Home for the Holidays, Facing Dementia

Coming home for the holidays carries with it many relational and emotional challenges. While there is hopefully some wonderfulness and childlike magic there are also expected and unexpected stressors. While I wish I could fully address all the many facets of emotional stress over the holidays all I will say is be gentle with yourself and others, its okay to find a closet or a parking lot to hide in for a while and ask for help when you need it.

Today I’m going to address a specific ‘home for the holidays’ stressor I rarely hear discussed at parties but I know to be a real and painful holiday experience.

When I worked in Geropsychiatry we often had a rise in admissions just after the Holidays when families would get together and realize “Dad’s not right”. Dementia in all forms comes on gradually and it is often those closest to the individual who miss the early signs. After spending more time with them during family gathering it feels like all of a sudden Mom is not okay. I wanted to briefly go over some things to watch for if you are at all concerned. Its important to note that the primary difference between a normal age related forgetfulness and advancing dementia is consistency and impact on daily living. Here are a few things to look for.

Forgets significant dates (birthdays, anniversaries).
Forgets routes to familiar locations.
Unable to follow a familiar recipe or balance a check book.
Demonstrates difficulty finding the right word in conversation.
Unable to remember the name of a family member or close friend.
Unable to keep appointments straight or remember what day it is.
Poor judgement in dressing (short sleeve shirt to the snow).
Poor judgement in spending.
Increased clumsiness or small vehicle accidents.
Losing items and unable to retrace steps to find them or finding them in odd places.
Mood swings.
Repetitive speech, talking in circles.
Loss of initiative, seeming to give up.
Paranoia or suspiciousness.
Constant crying or tearfulness with no obvious prompt.
Change in personality or behavior.
Unable to make simple meals.
Decrease in self care (bathing, grooming, changing clothes)
Not maintaining household duties (cleaning ect.) that are within physical abilities.
Gets lost in familiar areas.

If you checked more than 4 items or if the items you did check are to the point of impacting daily life and safety it would be a good idea to check in with your loved one’s doctor. Again look at the consistency or extremity. We all can forget a word occasionally but if its several times a day that's a concern. While all of the above are indicators of dementia they could also be caused by other things such as poor diet, not taking medication correctly, grief, stress, depression, infection, other physical issues.

We always want our loved ones to be okay and it is very common for us consciously or subconsciously to attempt to will them to be better, to rationalize or ignore signs. Currently there is no cure for Alzheimers disease but there are medications that slow the progression when caught early, there are also simple lifestyle changes that can improve quality of life when attended to early. The more proactive you can be before it becomes a crisis the better.

Any transition or shift in family situations can be difficult, recognizing your loved ones need for increased care impacts the entire family. It is very common to experience feelings of fear, anger, anxiety, depression and guilt. Such shifts can also revive, intensify or initiate family tensions or unresolved relational issues. It is important to seek help for yourself as you seek help for your loved one. I would love to accompany you on this journey or help you find someone who can, contact me here.

A few resources to get you started are the alzheimers association with local chapters in orange county and LA county if you are in the orange county area, Senior Care 101 is a monthly informational seminar on senior resources, for more information on alzheimers, the alzheimers family center is offering a mind boosters series in January. I won't overwhelm you with reading options but I will recommend The 36-hour day and I have to confess I’m a fan of the dummies books there's no shame in it, they are clear, thorough and comprehensive.

This is a lot of information and I'm really just scratching the surface. I plan to do more entries on Dementia and aging. If you have questions or specific topics you would like to hear more of contact me or comment below. I truly hope that your holiday season is one of grace and joy and that despite it all you are able to rest, enjoy a cookie, laugh with a friend, breathe in the smells and embrace what is good about right now.