Early signs of dementia or just a lazy mind?
I'm concerned about my 81 year old mother. My parents are very active at 84 and 81, maintaining 3 homes, and always busy around the house. What they are not, is curious minded or intellectual. They are wonderful people, just not well educated or terribly concerned about busying themselves with information. They passively watch the network TV news that caters to their biases and read the local paper and that is pretty much their information gathering.
They have their routines and are thankful for the experiences their children have opened them up to (travel in particular, they love our stories and sharing of information), but do not seek or explore much on their own other than home improvement projects. They eat, clean, repair, sleep and repeat. And they are happy with that. I'm not worried about their routine other than physically, they are getting a bit frail to handle all that they do. I only mention it because it offers a little background. Their life is a simple one, and they have never been intellectually curious.
My mom in particular, has always been what I would call lazy minded. As you would expect, this has gotten worse with age. My siblings usually just tell me to not worry about the increasing repetition and confusion, but this last visit, my sister was also concerned. An example, we were driving home from a lovely dinner out with the family and we talked about needing to get gas on the way and needing to buy some drinks for the next day's voyage home (a 15 hour drive). We stopped, got the gas, grabbed the drinks and headed home. The drinks were in glass bottles and were rattling a bit in the back so I joked that it sounded like we had milk bottles in the back. A minute later, my mother asked if we were going to stop for gas and buy the drinks. We were all a little startled and told her we'd just done that. Then another minute went by and she said the rattling sounded like a milk truck. Essentially repeating what I had said as if it were her own thought.
This kind of thing is happening with greater and greater frequency. It's not just repetition, but confusion. I don't think she forgot we stopped at the gas station, she just wasn't aware that's what was going on? I don't know. I can't dig in too much to find out the source of her confusion b/c she gets defensive and feels picked upon. I used to think she was just a lazy listener...perhaps just inattentive or a day dreamer who mentally wanders off. But...the car was stopped for 10 minutes. We filled up with gas, brought groceries into the car. It wasn't just drifting off for a bit or lazy listening.
My key worry right now is that maybe she's in the early stages of dementia or perhaps she had a minor stroke (TIA) and doesn't realize it. Not sure we should just write this off as just "mom being mom" or if there is something we should do other than treat her gently when she has these frequent moments of confusion/memory lapses.
She doesn't get confused about where she is and can get around well on her own. She still drives and can do all of her usual tasks. Maybe I'm overreacting? Perhaps it's just the chaos of having kids/grandkids in her space and doing things outside of her routine?
This is one incident that you observed. You do not live near and visit often so little things my be brushed off as having no meaning.
But you take all the little incidents that happen daily or more often in a day and you assemble them into a picture that has meaning.
Does your sibling have more contact with mom than you do? If so what have they noticed?
Do you call often? Think back to calls over the past year. Anything now seem odd or different?
What does dad say? Often a spouse is “covering up” incidents and making excuses. They may or may not even realize they are doing this.
It might be worth a mention to their doctor. If they have you listed on their medical forms you could send a message. Typically doctors might do a MME exam as part of a yearly physical. At least some doctors are. If there is need an appointment with a Neuropsychologist would be a good idea. Not only do they do the mental exams they will take into consideration the person’s educational level when assessing results.
I haven't mentioned anything to my father, who has always been short tempered (never violent, just very quick to anger/frustration over very simple things), isn't handling my mother's repetition or confusion well. He snaps at her and makes her nervous and they bicker a lot more than they used to. Likely b/c of the constant misunderstandings and poor communication styles each has.
Like I mentioned, neither parent is really intellectually inquisitive. My dad sees the issue as her "not listening" or "paying attention", and I think he's also embarrassed when she asks really obvious questions. He doesn't think what the root cause is. Why is she confused? Why is she repeating herself? Why does she suggest something someone just suggested? Why doesn't she get sarcasm any longer? Why is her language reverting to some old school colloquialisms we'd honestly never heard her say?
I think until she does something that seems dangerous like forgetting where she lives, it won't spark investigation. I have to spend time with my sister to discuss how we might encourage my mother to get assessed. We will have to do it carefully. She already feels like we (and me in particular) judge her or think she is "stupid" or "ignorant". She gets very defensive when we do point out an issue or concern. The other night the crickets were chirping loudly and mom commented "Listen to the crickets, I mean, the peepers". We have never heard her use the word peepers before. And she remarked several times the same way on different evenings. The second or third time we asked why she was correcting herself. We'd never used the term, never heard her use it and she said "we always called them peepers". But "we" never did. She may have as a child? Her speaking and writing grammar was always perfect when we were growing up, but as she's aged, she uses more rural colloquialisms that maybe her elders used. It's really peculiar. So much to unpack. Sorry for the very long response.
