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Index to Current Articles

May, 2010: My Parents—How Do I Know If They Need Help?
June, 2010: Memory and Alzheimer's Assessment Tool
July, 2010: Human Memory and Memory Loss (part 1)
August, 2010: Human Memory and Memory Loss (part 2) Signs and Symptoms of Memory Loss
September, 2010: Human Memory and Memory Loss (part 3) Myths About Memory Loss

Articles © Emeritus Corporation. Used with permission

My Parents—
How Do I Know If They Need Help?

As people age, their needs and abilities change. They may have trouble getting around the house or difficulty driving. They may not remember things as easily as they once did. And adult children of aging parents may notice that Mom or Dad is having difficulty – with their finances, perhaps, or with personal hygiene. We all want to support our older loved ones' desire to live independently, even when we have concerns about their safety and well-being. But how do we know when it's time to step in? Start with an assessment.

An assessment is a full review of a person's mental, physical, environmental and financial condition to determine his or her ability to remain safely independent. It identifies risks and helps determine options to reduce them. It's very important to involve your parents in the discussion and decision-making about their options.

How Do I Help Them Know if They Need Help?
While it is possible for families to complete assessments on their own using standard check lists, there also are experienced professionals who can help. While check lists and professionals will vary somewhat, here are some basic areas you and your older family members may want to focus on:

Physical Health. Have they been diagnosed with any chronic diseases such as diabetes, high blood pressure, arthritis or emphysema? Or other diseases, such as bowel or bladder problems, heart disease, stroke or cancer? Do they have vision or hearing problems, excessive weight loss or gain, or difficulty walking? Make a list of health professionals they currently see. Add any recent hospitalizations.

Mental Health. Have they been diagnosed with any psychiatric disorders such as depression, anxiety or psychosis? Have they been diagnosed with Alzheimer's or another form of dementia? Are they showing signs of confusion, disorientation or isolation? What about mood swings or forgetfulness? Sadness or loneliness?

Medication Use. What medications are they currently taking? What is the dosage? How often? Include over the counter medications. Are they taking their medication as directed?

Daily Living Skills. Are they able to dress, bathe, get up from a chair, use a toilet, climb stairs, use the phone? Do they know how to get help in an emergency? Can they shop, prepare meals, do housework and yard work? Can they safely drive?
Caring for Parents: My Parents-How Do I Know If They Need
Home and Community Safety. How safe is their neighborhood? Does their home have smoke alarms, and can they hear them adequately? Can they avoid telephone and door-to-door fraud? Can they maintain their house?

Support Systems. Do your older loved ones have frequent visitors or see friends? Do they go to a Senior Center, or get out of the house for other social reasons? Do family members live close by? Do they keep handy the names, addresses and phone numbers of key friends and family members who they can call in an emergency?

Appearance and Hygiene. How is their overall appearance? Hair clean? Teeth brushed? Shaved? Do they dress appropriately in clean clothes?

Finances. Can they live on their current income? Can they meet future needs with their current income? Are there any legal documents such as trusts, living wills, and/or durable power of attorney? Do they pay bills on time and make informed financial decisions?

Interests/Lifestyles. Do they engage in their favorite hobbies, read books, watch their favorite TV shows, exercise, play a musical instrument, go to church, keep up with their friends? Are they still engaged in the activities they have always enjoyed?

There are good assessment tools and professional consultants who can help you and your older loved ones decide when assistance is needed. Some hospitals and clinics offer geriatric assessment centers. Some city or county agencies on aging provide the service. There are also independent geriatric care managers (also called case managers). An assessment can lead to solving problems and allowing a parent to remain independent longer. It can result in fewer accidents and illnesses, a longer life, and a higher quality of life. It's not always easy to recognize when an older loved one needs help. Learning how to assess their needs will make it easier to know when, and how, to help.

Memory and Alzheimer's
Assessment Tool

(You may copy and use this checklist. Do not distribute or publish.)

Do you need help?
Use our assessment tool to learn where you may be in need of additional help. (Check if problems occur at least 2-3 times per week for your loved one)

Orientation
Trouble remembering recent events
Trouble remembering significant events from the past
Forgetting what day it is
Being unaware of time of day
Wandering or getting lost

Recognition
Unable to recognize familiar people
Unable to recognize familiar surroundings

Tasks
Starting but not finishing things
Difficulty concentrating on a task
Unable to follow verbal directions

Ambulation
Sitting down without warning while walking
Problem with falling or loss of balance
Unusual gait pattern (i.e. shuffling, fast pace, leaning)
Bumping into objects without seeing them

Anxiety/Fear
Asking the same question over and over again
Being suspicious or accusative
Being restless
Being constantly talkative
Seeing or hearing things that are not there

Dietary
Eating sweets excessively
Attempting to eat non-edible items
Decreased appetite*
Excessive appetite*
Refusing to eat*
*Can also be sign of depression
*Based upon Memory and Behavior Problem Checklist created by Orr-Rainey, Nancy and Tori, Linda 1990

