Aug 31, 2007

Dementia Revisited

In my previous post, I took a humorous look at dementia, from the aspect that it could be a result of not taking adequate estrogen supplements after a pre-menopausal hysterectomy. However, in all actuality there is nothing humorous about dementia at all.

It has been one of my experiences that elderly patients are at times over-medicated to the point where they literally do not know what pill they take is for what ailment. When they start describing their medications as the "blue pill" or the "yellow pill", that's not a good sign. And often times, they will not tell their doctor about whatever over the counter drugs they are taking. (This applies to us all, actually. The most common drugs we don't mention are alcohol and nicotine.) Sometimes just having one doctor go over their medications, and side effects of the medications, can actually eliminate many of the symptoms of dementia they might be experiencing. A drug being hailed as the wonder cure for migraine headaches, topiramate, is also one of the worst drugs in the world for memory problems.

When I worked in the hospital, it was quite common for elderly patients to develop a temporary condition on admittance where they became disoriented, agitated, confused, and at times, combative as the evening approached. We called it "sundowners." There is some school of thought that ties this condition to an early stage of Alzheimer's, but I believe it is just an overload of new information to an aging brain. Once the patient gets familiar with the routine, usually by the second or third day, the Sundowners usually diminishes.

Here are some of the symptoms of Dementia:

  • Having difficulty recalling recent events.

  • Not recognizing familiar people and places.

  • Having trouble finding the right words to express thoughts or name objects.

  • Having difficulty performing calculations.

  • Having problems planning and carrying out tasks, such as balancing a checkbook, following a recipe, or writing a letter.

  • Having trouble exercising judgment, such as knowing what to do in an emergency.

  • Having difficulty controlling moods or behaviors.Depression is common, and agitation or aggression may occur.

  • Not keeping up personal care such as grooming or bathing.*

As you can see, the list of symptoms could apply to a host of many disorders and diseases. Which means that dementia, in and of itself is not so much a primary condition, but a symptom of an underlying condition. Many alcoholics will display these symptoms because of a lack of B vitamins, B1, B12, in their diet. Unfortunately, the same can be true for the elderly, whether it be because of a lack of income, or an inability to prepare meals for themselves. Once these nutrients are replaced and replenished, the symptoms go away.

Hypothyroidism, strokes, diabetes, clogged arteries, insufficient oxygen to the brain because of breathing disorders, and depression can all cause these same symptoms. So, if you know someone who is exhibiting these behaviors, especially if they are of a sudden onset, then get them to a doctor. If they don't want to go, trust me, when the paramedics get there, and ask them a few questions, I can almost guarantee that they'll be going. It would be nice if a family member would intervene in this way. But, more and more, many elderly people are without immediate family, either by distance or lack of concern.

For all you know your crazy neighbor down the street who has taken to watering his petunia's in his jockey shorts may have a frontal lobe brain tumor the size of a pea.

Sometimes, we shouldn't mind our own business.

*courtesy of British Journal of Medicine


SpongyBones said...

My best friends grandma has Dementia. She is funny as hell and we all love "keeping an eye on her". Makes life a little less boring.

just me said...

I know, I've read some of the things she has gotten you two to do for her. You guys should write a book about this. I think it says a lot about your character Mr. Swinging Bachelor Guy, that you take the time to "keep an eye" on this lovely lady, even if she thinks you're a gay motorcycle gang member.

Anonymous said...

Deb, this is a most excellent post. Very informative.

It gets my goat when I see younger people disrespecting seniors and giving them a hard time. Would they treat children that way? No. They would cut the kids some slack.

I don't like to refer to seniors as children (it's very disrespectful) but the point I'm trying to make is seniors can develop medical conditions that make them dependent on us and we need to care for them and overlook their annoying habits just as we would care for other groups such as children.

Thanks for this post.

SJ said...

So if they put some vitamins in the alcohol we would have healthier alcoholics?

And those symptoms - sounds like all politicians have them too like difficulty remembering events.

Mary said...

SJ- LOL- Too true about the politicians!

Good stuff Deb. The sundowners is interesting. That exactly happened to my mother.

Scott from Oregon said...

They can be so funny, too...

alphonsedamoose said...

What an excellent post Deb. The elderly in our society are often over-looked and not taken care of properly.

Woozie said...

Dick Cheney had a sudden onset of dementia after being shown the now infamous 1994 Quagmire video. Has he been having a stroke since July (please say yes)?

Gardener Greg said...

I have occasional dementia, Whenever it is convenient, lol

just me said...

Woozie: Dick Cheney is way beyond dementia. He should be bled daily by a doctor-barber, to rid himself of evil humors.

SJ: Yes, take vitamins with your alcohol, and hopefully your liver will last a little longer.

Babzy, Moose: I get really upset at the way seniors are treated in this society as opposed to almost every other society I can think of. Instead of being honored for their wisdom and experience, they are tossed aside like yesterday's news. Don't get me started.

Scott: Every where I go, people laugh. (Dementia)

Mary: My Dad had sundowner's every time he went in the hospital, and one night in particular I honestly believe time stood still.

Greg: Mine is just the opposite, it hits me when its most inconvenient...."Well, of course I remember you! (haven't a clue!) How long has it been now? That long?" (damn, who is this person!)

Anne said...

Aw, crap. According to this, I've had dementia all my life. And here I thought I was just ditzy. I've never had one lick of sense of direction, terrible with names and not too great with money. Maybe I can move in with Spongy. Heh heh.

just me said...

anne, I'm sure Spongy would be most delighted. He is a horn-dawg, afterall. And a rootin'-tootin' cowboy kinda guy. Hell, I'll move in with

benjibopper said...

this runs in my family. it can be funny at times, heartbreaking at others. i guess that's why it makes such good movie viewing (away from her; Iris) - you laugh you cry, and whatnot.

I like the cartoons, especially the 'I don't care' one.