Potential early dementia - things that help

[LaBelleSauvage123]

My father is 86 and started to show signs of cognitive decline during lockdown, which are gradually getting worse, but are very inconsistent. He’s a very anxious person and his memory etc gets worse when he’s worrying about something; whereas at other times he is alert and with it. Red flags are:
Problems with word retrieval
Forgetting what he’s gone into a room to do
Forgetting names
Forgetting who he’s done what with ( eg my sister and I took him to a cafe for Father’s Day and today he remembered he’d been, but with my sister and ‘someone else’.
Uncertainty about spelling and how to write big numbers ( he has always been highly literate and had an academic career)
Fear of using technology ( which he used to be very adept with) ‘in case I do something wrong’.
As I say these signs aren’t present all the time by any means.
Is there anything I can do or suggest to help him cope and/or slow the decline? He’s very aware it’s happening ( which makes me think it might be age related rather than something like Alzheimer’s ) and it’s depressing him.

He’s also very reluctant to exercise which means his mobility has worsened significantly. He lives alone and independently at the moment ( still misses my mum terribly - she died 10 years ago)

I think the first thing would be to get your dad to see a GP and get a referral for an assessment. There are medications such as donepezil which can help slow progression if it is dementia. Also if your dad would be agreeable to it maybe a referral to social services or to a social prescriber for access to groups for socialising/ keeping active. Keeping busy and active is improving as far as your dad is able. Whilst dad is aware of his difficulties it may be useful to put things in place that will help him keep track of things day to day for example like a nomad system or medications alarm if he takes medications. The Alzheimer's society website has a lot of information and links to local support available, they also provide some services such as support groups themselves.

I think getting an assessment of key as earlier diagnosis will be easier if it is dementia as your dad will be able to understand and retain what is happening. Also if he is diagnosed it will help you with longer term planning. For example if your dad wanted to he could appoint a lasting power of attorney for finances and welfare decisions so that somebody can make these decisions on his behalf of at a point in the future he loses capacity to make decisions for himself.

Thanks - I think this would be ideal but it's getting him to do it. He has quite significant health anxiety and I think a diagnosis ( or even the thought of a potential diagnosis) would send him into a tailspin. My siblings and I already have power of attorney - he sorted that a while ago.

We never told my grandad or nan their diagnosis. There's no benefit to them knowing. It just allows you to do research and get the right help in place.
I really believe for older people with an Alzheimer's/Dementia diagnosis that ignorance is bliss. But it does help the family to understand behaviour better, and to get things organised in terms of how you can help him make day to day life easier.

You could try to just get a home GP appointment if able, and put it across that it's an annual check up, instead of an assessment.

He's still far too canny for any of that - he'd ask about the diagnosis and wouldn't accept a home appointment without knowing what its for.

He sounds similar to my dad a few years ago, in the early days the things that helped were a digital clock that shows the day and date as well as time - it worked even if unplugged (important as he went through a stage of unplugging everything), plus a write on daily planner - this was eventually used for meals as he was not eating well once he stated the decline. We put post it notes all over the house for some of the things that were causing issues / lock door/ do not unplug, have you got keys etc etc.
He also had a new cooker and gas fire that would turn off if he didn't light them. Finally a pill box that had all his pills sorted, first from the pharmacy and eventually a battery operated one supplied by the council that alerted us if he didn't take tablets.
All these (& probably many more things) kept him safer at home for longer but he is now in a care home where he is very happy, safe and well looked after.

I am wondering if it's 'just' age related decline rather than dementia as he doesn't need or do any of those things - he writes all appointments etc in a diary anyway and is very careful with locking, plugs etc. It's mostly when he speaks that we notice it.

I'm quite sure that GP's are used to waffling about the purpose of the visit and can assess your Dad. Assuming they'll do a home visit these days...
It's never too early to get an assessment. He may even be assessed as fine just now, but if he deteriorates, then you have a benchmark to measure against.

Look at the link between gut health and conditions such as Alzheimer's and dementia. There are health protocols to follow that can help.