Depression
Spending long periods of time inactive
Talking little or not at all
Appearing sad or depressed
Appearing anxious or worried
Dwelling on the past
Crying and being tearful
Commenting about death of self or others

Personal
Doing things that are embarassing to you
Difficulty with bathing and personal hygiene

Aggressiveness
Engaging in combative episodes (i.e. hitting, scratching, or biting)
Destroying property or personal belongings
Engaging in behavior that is dangerous to others or self

Miscellaneous Problems
Losing or misplacing items
Hiding things

Bring this checklist on your next appointment with your family physician to guide your discussions.  Contact the Alzheimer's Association for more information at: 1-800-272-3900 or at www.alz.org.

Human Memory and Memory Loss

Human Memory and Memory Loss

Part 1 (of 5)

Introduction to Memory and Memory Loss

Memory loss is a normal part of life. Even memory problems that increase as we get older are usually nothing to worry about. To understand why memory lapses are normal, it is helpful to learn more about the mechanics of human memory. We explain these in the following article and teach you how to improve your memory. We also discuss when memory loss is something to worry about as in the case of dementia and other cognitive problems.

Human Memory (What is Memory?)

Memory is the process we use to store and recall information.[1] There are two types of memory—short-term or working memory and long-term memory. Short-term memory allows you to recall information for several seconds up to a minute. It is possible to store about seven items at a time in short term memory. Long-term memory allows you to store information for longer periods but not indefinitely.

In addition to short- and long-term memory, memory can be defined by the type of information stored. There are two types: declarative and non-declarative memory.[2] Declarative memory is the type of memory that allows us to consciously recall information such as facts and events. Non-declarative memory involves skills, habits and reactions that we have that do not require conscious effort. Such a skill might be the muscle "memory" related to a golf swing.
There are two types of declarative memory. One involves something called episodic memory or the ability to recall events within our own lives. Examples include remembering your high school prom or what you had for dinner last night. The other type of memory is called semantic memory and it involves remembering facts such as the year Columbus discovered America or that 12 times 12 equals 144.

How Does Memory Work?

Initially, your five senses pick up information.[2] This information is stored as short-term memory. Short-term memory gives your brain the time to choose which information is important for further processing. If we didn't control incoming information this way, we would be overwhelmed quickly. Once information is selected to be processed, it is stored with similar information, such as the memory of an eggbeater being stored with the concept of kitchen utensils. Over time, memories may be strengthened or fade. Sometimes we fill in details that may not be accurate. We may even alter memories when retrieving them. So, memory is not complete and not necessarily accurate.

Short-term memory causes brain cells to release chemicals called neurotransmitters. These chemicals change the connections between brain cells making them either stronger or weaker. Forgetting seems to occur when these connections become weaker. Strengthening connections can either involve physical changes to the brain cell or it can increase the ability of a cell to release a neurotransmitter.

Information is stored in the same areas of the brain where it is normally processed. Thus, memory of smells is stored in the part of the brain where smells are processed. This makes it easy for the brain to compare similar experiences and store them together. Interestingly, different parts of a memory, for example, the smells and colors related to it, are stored in separate parts of the brain. Declarative memory--when Columbus discovered America, for example--is stored in a specific area. Skills, like playing golf, are stored in another area and emotions in yet another part of the brain.

References for entire series

Human Memory and Memory Loss Part 2

Signs and Symptoms of Memory Loss

Everyone experiences memory loss.[3] Changes occur in the brain very slowly over time and actually begin in our thirties. Eventually, as we get older, we begin to notice declines in memory. Forgetting occasionally where we put the keys or why we went upstairs is normal. This type of memory loss is less severe than losses from dementia and Alzheimer's disease and is considered normal.

By the time we reach our fifties,[4] it is common to notice some changes in memory:

• It may take longer to recall names or words.
• Learning new things takes longer, but once they are learned, we retain them.
• Multi-tasking may be harder to do.
• We may remember fewer details. For example, we may not remember all of the details from a movie that someone younger might remember.
• Recalling when something occurred may be harder. We can remember the event but not exactly when it happened.
• Visual spatial memory may decline. For example, it may be harder to understand three-dimensional instructions for assembling a cabinet.

Normal aging of the brain continues.[4] In our sixties, we experience the same losses as in our fifties, but they may be more noticeable. It takes longer to process things making it harder to learn a new task, for example. It also becomes harder to tune out distractions. That feeling of "it's on the tip of my tongue" may happen more often. While many people remain sharp into their seventies and beyond, signs of dementia are more common at these ages.

When is Memory Loss a Sign of Dementia?

