Coping with Elderly Dementia: Symptoms and Seeking Help

Regarding dementia in the elderly?

Hello Doctor, my grandmother has been showing symptoms similar to dementia for about five years (forgetting things, repeatedly asking the same questions, not remembering if she has eaten, forgetting to bathe).
However, after testing at the hospital, the doctor said it was just aging and not dementia.
I feel that her condition has worsened recently, with the same issues becoming more pronounced, and she seems to have some delusions, claiming events that never happened (for example, she says she had pneumonia as a child, but her siblings deny this, and she claims she lived in a house across from ours, which is not true!).
This symptom has been present for five years.
What should I do? Additionally, she is very resistant to seeing a doctor; previously, when she had a cold and was prescribed medication, she vomited the pills and criticized the doctor for being unkind.
She has discarded all the supplements given by the doctor five years ago and only trusts a seemingly unlicensed traditional Chinese medicine practitioner.
What should I do? Thank you, Doctor.

Grace, 10~19 year old female. Ask Date: 2018/01/05

Dr. Qiu Junda reply Psychiatry

Hello.
My grandmother may be experiencing what you refer to as dementia, which has been gradually causing difficulties in her daily life and with family over the past five years.
Please take her to the hospital for an evaluation and treatment at the dementia clinic as soon as possible.
However, the patient has poor insight into her condition (believing she is not ill) and may resist seeking medical attention.
I suggest that you encourage her to visit a psychiatrist or neurologist under the pretext of addressing physical symptoms (such as headaches or a cold).
You may also communicate with the physician in advance to discuss this approach.
This could help improve her condition sooner.
Thank you!

Reply Date: 2018/01/05

More Info

Coping with elderly dementia can be a challenging journey for both the affected individual and their family members. Your concerns about your grandmother's worsening symptoms, including memory loss, repetitive questioning, and the emergence of delusions, are valid and warrant careful consideration.
From your description, it seems that your grandmother may be exhibiting signs of cognitive decline that could be indicative of dementia, despite previous assessments suggesting that her symptoms were merely a part of the aging process. It is not uncommon for dementia to progress gradually, and symptoms can sometimes be misattributed to normal aging. The fact that she is experiencing delusions—such as recalling events that did not occur—suggests that her cognitive function may be deteriorating further.

Understanding Dementia Symptoms
Dementia is an umbrella term that encompasses various types of cognitive impairment, including Alzheimer's disease, vascular dementia, and others. Symptoms can vary widely but often include:
1. Memory Loss: Difficulty remembering recent events, conversations, or appointments.

2. Repetitive Questions: Asking the same question multiple times, often due to short-term memory loss.

3. Disorientation: Confusion about time, place, or identity.

4. Delusions or Hallucinations: Believing in things that are not true or perceiving things that are not present.

5. Changes in Mood or Behavior: Increased anxiety, agitation, or withdrawal from social interactions.

Seeking Help
Given your grandmother's symptoms, it is crucial to seek a comprehensive evaluation from a healthcare professional specializing in geriatrics or neurology. While she may have previously been assessed and deemed to have normal aging, her current symptoms suggest that a re-evaluation is necessary. This may include cognitive testing, brain imaging (like an MRI or CT scan), and a review of her medical history and medications.

Addressing Resistance to Medical Care
It is common for elderly individuals with cognitive decline to resist medical care, often due to a lack of insight into their condition. Here are some strategies to encourage her to seek help:
1. Empathy and Understanding: Approach her concerns with empathy. Acknowledge her feelings about past medical experiences and express your desire to help her feel better.

2. Involve Trusted Individuals: If there are family members or friends she trusts, involve them in the conversation. Sometimes, hearing the same message from different people can help.

3. Gentle Persuasion: Instead of insisting on a doctor's visit, frame it as a routine check-up or a way to ensure she stays healthy.
4. Alternative Options: If she is resistant to conventional medicine, consider exploring integrative approaches that combine traditional and alternative therapies, but ensure they are safe and evidence-based.

5. Home Health Services: If she is open to it, consider hiring a home health aide or geriatric care manager who can provide support and companionship, making it easier for her to accept help.

Supporting Her Daily Life
In the meantime, there are several ways you can support her daily life:
- Create a Routine: Establishing a daily routine can help provide structure and reduce confusion.

- Use Memory Aids: Consider using calendars, notes, or digital reminders to help her remember important tasks or events.

- Engage in Activities: Encourage her to participate in activities she enjoys, which can help stimulate her mind and improve her mood.

- Stay Patient and Calm: When she repeats questions or expresses delusions, respond calmly and patiently. Redirect the conversation if necessary, but avoid arguing about her beliefs.

Conclusion
Coping with a loved one's dementia can be emotionally taxing, but understanding the condition and seeking appropriate help can make a significant difference. It is essential to advocate for your grandmother's health while also respecting her feelings and autonomy. By approaching the situation with compassion and patience, you can help her navigate this challenging phase of life. Remember, you are not alone in this journey; many resources and support groups are available for caregivers and families dealing with dementia.

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