It’s a frightening feeling: the spouse you’ve known and loved for decades is changing. By familiarizing yourself with the signs, symptoms, and progression of cognitive impairment, you’ll be better equipped to care for your spouse who is struggling with issues related to memory loss.
Your brilliant husband is less verbally eloquent than he used to be. Or your wife feels overwhelmed planning your vacation, which she used to enjoy as much as taking the actual trip.
This is what memory loss looks like in the early stages.
Is It Age-Related Memory Loss, MCI — Or Dementia?
As we age, many of us find ourselves searching more often for the right word, or forgetting where we put our glasses. This is normal, age-related memory loss, and not cause for alarm.
When the deficit is more pronounced, however, it is known as mild cognitive impairment (MCI). Mild cognitive impairment does not necessarily mean someone is developing dementia, but that the way they process information is changing. Approximately 15-20 percent of those over 65 have some degree of MCI.
MCI symptoms include:
- Difficulty following a conversation or basic instructions
- Regularly losing your train of thought
- Forgetting appointments, birthdays, or scheduled events
- Feeling overwhelmed by planning and decision-making
- Getting lost in familiar places
- Frustration with these cognitive deficits, which can lead to anxiety, irritability, apathy, or depression.
While these symptoms can also signal the beginning stages of dementia, many people with MCI never get any worse. In some cases, such as when cognitive impairment is a result of a reaction to a medication or caused by another health condition, MCI can even be reversed. Studies show that only about half of those diagnosed with MCI will develop Alzheimer’s or another form of dementia.
Determining the Truth About Memory Loss
One of the first steps is to identify the cause of MCI. Though we can’t stop the aging process, there are a number of factors that can create or worsen memory loss:
- Medical conditions, e.g., high blood pressure, diabetes, high cholesterol, hypothyroid, or heart disease
- Infections, such as a urinary tract infection (UTI), which can cause dementia symptoms in the elderly
- Substance abuse: alcohol or drugs
- Lack of exercise
- Poor diet
Most, if not all, of these factors, are correctable. If your loved one has hypertension, diabetes, or heart disease, for example, check with their physician(s) to be sure none of the medications they’re taking are causing an adverse reaction (or interaction with other drugs) that presents as cognitive decline. Their doctor should also check that an undiagnosed UTI isn’t creating memory loss or behavioral changes.
Nutrition has been proven to play a critical role in mental health — and poor diet can induce memory loss. This is one important reason that fine dining, using fresh, wholesome ingredients, is a mainstay at The Kensington Redondo Beach. It’s also vital that a senior drink plenty of water, as dehydration is common in the elderly due to lack of thirst, and can cause confusion that mimics memory loss.
Similarly, a sedentary lifestyle atrophies the mind as well as the muscles. Research shows that physical activity helps to counteract cognitive decline, Alzheimer’s disease, and other forms of dementia. At the same time, it increases psychological well-being and enhances mood.
Finally, if your spouse has a problem with substance abuse, this will affect his or her mental health and must be addressed by competent health professionals.
If memory loss is caused or exacerbated by one or more of these factors, you may both happily discover that the memory issues reverse, once the health issues have been addressed.
10 Techniques to Boost Brain Health
Your spouse can compensate for mild cognitive impairment by transforming frustration and aggravation into constructive, brain-building activities.
Here are 10 techniques and tips your loved one can implement now:
- Take a pro-brain approach. Working crossword or jigsaw puzzles, solving math problems, reading the newspaper or a book, playing cards, listening to music, or learning something new will all help challenge your brain and stave off cognitive decline.
- Keep a journal, or create a scrapbook. Spend some time documenting your life. This will enable you to reflect upon who you’ve been, and allow you to share your experiences with those close to you. Your children and grandchildren will treasure these keepsakes, and the act of creating the journal or scrapbook will keep your brain healthy.
