Wednesday, August 27, 2014

Eldercare Helps: The Other 'D's That Aren't Dementia

Dementia, the dreaded "D-word," has copy cats.  As you monitor your aging parent's health, you may encounter one or more of these.  They all begin with D, and their symptoms are similar to dementia.

Delerium--This has a rapid onset of hours to days.  The person becomes confused and disoriented, with impaired memory and possible hallucinations and mood fluctuations.  Delerium is not a disease in itself, but is a syndrome or combination of symptoms.  Delerium has a medical cause.  In elders, it's often a result of a urinary tract infection, or possibly a reaction to a drug.  Once the basic medical problem is treated, the delerium goes away.

Depression--If your parent is experiencing lack of energy or motivation, or confusion or a slowing of thought, he or she may appear to have dementia.  But the cognitive loss could be due to depression. Elders often present with different depression symptoms than do younger people. Your parent may not use the word "sad," for example, but he or she still could be depressed.  Again, this is treatable.

Damaged Brain--If someone falls--and many older adults do from time to time, they can damage their brain, leading to confusion and slowing of thought.  For awhile, they may seem demented.  Usually over time, things get better.

Developmental Delay--Elders with developmental disabilities may think slowly, speak slowly and act as though they have dementia, when they may not.

Deficient Education--If an elder only finished sixth grade, he or she may have difficulty processing language.  The slowness of thought could be confused with dementia.

All of these D-diagnoses impact cognition.   But only one is dementia.

Carilyn Ellis, MA, discussed these in a presentation for Certified Senior Advisors called "Understanding Assessments, Determinators and Diagnoses--and Challenging Doctors When Needed."

When presented with a dementia diagnosis, Ellis advises to ask the doctor, "Is there anything else it could be?"

Wednesday, August 20, 2014

"She's NOT my mom! " Tips on advocating for other elders in your life

Do you have any of these elderly "non parents" in your life?
  • A widowed or divorced aunt who never had children and whose health is faltering.
  • An aging uncle who never married.  He needs care and support.
  • A relative with failing health who has no support system except you.
Advocating for an aunt, uncle or other relative often feels different than doing the same things for your parent.  That's because the bond with our "non parents" is generally more tenuous.

Sometimes our aunts, uncles or other relatives are like clay in our hands, willing to comply because they trust us. But often they don't, chiefly because their fierce independence has propelled them through life, and they're not about to give it up. We do more second guessing of our decisions:  "What if she refuses?"  "How can we persuade her to do the right thing if she digs in her feet?"

Take Aunt Grace, our somewhat eccentric and very independent maiden aunt who lived into her 90s on millet and porridge.  Unfortunately, dementia took hold. She moved from an apartment to a boarding home, accompanied by her cat.  Eventually Daddy was called in to help move her to a nursing home.  "I'm staying put," she said.  "And so is Kitty."

The struggle was ugly.  Daddy enlisted another younger relative to give him some perspective and help. Several days later, Grace, though not happy, moved to her new digs.  The cat found another home, and Daddy came away with a faceful of scratches.

Four pieces of advice if you're in a similar  position:

1.  Seek help from friends who can serve as sounding boards for your frustrations in dealing with the situation.

2.  Consider consulting with a Geriatric Care Manager.  These professionals have experience dealing with difficult family issues and can help you come up with "next steps," even if your relative is unwilling to admit there is a problem.

3.  Be as patient as possible, knowing that your relative isn't about to give up his or her independence without a struggle.

4.  Do your homework so you know the services in your area.  That way, if an emergency arises and you need to act, you'll be ready.

Do you have experiences helping a "non parent"?  Any advice for others?

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