Posted 4-9-20
Wow…4 weeks ago today was the last time I got to visit mom in person. But, for the safety of all of these folks, now we sit outside of the prison walls and digitally yodel, hoping we can be heard and understood… I am thankful for the Facetime although it certainly isn’t the same….
Regardless, we are heading, slowly but surely, to the weekend! Happy Thursday to all!
Speaking of head, we shall use our heads to think about the head and some possibly less obvious aspects of how the head is hurt by dementia. Obviously there are the 1,000,000 things we have discussed over the last 1.5 years and nearly 500 articles here since the epicenter of the dementia pandemic is in the brain. but, what else goes on in the noggin? Here are a couple of thoughts:
- Headaches. It appears here to be another chicken versus egg conundrum. Folks with frequent headaches appear to have a better chance of having dementia later. However, contrary to what I would have expected, headaches aren’t the cause or a good indicator of vascular dementia. Who woulda thunk it? I mean, restricted blood flow (narrowed) is a factor in migraines and other headaches. If part of the brain loses blood flow, depending on the severity and other factors, you have a stroke or vascular dementia. There are more factors at hand with this form of dementia.
- Speech challenges. Primary progressive aphasia is a neurodegenerative disease, which results from progressive deterioration of brain tissue in areas important for speech and language. There are other causes of aphasia (speech loss), most notably a stroke, but for our little nook of the speech issues world, this one is in view. Here is a great article on the topic, with lots of good tips. Summary: Speech starts declining fairly quickly in many patients and eventually for all. Mom had word selection issues first, then pronunciation issues, and now pretty much word salad. She still seems to have a conversational cadence and is trying to tell me stuff, but is also ok if I just seem to understand the not understandable. To me, empathy is soooo important here. Asking to repeat something is of mixed value at a certain point. Mom just wants to feel understood. As some of the above links mention, they are advancing some in “treating” this condition. Speech therapists also have ways to provide limited help too.
- Sight. Dementia changes vision in a host of ways because of how complex the process of seeing is. It narrows the field of view, causes visual-spatial problems (that uneasy feeling in hindered or impaired vision where depth and other cues are messed up that leads to confusion and falls), and processing what is seen gets very hard. Here is a great piece on this topic. For others, vision is completely messed up. Posterior Cortical Atrophy makes it impossible to see/process more than one thing at a time. Hallucinations are another visual concern, especially if the patient is diagnosed with Lewy Body Dementia. This piece is an outstanding look at these issues.
- Hearing. Hearing loss is common in seniors and perhaps more common in patients with dementia. Approximately 30 percent of adults aged 65 and older and 55 percent older than 80 years show some degree of hearing loss. Two primary things come into play here: not physically hearing well and challenges processing sounds. Hygiene (wax buildup) and ear infections can also be factors here, and patients often may not be able to tell you that they have a problem, so the hearing problem worsens. Hearing aids can be confusing for a patient and their maintenance must be managed carefully. There have also been many studies linking hearing loss to enhanced risk of dementia. Here are a few of discussions in that realm: Link Link Link Link Link
- Smell/Taste. Another cause/effect and/or chicken/egg deal here. An impaired sense of smell seems to be a sign, at the least, of dementia. The nose and mouth have trillions of cells dedicated to their purposes and brain loss can certainly hinder their work. However, like vision and hearing, sometimes it is a processing problem as much as an ability problem. Tasting a pickle as a pickle is one thing. Forgetting what a pickle tastes like or thinking a pickle tastes like a cheesecake is another one. Here are some links about this topic: Link Link Link Link Link Link
- Swallowing. As we discussed previously, aspirating food is a huge problem. It begins with the chewing and swallowing process, which certainly gets out of whack, especially in late stage dementia. There are also other considerations that we have looked into the last 18 months. Dentures…oh, the great denture adventures. Mom lost her dentures over and over until we finally just shelved them. One day we would find them in someone’s nightstand, the next in the sink. It just wasn’t worth it. She, like most in her situation, gets her food pureed anyway, removing the need of teeth. Another couple of aspects here, though, are important. First, holding food and not swallowing it is a problem. Whether they forget to swallow or forget how to swallow, it happens and needs to be watched for. Give frequent drinks to wash down this little hidey-hole’s food cache. In addition, swallowing meds was a nightmare for mom for the first 6 months she was in the memory unit. She would spit them out. Try to sneak them in food and she would root them out like a pig finds a truffle or my wife finds a coupon. We finally resorted to pureeing the meds and sticking it in yogurt. Talk to your med tech and/or care team if this is a problem. Not all meds can be administered this way.
What a challenging disease. 🙁 We need to find better and more treatments for these many symptoms we have discussed this week even if a cure isn’t on the horizon. Sigh.
#EndALZ
Update: I had a Facetime with mom as I finished up today. 🙂 All seems the same, for better or worse. I am glad the virus hasn’t found its way into the nursing home yet. Here are some cute pictures. 🙂 :
I enjoy your blog . My Mother lived with me and my sister (we shared her) for the last 5 1/2 years. She is 90 and has had dementia for at least 7 years. Due to her decline we have had to put her in the Care Center here in our home town. It has been devastating not being able to see her. We FaceTime as well but some days I am not sure she understands. We also have camera’s in her room so we can see her. I pray this virus comes to an end soon. Keep writing and God Bless you and may he keep your Mom safe!
Thank you for the encouragement! I am sorry that you too are separated from your loved one. I hope I don’t get to see mom too soon, because the only situations that allow for a visit are end-of-life related. Keep up the good fight. I am praying for you folks as I type. -Mark