Memory Care with Teresa Youngstrom
Signs and Symptoms of Dementia
- Hey, everybody, Teresa Youngstrom with Memory Care with Teresa Youngstrom. Thanks for coming back. You know, it's always great to see all of you. And it's so neat to see the base growing and how many people are starting to watch the podcast. So thank you. Thank you for sharing. Thank you for telling people about it. You know, there's so much to learn about dementia, so much this old nurse didn't know. And so I'm excited to share with you and anything you could do to further that would be excellent. So my company's a better approach to memory care. I'm Teresa Youngstrom and I'm a seasoned registered nurse and we'll just leave it with that, okay? Worked in a lot of different areas. And of course, I realized that I didn't know what I was doing with dementia when my mother got dementia and kicked me out of the house. So every week we talk about a different topic. Actually, sometimes I need two weeks to talk about a topic 'cause it's bigger than one week can do. And 'cause we're just doing approximately 30 minutes with you. So today I really want to go into what are the signs and symptoms of dementia? Because you know, just because as we get older, we miss an appointment or just because we can't remember someone's name or someone's date of birth or our kids say, remember when we went here and did this and you're like, I don't have any clue, all right, that doesn't necessarily mean anybody's got dementia, but there's a lot of fear out there because it seems to be more and more prevalent, especially here in the States. And so it is good to have a conversation with what is a real dementia and what is not? 'Cause a true dementia means, well, at least two parts of your brain are dying, okay? It's progressive, it's terminal. And right now we don't have a cure for it. We're certainly working on that. And there are organizations all over the world dedicating lots more time and money because it's become so prevalent. But we don't really have a cure for it yet. And there are lots of studies that you can get involved in if you'd like. But any time we start a medication, there can be side effects. And so weighing all that out, the pros and cons and the risks and the positives, that's a big challenge when it comes to this disease. But it is important to kind of know what's a real symptom and what's not. I was asked that today, I did a speaking event this morning and a woman came up and said, oh my goodness, I can just tell my husband's getting this. And I said, well, you know what I would do? I would keep a journal. And I would start journaling dates and times and what he did that made you think it was something worth worrying about. And we'll see if it progresses or if we'll see if it goes away. But it sure is helpful to a physician for you to have that kind of data. Just say, you know what? I've been seeing these symptoms since this year or this month and here's what we were doing and now it's progressed to this. Or I've had several people who I've given them that task of journaling, come back and say, you know what? It resolved. And I don't know if they were just having a bad week, a bad month, or if they maybe had some kind of virus that was making them, not be able to have kind of a foggy brain, but it passed. And I was thankful, thankful for that. So I would start with keeping a journal. But if we think about dementia, what is the most common symptom? That's right. Usually it's memory loss. And would you say it's short term or is it long term? Frequently short term. I can be long term, but frequently it's short term. We have a hippocampus in our brain. It's a part of our brain. That should be sticky. And so when experiences and memories come in or we read something or experience something, it should stick. And then when we sleep, those memories in short term should move back to our long term and they should be secured there. But when our brain is broken, that doesn't happen. And frequently, it's the short term memory that gets challenged. And you may not remember something day to day. Some folks don't remember things five minutes later. What time are we gonna leave? What time are we gonna leave? What time are we gonna leave? Okay? So memory loss, definitely a symptom. But I would keep a journal and just see if this is something that is progressing. How about getting lost? And we won't be able to talk about all the symptoms, but I just wanted to give you a nice overview of some things to think about. So getting lost, that can be a symptom. I've had clients who drove to, they were trying to get to a certain location, but they called from a mall and said, they said, "I'm not sure where I am." And I would recommend that if you have a loved one who you're concerned about memory, can we put a locator of some sort? You can put locators on cars, but you can also, if they carry a cell phone, you can have a locator there. My husband and I know we're each other. We know where we are all the time. And he can see where I'm working and how long I've been there. And if he's worried if I'm there too long or whatever. But I think that's perfect if you have someone in your life who's still driving, but you have concerns about their memory or them getting lost. Because I've read a statistic once that said, folks with memory loss can drive 300 miles looking for a sign that they're looking for a particular mall for JCPenney. And JCPenney doesn't exist anymore, but they're sure that's what they're looking for instead of maybe whatever replaced it the Macy's. And so how scary would that be? I did have a gentleman who drove to the next state and his car ran out of gas middle of the lane on an interstate. He had been incontinent. He was going to visit. Fortunately, he didn't hurt anybody, hurt himself. But the police officer said he was going to go visit a relative and he described this relative who between you and me had been gone for 15 years. So he was definitely confused and he definitely needed help and he probably shouldn't be driving any longer. And that can be a challenge in itself, okay? So getting lost could be a sign or symptom. But sometimes folks are able to still drive locally, maybe within a couple of miles of their home or maybe to the places