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Holidays offer chance to size up aging parents well-being – Canton Repository

Nov 29th, 2019

Adult children home for the holidays may be noticing something for the first time about an aging parent. Dr. Kathleen Rogers, chief of geriatrics for Cleveland Clinic Akron General, offers some guidance on how to approach the sensitive subject.

As local and out-of-town relatives gather for the holidays, it may be a time when they notice that aging parents or loved ones are showing different behaviors that might be a clue to potential decline.

Perhaps theres been an incident where the loved one has forgotten where they are going, or the house seems more disorganized. Or maybe your loved one is more agitated or has taken a fall.

Dr. Kathleen Rogers, chief of geriatrics for Cleveland Clinic Akron General, offers some guidance on how to approach the sensitive subject.

Q: What is geriatric medicine and at what age would someone see a geriatrician?

A: My definition of geriatrics are patients who are high risk. You might be a 40-year-old who has had a heart attack or stroke and youre in a wheelchair and ready to go to a nursing home. That would typically be a time for a referral to a geriatrician.

Q: So a geriatrician is a specialist and not meant for primary care?

A: Correct. Im a specialist. You can call a geriatrician directly, but I would recommend starting with your primary care physician since your doctor knows you better. We can partner with your primary.

Q: Is there a checklist of things family members should be looking for that might cause concern?

A: Watch their behavior. If theres too many people in the house, the person might be aggravated and aggressive or more quiet and withdrawn. Usually, thats a symptom of something deeper. Sometimes with memory loss, they dont want their family to know and their coping mechanisms are behavioral.

Another thing is disorganization. If a loved one used to be very organized and was able to plan a whole dinner for the holiday and all of the sudden, theyre burning the pot or dont know how to do multiple things, that could be a concern. If they cant hold a conversation, that could be a symptom of hearing loss or vision loss if they cant see well.

One of the biggest red flags would be finances. Did they miss or overpay a bill? Did they get scammed of thousands of dollars or suddenly go shopping or gambling? Those are symptoms of behavioral issues that may be a sign of a deeper problem like a memory issue.

Have they had a fall recently or having balance issues?

Has there been extreme weight loss, not from exercising, which could be a sign theyre not eating. Are there any issues with independence, such finances or cooking?

Q: How do you tell the difference between just getting old and potential dementia?

A: Sometimes it takes time. The earlier you can get a loved one to a specialist or primary care, the more testing we can do or see what diagnosis were dealing with. With dementia, your basic daily living functions are impaired, which could be shopping, finances, driving, remembering lists or appointments or names of people.

With regular aging, you dont normally see all these domains getting affected. Theyre still able to function well and have good coping mechanisms.

Q: Could it be a one-off? If mom forgets one bill, I dont have to rush her to a specialist?

A: Correct but if that happens, you may want to keep a close eye to see if other things are affected. Maybe she forgot to take a pill or two or forgot appointments. Or there could be behavioral changes. Maybe she put her jewelry somewhere to hide it thinking somebody is coming to take it, but with memory issues, she forgot where she put it and then paranoia comes in because she thinks someone did take it.

Q: Whats the difference between memory loss, dementia and Alzheimers?

A: Dementia is a symptom of an underlying problem. Dementia is also an umbrella term for multiple diagnoses, the most common of which is Alzheimers dementia.

Q: How does one approach this very sensitive subject?

A: Ask your loved one how they feel about whats going on. Depending on his or her personality, this could be a difficult conversation. If you notice theyre more nervous than usual, ask if theres a reason or situation causing them to be nervous.

For example, if theres too many people around, they maybe cant focus on one conversation and it may be a hearing loss issue, which can impair your memory.

I cannot stress enough that a lot of people dont think correcting vision or hearing is important. Your brain is like a muscle. If you dont use it, it atrophies. There can be memory loss associated with vision or hearing loss that is not corrected.

Q: How can you talk with your siblings about your concerns and without your parent feeling like the kids are ganging up?

A: Have a conversation with other family members and see if theyve noticed things. Then maybe sit down with the loved one one-on-one to candidly ask them about it without making it a big deal.

Q: What do you do if the parent gets agitated and doesnt want to talk about it, or is upset that the children are acting like the parent?

A: It depends on the situation. If you see there is possible for potential harm because there might be a pot left that might cause a fire, you may want to be a little more assertive and say Do you mind if I go with you to the next doctors appointment? Go with them to keep accountability not only with them, but their doctor.

Q: As a doctor, do you like advocacy on the part of adult children?

A: Yes. Ive had times when patients come all by themselves with pretty severe memory loss and because of their confidence and coping abilities, they can make up good stories which seem pretty plausible. When a family member is there to say Maybe Mom should not be driving because shes had four tickets going to the grocery store, that gives me a different perspective. I also encourage family members to call me, if they cant come to an appointment.

Q: Can physical things like falling also be a sign of mental decline?

A: A fall could be a sign of something deeper or something from a disease state. Maybe you have depression or have been laying in bed for days and youve lost muscle mass and maybe that made you fall. Or maybe you have an inner ear problem and have vertigo. Any fall in an older person should be investigated.

Studies have shown that once youve had a fall, the chances of you falling within the next three months is almost approaching 50%. It affects your physical state. Your doctor may want to test your blood to see if theres a reason you fell. Or maybe you need physical therapy to help your balance or muscle tone and reinforcing a normal gait with strengthening exercises to help prevent future falls.

The only two interventions proven over and over again for success for memory loss are physical exercise and a healthy diet.

Q: What kind of exercise do you suggest?

A: Moderate exercise of 30 minutes three times a week can moderately improve memory and function. Brisk walking, slightly higher aerobic exercises. Not heavy weight lifting. Something slightly more than normal or that challenges you more physically. Physical activity helps with circulation and there is a direct link to better cognition.

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Holidays offer chance to size up aging parents well-being - Canton Repository

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