This is an excerp from my new book An Achievable Balance.
If your loved one receives a diagnosis of cognitive impairment or dementia or is having trouble maintaining their independence, you doubtless have questions about how to help them and balance their needs with yours. An Achievable Balance provides answers.
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.
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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.