where they drive frequently. Maybe it's just to the grocery, to the pharmacy, to their doctor, things like that, things that are really close or to their, one of their relatives' home that is within a mile or two. But these long distant drives can be really scary for people that have memory issues. What about anxiety, depression, or even hallucination? You know, anxiety doesn't have to be associated with dementia, but sometimes it is. I know I would be anxious if I wasn't remembering things. You know what's challenging for physicians and for us in general, those of us that work in this area is that mental health and dementia, brain failure, can overlap and it can be very difficult to discern what really is causing the problems here, okay? And the doctor might be trying medicines that are really more for the mental health side and may or may not work, but it's just so important to evaluate. One challenge that I see is that frequently we don't see these physicians very often. And so they may start a medication and you may not see them for six months. And I would hate to be on a medication that's not effective or not working. And so I just want to empower you that if the medication is after two weeks, four weeks is causing side effects, negative side effects, you know, it'd be worth a phone call to the physician because maybe we could stop the problem early on instead of using that for six months until things get worse, but maybe it's really helping. And I would think that follow up in feedback would want to be received sooner than six months later. Anyway, it's just a challenge we're seeing is that we're not seeing our physicians as often as we used to. And they see so many people, it makes it tough, okay? But anxiety, depression, hallucination. Well, hallucination can be a side effect from medication, but it also can be associated with a couple of different dementia diagnosis such as Louis body dementia. And sometimes Parkinsonian dementia, we see it, we see hallucination with that too. It doesn't, I'm not telling you there can't be mixed picture and maybe it might be associated at another time too. But hallucination, I would just recommend as someone who works with these folks would be to not react and not correct. You know, if they tell you that you better get these little kids out of here, I'm not gonna put up with this. Well, then you come in and say, I am so sorry, that is not acceptable and validate their position and you tell those little kids better get out of here, grandma does not have to put up with this. And then you know what I would probably do is I thank her for letting me know and then I would probably ask her to come help me do something. I would change her location if possible and engage her in something that she likes to do. Maybe she's really good at peeling potatoes. Maybe she's really good at stirring and I've gotta whip up some biscuits or something anyway. And it'd be really great to engage her like that. Ask her to come help you. I would try something like that. So anyway, anxiety, depression, hallucination. They can be associated with some dementias, but sometimes they can be side effect to other things or we just might have anxiety and depression by itself. And it's not related to a dementia. But I would say a lot of folks who have awareness that they're losing their memory definitely have some depression. And so don't rule that out. It would be normal. Unable to perform simple tasks. That could be a symptom. Maybe grandma could make that apple pie. You know, by just, I would just roll off her tongue. She knew how to do that. She didn't have to look at a recipe book or anything. But for some reason now, that apple pie doesn't look right, doesn't taste right. And she's struggling with sequencing the different steps to making some of her famous and some of her popular recipes that she could always make. And so it might be sequencing. It might be understanding that the toothpaste goes on the toothbrush and then the toothbrush goes in the mouth. Not the hairbrush, things like that, okay? So unable to perform simple tasks might be a symptom of dementia. How about confusion as the evening hours approach? What's that called? Sundowning. Yeah, and you know, I've researched that word sundowning. And really, after much research, I came up with tired brain. And so whenever we're tired, our brains are not gonna work as well. And it's true for you and me too. I mean, I reach a certain point in the evening now where it's like, okay, I gotta be done. I know there's always work to do when you have your own business, right? But I have to be done at a certain point and rest is so important to keeping my brain healthy and being able to start the next day well. And so being able to turn it off and rest is really important. Sleep is very important to your person living with dementia. How about declining social skills or social interactions? You know, there's a loss of peripheral vision. They can become a little more insecure, not confident in their living arrangement or their settings where you've taken them. Even if you're taking them to common places like to their church or to their grocery store, things can look really big. And remember, they lose peripheral vision. What does that mean? Yeah, so as we age, it's normal for us to lose some peripheral vision, gets a little harder to check your blind spots, but you know your car seems to do that for you nowadays. It's interesting, but we lose peripheral vision, but if it is a true dementia, they will go to what's called a scuba mask type of a vision. So where do we approach these folks from? That's right, always the front. We don't come up from the side or from the back. You're gonna startle them and start a fight. I mean, their limbic system, that fight, fright, flight, part of the brain system frequently stays very much intact. And it's working effectively, but you also may cause someone to strike you because you startled them and whose fault would that be? That gets us in a real sticky spot because chances are sometimes family members and caregivers don't understand they shouldn't run up from behind and throw their arms around grandpa for a hug. Okay, so somebody gets popped. I use that you loosely, but and then we can get more doctor's