Misplaces Car Keys and Wonders Is This Dementia? – Encore

Are you caring for a loved one with dementia? You don't have to figure this out all on your own. Welcome to Truth, Lies Alzheimer's, the show that helps you reimagine a new relationship with your loved one, a relationship a little more free of stress and anxiety. Join host Lisa Skinner and her 30+ years of experience as she guides you on a new path to a better relationship with those you care for. Here's Lisa.

So hello to all of you who have tuned in to listen to this episode of The Truth Lies in Alzheimer's Show. I am Lisa Skinner, your host, and I'd like to shout out a very warm welcome to all of you who have joined us today Today. Thanks for being here. Now, the purpose of this show is to talk about every aspect of Alzheimer's disease and dementia, and that of course will include the good, the bad, and yes, the ugly. My goal is to get to the truth, dispel the lies and myths and unveil the secret faces of Alzheimer's disease in order for you to understand what it's truly like to live with a brain disease. My hope is to zoom outside the paradigm of it exclusively being a memory loss condition and to shift people's understanding of just how dramatically this disease impacts the lives of those who have it, as well as their caregivers, the family members— well, for that matter, anybody who is involved in the life of a person living with dementia. My story started almost 50 years ago when my grandmother began displaying some very unusual behaviors. I dropped in to visit her one day, and she began in Spanish fisting, that there were birds living in her mattress that would come out at night and peck her face. She told me about the rats that ran along her walls and that were invading her home. She talked about the men who were trying to break into her home to not only steal her belongings but insisted they were going to harm her. And the thing is, is she 100% believed everything she was telling me. Well, it turned out that this was the beginning of our 20-year journey with my grandmother's Alzheimer's disease. So fast-forwarding a few years, I became a behavioral specialist and have spent the past 30 years helping family members and caregivers understand understand the devastating effects of this disease so they too could learn how to best live with the unexpected surprises that emerge day after day. That way, they could spend their time focusing on what truly matters, and that is spending quality time with their loved ones. And I'm here for you now. To do the same thing. I've also authored several books on the subject, written a training program, and believe it or not, I have watched my— 8 of my own family members fall prey to one of the brain diseases that cause dementia. I'm also a certified dementia care trainer through the Alzheimer's Association, and I'm a certified dementia practitioner Lisa Skinner. There are so many aspects of living with dementia that are unexpected and can surface out of nowhere at any time, and these are what I call the hidden or secret faces of Alzheimer's disease. And as many of you already know, they show up unannounced and are completely unpredictable, and that's why it's so important to be prepared for anything that emerges on this journey. Knowledge is definitely power, and I am here to arm you with that knowledge so you too will have the power to negotiate the many challenges you will face having a loved one or while caring for someone living with dementia. Now, living with dementia is probably unlike anything any of us could ever imagine. Think of it as like falling into a rabbit hole and entering a world unlike anything you've ever known. Yes, just like Alice in the Alice in Wonderland story. She entered into a world that was completely unfamiliar to her. Well, that said, it's equally important to not only understand what will occur on a day-to-day basis, but why these things occur. What is happening to the person's changing brain as they progress through the various stages of Alzheimer's disease? Understanding these principles will be key to you being able to understand and be prepared for the challenges that you will likely face if you are caring for somebody living with Alzheimer's disease or if you have a family member living with Alzheimer's disease. And it is really critical for us to talk about all of this because it does take very specialized knowledge and training to know how to effectively respond to the situations that do arise with a damaged brain. That way you can avoid any situation from escalating into an extreme one. That is what we call a catastrophic reaction. And unfortunately, no amount of reasoning can talk the person who is experiencing many of these symptoms out of their beliefs, like my grandma. So we must rely on alternative strategies to manage them. Now, 90% of people with dementia will display the behavioral impulses that typically accompany brain disease. Isn't that reason enough to be prepared? Tonight, I am going to be talking about the difference between the normal aging process and forgetfulness and whether or not a more serious Brain disease may be developing. So, when was the last time you forgot where you placed your car keys or set your phone down? How about walking into a room and forgetting why you went in there? Have you ever been in the middle of a conversation and couldn't for the life of you remember the name of someone you wanted to share a story about? When that happened, did you frantically worry that you might be developing dementia? Well, if that's true, you're not alone because a lot of people do. According to the National Institute on Aging, many older adults do worry about their memory, but the things I just mentioned are usually not serious age-related memory problems but just part of normal aging. According to the Alzheimer's Association, signs of normal aging can look like this: you become a little more forgetful. Maybe you take a little bit longer to remember things. Perhaps you get distracted more easily, or you find it a little more difficult to do several things at once. This can just all be part of the normal aging process of forgetfulness that happens to most of us. Now, these changes in brain function may be frustrating but may only be a natural part of aging and not— I'm