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Evidence of dementia clear to neighbor but adult children in denial

Carol Bradley Bursack, Minding Our Elders columnist

Dear Carol: I'm certain that my 76-year-old neighbor, a good friend of mine, has dementia. She forgets what day it is, what groceries she needs and she seems terribly confused when she has to plan anything. Sometimes she seems frightened because of her confusion.

I've contacted her grown children who live out of town to let them know what I see, but when they come to visit she perks up and seems fine so they think I'm just the nosey neighbor. I've suggested that they ask her to bake something where she has to follow a recipe or give her a list of a few things to get at the store and see if she can follow through. That way they'd have some reference points.

I've also told them that I feel that she'd feel safer in an assisted living environment, or at least with in-home caregivers. I don't think she'd resist a change if her kids would encourage her. What else can I do to convince the adult children that their mom needs help? FC

Dear FC: You are a good friend to care so much and your ideas are excellent ways to evaluate someone for possible dementia, especially since they don't just test memory but they show whether or not your friend can follow through with a simple plan that would be used in daily living.

In addition to your own ideas, I would suggest that they look into how their mom is doing with paying her bills. Even without a potential dementia issue, it may be time for her to appoint someone to keep an eye on her financial life.

Checking for bad food in the fridge is an often recommended test. No one should become upset over a dish of food pushed to the back that has gotten old, but if there is a lot of moldy or past dated food, that could be a concern.

If she's lost too much weight, she may not be eating properly. She could be forgetting that she hasn't eaten or she may not want to bother. Additionally, regular hygiene is also something to be checked. Older people don't necessarily need a daily bath or shower since their skin tends to be dry, but they should still sponge bathe daily and take a full bath or shower every few days. If their mom is lacking good, basic hygiene, this could be a sign of dementia or depression, either of which needs attention.

Housecleaning can fall off as people age because of arthritic pain, eyes that aren't as keen, or simply not caring that much. Your friend shouldn't be held to rigorous standards, but if there is old garbage around, or the house has hazardous messes, those are issues that could indicate dementia or depression, or both.

The adult children are likely falling for the cheeriness that their mom displays when she sees them. They also may be in denial. Both are common and often related.

However, if you stress their mom's fear and confusion rather than memory lapses they many listen. Ask them to accompany her to the doctor for a professional opinion. You can offer to make a list of worrisome issues that you observe which they may or may not accept. At least you will have tried.

The problem could be something as easy to fix as a medication change since some medications can cause confusion and/or memory problems. This includes over-the-counter medications. Of course, she could have developed dementia. Either way, she needs to see a doctor. Bringing your concerns to the family's attention may be the best that you can do for now.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carolbursack@msn.com.

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