Hi everyone! MIL had finally moved closer to us, easing some of the caregiving burden on my spouse. But now that we interact with her more often we are noticing some issues that might be entirely normal or might be cause for worry.
Of most concern, is that she often replies with non-sequiturs in conversation. Her responses are usually within the broader topic; they are, however, often irrelevant to the specific issue being discussed. For example, a few days ago my spouse was discussing MIL's care directive with her and asking MIL about her wishes. MIL answered with an anecdote about one of the many times her late husband was taken to the ER with a UTI. She also often replaces words with filler words, such as "Whatever, whatever." And, yesterday, after we toured a two-bedroom unit in a condo she is thinking of purchasing, MIL was convinced we had just seen a three-bedroom unit.
But it might also be that this is cognitively normal for a 78-year-old who remained socially isolated for the better part of a decade while she was the sole caregiver to her husband who had Alzheimer's and whose only mental stimulation appears to come from watching reruns on TV. It is entirely logical that her cognitive skills might have atrophied from having interacted only with him for so many years and from having few intellectually stimulating outlets. Other than these verbal "moments" I describe above, she appears to be cognitively intact. For example, the town she has relocated to is a town she lived in three decades ago. She has been able to quickly reacquaint herself with the streets and neighborhoods and gets herself from point A to point B without a problem.
So, the bottom line is that we are not sure if the verbal problems we are noticing could be indicative of a disease such as dementia or Alzheimer's and, if so, what we should do about it. We are weary of pathologizing what could be merely normal, but also don't want to put our heads in the sand if there is reason for concern. Thank you in advance for any advice!
Now, she can hardly communicate, she just sits there, cannot focus or follow a conversation.
I did take her to a neurologist, a waste of time and money. They confirmed that she has dementia, proceeded to say that there was nothing that could be done, and then said "See You Next Month". Nope not us.
Read up, there is a lot of information on this site and others.
This is testing done by a neuropsychologist, who is generally a clinical psychologist with additional training in testing for neurocognitive issues like dementia of various sorts.
We had this done for mom as part of a comprehensive cognitive assessment including neurological and psychiatric exams and brain imaging. I recently had the same done for my husband.
The results were, in both cases, very enlightening and have us a better understanding of what sorts of deficits we were dealing with.
In retrospect, my mother started using "verbal filler" a few years before her dx of cognitive impairment. I wish I'd paid more attention to it.
Now I do not know if this is because they have had little outside stimulation while being a caregiver, or would they have been diagnosed anyway just because they would have developed dementia anyway or is it due to an age related decline? So many possibilities.
The only way to know what is going on would be to get her to a Neurologist for an exam.
You can get the ball rolling by suggesting that since she has moved she should see a doctor that is closer. That doctor doing a new patient exam should do a MME (I know not great) but if there are concerns you can bring them up and ask about a Neurologist. A full exam then.
By the way I would not have her get into a purchase of a Condo if there is a possibility that she has dementia. If she does get that diagnosis a place that has Independent living, Assisted living and Memory Care would be a better option. That way she can stay within the same building as she declines
Help her get all her legal ducks in a row: PoA, Advance Healthcare Directive, Last Will, etc.
If she lives by herself you will need to physically go to her home to see if it is in disarray: dirty, disorganized, unpaid bills, unopened mail, etc. Short-term memory loss is not often apparent. She is managing in her town because it is in her long-term memory, which is the last thing to be take by dementia. Remembering things from long ago is NOT an indication of "good memory" or cognitive sharpness.
Most of all you will benefit from educating yourself by viewing YouTube videos by dementia experts like Teepa Snow or reading books about dementia so that you have a deeper understanding of what it is, how it affects the sufferers and how you can more effectively engage with them as they lose their abilities of reason and logic. I wish you all the best.
1
Memory loss that disrupts daily life
One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.
What's a typical age-related change?
Sometimes forgetting names or appointments, but remembering them later.
2
Challenges in planning or solving problems
Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
What's a typical age-related change?
Making occasional errors when managing finances or household bills.
3
Difficulty completing familiar tasks
People with Alzheimer's often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.
What's a typical age-related change?
Occasionally needing help to use microwave settings or to record a TV show.
4
Confusion with time or place
People living with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
What's a typical age-related change?
Getting confused about the day of the week but figuring it out later.
5
Trouble understanding visual images and spatial relationships
For some people, having vision problems is a sign of Alzheimer's. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.
What's a typical age-related change?
Vision changes related to cataracts.
6
New problems with words in speaking or writing
People living with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have trouble naming a familiar object or use the wrong name (e.g., calling a "watch" a "hand-clock").
What's a typical age-related change?
Sometimes having trouble finding the right word.
7
Misplacing things and losing the ability to retrace steps
A person living with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.
What's a typical age-related change?
Misplacing things from time to time and retracing steps to find them.
8
Decreased or poor judgment
Individuals may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.
What's a typical age-related change?
Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.
Continued....
Withdrawal from work or social activities
A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities or other engagements. They may have trouble keeping up with a favorite team or activity.
What's a typical age-related change?
Sometimes feeling uninterested in family or social obligations.
10
Changes in mood and personality
Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone.
What's a typical age-related change?
Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
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Nobody can say whether the specific verbal issues you mention are indicative of dementia/AD or not; only a MoCA or SLUMS test administered by a doctor can tell you whether your MIL is on the dementia path or not. It's not necessary to take her to a neurologist for such a test b/c they may want her to undergo a 4-5 hour test which isn't necessary and may overwhelm her. Start with a call to her PCP for guidance.
Best of luck.
I will say I do lose words occasionally, and when I DO I will say "Dang, I know the word for that flower and it is RIGHT on the tip of my tongue." A minute later, there's "nasturtium".
It is quite disconcerting. But I am always able to say "senior moment". I would say that both myself and my partner, 83, are more forgetful. No question. So we feel our minds aging. In fact, those times I don't proof-read my responses here on AgingCare, and I go back to them later, the typos are quite numerous.
Yeah, I can still do those "spell Forum backwards" and "subtract seven from 100 five times out loud and let me know when you are done" and "draw a clock set at 11:10" BUT....
But the mind is aging, and I can recognize that. Multitasking is out of the question now. For instance my partner telling me a story about something while I am shopping and unloading groceries onto the conveyor. I just tell him "I can't multitask; tell me later". And I notice multitask thinking is no longer great for HIM while driving. Just drive and tell the stories later!
You may be seeing very early changes. I recently read in an article about seniors managing money and bills, that tests are proving there can be indications of early dementia about a decade before it is recognized by all that this senior should no longer be managing his or her own finances.
I am relieved your MIL has moved closer to you. You may notice if these things continue. Right now she is in process of a move, reacquainting herself with her hometown, buying and perhaps selling. Anxiety makes for brain fog, and any attempt at multitasking may be more difficult just now, so this may not be the time to come to any conclusion.
MIL has moved/will soon move, so she will need a new MD. It is time to consider getting wills, POAs, other papers done. There's no reason to request a simple mental check along with the physical, but early signs are elusive.
I sure wish you the best. I am glad she has someone so concerned. If she is able, and willing, discuss with her if she herself is noticing any changes. My brother told me ALL the symptoms concerning his early Lewy's, and in fact was diagnosed BY his excellent descriptions of what he experienced. She may herself be noticing changes I mention above, and she may be noticing MORE. For instance, I am more easily anxious about things I once took for granted--a airline flight for instance.
Good luck and hope you will update us in time.