going to repeat that— not necessarily a sign of dementia. People can begin to notice these changes starting as early as in their 40s or 50s. Learning new information and returning— retaining that information may decline slightly, usually when a person reaches their late 60s. Then they experience more noticeable declines in their 70s and 80s. Now, statistically, approximately 40% of people age 65 and over do have some age-associated memory impairment, but of the 40% who do— listen carefully— of the 40% who do, only about 1% of them will progress to develop dementia. Additionally, hearing problems may also be a culprit behind people missing parts of conversations and may appear to have a memory issue. Studies suggest that treating hearing loss with hearing aids may actually reduce the risk of developing dementia by as much as 19%. Now, if it becomes obvious that the onset of short-term memory loss after the age of 65 is consistently noticeable, it may be the early stages of mild cognitive impairment due to Alzheimer's disease. In a lot of people, though, mild cognitive impairment can be caused by several factors such as a nutrient deficiency or a hormonal imbalance, and once resolved, can be reversed, whereas dementia— 99% of dementias cannot be reversed. Now, not everybody who displays mild cognitive impairment will progress into dementia caused by a brain disease such as Alzheimer's disease. Mild cognitive impairment, also known as MCI, is commonly defined as a subtle but measurable memory disorder more severe than the normal aging decline. So it's a step above normal aging forgetfulness, but does not show other symptoms of dementia, such as impaired judgment or reasoning. Because the changes caused by mild cognitive impairment are not severe enough to affect daily life, a person with mild cognitive impairment does not meet diagnostic guidelines for dementia. People with mild cognitive impairment do have an increased risk of eventually developing Alzheimer's disease or another type of brain disease that causes dementia, but not everybody with mild cognitive impairment does and can remain stable and even improve, which is not the case with dementia. So, if your doctor tells you that you have mild cognitive impairment, you may stay with— that diagnosis for the rest of your life. Some will progress into Alzheimer's disease or another related dementia, and others will just stay right in that mild cognitive impairment bucket. Now, some of the mild cognitive impairment symptoms that you want to try to recognize may include Forgetting appointments or social events. Misplacing household items like car keys, etc. Having greater difficulty finding the correct words than your peers of the same age. Having trouble remembering events, instructions, or conversations. Occasionally repeating yourself and possibly occasionally missing a payment on a bill. With dementia, these things happen much more frequently, and the cognitive issues interfere with one's ability to function on a daily basis. The progression of symptoms generally corresponds to the underlying nerve cell degeneration, usually beginning with the cells that attack and destroy destroy learning and memory and then gradually moves to cells that control all aspects of thinking, judgment, and behavior. Now, that damage eventually spreads to the cells that control movement. Alzheimer's disease and other dementia affect people in different ways, and each person will experience symptoms symptoms or progress through the stages differently. And the stages, keep in mind, can also overlap, making it difficult to definitively place a person into a particular stage. Now, keep in mind, people also vary in the length of time spent in any one of these stages and in which stage the signs and symptoms appear. However, the progression always worsens with time due to an increase in brain decay. Now, some of the early and more common symptoms of Alzheimer's disease include confusion, memory loss, short attention span, struggling with problem-solving and decision-making skills, becoming easily agitated, restless, and displaying anxiety, difficult finding the right words when speaking or writing, and easily getting lost. Now, because Alzheimer's disease is caused by misshapen protein structures in the brain, which are called beta amyloid plaques and tau tangles. Over time, these malformations kill the brain cells they're in, limiting cognitive function. And because Alzheimer's disease is defined by these microscopic changes in the brain, doctors cannot say for certain whether a person has Alzheimer's disease without first performing an autopsy. The late stage of dementia is one of near total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious and may include becoming unaware of time and place, having difficulty recognizing relatives and friends, Having an increasing need for assistance with self-care. Having difficulty walking is another thing to recognize. Or experiencing behavioral changes that may escalate and include aggression. Now, what is the difference that I kind of use as an example, because I stated in the earlier stages, and it could be part of mild cognitive impairment, is misplacing your keys. So, another difference to look for is it's one thing to misplace your keys. We all do it, including me. Now, somebody that has a more serious problem developing in their brain and could be considered a red flag is if they misplace their keys and then find them or somebody else finds them and hands them that set of keys, the person with a more serious problem developing in their brain would not know what to do with those keys. They would not remember that the function of those keys is to put into the ignition of their car and that it starts the engine and you get in your car and you drive away. That's a huge red flag and the difference between normal aging forgetfulness and a more serious brain disease starting to develop. Experts have documented common patterns of symptom progression that occur in individuals with brain disease and therefore developed several methods of stage categorization based on these patterns. The progression of symptoms generally corresponds to the underlying nerve cell degeneration, usually beginning with cells that attack and destroy destroy learning and memory