Bamatina Posted April 2012
My dad is exhibiting signs of dementia and I'm terrified!
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He had heart valve replacement surgery in July 2011 and at first I attributed changes to medications, recovery, etc. But it's been close to a year ago and he is getting worse. He says things that don't make sense. He can't figure out how to do things he has done his entire life. A couple of days ago he couldn't remember the last 4 of his SSN. My mom is his primary caregiver but my sister and I are also caregivers. He is only 64 years old. I just don't understand how this happened so quickly. I'm honestly terrified of what is going on and have no idea what to do.
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That was over 20 years ago. He got through that rough period, with changes in medication and time. He's still alive today and has no signs of Alzheimer's or dementia.
Poor hearing and/or eyesight can also mislead unaware observers in thinking wrongfully that there are mental issues.
I agree with others here that you need to share your concerns with a doctor. Does your mother see these changes in your father? If so, she may have to be the one that raises the issue with a doc. Does you father know about your concerns? Do you think he will give you any trouble in pursuing this line of discovery with a doctor?
Don't jump the gun in coming to a diagnosis before talking to some professionals. It could very well be something else besides memory loss. I wish you the best. Please give us an update if/when you learn more.
Indeed, reading about Cognitive Impairment helped me. The disease can get worse if they remain passive. I have suggested to my ex that he read what he can in the library of the Veteran's home. I suggested he engage in some card games as that keeps his memory going.
The Diagnosis for my ex was eye opening as it is thought that some people are born with the gene that leaves them wanting in the desire to read or lack social skills. My ex never liked to read and expected me to do the reading of news and magazines for him. Now this diagnosis makes me see why. This gene can also cause an imbalance in the system. My ex had trouble marching while in the service and just had no rthymn in dancing. He did not make friends easily while we were married. Hard drinking also causes impairment. I hate to think of his getting worse with the disease. He is being medicated and well taken care of in the Veteran's Home. I wish I could care for him, but he needs 24 hour care and therapy.
Make immediate appointment with cardiologist - this could have a "cardiac cause". - irregular heartbeat, insufficient oxygen to brain, CHF, blockage, etc.
Next get geriatric specialist for any dementia exams. If your father was veteran be sure to evaluate for PTSD (post traumatic stress disorder). It comes back on the older ones when they finally retire and have time to think.
Many medical issues mimic ALZ/dementia. Check out all before starting drugs for dementia.
-Recent memory loss-ask you the same ??’s or do the same action over & over.
-Difficulty performing familiar tasks- cook a meal but forget to serve it. Put on pants but not panties.
-Problems w/language-may forget simple words or use the wrong words. They can’t finish a sentence. "Stall" when speaking.
-Time & place disorientation-get lost on their street. Can't exit a parking lot.
-Poor Judgement-forget simple things, like to put on a coat before going out in cold weather when it is obvious cold weather.
-Problems with abstract thinking. Classic example is balancing a checkbook, people w/dementia may forget what numbers are and what has to be done with them.
-Misplacing things – Putting things in the wrong places like iron in the freezer or a wristwatch in the sugar bowl.
-Changes in mood-fast mood swings, going from calm to tears to anger in a few minutes. They become suspicious, paranoid or irrationally fearful.
-Loss of initiative-may become passive.
None of these happen overnight or all at the same time. A lot of what happens depends on what type of dementia. My experience is that getting them evaluated by geriatric MD or neurologist makes a huge difference in deciding the best care.
DEMENTIA TESTS: 3 main tests. Different yet similar….
1. Folstein aka Mini Mental State Exam (MMSE) - 30 point test. Takes about 10 - 20 minutes & looks at math, memory, orientation, basic motor skills. Folstein is copyrighted & needs training to do, so usually done by resident or student MD’s @ teaching hospital or a nursing home with teaching hospital staff.
2. Mini-Cog: a 3 item recall & a clock drawing test. 2 -3 minutes to do. Should not be used alone as a diagnostic.
3. Memory Orientation Screening Test (MOST): 1. Memory -3 word recall; 2. Orientation - to year, season, time, month etc.; 3. Sequential – memory for a list of 12 items; 4. Time – organization and abstract thinking using a clock face. Takes 5 - 10 minutes. Gives a score from 0 – 29. My mom has had MOST done over 5 yrs, is now a 13 score so no more test. She still nails the clock draw though!
Other tests: If Frontotemporal dementia is suspected, can have an Addenbrooke’s Cognitive Exam done. Not all dementias are the same: orientation, attention and memory are worse in ALZ; while language skills, ability to name objects and hallucinations are worse in other dementia’s.
Data analysis found the MOST to be more reliable over time and more accurate in identifying cognitively impaired patients than either the Folstein Mini Mental State Exam or the Mini-Cog. The MOST also measures changes in a patient’s memory over time. This permits the doctor to identify progressive loss or positive responses to treatment.
Having a baseline tests done & repeated is really helpful to be realistic about what careplan to take. Same with scan on brain shrinkage & what part of the brain. If they are not a initial English speaker (US English from birth) or have limited education, there are issues with the tests. If that is the case you need to let them know so they can adjust the score.
They will also do a pretty detailed cognitive tests to see where he stands in the dementia spectrum and could narrow down the likely type he has. This is really important to all as each dementia has it's own issues and care plan. My mom probably has Lewy Body Dementia, Jeanne's DH does also - Lewy is quite different yet similar to what an ALZ or vascular dementia patient would exhibit.
The earlier the diagnosis and type the better. Good luck.
I hope that you find out what is going on soon.
I suggest a thorough examination for Dad, by a behavioral neurologist or a geriatric psychiatrist or a doctor who specializes in dementia. His primary care physician should be able to refer you to someone in your area. The first step is to get a professional evaluation. If this is indeed dementia, treating it in the earliest stage is very worthwhile. There are no cures for dementia but there are treatments to deal with symptoms and that can improve quality of life for the patient and the family.
If this is dementia, the next step is to learn as much as you can about dementia in general and about the specfic type your father is suspected of having, if known. Knowing what to expect and learning about various options for dealing with it can be very, very powerful.
Your father is younger than the typical dementia patient, but people in their 50s are stricken by the disease. Sometimes the signs of dementia come on very gradually. But there are also cases of sudden onset. My husband's onset was very sudden, happening on a particular day. It sounds like your father may have had about a year ramping up to where he is now. But fast or slow, suspecting that a loved one has dementia is vey hard on everyone.
Surgery often seems to be a trigger. It is not that surgery causes dementia, but if it is lurking in the background it appears to bring it more to the front.
I'm talking as if this is dementia, but you don't really know that yet. I think the first step is to get professional opinions.
Please come back and share what is happening as you go through this.