That’s very true

Agree that the GP can be canny about seeing them. I needed a close family member to see the GP as depression was affecting them horribly but they wouldn’t go.

I phoned their GP, after I’d explained what was going on they suggested that they wrote to them with an appointment for a “medicine review and health check”. To this day the family member does not know that I instigated all of this, but I’m so glad I did.

Hopefully, your DF’s GP will be just as good.

I didn’t realise I could do that - thank you

I didn’t realise I could do that - thank you

I didn’t until I had to, desperate times and all that

We got our mum seen by pretending it was a health check.

I think it’s the Alzheimer’s society site that has a useful checklist of dementia changes compared with normal age related changes

If he’s had an academic career, dementia possibly terrifies him more than anything else.

Slowing the decline - exercise would help. Don’t offer to give him lifts to do his shopping. Keeping involved with a wide social circle. Get his hearing checked if he starts complaining about you mumbling - hearing loss makes it easier to sit in the corner and let the conversation drift by. Persuade him to keep learning.

He might be happier to contemplate the possibility of “memory decline”

Practically push the button on future proofing immediately
+move him if he hasn’t downstairs accommodation with washing facilities, a wc and potential bedroom

• Introduce a cleaner or gardener or companion into his routine while he can still be accepting of them +Make sure he can use a microwave, an iPad and his mobile phone
• Persuade him to take an occasional taxi or transport other than him driving His world will inevitably narrow but if he has practical help and suitable accommodation it will be an awful lot easier for all Take film of him now when you and he can have meaningful chats and if you can and are strong enough, find out his views on things like funerals, end of life, living wills Not easy for all of you OP

Great suggestions @Mum5net. We’ve done this with my DM,.

Moving isn’t an option he would accept - he has thousands of books which are really important to him as well as all the memories of my mum tied up in the house. I think we’d have to get carers in. He is competent with technology though says he’s lost his confidence recently. He has a cleaner, a gardener and a woman who does his ironing. He’s talking about giving up driving - has lost confidence with that as well. We’ve talked to a certain extent about end of life stuff.

Exercise is a big issue. I started doing online shopping for him in lockdown and he wants me to continue doing it. He walks to the village shop ( about 200 yards away) and to friends’ houses but that’s it. His mobility has declined quite a bit over lockdown though he can still get around ok. His hearing is poor and he wears aids but isn’t happy with them - I’m trying to sort that out atm. Getting him to do anything can be a bit of a struggle - my theory is that he has been suffering from low level depression since mum died ( the only medication he takes is an AD ).

Have you drummed into him that exercise so far seems the best bet for delaying mental decline? You probably have.

It’s the most recently learned skills that seem to go first. My father went from complete facility on the computer to not even being able to send an email. So making sure he’s ok with zoom or FaceTime now isn’t necessarily going to ensure you can keep in touch with them 10 years down the line. Be prepared to slowly simplify the tech he uses.

Could you “forget” key items from his shopping?

Work out how you could create a wet room downstairs.

Do get the GP to check vitamin b12 levels too - deficiency is common in the elderly and can mimic dementia.

Madrush that’s a good point, though he takes a multivitamin. MereDin - the technology thing rings very true - he’s recently swopped his smartphone for a basic model and told me he rarely uses his laptop now.

My brother is going to see him today for the first time since lockdown 1 - will be interesting to see if he notices a decline.

DH is in the thick of this with MIL but a few years further on (89). She demands to know why there is a TV in the kitchen. She's already burned out an electric kettle by putting it on the hob so had she been au fait with microwaving from an earlier time, the electric cooker could be disconnected. Similarly with grandchildren across the UK all finding feet with their careers but all willing to FaceTime, she really misses out by being unable to use an iPad or a mobile. Alexa would have really helped, too. His world will inevitably narrow but you may still have time to prolong some really beneficial activities. Yes, it will be interesting to hear your brother's views.

Read The End of Alzheimers Programme biy Dr Dale Bredesen, it's amazing