and then gradually moves into cells that control all aspects of thinking, judgment, and behavior. The damage eventually spreads to cells that control movement. This is the progression of Alzheimer's disease and one of the other brain diseases that causes dementia. This does not happen with mild cognitive impairment. And it does not happen with the normal aging forgetfulness that we commonly see when we start getting into our 40s, 50s, 60s, and beyond. Now, mild cognitive impairment is commonly defined as a subtle but measurable memory disorder more severe than with normal aging decline, but does not show other symptoms of dementia, such as the impaired judgment or reasoning. So I'm repeating this, it's very important. Alzheimer's disease on the under— on the other hand typically progresses slowly in 3 general stages referred to as the mild or early stage, the moderate stage, which is the mid-stage, and the severe or late stage. There is another model that is used. I prefer the 3-stage model, but there is also a 7-stage model. But again, not everybody follows the symptoms that are within each stage exactly the same way, and they do tend to overlap. So, it's really meant to be a guideline and not set in stone. Since Alzheimer's disease and other dementia affect people in different ways, each person will experience symptoms or progress through the stages differently. Additionally, because the stages may overlap, it may be difficult to definitively place a person into a particular stage. And I used to lead a support group at a memory care unit for family members. I did that for 3 years, and I would kind of chuckle to myself because a lot of family members would come into the support group, they'd introduce themselves, and they'd say, "Yes, my mother is stage 6." And, you know, they were just adamant that that was the stage of their mother's disease, but I of course didn't want to burst anybody's bubble, so I didn't try to correct them if they really firmly believed that their parent was definitively into a particular stage. There's a saying in our industry, and I've said this before, if you've met one person with dementia, Guess what? You've only met one person with dementia because everybody, trust me on this, progresses through this disease differently. And because the stage— oh, people vary in length of time spent in any one of the stages and in which stage the signs and symptoms appear, but there's one thing that is consistent. The progression always worsens with time. The amount of time differs from person to person, but it's a foregone conclusion that it will progressively worsen. Now, the stages I described are really groups of symptoms that reflect an increase in brain decay, and although the rate at which this How the disease progresses varies. I mentioned that already. According to the Alzheimer's Association, on average, a person with Alzheimer's disease lives 4 to 15 years after diagnosis, but can live as long as 20 years depending on other factors. My grandmother lived with it for 20 years. That was a very long course she progressed through Alzheimer's disease, and different types of brain diseases progress more rapidly than others. Early stage, which is again called the mild stage, can be anywhere from 2 to 4 years leading up to and including diagnosis. Now, that's an average because I have heard of and I know of people that have lived a decade in the mild or early stage and they were practically asymptomatic. So, in other words, they were showing no symptoms of having cognitive decline. And I also told you all that the average person is not even diagnosed with Alzheimer's disease till they're well into the mid-stage of the disease, and this is part of the challenge that so many doctors have is because the earlier symptoms are so difficult to differentiate between the normal aging forgetfulness that we just talked about and the mild cognitive impairment that we just talked about. So, again, a person may seem to function quite normally in the earliest stages of the disease. He or she may begin to forget familiar words or the whereabouts of such items as their reading glasses, their house keys, etc. He or she may still seem capable of driving, working, and participating in usual social activities with no significantly noticeable changes, or friends and family may begin to notice some very subtle changes and difficulties. But over time, people with dementia often find it difficult to express themselves and to understand others. That's typically one of the first signs you're going to want to listen for. Difficulty finding the right word to go— to fit into whatever it is they're saying. Memory loss is evident in normal aging but differs from memory loss caused by Alzheimer's disease and other related dementia. It is not common for the elderly to experience some rate of decline in cognitive thinking and reasoning abilities that doesn't necessarily mean they have brain disease. However, the elderly can still learn and retain new information, whereas with brain disease they cannot. That's another important sign to look for. If they try to retain some new information, with Alzheimer's disease they're not capable of doing that. An example of normal forgetfulness Again, very commonly is misplacing car keys, whereas abnormal forgetfulness may not be knowing what the function of those car keys are. Other signs of difficulties associated with brain disease in the early stages and not with the normal part of aging may include difficulty coming up with the right word or name. Difficulty remembering names when introduced to new people. Having greater difficulty performing tasks in social or work settings. Forgetting material that one has just read. That's an obvious clue. Losing or misplacing valuable objects. Increasing trouble with planning or organizing. Using familiar words repeatedly. The person will tend to repeat questions, phrases, or stories in the same conversation. Inventing new words to describe familiar objects. We call this confabulation. So, they can't think of the word, so they just replace the right word with just something that they think up. They invent a new word. Frequently losing their train of thought or difficulty organizing words in a logical order. Reverting to speaking. This is another really