Long married couples are often said to “finish each others sentences.” They work as a unit, and friends and family members are used to this interaction. This ability to work as a team is a wonderful thing until one of the team isn’t functioning well and the other is in denial. When couples cover up for each other, precious time can be lost. So, adult children need to be on the lookout for signs that things aren’t going well.
Deciding when to act
Healthy aging brings with it some losses, but if seniors have a mate, they often can live independently for a longer time as they fill in the gaps for each other. Dad’s hearing is getting dim, but Mom coaches him and he does okay. Mom’s driving is questionable, but Dad does most of the driving when they are in high traffic areas, so she still gets around fine.
However, what if Dad’s hearing is not just a physical problem? What if he doesn’t understand what is said to him because his brain isn’t functioning properly? What if Mom’s driving skills are declining because, rather than just easily rattled by traffic as she’s always been, she forgets where she was going?
Teasing apart a decades-long team effort to present a united face of viable functioning to the world isn’t easy, but careful observance can generally penetrate their act.
Covering up isn’t always a team effort, as even a single elder can mask dementia symptoms. An article on Forbes.com, by Carolyn Rosenblatt, examines this issue.
Rosenblatt writes that action should be taken even if a dementia diagnosis isn’t made by a physician. In her article she says, “Here’s what’s important: it doesn’t matter if you have a diagnosis for your aging parent or not. It matters how your aging parent functions. It matters how you deal with what you see…If your aging parent or loved one is showing persistent memory loss and starting to mess up the basics of life, it’s a warning you should not ignore…”
Changes in behavior are the key
Most Alzheimer’s experts would agree with Rosenblatt’s statement. The key to dementia is often in the changes we observe in our elders. Using the example above of Mom’s driving, what is important is the change in her functioning. Many people hate high traffic driving. With normal aging, our reflexes aren’t as quick, our eyesight isn’t as keen, and we may avoid some of these situations more than when we were younger. This is a wise decision. However, if Mom is avoiding driving because she gets lost even in familiar territory, she is showing signs of possible dementia.
If Dad, who made a living as a businessman, often crunching numbers in his work and also ran the family finances with precision and accuracy, is making a lot of financial errors, something may be wrong. Suddenly, or so it seems to his family, he’s late paying bills or he over-draws the checking account. This could be a sign of stress, or a sign that his medications are affecting his ability to think well. It could be a sign of an infection in his system. Or it could be a sign that he is developing dementia. Only a complete checkup by a skilled specialist is likely to give you an answer.
However, you, the adult, may not know what is happening to your parent because he’s not telling you he is having problems. He’s afraid. He knows there may be something wrong that can’t be fixed, so he’s covering up. It’s up to you to watch for signs of these changes so you can help.
Many problems aren’t caused by dementia
If more people realized that there can be many reasons for dementia-like symptoms, other than dementia, they maybe would see a doctor sooner. Also, if they knew that an early dementia diagnosis could mean that a prescription may help stave off the worst symptoms longer, they could be more willing to see a doctor.
Your parent may be covering confusion or memory loss out of fear. So, if you see signs of this, please try to talk with him or her gently and reassuringly, and get him or her to a doctor. After that, whether or not the diagnosis is dementia, you’ll have some grounds for moving forward with any plans that need to be made for future care.
Would you take a person with dementia to the beach?
This might not really be an idea you would think of. There are several possible constraints: difficulty with travel, for example, being one. And what if, having succeeded in getting the dementia sufferer there and back, the next day you asked if they enjoyed their day out and he or she just stared at you with a confused gaze as if to ask, ‘what are you talking about?’ If you think it makes little sense to take persons with dementia to the beach, it will surprise you that a nursing home in Amsterdam has built a Beach room.
