Caring for an Elderly Relative: Signs of Dementia and What to Do

Elderly individuals with dementia at home?

My grandmother at home is 92 years old and, considering her physical condition, she is doing quite well.
Her mental state is also relatively stable; she can still walk around with a cane.
However, recently I have been concerned that she may be developing dementia.
Her sleep schedule is reversed, and although I can hear her snoring, she insists that she is not asleep.
She frequently asks if it is dawn, sometimes asking three times within five minutes what time it is.
She often experiences auditory and visual hallucinations, and this has become more severe lately, as she talks to herself and alternates between laughing and crying.
Her memory of family members is deteriorating; she even asks my mother to hold her, despite me being 25 years old.
It seems like her memories are stuck in the past.

Our family is small; my father, brother, and I all have to go to work, leaving only my grandmother and mother at home.
However, my mother sometimes has to go out for errands and cannot always be at home.
I worry that my grandmother might wander out when no one is around, which could be dangerous.
I researched online and found that these symptoms could indicate dementia.
Is this true? Given our situation, how should we handle this? My mother previously suggested taking her to the hospital for an evaluation, but my father was not very supportive, saying that this is normal for her age.
What should I do? Thank you!

Xiao Fei, 20~29 year old female. Ask Date: 2003/06/22

Dr. Ouyang Wenzhen reply Geriatrics

Hello, Xiao Fei! Your grandmother may indeed have dementia, specifically Alzheimer's disease.
The likelihood of developing dementia increases with age, and by the age of 85 and older, approximately 20% of individuals may have dementia.
Your grandmother's tendency to only remember "past events" and her repetitive questioning are cognitive symptoms associated with dementia, particularly indicative of poor recent memory.
Additionally, experiencing auditory hallucinations or unusual thoughts is also quite common in dementia.
You can visit a nearby large hospital or a public health center's psychiatry or neurology department that specializes in dementia (or cognitive impairment) for a memory clinic.
Currently, there are new generation medications available for mild to moderate dementia that address memory issues and associated psychiatric symptoms (such as hallucinations, delusions, and depression), which have fewer side effects and are quite effective.
Wishing you all the best! Ouyang Wenzhen 92.06.24

Reply Date: 2003/06/22

More Info

Caring for an elderly relative, especially one who may be showing signs of dementia, can be a challenging and emotional experience. In your grandmother's case, at 92 years old, it is understandable to be concerned about her cognitive health given the symptoms you described, such as sleep disturbances, repetitive questioning, hallucinations, and memory issues. These can indeed be indicative of dementia, but they can also stem from other medical conditions or even normal aging processes.

Signs of Dementia
Dementia is characterized by a decline in cognitive function that interferes with daily life. Common signs include:
1. Memory Loss: Difficulty remembering recent events or conversations, as you noted with your grandmother frequently asking for the time.

2. Disorientation: Confusion about time or place, which can manifest as asking if it is morning or evening.

3. Changes in Mood or Behavior: Sudden emotional shifts, such as laughing or crying without clear reasons, can be a sign of cognitive decline.

4. Hallucinations or Delusions: Experiencing things that are not present, such as hearing voices or seeing things that aren’t there.

5. Difficulty with Communication: Struggling to find words or follow conversations, which can lead to frustration for both the individual and their family.

What to Do
Given your grandmother's symptoms, it is crucial to take the following steps:
1. Consult a Healthcare Professional: It is essential to have a thorough evaluation by a healthcare provider, preferably a neurologist or geriatrician, who specializes in cognitive disorders. They can conduct cognitive assessments and rule out other potential causes of her symptoms, such as vitamin deficiencies, thyroid issues, or infections.

2. Document Symptoms: Keep a detailed record of her behaviors, including when they occur and any patterns you notice. This information will be valuable for the healthcare provider in making a diagnosis.

3. Create a Safe Environment: Since you are concerned about her wandering off when family members are not home, consider safety measures such as:
- Installing locks that are out of her reach.

- Using door alarms to alert you if she tries to leave.

- Ensuring she has identification on her in case she does wander away.

4. Engage in Activities: Encourage her to participate in activities that stimulate her mind and body, such as puzzles, reading, or light exercise. Social interaction is also beneficial, so consider arranging visits from friends or family.

5. Consider Adult Day Care: If your family’s schedule allows, look into adult day care programs where she can engage with others and receive supervision while you and your family are at work.

6. Educate Your Family: It may be helpful to have an open discussion with your family about your grandmother’s condition. Emphasize the importance of seeking medical advice rather than dismissing her symptoms as typical aging. Sometimes, family members may be in denial or may not fully understand the implications of dementia.

7. Support for Caregivers: Caring for someone with dementia can be overwhelming. Look for local support groups for caregivers where you can share experiences and gain insights from others in similar situations.

Conclusion
It’s important to approach this situation with compassion and understanding. Your grandmother’s behaviors are likely not intentional but rather symptoms of a medical condition. By seeking professional help and implementing supportive measures, you can improve her quality of life and ensure her safety. Remember, early intervention can make a significant difference in managing dementia and its effects on both the individual and their family.

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