appointments and more medications because we're being labeled as aggressive. So I wanna hit the pause button and just wait and just see if it's something we could do to not cause these type of reactions in people living with dementia. So declining social skills, I usually will keep my ability to be cordial with folks. I tend to want to greet you and things like that, but I may not know who you are. And if I make a couple of mistakes, people that have awareness that they're making mistakes, it can cause me to not want to go out anymore because I remember that that made me feel bad. It seems like people living with dementia, they don't always remember all the words that were used, but isn't it very interesting that they tend to remember how we made them feel or how someone else made them feel. And if they make a couple of mistakes out doing social things, it can get them to not want to return to that place or not want to go out. I know there are a lot of people living with dementia who eventually don't want to even leave their home, leave their living space because they're just become too afraid. Okay, we need to respect that and figure it out. I was talking with a family yesterday who they're having trouble getting their sister to go to the doctor, to the neurologist. And I told them that'll happen eventually. She probably will need just a visiting physician to come to the home. And we did that with my mom too and it worked very well. It really was just a copay. She certainly qualified for it. And so it was just a copay on her Medicare and it worked out very efficiently. We didn't tell her when they were coming because they tend to get upset and not want someone to come if they know they're coming. It can be agitating, but this ability to be cordial that seems to be on the right side of the brain, it's a great tool, they can be nicer to a stranger than they can the people that they are most familiar with. What's that? I know it's hard, but you might be, but with the filters being out for the people they are most familiar with, they just might be more cordial and consider it to a stranger that walks in the door. And that's why they tend to sit up a little taller and tell the doctor that they're fine, we're fine. Okay, so declining social skills or social interactions. How about being defensive, never wrong or always the victim? We see that sometimes with some dementias. It's typically the individuals that do not have awareness that they have dementia, they don't have awareness, meaning there are individuals who they know they're declining and they'll even tell you, honey, I'm just not anymore, I'm not. And they typically are sad, depressed, insecure, clingy, they want you to stay with them, they're afraid. And then there's the flip side, individuals who may progress over to another side where they don't see the disease anymore and they can actually develop a secondary diagnosis called Anisognosia, A-N-O-S-O-G-N-O-S-I-A and it's the inability to see the deficit so they can no longer see that they have dementia. Okay, that's a game changer and that's certainly a care plan changer because you can't come in and offer to help somebody who doesn't realize they don't need help. So these are the ones who are typically defensive, never wrong, always the victim, paranoid and suspicious and you know what, it's all your fault. It's all your fault. And so we have to figure out how to love them along too even though those are their symptoms. And so we need to change the way we do things. I always say change the care plan and instead of coming in offering to help, I'm gonna ask them to come help me. With my mom, she definitely had Anisognosia and thankfully it was Tipa Snow who taught me about that because it was an absolute game changer and how we cared for her. She was irritated beyond measure when someone would come in and wanna help take her to the bathroom. Hands on the hip, excuse me, I do that myself and which wasn't true and we'd been toileting her for the past three years at that point. But if I were to ask her to help me 'cause I needed a band aid, you know what? She'd say, honey, take me back there because she thought she was these people that have Anisognosia, they think they're the smartest person in the room anyway. We call her the boss and we completely, we never ever talked about memory loss, dementia, vascular dementia, we never talked about it again. 'Cause she was never gonna believe it and why would we go there? Why would we irritate her, play your cards right? Position yourself to win all those things and the things that don't work, well, put 'em on a list over there, don't do these things and these things that work, how about we put 'em on this list over here? Hey, by the way, we're still offering the bonus page for people who listen to the podcast to the end and you'll find the link in the show notes. One thing I learned that on the website where they're posting the podcast, you can't always get to the show notes. So if you want the bonus page, a link to the bonus page, you will have to watch till the end and get to the show notes where it says bonus page and you click on that, put your email in and they'll email the bonus page for September to you and it's a really great tool called Starts and Stops and it's gonna give you great information on things to start doing with your loved one and things to stop doing with your loved one, okay? So be sure and hang around till the end. How about wandering or trouble sleeping? Would that be a symptom of dementia? It can be, not always, trouble sleeping. I think any of us can have trouble with sleeping for a variety of reasons. My goodness, it could be I'm too busy. I could be eight the wrong things, right? There are a variety of reasons why we can have trouble with sleep but people that have dementia tend to, there are some who develop challenges with sleeping, okay? How about a challenge unable to follow the conversation? So maybe these people, maybe your loved one who's struggling is on that journey with dementia. You know what, they can't carry on these longer conversations or they're unable to follow the conversation especially if they're in a room that has a lot of people talking and it can be really difficult, almost annoying to them