Editor’s note: The Caregiving Chronicles blog has partnered with the Natick Visiting Nurse Association to bring additional expert information and advice to the MetroWest caregivers we strive to serve at CaregivingMetroWest.org. The Natick VNA has allowed Caregiving Chronicles to get some valuable insight from its staff for our ongoing series of Q&A sessions with caregiving experts. 

CGMW: How do you differentiate between memory issues that could signal dementia and the memory lapses that are often typical age-related changes?
Kingsley: Absolutely, we often struggle with remembering certain dates or names or where we put something as we age. However, this memory loss is not disrupting our lives, it is a nuisance. If memory loss is disrupting daily life, then a caregiver should be concerned.

CGMW: Memory issues are usually the first thing people think of when talking about Alzheimer’s or other dementias. But these conditions actually affect all cognitive functions. Beyond memory loss, what other cognitive issues or functions of the brain can be affected by dementia that caregivers should be aware of?
Kingsley: As the confusion and memory loss increase, bladder and bowel incontinence may emerge, dramatic changes in mood and withdrawing increase. Wandering and getting lost is a concern as six out of 10 patients with Alzheimer’s have wandering events. In the later stages of the disease, family members with dementia ultimately forget how to swallow, sit, speak and walk. They also become more vulnerable to infections like pneumonia.

CGMW: How can you differentiate between normal age-related changes and possible signs of dementia in these other cognitive areas like judgment, language, attention, abstract thinking and problem solving?
Kingsley: There is no single test or sign or symptom that brings a diagnosis of Alzheimer’s. Medical professionals will evaluate overall health and identify any other conditions that could affect how the mind is working. When other conditions are ruled out, then the doctor can determine if it is Alzheimer’s or another form of dementia.

CGMW: Can changes in mood or personality also potentially be an early sign of Alzheimer’s? How would those changes signify dementia as opposed to typical age-related changes?
Kingsley: This is a great question and highlights the need to follow up with a doctor with whom you feel comfortable. It can be your primary care physician who may refer you to a neurologist or a psychiatrist or psychologist.  The medical professional will ask some background questions such as what kind of symptoms have occurred, when they began and whether they have become worse. They’ll review medical history, evaluate mood and mental status, perform a physical exam and a neurological exam. There is no single test that proves that one has Alzheimer’s.
What should you do if you do see indications of what could be early signs of Alzheimer’s? It’s very important for the family member and their caregiver to see a medical professional and get a diagnosis. You need to understand where the person may be in the course of the disease and what to expect in the future. Alzheimer’s is life-changing for both the patient and their family.  It’s so helpful to be proactive in considering how you’ll provide increasing levels of care as the disease progresses and how family will cope with these changes.  The disease can be very stressful for the patient and the caregiver.

CGMW: What are some resources for more information or support for someone caring for a loved one who may be exhibiting early signs of Alzheimer’s?
Kingsley: The Alzheimer’s Organization is a phenomenal resource. There are support groups available for caregivers in many senior centers or councils on aging.

CGMW: Is there anything else some caring for a loved who may be showing early signs of Alzheimer’s know or do?
Kingsley: From the very beginning, remember: Caregiver stress is real. Please take care of your physical and emotional health. Don’t be afraid to see a therapist for the anxiety and sadness you  may feel. Ask for help.