Have you been worried about an older person’s memory or thinking skills? If so, you’ve probably found yourself wondering if this could be Alzheimer’s, or another dementia.
What to do next? If you look online or ask people, the advice is generally this: tell the doctor.
This advice isn’t wrong, but it’s incomplete. Yes, you should tell the doctor. But you’ll dramatically improve your chances of getting to the bottom of things if you come to the doctor with useful information on what you’ve observed.
In fact, research has found that interviewing family members about the presence or absence of eight particular behaviors can be just as effective, when it comes to detecting possible Alzheimer’s, as certain office-based cognitive tests.
8 Alzheimer’s Behaviors to Track
For each of these behaviors, try to make note of the following:
- Whether there’s been a decline or change compared to the way your parent used to be
- Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities
- When you – or another person – first noticed problems, and what you observed
- What kinds of problems you see your parent having now
If you don’t notice a problem in any of the following eight areas, make a note of this. (E.g., “No such problem noted.”) That way you’ll know you didn’t just forget to consider that behavior.
Have you noticed:
- Signs of poor judgment? This means behaviors or situations that suggest bad decisions. Examples include worrisome spending, or not noticing a safety issue others are concerned about.
- Reduced Interest in Leisure Activities? This means being less interested and involved in one’s usual favorite hobbies and activities. You should especially pay attention if there isn’t a physical health issue interfering with doing the activity.
- Repeating Oneself? Has your parent started repeating questions or stories more than he used to?
- Difficulty Learning to Use Something New? Common examples include having trouble with a new kitchen appliance or gadget. This can be a tricky one to decide on, given that gadgets become more complicated every year. But if you’ve noticed anything, jot it down.
- Forgetting the Year or Month? Especially once one stops working, it can be easy to lose track of the date or day of the week. But if you notice your parent forgetting the year or month, make a note of this.
- Difficulty Managing Money and Finances? Common examples include having trouble paying bills on time, struggling to balance the checkbook, or otherwise having more difficulty than one used to have managing finances.
- Problems with Appointments and Commitments? If you’ve noticed that your parent is having more trouble keeping track of appointments and plans, make note of this.
- Daily Struggles with Memory or Thinking? It’s normal for older adults to take a little longer to remember things, since many brain functions do slow a bit with aging. But it seems that your parent often can’t remember things that happened, or otherwise seems to be more confused with thinking, make note of this.
For more on diagnosing Alzheimer’s and other dementias
- If you’re worried that your older relative might have dementia, I recommend you learn more here: How We Diagnose Dementia: The Practical Basics to Know
- My book, “When Your Aging Parent Needs Help“, also comes with worksheets to help you check for signs of dementia, a handy checklist of what information to bring to the doctors, and more.
- In this Youtube video I share 10 early warning signs of Alzheimer’s Disease that often catch my attention, and what to do if you’ve noticed these warning signs.
- In this Youtube video, I cover 21 signs and behaviors that families sometimes assume are “normal aging,” but in fact are usually signs of a brain health disorder. It includes the 8 behaviors listed in this article, and many more.
Remember, being proactive usually leads to better results and less stress overall!
Carol says
Both of my parents are 90 years old and living together in their home. They both have experienced several medical/cognitive issues over the last two years. I am listed on a durable power of attorney as a person to give consent only if both parents are incapacitated or the other is deceased.
My father recently has lost control of his stool and urine. He presently has a temporary Foley in place for his urine and nothing is being addressed for the loss of stool control. He refuses to wear adult diapers and insists that my 90 year old mother must clean him. She dutifully does but it is a mess and she is confined to a transport chair 90 percent of the time. Consequently, the floor is not cleaned correctly. His stool accidents have decreased in recent weeks, but still a huge concern. Although he sees his general practitioner regularly, he feels that the good doctor is GOD and will not tell him everything that is happening or can’t remember everything. My mother has the beginning stages of Alzheimer’s and does not remember much about the visit to the doctor. She fell and broke her left leg seven months ago, was in the hospital for nearly 3 weeks because of the onset of sepsis and pneumonia, and was put into rehab for 6 weeks. My father had her removed from rehab prematurely because she cried to him and said she wanted to come home. They have no in home nurse or care provider. My father has cared for her basic needs. Sometimes she goes for weeks without showering. She no longer cooks because she doesn’t remember or has no interest in doing it. She no longer takes Donepezil because my father says it makes her too sleepy. My mother and father are in charge of taking their own medication.
