The Early Signs of Dementia - What to Look For

You don't see it coming.

You believe it's simply a natural progression.  Memories become confused and you're left wondering - "Was I thinking something else happened?"  You begin questioning yourself; after all this is your parent and you've trusted most of what they say for your entire life.   You just go on believing something will pop them back into sync.

Next come small incidents.  Perhaps it's getting lost because they've lost focus, or - as it was with Mom - they've been chattering away while driving and not paying attention to the road signs.  Perhaps it's a fall or leaving something on the stove and causing a fire - there are many that could be considered, but they're nothing completely cataclysmic (although a fire could be).

Soon, you realize Mom isn't doing the things she once did;  she has begun to lose interest in most of the activities in which she was once engaged - Bridge, Pickle Ball, Tennis, Hiking, Book Groups, among others. She finds excuses that might seem normal.

She begins sleeping more and more, not being able to stay awake as once she did.     There were times I nearly went into her room (while I was visiting) to place a mirror under her nose to see if she was alive.  She obsesses over tiny matters when she's awake, but isn't always willing to follow through with whatever activity she's been pushing (Christmas 2012, Mom kept wanting to go shopping for gifts, but was unwilling to go to the stores).    And you begin not telling her you're coming for visits until a few days before, as she confuses the dates and keeps phoning wondering what time you're leaving that day.

There is the repetition of questions to which the response is always the same - but frustration crawls into your voice as you wonder why you're required to answer over and over again and again.

Then the calls begin.  "What is your father's cell phone number?"  "Do you have your grandmother's phone number?"

There is a gentle but definite change.  It's not depression, although the doctors are beginning to treat the condition as such, not wanting to rule anything out.  But the apathy has grown and she knows something is wrong - but she won't be forthcoming with all the information they require (she follows a 'need to know' philosophy).  She hasn't informed them her mother had Alzheimer's, and her thinking has been confused while she's finding herself shaking with tremors that have gradually increased, but are not constant.

These were the signs, and until the hallucinations began we fought to keep thoughts of dementia out of our minds.

So, what are the early signs?

Along with mental confusion or problems with memory,  dementia also holds fast to one or more of the following:

• language
• communication
• focus
• reasoning

There may also be subtle symptoms of short-term memory loss.    At first this may seem benign, but soon the ugly head will rear itself when this is realized not as an anomaly but as something permanent. 

 Difficulty finding words is another sign.  When speaking and conversing with others hits obstacles and the speaker is not at a loss for words, but simply cannot locate them, this belies another symptom. 

Difficulty Performing Normal Tasks is another warning sign.  Mom was never a great housekeeper, although her house was usually kept in relatively good order.  It wasn't until nearly 10 years ago I began noticing she wasn't dusting very often nor did she seem to care.  She began rinsing her dishes and putting them back in the cupboard if she thought this would do the trick.  How often I found mugs with small traces of coffee in them, or milk on plates or bowls.   She would defend this by telling me that dish soap was toxic, and her good friend, a former chemist, had told her such. 

Apathy begins to creep in.  Soon Mom began to not really care about anything much, as I stated above. Her only concern was for herself (which wasn't out of the ordinary - a narcissistic personality would define her, for the most part), but it was her not wanting to do very much.  Of course, when push came to shove she did activities that she believed would be interesting or stimulating and she would have someone to share them with.

Confusion becomes the new normal.  Remember the story I told in earlier blogs about her not knowing we were at her house during Christmas?  She thought we were at our old house in Portland, then we were at my house, and she refused to believe we were at her home in Port Angeles - she accused me of trying to confuse her.  That's what it's like. 

Difficulty Following Story Lines becomes frustrating.  Mom began to love going to the IMAX in Victoria as it was comfortable for her to "rest her eyes" and she could understand the story of the documentaries.  Soon, though, it became obvious she understood and retained only some of the photography rather than the thrust of the presentation. 

Losing Sense of Direction began to occur more and more often.  My brother tells of a day when Mom went to see her broker.  She drove around and around looking for his office, and it was right there.  The broker called my brother out of concern when he observed the phenomenon.    

This also includes having difficulty following directions, as well.  Given a simple task and told to follow the instructions Mom felt lost rather quickly, not knowing what to do next.  She would complain it was too technical for her (even though it was usually something she'd been doing for years).  

Repetition finds its way into conversations and activities.  So many times Mom would wander back and forth looking for something she already had, or she'd need to check on something.  This is a form of obsession - I'm not talking about thinking someone left the iron on, but checking for letters or items of clothing.  She would even begin checking her answering machine several times in the evening, believing someone may have phoned and she'd not heard. 

Difficulties with Adaptation is another hallmark.   Mom didn't savor the idea of uprooting herself to move to Portland when we first confronted her.  This was a tad odd, as just a few years earlier she began to play with moving back to Portland.  This was short-lived, though, much to our relief (at the time).   She did not adapt well to the hospital in Seattle (London, she believed and did not adapt well, at first, to St. A's, but after a bit she began to make herself comfortable.  She still speaks of moving home, but this is quite limited and infrequent.  

There you have it.  Hopefully, this will help someone somewhere sometime.