How to deal with memory loss

[choccyyulelog]

We lost my dad a few years back. He had been unwell for a long time.

Around the time he died, the Carer mentioned to me that mum's memory wasn't great and that she kept repeating herself. Mum is mid 70s.

Since then, we have noticed her short term memory worsen. She'll ask the same questions several times, forget information related to her and is beginning to mislay things. Other people have noticed it too.

I've been suggesting that she gets a referral to the memory clinic but she is dismissive of this.

Yesterday, we had the same conversation and she said she was perfectly fine and she felt I was picking on her. I named other people who had raised her memory loss with me and assured her that is was because I was worried about her. She got very stroppy with me and stormed out of the room,

I am worried that it will escalate and matters will worsen. She hardly goes out (despite me inviting her over and visiting her myself) but on the odd occasion she does, she will mislay her bank card (thankfully each time it has turned up at home).

How do I deal with this?

LPA (both types) is being processed but I don't want to pull the rug from under her feet and start forcing decisions on her.

Any ideas?

I would get the LPA sorted first and then ask her GP for help with a referral to memory clinic based on your concerns. If she is having problems early medication may hold dementia at bay. Best not to address it too directly with her if it upsets her.

To be honest there’s not really any treatment (the treatments for Alzheimer’s e.g. Aricept don’t do much, if anything, to relieve symptoms, don’t modify the course of the disease and sometimes cause GI problems) so imo there’s little point going through the diagnostic process and it will probably just distress her. I would make sure she’s not driving, if you have any concerns about it, get LPAs in place as you are doing, and do something about any safety concerns in the home. You can think about introducing memory aids such as a wall calendar and white board if necessary. It may well just be mild cognitive impairment at this stage and that doesn’t always progress.

Thanks for replying.

This was my initial plan but it is taking ages for the LPA to come through due to COVID.

I agree that it is best not to keep on at mum - I only mentioned other people noticing so she didn't think it was just me.

In terms of what a memory clinic would do, they would likely do a quick diagnosis, get her started on Aricept if appropriate, arrange a few calls from the Alzheimer society and then discharge her back to her GP. They don’t usually offer any ongoing support or treatment.

She is still driving (rarely goes out though) but keeps knocking her wing mirrors.

Since dad died, I've been encouraging her to sell the house and look for a luxury retirement home (near me and local amenities so she doesn't have to drive) - again, she makes the right noises but it's lip service.

I'm hoping it is mild cognitive impairment .

Dementia means loss of autonomy, having people look after you who don't know or perhaps care about all the tiny things that are important to you, not being able to eat what you like when you like, not being able to get up in the middle of the night when you can't sleep, never being able to go out for a walk on your own, being "kept safe" when perhaps you don't want to extend this life that has lost all its meaning for you.

So when you notice your memory isn't what it was, you're hoping that this is merely a "senior moment" while at the same time being petrified that it's the beginning of the end.

There will come a time when the not knowing is worse than the fear.

Meanwhile, support her in ways of making her life easier, and see if your can persuade her to be checked for other things that can cause memory problems, eg anaemia.

Meanwhile try to do the things that may delay the progress, although it looks like a non-starter in her case - keep her physically active, and persuade her to learn new things.

You can't force decisions on her, but you can support her in decisions - explain the options to her, then write down what she decided so she has it to refer to.

Have you set up the LPA Financial so it can be used while she still has capacity? That would allow you to split finances so the bulk of income is channeled into an account that you manage and pay major bills from, and she has a day-to-day account. That limits the amount she could lose if she were the victim of a scam or simply lost her bank card.

Don't rely on conversation to make arrangements, always duplicate in writing. Get her a clock which shows day and date as well as time - we all know from lockdown how difficult it is to keep track when there's nothing marking out the days as different. Start looking into things like Alexa so later it can be used to issue reminders "don't forget to lock the door" or track her progress round the house so you know if she's got up that day.

Look at the alzheimers society website.

What we did with my Mum (still driving, still compos mentis enough to organise coach trips and participate in investment groups and deal with her tenants, but would ring me to ask why I hadn't rung ten minutes after I'd rung etc) was have a word with the GP who called her in for a memory test. She said "it's one of those things the surgery calls everyone in for" and we went along with that. Scan revealed mild-moderate damage at the time. She was able to drive and continue with her activities for about a year after that but the first steps had been taken with the authorities.

