Signs of Dementia

Let’s face it – as we get older, we tend to forget things.  But, when we seem to notice it more and more, when do we need to get concerned?  While this blog is not meant to be medical advice, it may help you put some things into perspective for either yourself or a loved one. 

There are many levels of dementia.  The first is mild cognitive impairment where some memory problems are experienced, but the individual can live independently.  Some physicians do not consider this to be a “stage” of dementia at all as the symptoms are simply normal age-related cognitive decline.

The second level is mild dementia where the impaired memory and thinking skills render the individual to no longer be able to live completely independently and may require assistance with finances, grooming, dressing, meal planning and cooking.  Confusion may be experienced when in public.  Less interest in hobbies or activities may occur. There is an unwillingness to try new things; inability to adapt to change; a show of poor judgment; losing items and blaming others for the loss; becoming forgetful of recent events; being more irritable or upset if they fail at something. 

Moderate dementia – the third level – is when the memory impairment becomes more severe and difficulty in communicating occurs.  Independent living is not suitable and help is needed for basic activities.  Going out in public is done only with assistance.  There can be confusion regarding time and place, the forgetting of names of family or friends may occur, wandering to the point of becoming lost, behaving inappropriately, being repetitive, have noticeable mood unstableness or becoming neglectful of hygiene or eating. 

The fourth level is severe dementia where the person experiences severe problems with communication, incontinence and requires constant care.  Help with dressing and eating is needed and the individual is too impaired to go out in public.  There is the inability to remember things even for a few minutes. They fail to recognize everyday objects, may be disturbed at night, be restless, aggressive, have uncontrolled movements and even have difficulty walking. 

Lastly, the severest stage is profound dementia where the individual is usually bedridden. 

As dementia progresses, the individual does not necessarily lose their sense of touch and hearing or their ability to respond to emotion.  How often do we unconscientiously speak loudly to someone who is disabled, even if it is physical disability, thinking that the louder we speak the more likely they will be able to understand?

If an individual suffers from dementia, that does not necessarily mean that they are unable to complete estate planning. It is best to let an attorney determine if the individual is able to do so. 

When communicating with someone with diminished capacity, speak distinctly, speak slowly and pause before changing the topic.  Stay in the line of sight and make strong eye contact.  If trying to have more than a casual conversation, reduce the distraction in the surrounding area. 

Remember to be gentle with someone with diminished capacity.  It is not their fault and they are probably more frustrated than you with your interactions. 

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About the Author

Kay Sowa is a paralegal in the Trusts and Estates Group at Capehart & Scatchard, P.A. She is an IRS Enrolled Agent, an Accredited Estate Planner®, and a Certified Trust and Fiduciary Advisor. She oversees the trust and estate administration practice for the firm. She is an accomplished author and lecturer who has frequently spoken on behalf of a number of organizations including the National Business Institute and the Institute of Paralegal Education.

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