and it's good to keep an eye out on them when you're in those situations and you may eventually need to not take them to events, family events, group events where there's too much stimulation. Just everybody's different, but pay attention to that. But they can have challenges following the conversation depending on what kind of dementia they have. You know, dementia's not really the diagnosis, there are more than 120 diagnosis. They give us symptoms of dementia but there's just a slew of different diagnosis. You know, reasons why we would have symptoms of dementia but your symptoms will be different from mine. Your moms will be different from mine, okay? We are different kinds of people where we're wired different. We like and dislike different things already, okay? So just, we can't just put this in a box and tie it up with a bow and make it real pretty 'cause it's not. It's challenging, it's difficult and I had no idea how complex dementia was until I started studying. All right, how about a lack of initiative for hygiene? You know, this can be a real common challenge with people living with dementia, the whole hygiene issue. If you have great routines established early on, wow, you're way ahead of the game, way ahead of the game. But if you have an individual who has developed dementia and now you're having caregivers come in and try and get them to take their clothes off for them, that can be really hard. And there's some skills that need to be learned in order to get that done. I frequently will go for an either or, are you gonna shower today or just wash up? 'Cause in my world, either one of those will do and will work. And if we're caring for this person at home, we get all day to get all these different parts washed. If my mom would only allow me to wash her face and change her brief, then that's what we did. If she started getting irritated beyond that, well, we'd head out to breakfast and start the day. And one of the times when we were back using the bathroom, I would jump in and finish another body part and work on that bath. And then maybe we have a spa day and we get the legs done and lotioned up and who knows? Maybe it's time to paint those toenails, okay? I want you to keep it creative and keep it fun. But people who have established great routines with their loved ones suffering on this journey with brain failure, they seem to have an advantage. And that is awesome. So we've gone over some of the symptoms of dementia and it's just important to remember that they're all different. And a Batipa always reminded me that a true dementia means two parts of the brain are dying and nothing's stopping or curing it right now. It's progressive, it's changing, but it is always terminal. But you know what, so is life. And so don't lose sleep about that. We're all gonna get something. But I just want you to try and take care of yourself and do what you can to help your statistics to maybe not develop this. So how about we eat right? How about we watch all the sugar we're putting into our systems? I think nutrition is a huge factor in our foggy brain and things like that. I mean, if you have a brain tumor and it's causing you challenge with dementia, I would say, I don't think whether you ate donuts or not necessarily cause that, but what do I know? I'm not a doctor. But I would say things that would be in your favor, let's keep exercise and let's keep moving these bodies. That's so good for us. Let's drink our water and quit drinking the pop and the alcohol. Let's cut back on all these over-the-counter medications. You know, talk to your doctor, but do you need all these things? And what can you do to clean up your diet? How can you eat clean? What does that even mean to eat clean? I know for some of you, this is like foreign language, but I really want you to start reading ingredients. And notice how many words are listed in the ingredients that you can't even pronounce or you've never seen before. You know, you have ingredients like that. Stop, stop putting chemicals in your body, stop putting processed foods, stop putting, you know, these inflammatory foods and start thinking about your ingredients. I want you to eat clean. And that means we don't want it full of chemicals and all processed. So I would say we want to try and eat food. So it looks like what it looked like coming out of the field out of the garden or, you know, and meets that are not processed and full of, again, chemicals and preservatives, especially preservatives. So we need to eat clean and we need to drink our water. Drink our water, it's good for our bodies and you need to get sleep. Sleep is really important for your brain health. Really important. And I also think we need to do mindful things. And so get off the computer, get off of the screens, maybe sit outside and listen to the birds. Maybe whether you're going to have a prayer life or spiritual life or meditate, go for a walk. Do some things that are going to help your brain and watch the anxiety levels too, okay? Sometimes we need to simplify some things in our life. And be cautious. I was at a women's retreat recently and they talked about joy and what is sucking the joy out of your life? And it's interesting, they gave us little compacts so we could open that up and think about our joy. And when you would look in that, you know, think about joy and think about what in your life is stealing your joy and can you change some things, whether it's people stealing your joy, whether it's maybe it's a job that is completely stealing your joy, but how can you change some things to have a healthier lifestyle and maybe your circle of friends have a more positive circle of friends around you, just some food for thought guys. I just want you to have the healthiest brain. I want you to be part of that statistic that doesn't get dementia because we're gonna be needing to help folks who do get dementia. So again, my name's Teresa Gungstrom. My company is a better approach to memory care. I hope you'll go to the show notes and get the bonus, the bonus page, the starts and stops bonus page so that you can have some more tools when you're caring for a loved one who has dementia. I know you got this, okay? Bye everybody. 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