Is mixing up experiences a sign of dementia?

Dear Mary:

Thanks for a great question, and for carefully noting the behaviors that are raising your concerns.

For obvious reasons, I can’t tell you what it is that is See also:
Two months after my father-in-law's passing, my mother-in-law with dementia no longer recognizes my wife. What could have triggered this?

See all 184 questions about Alzheimer's Signs and Symptoms underlying your husband’s forgetfulness. And yes, a certain amount of forgetfulness does, for some, come with age. However, what you describe could be due to cognitive impairment or to several other potential causes. Nevertheless, you’re right to want to have your husband seen by a competent physician to determine the problem.

Since your husband seems to view you in the role of either a “nagging wife” or adversary who is noticing things that he forgets and consciously denies, you need to find a willing advocate for yourself. Do this now without discussing it with him, as your concerns are out of love and caring, even if your husband doesn’t see it that way.

My suggestion is that you call his primary physician and have the doctor’s office then contact your husband to schedule a “routine” exam. Let the doctor take the lead as to why he wants to see your husband, he’ll be more credible in your husband’s mind. You can then be the supportive wife.

Your role in this is to document the memory and behavior issues that you’ve noticed. Write everything down - forgetfulness, moods, anger, etc. - and email or deliver your notes to your husband’s physician prior to his visit.

Be sure to tell the doctor to focus on issues of memory and cognitive behavior with your husband. Be very clear that you want the doctor to share the results of the examination with you, as you husband may not be forthcoming. By the way, with early cognitive loss, your husband is most likely very aware that things like his memory are not what they used to be, but admitting that is very difficult.

If during the exam, the primary doctor does not see any signs of the problems you mention in your notes, either because your husband has an “on” day or is able to bluff his way through the examination, you might let the doctor know that if possible, you’d like him to suggest a referral to a geriatric neurologist.

The neurologist is someone who specializes in memory loss and can provide a more complete examination and testing to determine if the problem is cognitive impairment. The doctor should be willing to do that, particularly if s/he does not have a great deal of experience with diagnosing problems of memory loss with patients.

Your husband’s memory issues do not sound to be those of normal forgetfulness. But to be certain, you must get the proper professionals involved, and do so as early as possible. Denial is one of the defense mechanisms used by patients with early cognitive issues, as are accusations, anger and simply digging in their heels. No one wants to receive a bad medical report, particularly if there is the possibility of having to hear a diagnosis as shattering as dementia.

Because your husband’s condition could have been the result of a mini-stroke, or may be related to other physiological problems, it is in his best interest to get an immediate, clear diagnosis. If he has a condition that is treatable, wonderful, it will be treated. But if his signs and symptoms are of early cognitive loss, you want to be able to start whatever treatment may be available, and more importantly, you want to start planning for what the years ahead may bring to both of you. But first you need a diagnosis.

For now, you take one step at a time. Get his primary doctor on-board as your ally and get your husband evaluated. Once you and your husband know what it is he is dealing with, you can then start taking the necessary next steps. Be aware, should the diagnosis be a cognitive problem, his denial and other behaviors that have started to manifest will most likely continue and may escalate.

Your role may change, and based on what you find out, I suggest you contact Caring.com again for what the next steps might be for you once you have clearly defined the problem.

One last thought, don’t allow the doctor to tell you that your husband’s behavior is normal or there’s nothing wrong. Your recent anecdotal evidence and documented experiences are strong enough to have raised my level of concern. Good luck.

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