Aging Well Long Island
Helpful tips for family caregivers

Reversible or pseudodementia

Is your loved one forgetting appointments? Repeating stories? Struggling with tasks that once seemed easy? It’s natural that you fear dementia. But don’t assume the worst. Many factors affect brain function. Your relative’s condition may not be permanent. Some causes of what seems like dementia can be treated or improved once identified.

What exactly is dementia? Dementia is not a disease in and of itself, but an umbrella term for changes in memory, thinking, and behavior that affect daily life. Alzheimer’s disease is the most common form. Other types of dementia diseases include vascular, Lewy body, Parkinson’s, and frontotemporal.

Only a doctor can tell. A wide variety of causes can bring about symptoms that seem like a dementia disease. It is important to get a full medical evaluation for your loved one before accepting any diagnosis. Certain underlying issues can be treated. In some cases, cognitive decline can be slowed, stabilized, or reversed.

Dementia-like symptoms may be caused by

• issues with the thyroid, liver, or kidneys
• infection
• ministrokes, head injuries
• depression or poor sleep
• side effects from medication or chemotherapy
• vitamin deficiencies

It is also important to know the difference between normal aging and warning signs. Forgetting names now and then is common. Pay closer attention if your relative seems confused about the day’s activities. Or if they get lost in places they know well. Or if you notice changes in judgment, behavior, or personality.

If you are concerned about a loved one’s cognition, schedule a full medical evaluation as soon as possible. Bring a list of medications and supplements. Also jot down some worrisome symptoms. Ask about blood labs for vitamin deficiencies or thyroid problems. Maybe other workups for infections and sleep disorders. And a brain scan. Request a referral to a neurologist or memory specialist if concerns continue. Even if your relative has mild cognitive impairment or one of the true dementias, early diagnosis may help preserve independence and improve quality of life options.

Visiting the doctor after a fall

A surprising number of conditions, from simple to serious, can contribute to an older adult falling.

If you observed the fall or arrived soon after, find out if your loved one had a warning or felt dizzy beforehand. Any chance they fainted? Was the fall from stumbling on an obstacle? Or more from missing a step on the stairs? These details can be important clues for the doctor.

Even if there are no injuries, it’s wise to see the primary care provider and ask them to review

• medications. Many common drugs have the side effect of dizziness or sedation. This includes medications for sleep, pain, and anxiety, as well as some antidepressants. If diabetes is poorly managed, that can cause dizziness or numbness in the feet. Faulty blood pressure medication dosing can also be at the root of a tumble.
• sitting versus standing blood pressure. Some people experience a sudden drop in blood pressure when they stand. This can easily lead to dizziness or fainting—and falling.
• possible infections. In many older adults, a urinary tract infection or even pneumonia can develop without the “usual” symptoms. Infections can cause weakness or dizziness. Lab tests are needed for diagnosis and treatment.
• physical pain. Something as simple as painful joints or tight-fitting shoes can cause a change in gait or sudden shift in weight from one side to the other, leading to poor balance and a fall.
• vision. Cataracts, glaucoma, and macular degeneration impair vision. Any of these may cause an older adult to overlook a trip hazard.
• potential significant conditions. It’s important to rule out conditions of the heart, brain, and circulatory system that can result in a fall. For example, a ministroke, atrial fibrillation, Parkinson’s, or even dementia.
• home safety. Ask for a home visit by an occupational therapist to identify any trip hazards and recommend appropriate modifications.

Honoring a loved one who has died

Have you lost a loved one this past year? Or perhaps years have gone by, but grief is still poignant. As you reflect on a relative who has passed on, you might consider new ways to honor them. Ritual is a helpful way to transform a lifetime bond so that your once-vital connection is sustained in a new way.

You might create a new personal or private family ceremony to occur on a day that feels right for you, or make plans to join an existing event during the year. For instance:

• Light a candle. The candle flame is a universal symbol of vigil and honor. Start your own annual candle-lighting ritual. Tell a story, read a letter to your loved one, or just observe a moment of silence.
• Create a sacred space. Assemble a “memory box” of photos and small personal items to open annually. Or create a home altar as a space for reflection in the privacy of your own thoughts. For public honor, arrange to plant a tree or donate a bench to a nearby park.
• Walk, run, or ride for a cure. Gather a team or go by yourself to raise funds for research in your loved one’s name. The Alzheimer’s Memory Walk , the Susan G. Komen Race for the Cure  (breast cancer), and the Diabetes Tour de Cure are among the many disease-specific annual events held nationwide.
• Take up their passion. Learn your relative’s beloved hobby: growing dahlias, bird watching, or playing violin? Host an annual family gathering and serve your loved one’s signature foods. Or play their favorite music and games. Make a yearly contribution to your loved one’s favorite charity or club.

Memorializing a loved one can be a complex experience. Prepare for the possibility of difficult emotions arising. That said, ritual is often also a source of comfort and healing.