- Exercise. Ask your doctor for an exercise program that fits your changing needs. Exercise contributes to good physical and mental health and reduces stress. Here at The Kensington Redondo Beach, we strive to ensure seniors live an active, healthy lifestyle every day, in a uniquely beautiful setting. Our elegant new community beckons people outside to enjoy our perfect year-round weather.
Exercising is easy here; in addition to the outdoor amenities we have on-site, the beach and boardwalk are nearby, and we also offer many indoor fitness activities to choose among. Whether it’s walking, dancing, yoga, or stretching, we encourage all our residents to keep their bodies moving.
- Stay social. This is not the time to isolate yourself! About 40 percent of people age 65 and older in the U.S. have some degree of age-related memory loss, and jokes about having a “senior moment” abound. You’re in good company, and the company itself is good for your brain: social engagement has been proven to reduce stress, keep the mind sharp, and increase feelings of worth among seniors. Continue to participate in family events as you’re able, and keep in touch with old friends.
- Eat well. Nutritious foods boost brain health as well as physical health. It’s one of the main reasons fine dining is so important at The Kensington. Our Director of Dining Services, Kieran Harrington, aims to make every meal a five-star experience in cuisine, presentation, service, and atmosphere.
- Cultivate patience. You may not be as cognitively quick as you once were; then again, most of us aren’t as physically fleet of foot at 60 as were at 20, either. Begin to make peace with this change. Understand that you may feel frustrated, anxious, or sad at the loss of some abilities. See if you can reframe slowing down as an opportunity to become more contemplative in the process of completing a task.
- Research MCI. Increase your awareness of MCI clinical trials, and share your knowledge of MCI with those around you. This will enable friends, family, and neighbors to better understand the changes mild cognitive impairment engenders, and how they can best support you.
- Find a support group. Beyond your family, it’s valuable to have a support network that understands what you’re going through and can help you constructively release any anger and frustration you may feel. Encourage your family members to seek out counseling and support to meet their needs.
- Celebrate yourself. You’re more than an MCI label. Focus on your present abilities and not what might happen in the future. Know that there are many ways to live an active and productive life.
- Advocate for yourself and others with MCI. If you’re politically minded, write letters and make phone calls to local and state representatives, and assist community agencies in training staff and professionals about MCI.
How to Support Someone with Short-term Memory Loss
The first step is testing for memory loss. There are a number of simple memory tests your doctor can administer to see if there is a problem.
While most people think forgetting what they ate for dinner last night is an example of short-term memory loss, this is actually a long-term memory deficit. Short-term memory is learned and retained just long enough to use or transfer the information into long-term memory: for example, someone’s phone number as you grab your phone and punch in the digits, or an item you need to buy for dinner as you push your cart to the correct aisle.
Short-term memory, also called working memory, declines with age just as long-term memory does. Fortunately, it’s easily remedied.
Here are five simple memory aids you can use to help your spouse deal with short-term memory loss — and reduce caregiver stress:
- Prominent time and date. Since one of the hallmarks of short-term memory loss (and one of the most disconcerting for both the person with memory loss and their spouse) is knowing what day it is, or the time, they may ask this question repeatedly. A trio of solutions:
- Analog clock. People in their 60s, 70s, 80s and older did not grow up with digital, and they are more likely to recognize the pattern of hands on a clock face, with a second hand ticking off the time, than a digital readout. This yesteryear reminder can be comforting, as well as jog their memory.
- Day calendar. A daily desk calendar that displays the date with a large number is another inexpensive reminder. Ask your spouse to tear off each day as it passes.
- Whiteboard. Write the month, day, season and weather to help someone with short-term memory loss orient themselves and know how to dress.
- Monthly schedule. If your daughter comes over on Wednesdays, or you typically take your spouse to the park on Thursdays, it’s helpful to indicate these regularly scheduled events on a large monthly wall calendar that you can hang in the kitchen or bedroom. As with the analog clock, a monthly calendar is likely something you’ve had in the house for years, and that your spouse is familiar with from before. The pattern of a month of days will be soothing and recognizable.
