Ask the Expert: Forgetfulness: When to Call a Doctor

Q. My mother, Meg, has not been herself lately. Last week, when going to the neighborhood post office, she got completely disoriented and lost. She asks the same questions over and over again and often repeats stories. She even forgot the ingredients for dad’s favorite soup last week, which she has been cooking for 40 years. I am beginning to get concerned about her. I know seniors often experience normal, age-related memory changes. How can I tell if that is what is happening with mom, or if it is time to call a doctor?

A. As we grow older, some change in memory is normal. However, memory loss that disrupts daily life may be a symptom of Alzheimer’s or another dementia. Alzheimer’s is a brain disease that causes a slow decline in memory, thinking and reasoning skills. People with Alzheimer’s experience difficulties communicating, learning, thinking and reasoning – problems severe enough to have an impact on an individual’s work, social activities, and family life.

It’s always a good idea to check with a doctor if a person’s level of function seems to be changing. The Alzheimer’s Association believes that it is critical for people diagnosed with dementia and their families to receive information, care, and support as early as possible. Below are some common symptoms from Alz.org to help you recognize the difference between normal age-related memory changes and possible warning signs of Alzheimer’s disease or some other type of dementia:

• Memory loss:
  • Typical Age-Related Change:  Anyone can forget details from a recent event or conversation and recall them later.
  • Possible Dementia: One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or asking for help from family members for things they used to handle on their own.
• Abstract thinking, planning, and problem solving:
  • Typical Age-Related Change: Making occasional errors when balancing a checkbook.
  • Possible Dementia: Some people may experience changes in their ability to develop and follow a plan or work with numbers, and may forget what numbers are for and how they should be used. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
• Problems with writing or speaking:
  • Typical Age-Related Change:  Struggling to come up with the right word occasionally
  • Possible Dementia:  People with Alzheimer’s or other types of dementia can have problems remembering even basic words. Their way of speaking may become contorted and hard to follow. They may stop in the middle of a conversation and have no idea how to continue. They may struggle with vocabulary, have problems finding the right word, or call things by the wrong name (e.g., calling a “watch” a “hand-clock”). They also may repeat stories, sometimes word for word and may keep asking the same questions, no matter how many times they’re answered.
• Personality changes:
  • Typical Age-Related Change: Developing specific ways of doing things or becoming irritable when a routine is disrupted.
  • Possible Dementia: People with Alzheimer’s or other types of dementia may have sudden mood swings. They might become emotional – upset or angry – for no particular reason. They might become withdrawn or stop doing things they typically enjoy. They could become uncharacteristically suspicious of family members — or trusting of spammers, solicitors, or telemarketers.
• Disorientation and confusion:
  • Typical Age-Related Change: Misplacing things from time to time and retracing steps to find them.
  • Possible Dementia:  People with dementia may get lost in places they know very well, like their own neighborhoods. They may have trouble completing basic and familiar tasks, such as cooking dinner, bathing, or shaving. They may place objects in inappropriate places, such as putting a toothbrush in the freezer or milk in the cabinet under the sink. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing.
• Lack of hygiene:
  • Typical Age-Related Change: Wearing pajamas and slippers all day, leaving the house in a rush without deodorant, or wearing a shirt with a stain, and not noticing it is there.
  • Possible Dementia:  People who have dressed smartly every day of their lives might start wearing stained clothing or stop bathing
• Poor or Decreased Judgment:
  • Typical Age-Related Change: Making a questionable or debatable decision from time to time.
  • Possible Dementia: Those with dementia may dress inappropriately, wearing several layers on a warm day or shorts in the snow. They may show poor judgment, such as giving away large sums of money to solicitors or telemarketers.

If your loved one is exhibiting any signs of dementia described above, don’t panic. Having these symptoms doesn’t mean that your loved one necessarily has dementia. Other conditions that can cause similar symptoms can include vitamin deficiencies, thyroid problems, depression, drug interactions, and alcohol abuse. Many of these conditions are treatable.

If your loved one does have in fact have Alzheimer’s or another type of dementia, the earlier you catch it and the sooner you plan for it, the more time you’ll have to learn about the condition and prepare for what’s ahead.

Medicaid Planning for Dementia

A diagnosis of Alzheimer’s or any other type of dementia is life-changing for both diagnosed individuals and those close to them.  While it’s not easy to think about, if your loved one has recently been diagnosed, it’s imperative to make an appointment with a Certified Elder Law Attorney, such as myself, to determine who to name to make legal, financial, and medical decisions when your loved one is no longer able to do so. In addition, if your loved one hasn’t done so already, it is also of utmost importance to determine how he or she will pay for long-term care without financially bankrupting the family.

Medicaid Asset Protection

Persons with Alzheimer’s or another type of dementia and their families face special legal and financial needs. At The Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  If you have a loved one who is suffering from Alzheimer’s or any other type of dementia, we can help you prepare for your future financial and long-term care needs.  We can help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. Please contact The Law Firm of Evan H. Farr, P.C. in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, in Rockville, MD at 301-519-8041, or in Washington, D.C. at 202-587-2797 to schedule your appointment for a no-cost initial consultation.