Is mixing up experiences a sign of dementia?
I suspect my husband has early Dementia. I can't talk to him about it or he will get very angry with me that I would think such a thing about him. Also paranoia would set in and then if it isn't Dementia I would feel really bad. He also would not go to a doctor to get tested and would feel insulted that I would think such a thing. With this in mind I need to talk about some things he has done and see if you tnink it is a possibility he had Dementia or it is just that we are getting older. He will be 75 this August and he gets around very well and has good health. He reads a lot and can converse on just about any subject. With this in mind these are the things I have noticed that concern me: When his mother wasn't feeling too well his brother-in-law named Meredith came down from California to visit. He and my husband got her some icecream. Later Meredith went went back home. Two days later his other brother-in-law named Ed came for a visit too. We were all talking about the icecream and my husband said to Ed that they went out to get the icecream for his mother. I whispered to him that it was Meredith he went with to get the icecream but he wouldn't pay any attention to me. Ed told Gary - my husband tha it wasn't him that went with him. Gary couldn't comprehend this. He looked dumb structed and had a very blank look on his face. Ed called him on it and was very concerned. He asked him what was he going on that he couldn't remember this in a stern way. Gary was just lost with this and never could get the memory of what had occured back. He came home and tried to remember who it was he went with to get the icecream and he couldn't remember. The other occurances don't happen very often but occasionally, probably around 3-4 times a year or a little more, he will park the car in a strip mall where we go all the time. He will come back out and forget where the car is and spend time looking for it. This concerns me because it isn't hard to find the car because he parks it right out in front of the store he is going into and it is a very small strip mall. He walks around everywhere and eventually he will find it. This concerns me. If we go any where we don't usually go and park in a huge parking area with lots of parking levels he can forget what level the car is on and become disorinted. This doesn't happen all the time. Another time we were driving to an area that we had only been too a few times and he became disoriented and wasn't sure how to get there and find the store. Sometimes these things happen and other times he can function just fine. The other thing is that he is more forgetful about things I tell him about. He will ask me several times what time we are supposed to be somewhere. He will go to the store and forget what it is I have asked him to pick up. Then other times he will remember what I ask him. He can become more angry than he used to be if he gets upset. Now I don't know if this is the way everyone behaves when they get older or it is something that is more serious. Please let me know what you think as I am very concerned. Any help you can give me will be greatly appreciated. I forgot my screen name so I'll use Mary. t
Expert Answer
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 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.