I pushed my mum to go to the GP when we first really became aware of problems - repeating things, losing words, struggling with numbers, forgetting things. We pushed her, against her will (she was scared) to refer herself on several occasions over time.

It took FIVE YEARS for the doctors and the memory clinic to agree there was a problem, by which time she could no longer make a cup of tea, answer most direct questions or follow a TV programme.

At no point would they consider her current condition in relation to her 'normal'. She may have been in her late 70s but had still been doing the Guardian crossword daily, hosting dinner parties, engaging in quick fire banter etc.

'Within normal bounds for her age' left her declining with no medical support or care, then when they finally did diagnose dementia they said it was probably too advanced for anybdrugs or intervention to make a difference, which appears to have been the case. She felt so much worse for being repeatedly told there was nothing wrong, when she knew there was.

I feel so guilty, although I don't know what else we could have done in the face of such refusal to recognise that we - and she - knew there was something very wrong.

I would recommend getting some useful tech now, so that she can use it well, if/when she declines.

Things like an Alexa as pp mentioned. Also either a tablet with Skype or similar, or a big button phone with pictures. And pill boxes with labels. Maybe introduce the tech as something that will be useful when she is older in case she falls etc.

It is so much better to learn new tech and systems earlier, even without memory loss. My gran has has a terrible time adjusting to her new phone after her sight went downhill quickly. So much better to use it regularly before things go downhill. That way your mum will have more independence in her 80s.

List of products here shop.alzheimers.org.uk/daily-living-aids
See if any would be useful to introduce early.

@Scarby9 that is awful.

And yes, yes, yes to making any changes as soon as possible.

New tech ( tablet? Alexa?), TV maybe that she can learn to use now.

We didn't deal with the bathroom in time so they have no shower and my mum can't get in the bath anymore ( mobility problems, not the dementia) but absolutely can't cope with any disruption or change to her environment now.

I would even consider talking to her about moving, if where she lives isn't future proofed. Better some disruption now than potentially complete disorientation later.

Very sorry to say this, but it probably will escalate and it probably will worsen. Whether diagnosis is useful is a moot point - I think it is as it makes it easier to access support from charities etc later on but my feeling is there is no need to rush. I would say make sure LPA is in place then you can either carry on pushing her to speak to the GP or you can wait until there is a noticeable issue or minor crisis that makes it happen for you.

The assessment I think was useful for us, as we had been a bit "oh, it's just her age", when really, we knew it wasn't.

In our area (but I don't know if it's national) the assessment led to these monthly groups which she enjoyed ("I don't know why I bother going but there are some nice people and I don't have anything on that day") and also a fortnightly home visit. ("The doctor is really good you know, once you get to my age they send someone round every so often to make sure you're not dead haha") And you go along with the comments like that.

@ScorpioSphinxInACalicoDress The only thing we can think is that she was always very sociable, and even now can slip straight back into that mode with strangers. She has a whole series of greetings and questions and remarks which completely mask her condition and the fact that she is taking in hardly any of the responses, so I am sure she presented well to the medics.

However, they did the tests on her and are surely experienced in seeing through that.

She mostly ended up in tears at the consultations so they stopped the testing and questions as she was distressed. But didn't seem to recognise - or recognise sufficiently - that she was distressed because she couldn't answer the questions and knew she was getting the answers wrong or couldn't do the tasks.

Throughout, she has been very aware of the contrast betweeen what she was like and how she is now.

Thanks everyone for your useful suggestions.

Have been through the process with both of my parents OP. In the early days, I too put a lot of gentle pressure on them to move to more suitable accommodation which would have been nearer me/smaller/easier to manage. In the end, they kept putting it off, or refusing, and I am so glad that they did. Although it meant a lot more travelling for me, they got a lot of peace of mind from being in their own home. They both get far worse, and very agitated somewhere else, where they don't know the way to the loo, or the kettle, for example, and where they look out of the window and it's not their own garden out there.

You may be able to manage to move her, but you may find that in the end, that it's the right thing for her to stay.

PS Her anger with you at raising the memory tests will be because she is afraid. My mum masked the symptoms for years and denied that there was anything wrong. They become very adept at adapting to/hiding errors.

YY to the dementia clock - like one of these It was a lifesaver, along with an easily read/easily written on calendar.

Best of luck OP.

Notverygrownup yes, that's a good clock as it doesn't scream "dementia" in the way that one of those with the sun or moon on it does. My father has accepted it (and I kept the box out of his way so he didn't see the D word)