noticeable one and it happens actually very commonly. Reverting to speaking to their native language. So if their first language is Spanish, a lot of times when people are developing a brain disease, they start reverting to speaking their first language and not the second or third languages that they learned. Cursing or using offensive words. Troubling with words is common, and I talked about this when I went through frontotemporal dementia in one of our previous episodes. That's actually a common symptom of FTD. Speaking less often and then relying on nonverbal gestures. Now, memory loss will become a problem when it affects affects the person's ability to perform everyday tasks that are not part of normal aging. One of the most common early signs of dementia is forgetting recently learned information. What are those? Somebody's name. You introduce somebody and you say, "Hi, this is John," and the person with brain disease reaches out their hand to say hello and the name just escapes them. That is a common beginning sign of dementia. It's perfectly normal to forget appointments, names, telephone numbers, but people with dementia will forget things more often and not remember them later. They may also experience challenges in following a plan, like a familiar recipe, trouble keeping track of monthly bills, have difficulty concentrating, taking much longer to perform a task, difficulty completing familiar tasks, difficulty Following directions, difficulty understanding large amounts of information, difficulty writing, difficulty speaking. Somebody's showing signs of dementia, I'm going to give this to you as a really good example. They want to go to the store and they're trying to write down a list of the groceries that they need to prepare a couple of the meals that they are very familiar with and cannot remember what those ingredients are to put on the list that they need to purchase so they can make a meal that they might be planning to make during the week. That just is a very difficult thing to do with dementia. When Alzheimer's disease or other related dementia have been diagnosed early, the loss of abilities, again, is often mild, and with a little bit of help, the individual can continue to live independently. However, more often, by the time the disease is diagnosed, again, typically in the mid-stage of the disease, they've already progressed and therefore may need considerable help with activities of daily living. So, there are some very big and significant differences between mild dementia, the early stage, that are difficult to differentiate between the normal aging for forgetfulness that a lot of us experience, mild cognitive impairment, which is a little bit step above normal aging forgetfulness, and something like Alzheimer's beginning to develop. And this is why it has been so challenging for doctors to make a diagnosis until it becomes so obvious that there is something really serious going on. And that's typically when they begin to enter the mid-stage. And then by that time, they're really going to start to need help with their activities of daily living. So, other things that I just want to bring to your attention that can mimic the same symptoms and behaviors as— what we just talked about, typically more early stages or mid-stage of dementia, are urinary tract infections, Lyme disease, strokes. I want to use Kris Kristofferson, the actor and musician. He was displaying many of the common symptoms and signs of Alzheimer's disease. His doctor made a diagnosis of Alzheimer's disease, and he was treated for it for 3 years. His doctor suggested that he be tested for Lyme disease. So, he was. And lo and behold, Chris— Christofferson tested positive for Lyme disease. Again, he had an initial diagnosis of Alzheimer's disease, was treated for it for 3 years, and it turned out to be Lyme disease. And the important point to this is there is right now no definitive test for Alzheimer's disease other than performing an autopsy after a person has already passed away. So, if they are They're displaying these symptoms. Keep in mind, the doctors most often will use a process of elimination, but just make sure you act as your loved one's advocate and make sure they test for urinary tract infections and Lyme disease. Now, another thing you want to look for is when their symptoms and signs can put them in dangerous situations. When it interferes with their activities of daily living, that is not part of the normal aging process. If your mother has been going into her kitchen for 50 years and making coffee, whether or not it was from a percolator decades ago, or a Mr. Coffee coffee maker or a Keurig machine today, if she has Alzheimer's disease or another related dementia, eventually she will forget how to make that cup of coffee and use that machine even though it's been part of her routine every single day. So, I want to thank you. All for listening today. We have so much to cover in our upcoming episodes, and I want to provide you with information that you will find helpful and valuable throughout this journey. Remember, dementia awareness is every day, and kindness is the ability to speak with love, listen with compassion, and act with patience. These are all very necessary attributes to have in order to outlast dementia. If you'd like to send me any of your comments or give me any feedback or maybe some topic ideas that you may like me to present on one of the episodes, you can send them to my personal email, which is dementiawhisperer1@gmail.com. Also, if you're listening to this on YouTube or if you got here through our social media page, please leave your comments or questions and I will do my best to address them. I genuinely look forward to receiving your thoughts and ideas and comments, and in the meantime, take care of you and I'll talk to you next week.

Thank you for listening to Truth, Lies Alzheimer's. We hope you found something in today's episode that helps. We understand that caring for a loved one with dementia can be the challenge of a lifetime, but you don't have to do it alone. If you're ready for exclusive access to even more great content and resources, head on over to Facebook and join Lisa Skinner's Minding Dementia support group, where a community of like-minded Caregivers, and we're here to help.