In this room, residents can enjoy the feeling of sitting in the sun with their bare feet in the sand. The room is designed to improve the well-being of these residents. The garden room at the centre of the home has recently been converted into a true ‘beach room’, complete with sand and a ‘sun’ which can be adjusted in intensity and heat output. A summer breeze blows occasionally and the sounds of waves and seagulls can be heard. The décor on the walls is several metres high, giving those in the room the impression that they are looking out over the sea. There are five or six chairs in the room where the older residents can sit. There are also areas of wooden decking on which wheelchairs can be parked. The designers have even managed to replicate the impression of sea air.
Visits to the beach room appear to have calming and inspiring effects on residents of the nursing home. One male resident used to go to the beach often in the past and now, after initially protesting when his daughter collected him from his bedroom, feels calm and content in the beach room. His dementia hinders us from asking him whether he remembers anything from the past, but there does appear to be a moment of recognition of a familiar setting when he is in there.
Evidence is building through studies into the sensorial aspects of memorizing and reminiscing by frail older persons in nursing and residential homes. Several experimental studies have noted the positive effects of sense memories on the subjective well-being of frail older persons. For instance, one study showed that participants of a life review course including sensory materials had significantly fewer depressive complaints and felt more in control of their lives than the control group who had watched a film.
The Beach Room is an example of a multisensory room that emanates from a specific sensorial approach to dementia. The ‘Snoezelen’ approach was initiated in the Netherlands in the late 1970s. The word ‘Snoezelen’ is a combination of two Dutch words: ‘doezelen’ (to doze) and ‘snuffelen’ (to sniff ). Snoezelen takes place in a specially equipped room where the nature, quantity, arrangement, and intensity of stimulation by touch, smells, sounds and light are controlled. The aim of these multisensory interventions is to find a balance between relaxation and activity in a safe environment. Snoezelen has become very popular in nursing homes: around 75% of homes in the Netherlands, for example, have a room set aside for snoezelen activities.
On request by health care institutions, artists have taken up the challenge to design multisensory rooms or redesign the multisensory space of wards (e.g. distinguished by smells) and procedures (cooking and eating together instead of individual microwave dinners). Besides a few scientific evaluations, most evidence is actually acquired from collaborations of artists and health professionals at the moment. The senses are often a better way of communicating with people affected by deep dementia. Like the way that novelist Marcel Proust opened the joys of his childhood memories with the flavour of a Madeleine cake dipped in linden-blossom tea, these artistic health projects open windows to a variety of ways of using sensorial materials to reach unreachable people.
So, would you take a person with dementia to the beach?
Yes, take them to the beach! It can evoke Proust effects and enhance their joy and well-being. Although, we still do not know what the Proust effect does inside the minds of people with dementia, we can oftentimes observe the result as an enhanced state of calmness with perhaps a little smile on their face. People with dementia who have lost so much of their quality of life can still experience moments of joy and serenity through their sense memories.
This fantastic video is presented by TED-Ed and features animation by STK Films.
Alzheimer's disease is the most common cause of dementia, affecting over 40 million people worldwide. And though it was discovered over a century ago, scientists are still grappling for a cure. Ivan Seah Yu Jun describes how Alzheimer's affects the brain, shedding light on the different stages of this complicated, destructive disease.
Additional Resources for you to Explore
- Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD), is one form of dementia that gradually gets worse over time. It affects memory, thinking, and behavior.
- Learn more about Alzheimer’s disease here.
- Is it possible to predict the possibility of Alzheimer’s disease? See more here.
- Learn more about the different treatments for Alzheimer’s disease.
- What are some of the drug therapies for Alzheimer’s disease that are currently being researched on?
- The brain is what makes us function, yet we understand so little about how it works. We are learning more about the brain by using new technology to monitor epilepsy patients during surgery. Moran Cerf explains the process doctors use to explore the brain further.
- Two thirds of the population believes a myth that has been propagated for over a century: that we use only 10% of our brains. Hardly! Our neuron-dense brains have evolved to use the least amount of energy while carrying the most information possible -- a feat that requires the entire brain. Richard E. Cytowic debunks this neurological myth (and explains why we aren’t so good at multitasking).