Deborah Bier, PhD, is Director of CCHC's Concord office
I’m middle-aged, and I go through this all the time: where are my house keys… purse… car in the parking lot? How did I forget those printouts for the meeting… to defrost tonight’s dinner… to move the wet wash to the dryer before it gets moldy? Sometimes, I’m suddenly concerned I’ve forgotten an important meeting, but can’t recall quickly what day of the week it is today — much less when that appointment was to take place — which sends me scrambling for my calendar.
Now, I was about to make an important point here, but I’ve forgotten what it was… darn! Looking above for reminders… oh, right!
We middle-aged people caring for parents, children, spouses, paid work, projects, community work, and somehow ourselves often become forgetful and distracted. Many of us worry that we are acting uncomfortably like our parents and other elders who have been diagnosed with Alzheimer’s Disease and related dementias. Do we have it, too?
Well, maybe: there are early-onset cases of dementia involving people in their 50s and 60s. But this is unusual. It’s more likely what I call MLDS: Mid Life Distraction Syndrome. To state it idiomatically: we have too many balls in the air, are up to our eyeballs, and struggling to tread water while having too much on our plates. But still, we wonder: are we experiencing “normal” forgetfulness?
We may also wonder about our elder parents, spouse or other aging loved ones. Should we be concerned about certain behaviors we see? What does forgetfulness that is not “normal” look like?
I’m not going to answer by focusing on physiological processes or diagnostic criteria, but on simple, everyday functioning. I encourage you to consult your physician if this topic continues to worry you, or the following seems to point to something that is outside the norm. Try these six points on for size.
- Forgetting a name, a word or a part of an experience, but remembering some time later either spontaneously or after thinking it over is “normal” forgetfulness. Not being able to remember an experience, name or word — or even a person or place that should be familiar — is not “normal” forgetfulness.
- Being able to reconnect to a name, word or experience after someone or something gives a reminder points to “normal” forgetfulness. Reminding might not help recall in cases of forgetfulness that is not “normal.”
- Being able to effectively use notes or a calendar to compensate for forgetting indicates “normal” forgetfulness. Decaying ability to effectively use a calendar or notes to aid memory is not “normal” forgetfulness. Memory problems when trying to do too many things at once, or at times of high stress or fatigue is “normal” forgetfulness. Diminished ability to remember how to do or figure out the sequence within tasks that had been accomplished previously, is not “normal” forgetfulness.
- Feeling frustrated with forgetting, but exhibiting the usual personality and behavior while responding to such challenges points to “normal” forgetfulness. Uncharacteristic anger, defensiveness, or changes in personality and diminished problem solving and judgement may indicate that the memory problem is not “normal.”
- Being forgetful, but still able to consistently perform self-care of basic needs such as bathing, dressing, and eating is “normal” forgetfulness. Uncharacteristically poor hygiene, unchanged or soiled clothing, weight loss or gain due to forgetting to eat, or eating a meal multiple times because the previous one consumed was not remembered, are not indications of “normal” forgetfulness.
As we can see, forgetfulness that is not “normal” is a pattern of deteriorating functioning, not just incidents of forgetting that can be corrected. Where there is loss of abilities previously held, and/or negative changes in long-established, characteristic behavior and personality patterns, this is when we should be concerned.
We can more gracefully adjust to the challenges of “normal” distracted or age-related forgetfulness. We give ourselves and our loved ones more time to recall events, names, and words as we age, because “normal” recall can take longer. Recognizing that multi-tasking may become more difficult the older we grow, we take this into account when planning. Fatigue and stress are great thieves of memory. Many folks taking care of aging loved ones — particularly if that person has dementia along with other chronic illnesses — exhibit memory slips that correlate with their exhaustion level. Use this as an indicator that additional help is needed, such as respite care to relieve the caregiver.
We now know many ways to help a person with dementia function better through changes to their environment — whether in the person’s home or in a facility — and with daily care that reflects best practices. This is often referred to as “habilitation”, and we will talk about these methods in future columns.
Deborah Bier, PhD, is director of Caring Companion Home Care’s Metrowest Boston office, headquartered in Concord, MA (www.CaringCompanion.Net). She holds a doctorate degree in counseling, and is certified to both educate dementia caregivers and coach families of dementia patients. She can be reached at Deborah.Bier@CaringCompanion.Net.