While it's normal to have some memory loss as we age, there are signs of greater concern that are related to dementia:[5]

• Asking the same question over and over again.
• Difficulty doing familiar tasks such as a cooking a favorite meal.
• Problems with language such as a forgetting simple words or using words incorrectly.
• Problems with place and time including getting lost on a familiar street or not remembering what day it is.
• Poor judgment such as forgetting to put on a coat when it's cold outside.
• Misplacing things such as putting a wristwatch in a sugar bowl.
• Mood changes. Everyone has mood changes, but for people with dementia they are more rapid.
• Personality changes such as being irritable, suspicious or fearful.
• Loss of initiative or interest. People with dementia may become very passive. They may not want to go out or see people.

What Causes Short- and Long-Term Memory Loss?

 There are many causes for memory loss.[6] Here are some of them:

• Aging
• Alcoholism
• Alzheimer's disease
• Brain damage due to disease or injury
• Brain growths caused by tumors or infection
• Depression or emotional trauma
• Drugs such as barbiturates or benzdiazepines
• Electroconvulsive therapy, especially if it is long-term
• Encephalitis (swelling in the brain) of any type including that caused by herpes, West Nile, or Eastern Equine encephalitis
• General anesthetics
• Head trauma or injury
• Hysteria, often accompanied by confusion
• Illness that causes loss of brain cells or degenerative brain disease
• Nutritional problems including vitamin deficiencies such as low B12
• Seizures
• Stroke or transient ischemic attack (TIA)
• Temporal lobe brain surgery

References for entire series

Myths About Memory Loss - Part 3

Myths About Memory Loss

Part 3

Sometimes when scientific information is simplified it can lead to inaccurate beliefs.[7][8] Here are a few examples of myths about memory loss and dementia:

• Because there is no cure for Alzheimer's disease, nothing can be done for people who have it. With a timely diagnosis, there are steps that may slow the decline associated with Alzheimer's disease. These steps include certain drugs, physical exercise, diet, and mental and social activity.
• Because mental decline is a normal part of aging, there is nothing that can be done for it. It may be possible to slow the worsening of mental decline by exercising, doing mental games (for example, crossword puzzles), and being socially active.[9]
• Drinking out of aluminum cans or cooking in aluminum pots and pans can cause Alzheimer's disease.[10] Scientists no longer believe that aluminum is associated with Alzheimer's disease.
• Aspartame, the artificial sweetener, causes memory loss.[10] The Food and Drug Administration (FDA) indicates there is no scientific evidence to support this claim.
• Flu shots increase the risk of Alzheimer's disease.[10] Several studies have indicated exactly the opposite‚Äîthat flu shots may be protective against Alzheimer's disease.
• Silver dental fillings increase the risk of Alzheimer's disease.[10] According to the best available evidence, there is no association between silver fillings and Alzheimer's disease.
• Medicine to treat Alzheimer's should be stopped after a few weeks if there is no improvement. The truth is that it can take several months to tell if the medicine is working.
• You should try a memory supplement or herbs to improve memory before trying prescription medicine. The truth is that you should discuss this with your doctor first. Supplements and herbs have not been studied and their effectiveness is not proven plus they may have risky side effects.

Techniques for Improving Your Short- and Long-Term Memory

You can do many things to help your memory.[3][9][11] Here's a list of things you can do:

• Stay mentally active. Do crossword puzzles or read the newspaper. Try driving a different route home, take up a musical instrument, take language classes or learn another new skill.
• Keep socially active. Staying in touch with family and friends can ward of depression and stress. Both depression and stress can lead to memory loss. Look for opportunities to get together with people. If invited out, accept! Volunteer in your community, local school or place of worship.
• Get organized. Being organized helps you find things and eliminates frustration. Keep a list of tasks you need to take care of and use a calendar for appointments and events. Try saying each item out loud as you write it down. This will help you remember them. Check off items you've completed. Pick a place where you will always leave your wallet, keys and glasses, so you can find them easily.
• Stay focused. Limit distractions like TV and avoid trying to multitask. Do one thing at a time rather than several.
• Eat a healthy diet. Eat a lot of fruits, vegetables and whole grains. Include low-fat protein such as fish, skinless poultry and lean meat. Be sure to get enough water and limit alcohol. Drinking a moderate amount of alcohol can be helpful.
• Stay physically active. Regular exercise is important. It increases blood flow to the brain. Talk with your doctor before starting an exercise program. Start with 30 minutes a day and work up from there. Walking is a great way to start.
• Get an appropriate amount of sleep each night‚Äîusually about seven to nine hours.[12]
• Manage chronic health conditions. Be sure to follow your doctor's advice concerning high blood pressure, thyroid problems, depression and any other conditions you may have.
• Discuss all your medicines and supplements with your doctor. Some drugs can cause memory problems.
• Don't smoke. Smoking can lead to memory loss and increases the risk of Alzheimer's disease.[1]

References for entire series

Coming in October: Myths About Memory Loss

Human Memory and Memory Loss

Part 4

"Research indicates that exercising your mind can help with memory loss. ...."

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