- A place for everything, and everything in its place. For someone with short-term memory loss, it’s helpful to develop a system for objects you use regularly, so your spouse can locate them more easily. For instance: the TV remote always goes on the left-side end table by the bed. Reading glasses go next to the books on the table in the den. You can write these locations down on the whiteboard, too. To assist your spouse with household tasks they’ve done and would like to continue to do, get visual. Place pictures of eating utensils, dishes, dishtowels, and dry food on the outside of the cabinets and drawers where they’re stored. Such small assists can go a long way toward helping a loved one with memory loss be more independent.
- Telephone triggers. Your loved one may have a smartphone with pre-programmed numbers. If they use a landline, this memory hack works well: place a large magnetic board next to the telephone (on the wall or fridge, for example). Write down family members’ and friends’ names, phone numbers (with area code), and include a recent picture of each person. The combination of name and image will trigger memories that a name alone might not.
- Reminder notes. Everyone uses these, whether or not they have memory impairment: reminder signs that ask employees whether they’ve washed their hands, or teens if the front door is locked. You can place Post-it notes or more permanent signage in strategic areas, such as the bathroom, kitchen, and front hallway, so your loved one will remember to flush the toilet, wash their hands, turn off the stove, take their wallet or purse, and lock the door.
Crucial Steps to Take When A Spouse Develops Memory Loss
People who develop dementia typically live a shortened life span, but this depends on how old they are when diagnosed.
For instance, in one research study, those diagnosed with Alzheimer’s between the ages of 65-69 lived an average of 10.7 years after diagnosis. By contrast, people diagnosed in their 90s lived just 3.8 years. Someone with MCI can live the rest of their typical life span with this condition if it does not worsen.
Whether you’ve become a caregiver gradually or overnight, you may feel overwhelmed and unprepared. Caregiving is unique for each spouse and family, yet there are guideposts to help you on this new journey you and your loved one are setting out on together.
Here are eight essential steps to take now:
1. Meet with medical professionals. Even if you’ve ruled out the memory loss mimics described above, it’s important for your spouse to have a complete physical and mental health assessment from a qualified health care team. Once you have a diagnosis, you can determine treatment options, identify risks, and plan for the future.
2. Educate yourself and your family. Information is power. Although memory loss is a classic dementia symptom, in other types of dementia, such as frontotemporal dementia, the dominant symptom is personality changes. The more informed you are, the better equipped you’ll be to manage symptoms as they manifest.
Besides doctors and other health professionals, you’ll find a wealth of reliable information on trustworthy sites such as:
3. Discover what your spouse needs most right now. Would he or she benefit from emotional reassurance that these memory lapses are minor, and not necessarily indicative of a downward spiral? Does your spouse need medication supervision or encouragement to eat healthier meals?
There are various assessment tools that can help you determine the level of assistance someone needs, and establish their care preferences (e.g., bathing in the morning rather than in the evening).
Assessment tools typically focus on 5 core areas:
- Activities of daily living: bathing, dressing, toileting, grooming, eating
- Healthcare: medication management, doctors’ appointments
- Emotional: companionship, conversation
- Household: cooking, cleaning, laundry, shopping
- Supervision: staying safe at home, wandering watch.
4. Create a care plan. Once your spouse has a diagnosis and needs assessment, you and your family can create a plan to provide the best care for you both.
Because both the person needing memory care and the care provider’s needs will evolve over time, this plan is bound to be a work in progress. In conjunction with your spouse, decide what your spouse would like help with now, what you are capable of providing, and who might be a good resource to begin building a support team.
5. Safety-proof your home and spouse. If you’ve raised children, you know it’s essential to protect them from harm through exploration. The same holds true on the other end of the life spectrum. One of the best ways to help a loved one with memory impairment is to develop and maintain routines they can rely on to stabilize their days, and to age-proof the home to prevent injury.
