dementia.

Sadly, paranoia often follows dementia and your loved one may accuse you or others of stealing items they cannot find. If they are missing an item and you are the last person they saw, their jumbled thoughts may string together that they cannot find their watch, you are the last person they saw, and therefore you took their watch. Families may want to put away valuable items and also learn where a person’s favorite “hiding” places are.

The person with Alzheimer’s has trouble following directions or doing things in order. You may have noticed Grandma struggling with a recipe she has made for years or Grandpa getting confused while playing a game with the grandkids. Sequencing becomes more difficult and you may even notice difficulty with dressing. This often leads to frustration, and a person may behave in agitated ways and experience depression or anxiety.

Difficulty with word-finding is a common symptom of Alzheimer’s. Your loved one may have gotten lost in conversations or even withdrawn from conversations altogether. Due to the short-term memory loss, they can no longer follow a conversation and it becomes too frustrating to try. People will often use a common word like “nice” repeatedly because they know it works in many situations. They may also describe an object for which they cannot find the word like “that thing that changes the channel” or a person as “the little girl with brown hair.”

People often state that Dad did not seem to enjoy the family being there and would “zone out” or even leave the room. This is not a matter of him not being happy to see you but more an issue of being overwhelmed by the noise and being unable to follow one conversation when there are many going on. It gets increasingly difficult to focus on one person talking and tune out the others so often the person will cope by leaving the room.

There are a few other things you may have noticed. Maybe Dad always kept a perfect lawn but it is now overgrown and unkempt. Perhaps there were piles of mail that have not yet been opened. Your mom may have always kept a spotless house but you noticed things were very much out of place. You may have seen dents or scratches on the car that cannot be explained. There may be unpaid bills because they have forgotten the process of writing checks or online banking. Oftentimes people see that their loved one is asking the same questions over and over as if they had not already heard the answer. Sometimes they will tell stories from long ago as if living in the past.

If you have concerns about a loved one and need guidance on what to do, please reach out to Alzheimer’s Tennessee at 615-580-4244. We will be happy to have a family consultation with you and connect you with resources for getting an accurate diagnosis and providing the best care for your loved one. You can learn more about programs and services by visiting alztennessee.org.

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Cheryl Blanchard is a dementia care specialist and the Middle Tennessee Regional Director for Alzheimer’s Tennessee, a statewide nonprofit organization providing programs and services to families facing Alzheimer’s disease or a related dementia. Contact her at cheryl.blanchard@tnalz.org.

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