But it would hurt to have Mom get a good physical. Labs will tell her how her numbers are. There could be something physical. Thyroid does a job on the body if out of wack. Low potassium, high sugar and dehydration can produce Dementia type symptoms. The doctor can perform a cognitive test but in early stages she may do well.
For example in this case, what would the opposite of “lazy” be? If someone is “lazy” how should they be expected to act to be “not lazy”?
I’m fine with “confused preoccupied forgetful inattentive……” any of those and more, but “lazy” implies a deliberate lack of…….something?
Since lockdown and subsequent Covid infection, I’ve had symptoms like your mother’s. I’d certainly prefer that observers would be congruent with the fact that the changes in our recent lives have been fairly devastating to some of us.
On the other hand, if she is not seen on a fairly regular basis by a medical professional who is keeping track of her blood pressure, blood chemistries, basic good health practices for 80 year olds, YES, it’s definitely time for that.
I understand your concern, OP, and I’m not criticizing you. Just continue to be a good observer.
I'd love a better term to describe her more generously. I attempted to paint the picture that we are not talking about someone in steep decline, rather a gradual sloping toward increased confusion and short term memory loss.
And the whole gas station thing and the 'parroting' what other people say has been common in MIL too. For a while. You may be at the start of the journey, but it may be a long one. It has been for us, and without proper testing and a real diagnosis, it is just one day at a time.
We've done blood work and everything was fine, including B12, thyroid and vitamin D. All can lead to issues. Some meds can cause confusion so I've worked with docs to eliminate/reduce these. So far, have not found any cause and minor med changes have not helped at all.
Next stop is a sleep study since in the fall when in hospital from knee replacement, nurse thought she might have sleep apnea which could definitely be a contributor to wacky behavior and confusion.
The other day I said to her " that should do the trick" and she was very confused. "The trick??". Yes, it's a saying. That I've probably used hundreds of times.
Just goes on and on and on. Some days, I can barely stand it.
Taking her back to doc that made med changes a month ago to see what's next on our agenda. Blood work to compare for any positive or negative changes.
At some point I think I want a CT scan or something to show if she does have dementia or if we end up in the AZ category if no cause is found.
Not sure how to go about encouraging her inquire about a CT scan. Will work with my sister on ideas.
I am so ready to have what you call a "lazy mind". When I retired I thought, great I don't have to think anymore. Well from 2011 to 2017 thats all I did, Forms, Forms, Forms. Helping nephew get his Medicaid and SSD. Working with local and state Disability Depts. Then my Mom was diagnosed with Dementia. Getting her placed in an AL and later LTC. Forms. After her death, minding her house until it sold 2 yrs later. Then, my GS had a brain operation and for the last year helping him with unemployment and Disability. Forms again. I will be glad when I don't have to think anymore. I don't have to fill out another form.
As we age there is some cognitive decline. If your parents are happy with the status quo, then let them be. With the world the way it is now, they don't really need to know what's going on or travel. They are too old to change things.
She started as a hobby at 91.
I noticed by approx 2010 (she was 85) she was parroting conversations that had just taken place. By 2015 she was starting to become easily agitated, as well as, paranoid and prone to embellishing more. Dad indulged her and when I spoke to him privately asking if she was okay he'd always deny there was a problem.
By 2017 she had stopped coming to the phone as frequently (I realize now it's because she didn't want me to know she had dementia. I remember being 8 yrs old and her saying "never put me in a home. Promise me you won't")
I suspect had her little old body not broken down and made it impossible for my dad to take care of her on his own, they would have continued on. I got them to safety in Sept 2018 by at least in getting them into LTC room together and we lost her 6 months later but at least it was easier on him because he was surrounded by caregivers who had known the woman he loved.
In my heart of hearts I knew something was going on. Trust your instincts and good luck.
It could be a number of things or nothing. My mother is 88 and the RN sent by Insurer just did the cognitive test on mom and she passed. She has been diagnosed with MCI (Mild Cognitive Impairment) - she complains that the shut down made her MCI worse - that may be. Mom has always been slow in picking the words she uses (when younger and living at home I used to finish her sentences). I have noticed that she speaks even slower these days. But she is living in an IL facility; doesn't have to cook; has housekeeping every other week.