Be aware of potential hazards involving:
- Fire: stoves, ovens, lighters, matches
- Sharp objects: knives, razors, scissors
- Poisons: medicines, household cleaners, personal care products
- Tripping: rugs, furniture, cluttered pathways, uneven pavement, improper footwear (e.g., heels)
- Hot water: adjust water heater temperature setting to avoid burns
- Grab bars and grips, non-skid mats, plastic cups and plates in lieu of glass and china
- Emergency locks, door alarms, and an identification bracelet or personal emergency response system (PERS)
- A tracker designed for someone with a cognitive disorder, a wearable like SmartSole, which is a smartphone-in-a-shoe, or MindMe, a GPS and alarm button in one
- A list of emergency phone numbers on the refrigerator door
- Medication monitoring. Again, technology is your best resource here, with innovation such as Med-Q Pill Reminders, designed by caregivers specifically for those with dementia
6. Face your finances. This might be one of the toughest areas to tackle since most people are highly private about their finances. Especially if the spouse with memory loss has always handled the family’s financial affairs, it behooves the caregiver to familiarize themselves with these important assets ASAP.
Make a list of your financial assets and liabilities:
- House: is there a mortgage or reverse mortgage?
- Checking and savings accounts
- Social Security income
- Retirement pension(s)
- Insurance policies and annuities, etc.
You may want to enlist the help of a reputable elder financial planning resource at the outset. Ask your attorney, family members and friends for a referral to a trusted resource.
7. Review legal documents. There are a number of crucial legal documents that will affect both of your futures. Ideally, you’ve had these discussions before your loved one manifested symptoms of memory loss. Either way, these are the documentation discussions to have now, to ensure your spouse’s and your needs are met:
- Advance directive. Also known as a living will and durable power of attorney for healthcare, an advance directive lets medical professionals know your wishes regarding end-of-life care when you are unable to articulate them yourself. According to the National Institutes of Health, only about a third of adults have completed an advance directive. Even more essential is the newer Dementia Directive, which must be completed well in advance of needing to be implemented, for obvious reasons.
- POA. If you are your spouse’s financial power of attorney — the person who will handle his or her financial decisions if your spouse is unable to make them — make sure this form is up to date.
- Long-term care. What long-term care possibilities have you considered? An assisted living community that includes memory care may be an ideal solution, but as with the dementia directive, you should plan for this possibility well in advance.
- Will or Trust. Do you and your spouse have wills or a revocable living trust? Are these legal documents current?
- Retirement accounts. Do you have current beneficiaries listed on your investment accounts, life insurance policies, IRAs, and 401K accounts?
8. Take care of yourself. Being a caregiver is a demanding responsibility, and there are many resources, both virtual and in-person, available to support you. For example, at The Kensington Redondo Beach, we offer Caregiver Connect every Thursday to enable caregivers to connect with others in similar circumstances to discuss common challenges.
This group validates the importance of your caregiving role, helping to preserve your well-being by supporting you to stay positive, manage fatigue, and make the most of each moment as your loved one’s memory changes.
Because caregivers for those with dementia are at high risk for their own health, we advocate taking the same preventive self-care measures we recommend for all seniors:
- Eat healthy meals every day
- Get regular daily exercise
- Don’t skimp on sleep!
- Take time to relax and recharge
- Get regular health check-ups
Ask friends and other family members for assistance. Others want to help, but they may not know how. Let them know how they can best support you and your spouse.
Coping Strategies for Caregivers
Caring for a spouse with memory loss is one of the most challenging roles you’ll fulfill for your loved one. In addition to online caregiver support communities such as Caregiving.com, here are a dozen coping strategies to support you both on your memory care journey:
- Acknowledge the memory loss. There is little more distressing than “watching the lights go out,” as one senior with memory loss expressed it. Your spouse knows what is happening, and acknowledging the change affirms who they have been, and still are. Remind your loved one of how much they can do for themselves, and reassure them that they are still loved and valued.