I live 3 blocks away. I have pleaded with them to let me help them cook, clean, take care of yard, run errands, handle their medication, and attend doctor appointments. They refuse! I know that their doctors get only half the necessary information and do not see what is really happening. My father can come off as put together but give him a few minutes of conversation and he will recite the same story over and over. I have asked several times for them to go into assisted living, but that is met with anger and flat out refusal. I have asked to be put on their paperwork at doctors offices as a person to speak to and again that is a loud NO! My father is very proud and will not let anyone help. I am one of four children, but the rest are too far away to get involved or tell me to stop getting Dad angry.
How can I speak to their GP and specialists if they won’t allow me to be involved?
Nicole Didyk, MD says
Oh Carol, you have a lot on your plate! But this is a common story.
First, I recommend that you check out Dr. K’s new book: “When Your Aging Parent Needs Help: A Geriatrician’s Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, & More”. You can learn more here: https://betterhealthwhileaging.net/education-and-support/when-your-aging-parent-needs-help/
Dr. K also has the Helping Older Parents Membership which is an amazing resource and community for those like yourself caring for a parent with age-related health challenges. Click on this link to find out how to join: https://betterhealthwhileaging.net/hop-membership-invited/
I think you’ll find those resources very helpful in navigating the helping journey. It’s very complicated when your parents seem to be making choices that affect their health, and that of the other parent. For decades, likely, your parents have had each other’s backs, naturally stepping in and protecting each other when one of them is failing. This loving bond can interfere with getting needed help, especially when there’s dementia.
Unfortunately, sometimes there has to be a crisis for parents to accept help, from family or professionals. Your idea of a crisis may be very different to that of your dad or mom, and that’s frustrating.
In terms of being involved with their health providers, your parents may not want their doctor to share information with you, but you can certainly share your observations and impressions with the doctor. Consider writing a letter and sending it to the office. I get communication like that all the time and find it very enlightening.
Ashley says
My father is 60 years old and we started noticing small issues about 2 years ago, (he had a major business set back that caused a social backlash with in the small community we live in, family issues with my divorce this really hurt him, and other stresses from family to his father dying last October) but it has progressed significantly over the last year. significant short term memory loss but can hyper focus when he is interested, during this he also had to get hearing aids and at first we thought, well that must have been the problem he can’t remember something he can’t hear so we thought this would be the answer but it wasn’t. and he has been diagnosed with diabetes and it is very difficult to make him follow a low sugar/no sugar diet. is it possible that his diabetes could be causing the memory loss and the loss of concentration? or is it possible his medications/the combo of the medications could be the culprit? here is a list of them: amlodipine, metformin, paroxetine,donepezil, atorvastatin. or could all the stress in the last few years have caused the issues?
Nicole Didyk, MD says
You provided a great summary, and I’m sorry to hear about all of the challenges your father has had to deal with in the past while.
I often see older adults in my practice who are noticing changes in memory and concentration, but also have a lot going on medically, socially and emotionally. In my opinion, it’s best to wait until all of these issues are sorted out (at least as best as they can be) to evaluate what’s happening with cognition. I have a video about dementia mimics that might be helpful: https://youtu.be/Qs8eF8tzmco
Shannon says
My mother has been given a “differential diagnosis” of Alz disease/dementia vs. Vascular dementia, Frontoparietal Lobe Dysfunction, Cogwheel Rigidity, Sundowning with Paranoid Delusions, Visual Hallucinations… All pending further testing, by a Neuro who literally left town the week after he saw her. Her VERY OLD doctor primary care Dr. won’t send her for further tests as he “saw no evidence of significant decline”. She passed the MMSE test and he refused to listen to the things she does. She has finally agreed to let my sister help with her bills, but her functions for everyday living are rapidly declining. She lives alone and barely remembers how to used the stove and microwave, yet still has a Driver’s License. She talks about “laying there dying because no one will help her” but they seem to thinks she is functioning normally. I have demanded another referral to see a new Neurologist, and I hope she will go without kicking and screaming. Mood swings are angry, confused, distrustful, and depressed. Why won’t doctors listen to you about what you are seeing? I want her to live somewhere with social interaction (Assisted Living), not the current self imposed isolation she begs to leave, but no one hears us….
Nicole Didyk, MD says
It sounds like a very frustrating scenario, and I can understand not feeling heard. Unfortunately, this story is not uncommon, and it’s often a long journey to diagnosis and a change in living situation.
It may be possible to move forward with a move to Assisted Living even without a formal diagnosis, just based on the functional level you describe.
I would highly recommend checking out Dr. K’s new book called: “When Your Aging Parent Needs Help: a geriatrician’s step-by-step guide to memory loss, resistance, safety worries, and more”. This is a practical guide to how to start helping an aging parent, even when you don’t know where to start. You can learn more here. The book can help you to set small goals and make progress towards helping your mom. You can find more info here: https://betterhealthwhileaging.net/education-and-support/when-your-aging-parent-needs-help/