My grandmother in her later years experienced TIAs and you could see her go fuzzy for a few moments then she'd come back.
My father had AD. While in the early stages he still drove but his AD got worse his driving diminished and once left for a funeral but came back home because he got lost. (Oh the nightmares I had before he finally agreed to stop driving.) Even before he died (unrelated to his dementia) he could hold a conversation though sometimes he wasn't all there.
I'm sorry but I feel calling them intellectually lazy to be demeaning. Don't be upset about them not being intellectually curious - at their age maybe I would be less curious about what goes on around me - especially with all the continuous turmoil and hate reported these days. As for watching shows that enforce their biases - don't most of us?
With regards to the lazy comment, it is demeaning. I use the term in an effort to encapsulate several issues and offer a more simplistic term for the purposes of this post. Without digging too deep here, I would say she likely has suffered from depression and insecurity her entire life and it resulted in her lacking motivation and self confidence, and thus she appears lazy.
Also, I'm not judging them for watching "their" news, rather, the point is that network TV is full-stop her consumption of information. No books, no magazines, no talk radio, no classes, etc. Again, no judgement. My description and details were shared only to paint the picture that this is not a steep decline, and ask, should I be worried given who she is.
Sign 1: Memory loss that affects day-to-day abilities
Is the person you know, forgetting things often or struggling to retain new information?
It's normal to occasionally forget appointments, colleagues’ names or a friend’s phone number only to remember them a short while later. However, a person living with dementia may forget things more often or may have difficulty recalling information that has recently been learned.
Sign 2: Difficulty performing familiar tasks
Is the person you know, forgetting how to do a typical routine or task, such as preparing a meal or getting dressed?
Busy people can be so distracted from time to time that they may forget to serve part of a meal, only to remember about it later. However, a person living with dementia may have trouble completing tasks that have been familiar to them all their lives, such as preparing a meal or playing a game.
Sign 3: Problems with language
Is the the person you know, forgetting words or substituting words that don’t fit into a conversation?
Anyone can have trouble finding the right word to express what they want to say. However, a person living with dementia may forget simple words or may substitute words such that what they are saying is difficult to understand.
Sign 4: Disorientation in time and space
Is the person you know, having problems knowing what day of the week it is or getting lost in a familiar place?
It's common to forget the day of the week or one's destination – for a moment. But people living with dementia can become lost on their own street, not knowing how they got there or how to get home.
Sign 5: Impaired judgement
Is the person you know, not recognizing something that can put health and safety at risk?
From time to time, people may make questionable decisions such as putting off seeing a doctor when they are not feeling well. However, a person living with dementia may experience changes in judgment or decision-making, such as not recognizing a medical problem that needs attention or wearing heavy clothing on a hot day.
Sign 6: Problems with abstract thinking
Is the person you know, having problems understanding what numbers and symbols mean?
From time to time, people may have difficulty with tasks that require abstract thinking, such as using a calculator or balancing a chequebook. However, someone living with dementia may have significant difficulties with such tasks because of a loss of understanding what numbers are and how they are used.
Sign 7: Misplacing things
Is the person you know, putting things in places where they shouldn't be?
Anyone can temporarily misplace a wallet or keys. However, a person living with dementia may put things in inappropriate places. For example, an iron in the freezer, or a wristwatch in the sugar bowl.
Sign 8: Changes in mood and behaviour
Is the person you know, exhibiting severe changes in mood?
Anyone can feel sad or moody from time to time. However, someone living with dementia can show varied mood swings – from calmness to tears to anger – for no apparent reason.
Sign 9: Changes in personality
Is the person you know, behaving in a way that's out of character?
Personalities can change in subtle ways over time. However, a person living with dementia may experience more striking personality changes and can become confused, suspicious or withdrawn. Changes may also include lack of interest or fearfulness.
Sign 10: Loss of initiative
Are you, or the person you know, losing interest in friends, family and favourite activities?
It's normal to tire of housework, business activities or social obligations, but most people regain their initiative. However, a person living with dementia may become passive and disinterested, and require cues and prompting to become involved
Good threads here, and a dedicated spouse thread:
https://www.alzconnected.org/discussion.aspx?g=topics&f=151
I found these very helpful:
https://www.youtube.com/watch?v=pqmqC-702Yg
https://www.youtube.com/watch?v=TIkTO4d8YyI
http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf
https://tamcummings.com/stages-of-dementia/
https://www.youtube.com/watch?v=ilickabmjww
Best wishes,