Wednesday, March 25, 2009

Memory loss

I felt I had to respond to the "Dear J" column about memory loss on ttp://
I have a unique perspective on the issue of memory loss because
A) As a medical social worker, I studied and worked with the elderly and terminal patients.
B) I went through this stage of life with my mother, father-in-law and mother-in-law, and
C) I currently have many of the same issues as a result of a stroke.

Here are my suggestions:
1) Anyone can hold it together for a couple of hours. You need to spend at least a couple of days with the person to judge their functioning -preferably, not in their own home. We develop a system in our home,the familiarity and routine can mask a lot. Ever watch a blind person fly around their home, cooking and cleaning?

2) Observe the person objectively, don't think of them as your strong dad or mom, wife, husband, sister or brother.

3) Look for coping mechanisms they use to deal with diminished capacity, thing like:

  • pads of paper everywhere to make notes or jog memory-especially with with phone numbers or information they once knew well.

  • instructions or labels on how to operate household appliances, TV,etc

  • less desire to go out or do things that were once pleasurable- movies, or social activities.

  • not wanting to use the phone as much or passing it over to someone else in the home- 'here, dad wants to talk to you"

  • using "catch phases" that fit a number of situations "that wouldn't be bad now, would it?"

  • using humor to deflect or not directly answer a question. My dear father-in-law was so good humored, many things were missed. When asked by the doctor what brought him to the emergency room, he replied, "the ambulance". Everyone in the room laughed, someone else filled in the medical issue and the doctor never ask him again.

  • avoiding large crowds, loud environments, or a lot of things going on at once. The more stimulation, the less ability to function.
  • abnormal fear of falling or taking avoidance of taking showers or baths. Letting other personal grooming slip getting angry over little things they have trouble doing or becoming frustrated with a task and leaving it. No longer doing hobbies, they once liked.
  • Having trouble making change or completing paperwork. "I can't read this - the print is so small or I left my glasses, etc"Turning over tasks they once did themselves, such as paying bills or volunteer work - seeing over due bills or being overdrawn at the bank.

  • accusing others when unable to find something, "so and so took it."

  • Seeing stashes of money in various places or hoarding some items

  • Weight loss, are the fixing meals and remembering to eat or just snacking? Ask what they had to eat for breakfast, lunch or dinner - how about yesterday?

  • Looking to others to answer for them or saying the spouse "takes care of all that"

  • Taking a long time to do a task that was easy in the past (some of my short blogs or this response can take many hours (sometimes days for me to complete).

There are so many things people can do to cope. But use some common sense. I am reminded of the lists of things to watch for if your teen is taking drugs. So many of the things listed is normal teenage behavior.

Make sure they have had an eye exam and a hearing test. Everyone thought my mother-in-law just didn't hear things. After her hearing aids it was obvious the problem was her memory and comprehension.

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