- Be open about your spouse’s memory care needs. Family, friends, neighbors, and others who will have regular contact with your loved one should be told what is happening, so they can be aware and alert to any problems. People tend to respond more appropriately and offer assistance when they understand the situation.
- Encourage reminiscence. With memory loss, the past is more accessible than the present. Reminiscence therapy, pioneered by Pulitzer Prize-winning gerontologist and author Robert Butler, involves the discussion of past activities, events, and experiences, usually with the aid of prompts such as photographs or music. It’s been found to boost the brain, mood, and behavior of people with dementia.
- Accept repetition. This is going to be the “new normal” for you. Use a calm voice when addressing your loved one. Make brief, simple statements with direct eye contact, and touch them if possible. This behavior on your part will help your spouse remain calm and receptive. Remember: they don’t realize they asked the same question a few minutes ago. Try to see every moment as brand new, as they do.
- Limit choice. While most of us love having lots of choices in life, with memory loss, this only adds to the confusion. Aim to give your spouse a clear choice between two alternatives, rather than asking them open-ended questions.
- Reinforce the positive. Praise helps someone with memory loss maintain social and self-care skills. When you want to correct a behavior, suggest a positive approach rather than telling them what not to do, e.g.: “Let’s try it this way.”
- Avoid or leave stressful situations. Since reasoning and logic will not work well with a memory-impaired individual, change the scenario. If they are agitated by something that is happening, remove them from the situation.
- Create a calm environment. Clutter, noise and excessive activity are stressful for almost anyone. Keep the home environment as serene as possible. You may be inspired by one assisted living executive, who created a memory care residence where the indoors looked like outdoors, complete with ceiling lights programmed to resemble sunrise and sunset (which helped reset residents’ biological clocks and improve brain function), and floors painted to look like sidewalks, complete with grass.
Something similar is underway with Dementia Villages. In both cases, the concept is to help those with memory impairment feel at home — in the past, now the present.
- Keep to a routine. Familiarity is the watchword of memory care. If you’ve installed a daily and monthly calendar, and are doing your best to use reminder notes and habitual placement of objects, this is a great start! When it’s time for a change to the routine, such as a visit to the dentist, don’t bring it up until just prior to leaving for the appointment. This way, you’ll avoid unnecessary days of repeated questions.
- Anticipate problems in order to prevent them. If certain subjects provoke anger or agitation, try to avoid discussing them. Distract your loved one from an irritating topic by switching the conversation to something they find pleasurable, such as looking at family photos. If they continue to act querulous, seek the reason behind the behavior: are they frightened, in pain, or needing to use the bathroom? Respond to the need or emotion you feel the person is trying to express.
- Consider respite care. Arrange for someone else to assume your caregiving duties for several hours at a stretch on a regular basis so you can leave the house and recharge. You cannot provide good care for your loved one if you neglect your own needs. Respite care can take place in your home, an adult day care setting, or a residential facility.
- Be patient with yourself. Recognize that you will make mistakes. It’s normal to become angry and impatient at times; caregiving for someone you love, who was an equal partner for so long, is very difficult. Know your limits, and let go of guilt when you say “no” to others. You’re doing the best you can under challenging circumstances.
How The Kensington Helps Loved Ones with Memory Loss
At The Kensington Redondo Beach, we treat each resident with the same love and respect we give to our own family. This is our promise to you, and we live it every day by helping our memory care residents feel safe, treasured, peaceful and valued.
We specialize in customized care that emphasizes independence and self-sufficiency. While we’re always ready to assist as needed, we strive to ensure that each resident is able to live as independently as his or her circumstances allow.
To aid this process, we offer on-site rehabilitation services, clinical services, and an on-site physician’s office, as well as full-time nursing staff. You can be confident that your loved one is in capable, professional hands at all times.
The best “therapy”, of course, is being among family and friends. We encourage you to visit as often as possible. Come join us soon for a healthful meal in our elegant dining room, or to tour our suites with options for private companion living.
We look forward to welcoming you and your loved one to The Kensington Redondo Beach.