How to Determine What is Going On
Lest you feel like that poor fellow, the best direction to take when trying to determine what to do when someone is showing signs of cognitive decline or dementia is to get them to see their primary physician. What happens next depends on what the physician says. Getting them there can sometimes require supreme delicacy, but it must be done. First, we will look at some things pointing to possible reasons for such behavior, especially in the elderly.
Book a date and time with me for your FREE 15 minute Get Acquainted Call.
Is it Depression or Dementia?
Charlene feels sad and has trouble remembering to book events on her calendar let alone show up for them. She is anxious, has trouble sleeping yet sometimes sleeps too much, experiences increased aches and pains, and has little or no appetite. Clive experiences the same symptoms. It turns out that Charlene is depressed, and Clive suffers from progressive dementia.
Now consider Greta who has all those symptoms and is diagnosed with both dementia and depression. Then there is Henry who has none of those symptoms but over the period of several weeks goes from perfect cognition to mild confusion to full-blown delirium. Henry’s problem is a urinary tract infection (UTI), an acute form of reversible dementia.
All of these individuals have symptoms ranging from depression to dementia, with dementia being either progressive or reversible.
Depression and dementia are two separate and complicated illnesses with very similar symptoms. Reading about them online is not enough to differentiate between the two, yet people try to, and armchair diagnosis is dangerous. Only a physician can make a diagnosis of depression, dementia, or a combination of both.
Behavior caused by dementia can be temporary when it is brought on by medications, dehydration, vitamin deficiencies, undiagnosed medical issues, environmental toxins, and substance abuse, among other things. It is worth emphasizing that in older people sometimes the only symptom of a UTI like Henry’s may be confusion or delirium, and if left untreated a UTI can lead to sepsis or death.
The good news is that once a temporary physical or toxic environmental problem is resolved successfully, the acute dementia-like symptoms stop and progressive dementia is ruled out as the cause for the behavior.
If physiological problems are not reversible by prescribing or changing medication, finding and treating unknown medical conditions, or making changes to lifestyle and/or environment, the patient must be sent to an appropriate specialist. Problems related to heart, lung, thyroid, kidney, strokes, and chest or urinary infections are famous for masquerading as dementia. For example, suppose a person shows dementia-like symptoms and is experiencing depression for the first time as an older adult. In that case, the problem may be a result of restricted blood flow to the brain and could pose a risk for high blood pressure, peripheral artery disease, heart attack, stroke, or other vascular illness.
When dementia-like behavior is not brought about by a physical ailment but attributed to depression, some primary doctors may prescribe antidepressants for their older patients and others may refer them to a mental health specialist. Depression can creep up or it can swoop in like a flash flood for anyone of any age, and it is not unusual that depressed behavior can imitate dementia in older patients like Charlene. When someone is experiencing loss or loneliness or is having difficulty dealing with physical problems caused by a chronic disease, depression is a common side effect. If depression is the only problem, a combination of exercise, proper nutrition, psychological therapy and medication is generally regarded as the best way to manage or eliminate the symptoms.
When your unique circumstances require that change be made to meet your goals concerning health, safety, socialization and/or independence, I craft a plan to make change successful. Our meetings are structured so that I can get to know you, your loved ones, and your specific situation.
My approach to senior care planning focuses on introducing necessary changes as slowly as possible and providing the guidance needed to navigate each new stage in your or your loved one’s life at a pace that is comfortable for everyone. When abrupt change is necessary, transition is made easier by my years of experience handling such events.
Book a FREE date and time with me for your 15 minute Get Acquainted Call.
Kathy C. Faenzi MA is a Clinical Gerontologist and Senior Care Consultant based in San Mateo, CA.
JC Spicer, M.Ed. is a Freelance Social Science Writer and Developmental Editor based in the U.K.