An Aging Parent’s Behavior

Are you concerned about an aging parent’s cognitive skills? If you have concerns about an aging parent’s behavior or memory, you’ve probably wondered if they have Alzheimer’s or another dementia. What should you do about your worries? Tell the doctor.

If you’d like to share your concerns with your parent’s doctor but are worried about upsetting your parent, send the doctor your concerns in writing. No HIPAA authorization is needed for you to share your concerns with a parent’s health professional.

However, if you, your parent and your parent’s doctor truly want to get to the bottom of things, you take a simple approach that is incredibly effective: start taking notes on the behaviors known to correspond with Alzheimer’s.

By doing so, you’ll be gathering the kind of detailed information that doctors need in order to confirm cognitive issues and likely detect the disease.

Eight Alzheimer’s Behaviors to Track

• There are eight Alzheimer’s behaviors to track and for each of the behaviors, it’s important to take down the following:
• What kinds of problems you see your parent having now
• When you — or another person — first noticed problems, and what you observed
• Whether there’s been a change or decline compared to the way your parent used to be
• Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath, or physical disabilities

Note: If you don’t notice a problem in any of the following areas, be specific in documenting this, e.g. “no problem detected.” That way, you and your family will know you didn’t forget to consider that behavior.

1. Daily Struggles with Memory or Thinking
It’s normal for older adults to have a lapse here and there. But if your parent seems to experience a memory or thinking problem every day, make a note of this. It’s a good idea to add specific examples describing what you or another person observed.

2. Difficulty Learning to Use Something New
Any difficulty learning to use a new appliance or new gadget, such as a smartphone? Make note of what your parent has difficulty adapting to and how he or she tried to manage.

3. Difficulty Managing Finances
Have you noticed any problems managing bills, expenses, or taxes? You might have to ask your parents about this if you aren’t usually involved in their finances.

4. Forgetting the Month or Year
Any difficulty keeping track of the current year or month? If it happens more than once, make a note of that especially.

5. Poor Judgment
Have you noticed any behaviors or situations that seem to indicate bad decisions? Any excessive or unusual spending? Or perhaps a poor understanding of safety concerns that everyone else is worried about? Write down anything you or another person close to your parents has observed.

6. Problems With Appointments and Commitments
Has your parent missed any appointments or forgotten about a get-together that you’d planned? Everyone forgets something occasionally, but if this happened repeatedly, be sure to document when it started and how bad it’s gotten.

7. Reduced Interest in Leisure Activities
Have you noticed that your parent no longer seems interested or involved in any hobbies? For example, did your mother read voraciously but now seems disinterested in even picking up a book? Any change in hobbies or leisure activities should be noted, especially if such a change doesn’t seem to be related to a problem with physical health.

8. Repeating Oneself
Any repeating of stories? Any asking the same questions repeatedly? Has your parent been declaring the same thing, e.g. “I really love those roses you gave me!” over and over again? If so, write it down.

How to Detect Alzheimer’s Disease

The eight behaviors previously mentioned correspond to the brain’s ability to learn or manage memory and judgment. To diagnose Alzheimer’s or another dementia, your parent’s doctors must document that your parent has been having persistent difficulties in two or more areas related to brain function. (This is necessary but not sufficient for diagnosis as doctors must also rule out other causes for thinking problems).

Now, doctors can assess the different aspects of brain function through certain office-based thinking tests. However, research has found that asking family members about the behaviors above can be just as effective when it comes to spotting probable dementia, including Alzheimer’s disease.

Getting this type of observational information from family members helps doctors determine whether the behavior is a persisting, and maybe even worsening, problem. This matters because a single office-based test only provides a snapshot of how your parent’s brain is doing on that particular day.

As a rule, most doctors appreciate getting these kinds of behavioral observations from families because it provides very practical information related to people’s daily lives. By knowing more about what kinds of problems an older person has been experiencing, doctors can make useful recommendations right away to help families with family conflicts, independence, and safety.

Ways to Help Your Parents Get the Right Care

Doctors who are knowledgeable about dementia will ask a family about problems related to the eight behaviors above. Unfortunately, many primary care doctors aren’t experienced in evaluating dementia. It’s not unusual for a physician to wave off concerns or tell the family that this is just what happens when people age. This can often easily happen partly because families are often a bit vague when they voice concerns. This means the doctor has to do more work in investigating the concern and in documenting specific problems that can help diagnose Alzheimer’s. Some doctors will do this work, but since office visits are often rushed, many of them won’t get around to it.

Unless that is, you bring detailed information to help the doctors take further action. The more specifics you can share regarding what you’ve observed, the more likely you’ll get the help your parent and your family need. Plus, whether or not Alzheimer’s caused these behaviors, they often cause anxiety and frustration within families. So it’s important to bring them up to a doctor so that you can get help understanding the cause and learn what to do next.

Don’t go on for too long with the worrying and the wondering. Take notes so that you can then take better action.