When most people hear the words “dementia” or “Alzheimer’s” they immediately think about a person with memory problems. But it is so much more than memory loss as I discovered through my personal journey.
Until my father was diagnosed with dementia in 2011 and then Alzheimer’s in 2012, I didn’t have an understanding of the full scope of the diseases. Like most, I knew there were memory problems. My dad was losing words, forgetting names, getting dates and events mixed up – very common symptoms in the early part of the disease.
Memory is one of the first things family and friends notice because we know more about the life experiences of our loved one than a casual acquaintance or stranger. We begin to see stories merge into one – summer vacation and a weekend away becoming one event in their mind. These things begin slowly at first and then become more and more common as the brain changes from the progression of the disease.
Related: Life with Alzheimer's Disease
It is common to hear someone say, “They don’t have short term memory anymore.” But the fact is, that they are losing the ability to create a memory in the first place, short term or otherwise.
Changes with Alzheimer's: It's not just memory loss
As I researched and learned more, I discovered that in addition to memory, there are 6 other abilities that are greatly impacted by dementia and Alzheimer’s.
- Language. Language, vocabulary and the ability to find the words they are looking for is a result of dementia. While we all might forget a name or word here and there, it becomes more common and persistent when it is because of dementia. The person’s ability to communicate with words diminishes so it is more important than ever to watch for visual cues like facial expressions and body language, as well as the tone of voice, to truly understand what they are trying to convey.
- Motor Skills. Dementia begins to affect the area of the brain that controls coordination, balance and fine motor skills, as well as language and memory. People will begin to walk slower and more cautiously; they may have trouble with buttons and shoelaces. Watch for potential safety hazards like area rugs or other things they may trip on to avoid fall-related accidents.
- Attention. A person’s ability to pay attention to a single task becomes harder and they can become more easily overwhelmed by too much stimulus – too many “things” to look at, too much noise, etc. As the disease progresses people with Alzheimer's often go from being unable to focus to laser-focusing on a thought or emotion and are unable to get themselves out of the cycle.
- Perception. People begin to have trouble recognizing everyday things or knowing what they do. For example, they may see a toothbrush, something they have used all their life, but not know what to do with it. It becomes helpful to name things and provide cues about what to do so they aren’t left confused too long. Confusion can lead to anxiety, which can lead to difficult behaviors.
- Reasoning. Life becomes very literal as the brain changes and the disease progresses. Many people with dementia become unable to understand sayings, sarcasm or slang – something that may have been a large part of how they communicated in the past. If you notice this, it is important to be clear and precise in your language so they will understand what is being communicated. Reasoning also affects the ability to understand non-concrete concepts like time: understanding 9 am vs. 9 pm becomes hard, they just know 9 o’clock. This can cause conflict if they decide they need to be somewhere they usually go at 9 am when it is 9 pm.
- Judgment. Judgment is usually due to an accumulation of other issues – when language and memory and reasoning are all impaired, it is a recipe for poor judgment. This is a time when people with Alzheimer’s are susceptible to scams or may lose track of paying bills. They also have a hard time with spur-of-the-moment changes or decisions. Watch for changes in judgment and make sure someone is helping with or taking over finances so they don’t lose money they will need for care.
As you can see, dementia and Alzheimer’s affects so much more than memory. If you understand what to look for, you will be able to better support your loved one by adjusting their environment, how you communicate with them and more so they can remain as independent as possible. You will also have a better understanding of where new and unusual behaviors are coming from so you can be as compassionate as possible as everyone, including you, are adjusting through the journey.
Bio: Tara Reed helps people with a loved one with dementia or Alzheimer's navigate the journey. She is the author of “What to Do Between the Tears… A Practical Guide to a Dementia or Alzheimer's Diagnosis in the Family” and offers resources and personalized support for family caregivers on her website at PivotToHappy.com.