Friday, 19 June 2015

Elderly and dependent ~ minds moving differently ~ definitions and links

As we age our brains undgergo physical aging in the same way as do other parts of our bodies and physical functions, and we all age differently, in a personal mix of heredity, environmental factors, good or bad fortune, and who knows what else besides.

A common feature of old age is the slowing of mental processes and a certain amount of memory loss: for many people this shows up in responding to situations or conversation more slowly; new experiences and the formation of new memories may take longer, sometimes a lot longer, or may not seem possible.  For those of us who are younger and more able this can be hard to accept and understand.  We may think that the person who is slower and forgetful just needs to make more of an effort, but that's not necessarily the case.  It's so important to be patient, whether one is aged and experiencing this slowing down, or whether one is engaged in helping.  For children with aging parents it's often a new situation for everyone.

The topic of reduced brain function can difficult, even alarming, and it can be helpful to get to know some of the terms used and a little of what they mean so that medical terms can be properly understood and discussed.  This is not a field in which I have expertise, so follows is very much at the lay person's level. 

Once we know what we are dealing with it's possible to be practical and to find the way forward constructively.  By establishing this early on and finding out about possible treatments, medication, care and residential options we allow all concerned the widest possible choice.  This is important as in this sort of situation we may feel we are in a position of reduced personal power and control, and the exercise of any choice at all can make a vital difference to our sense of wellbeing.  It may also make the difference between getting the help we need in a timely manner, and being swept along willy-nilly by increasingly difficult circumstances which, believe me, greatly increases the level of difficulty for everyone.

Definitions of the following brain conditions / disorders are lightly outlined below: 
Confusion, delirium, mild cognitive impairment (MCI), cerebral atrophy, dementia (senility), and Alzheimers disease (AD).  Links to further source material are included.  Many thanks to the Medline Plus website for permitting the quotation of Summaries as shown in quotation marks below.

Confusion: as defined on the Medline Plus website is...   
"...the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembering, and making decisions.

"Confusion is more common in the elderly and often occurs during a hospital stay." (my italics for emphasis)
For the full summary here is the link:

Delirium: is "sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness...  [It is] usually temporary and reversible" and can result from the shock of an accident, infections such as urinary tract infections or pneumonia (my italics for emphasis), as a side effect of medication, or other causes.

For the full summary here is the link:  

Mild Cognitive Impairment (MCI): included in the Medline Plus definition it is stated that:
"Some forgetfulness can be a normal part of aging.   However, some people have more memory problems than other people their age...  People with MCI can take care of themselves and do their normal activities."  (Quotation from the Medline Plus website.)
For the full summary here is the link: 

Cerebral atrophy: is a common feature of the aging process which occurs in varying degrees.  It may or may not be associated with specific diseases such as Alzheimers.  I have included the definition provided in Wikipedia as information provided by other websites was either too specialised, or jumbled in with distracting advertisements, and so on.
Those interested in more detailed discussion about the connection betwen cerebral atrophy and general aging as well as specific diseases may find the following article of interest:

Dementia (also called Senility): is not a disease as such but "a group of symptoms caused by disorders that affect the brain" as outlined in this definition:
"Memory loss is a common symptom of dementia.  However, memory loss by itself does not mean you have dementia.  People with dementia have serious problems with two or more brain functions, such as memory and language.  Although dementia is common in very elderly people, it is not part of normal aging."
For the full summary here is the link:

Alzheimers Disease (AD): as defined by the Medline Plus website:
"the most common form of dementia among older people... AD begins slowly.  It first involves the parts of the brain that control thought, memory and language.  People with AD may have trouble remembering things that happened recently or names of people they know...  Over time, symptoms get worse.  People may not recognize family members or have trouble speaking, reading or writing.  They may forget how to brush their teeth or comb their hair.  Later on, they may become anxious or aggressive, or wander away from home.  Eventually, they need total care."
For the full summary here is the link:
At this time there is at this time no known cure for Alzheimers Disease, although certain medications may be helpful in treating symptoms.

These definitions, while slight, may provide the stepping stones to more substantial knowledge. 

While these conditions may sound daunting it's not all doom and gloom.  However, the emergence of one or more of these conditions is likely to cause a degree of change in function, and the ability to relate to others may alter.  Different ways of relating may be learnt or simply emerge.

Every case is different.  Since my mother moved into rest home care I have got to know her a great deal better.  Her memory may have become patchy, but she is just as shrewd about people and situations as she ever was and great company.  She has slowed down considerably.  I have had to get better at listening, which is a good thing: while she gathers her thoughts in response to mine I allow silent spaces to develop, to be filled by her in her own time.  I have had to slow down too.  All this has been good for me to learn.  At times unexpected things crop up, patches of confusion or things she needs help with, but we have learned to trust each other to work things out together and it's been very satisfying.  I have become her advocate as well as her trusted ally and friend.  At times she helps me, listening, contributing, sometimes advising.  It has become much more than a mother-daughter relationship.  Then again, while much has changed much remains the same.

A friend had a very different experience: her mother suffered from Alzheimers, and eventually she had to go into residential care.  Like anyone she had good days and bad days.  For my friend a good day was when she remembered her; for her father these 'good' days were bad, because she remembered her home and wanted to return to it, which wasn't possible.

There are no easy answers, and these situations have to be lived through with as much care and dignity as we can muster.  Talking to others dealing with similar issues and experiences may be helpful, which is part of my reason for writing this series.

I will continue this theme in future articles. 

To find my other articles in this series click on the link below:

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