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Published October 05, 2013, 10:02 PM

Minding Our Elders: Is dad’s problem grief or dementia?

DEAR CAROL: My dad’s 73 and has been quite well physically, but he’s slipping mentally. This mental decline began after my mom died a year ago, but he’s never pulled out of it.

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: My dad’s 73 and has been quite well physically, but he’s slipping mentally. This mental decline began after my mom died a year ago, but he’s never pulled out of it.

When I mention to him that he’s repeated a story twice in an hour he says I’m wrong and that I’m just trying to annoy him. When he forgets to pay bills and gets second notices, he says it’s the company’s fault. When he goes grocery shopping and is gone much longer than necessary, he says he stopped along the way for coffee. I know that there’s no coffee on the route to the grocery store he uses.

I’ve told him that he should see a doctor about his mental condition but he refuses. What can I do? – Rosie

DEAR ROSIE: Your dad is likely still grieving your mother’s death and grief can affect how well we function in many ways. Some people remain mentally foggy for quite some time. Still, some types of dementia begin decades before there are symptoms. Then, a trauma serves as a sort of kick start to the symptoms. Your mom’s death certainly qualifies as such a trauma. There are other possibilities, of course. Your dad could be having a negative reaction to a medication he’s taking or perhaps he has an infection he’s not aware of. The only way to find out is to get him to a doctor.

I’d advise you to back off from mentioning cognitive issues unless you feel he is endangering himself or others. Then, begin a journal noting his behavior, positive and negative. After a time, try to tie something unusual he’s done to a medication he takes. Many medications have confusion or memory issues as a side effect, so that shouldn’t be too hard. Or, if the timing is right, remind him that he needs his regular checkup to get his blood pressure or other medications updated. Be kind but firm. If you feel that he’s rebelling against you because you’re his daughter, enlist the help of one of his friends. A peer can be very helpful when it comes to elder issues.

Before the appointment, use your journal as a guide to write a letter to your dad’s doctor noting your concerns about his behavior so that the physician has that knowledge ahead of the exam. List everything problematic that you’ve noted and the frequency of this behavior. Dates can be useful. Be sure to mention your mom’s death in the letter so the doctor is fully informed.

If your dad’s primary doctor feels that there are cognitive issues apart from grief, then the doctor should schedule an appointment for him with a neurologist. The doctor should be able to make it clear to your dad that an early diagnosis can help him cope with the dementia better and may even slow advancing symptoms.

Should the doctor feel that your dad is basically healthy except for his persistent grief, a counselor may be able to help him work through that grief.

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 carol@mindingourelders.com.

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