AMARILLO What do you do if you find your 83-year-old mother’s car keys in the refrigerator?
What if your elderly father suddenly starts neglecting his personal hygiene?
What if they forget your children’s names?
A Texas Cooperative Extension expert suggests the first step should be: Don’t panic.
Many adult children might assume their forgetful parents are showing the first signs of Alzheimer’s disease, but that’s not necessarily so, said Andrew B. Crocker, Extension program specialist in gerontology and health.
“A person’s feelings may affect his behavior,” Crocker said. “Feelings of loss, worry, anxiety, vulnerability and helplessness may be the most common. Illness, pain and medication may also significantly affect a person’s thinking and behavior.”
Changes in behavior and even changes in memory might have simple explanations, he said. Try to find out what those explanations are.
“Ask your mother if she knows where her car keys are,” Crocker said. “When they are discovered in the fridge, ask why. There may be a perfectly good explanation. Maybe they ended up in there accidentally when (she was) unloading groceries.”
For example, Crocker told of his own grandmother, who keeps her car keys in the refrigerator because she read an article that said the cooler temperatures give longer life to the batteries inside the “clicker” that opens the car doors.
“Someone who didn’t know this would think that she’s crazy,” he said. If a parent starts avoiding taking a bath or getting a shower, try to find out why. Does he have arthritis that makes the process of undressing and bathing painful? Are the knobs in the tub difficult for him to turn? Is he worried about falling? Has he recently lost a loved one spouse, sibling or close friend and is too grief-stricken to think about bathing?
As for forgetting a grandchild’s name, everyone forgets a loved one’s name now and then, Crocker said. Most of the time that’s just human nature; it gets serious if they forget the grandchild.
In each one of these instances, he said, the key is to ask questions.
“Communication is so important. You should want to try understanding the root cause of the problem,” he said.
“If the explanation doesn’t quite make sense, this should be something that makes you want to look at other things that might be happening.”
These other things might include delirium, which may have easily remedied physical causes, Crocker said. Symptoms are rapid onset, short attention span and “disturbance of consciousness,” he added.
As many as 30 percent of older adults might experience delirium and many might not know they have it, he said.
“Delirium is characterized by an altered and fluctuating level of consciousness,” Crocker said. “It can be caused by almost any medical illness or drug. Often a specific cause cannot be identified.”
Because it has such a rapid onset, determining when it started is usually fairly simple. As many as 30 percent of delirium cases can be traced back to medications, Crocker said, so changing medications may completely eliminate the problem.
“Many times delirium may occur by a change in environment, such as moving out of one’s home into an assisted-living facility or moving to a new town,” he added. For these reasons, “delirium may be largely or completely reversible.”
But an older parent’s forgetfulness is more likely to cause their adult children to worry about the onset of dementia, Crocker said.
“The two most common types of dementia are vascular dementia and Alzheimer’s disease,” he said. “Alzheimer’s disease is usually characterized by an inability of nervous signals to be transported across a synapse. Vascular dementia is usually caused by a stroke.”
Symptoms of dementia are:
- Gradual onset,
- Increased risk with age,
- Gradual progression, and
- Change in attention span.
“Dementia affects about 4 million people in the United States,” Crocker said. “About 1.5 percent of people have dementia by age 65 and about 30 percent develop it by age 80.”
Although most dementia is not reversible, some cases that have been linked to over- or under-active thyroids are, he said.
If a parent’s forgetfulness starts coming more and more frequently, Crocker said, and the adult children are concerned about delirium or dementia, communication is still the place to start.
“Talk first and try to find out what’s going on,” he said. “Is it a broader issue linked to an illness or to a difficulty completing a task? Is it an emotional issue? Try to determine if there have been any significant changes in life since your last visit, such as the death of a close friend.
“If you feel there is a problem, I think the first trip is to the family physician for an evaluation. Make sure that hormones, body chemistry and so forth are normal. Make sure the person is not over- or under-medicated.”
And if you do find yourself dealing with a parent who may be slipping into dementia, he said, “the other important thing is to pick your battles. Pick and choose what’s important and leave the rest alone. You can’t fix everything.” In other words: Don’t sweat the small stuff.
For more information on this and other issues of older adults, visit Extension’s Family and Consumer Sciences Web site at http://fcs.tamu.edu/ and click on the link to Family Life.