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Assessing cognitive impairment in a parent

A recent blog touched on the topic of getting a parent to accept that he or she can no longer live alone and requires the care assisted living can provide. This entry will delve deeper into the topic while detailing how adult children can get an accurate - yet informal -assessment and evaluation of their parent's cognitive state.

Those who see their parent frequently in the familiar environment of the parent's long-time home environment may miss early signs of cognitive impairment. Remember that it is relatively easy for someone to function normally at least for a short while when there are no distractions or unfamiliar territories to navigate. It's the adult children who see their parents only infrequently (due to distance, work schedules or whatever reasons) that can be alarmed by the obvious physical and mental deterioration between visits.

Beware of parents' compensating behaviors

In the early phases of the disease, while it can be incredibly frightening for them to confront, most dementia patients are aware that they are losing mental ground. Because this is so alarming to them, they may go to great lengths to conceal these slippages from others, including spouses, who may also be grappling with the same frightening symptoms.

Approximately 10 percent of those age 60 and over have a degree of significant memory loss. Most of us of all ages have moments where we simply blank out and can't remember what we did with the car keys or the TV remote. That's not dementia. If all of a sudden we can't remember what happened to our car or forget the name for the screen with pictures of the people on it, that would be a good indicator of a memory problem linked to dementia.

Pay attention to the way your parents go about their daily tasks. If your mom baked a loaf of banana bread from scratch without a recipe every week for the past 50 years but now suddenly must revert to a recipe, or worse, can't manage to bake it at all anymore, she could be suffering from the early symptoms of Alzheimer's disease.

Watch out for a decline in hygiene, housekeeping and pet care

Maybe your father retired from the Navy and always kept the house in shipshape order, wore clean clothes and close-cropped hair. But on this visit, the house is unkempt, his clothes are unwashed and for the first time in your lifetime, you've seen his hair longer than his ears. He might smell a little musty, too, from neglecting to take a daily bath or shower.

If the beloved family dog suddenly is growing thin from not being fed regularly, and the water bowl is dry when you visit, these are additional signs that Mom or Dad just can no longer get it together to maintain themselves and their pet.

Other worrisome indicators

Offer to take your father out for a shave and a haircut to his favorite barber. Maybe he is simply unable to get around as well as before and neglected his appearance because of that. But watch as he interacts with the man who has jovially "lowered his ears" for the past three decades. Does your dad appear to know the man and interact appropriately with him or does he mumble his answers and avoid eye contact with his former friend? That could be a sign that he no longer has any idea who the barber is or why he is even there.

Repetition of stories is part of many older folks' method of communicatio n, but if they repeat themselves only minutes after saying something or become hopelessly lost at following a conversation, dementia may have set in.

What to do when there are red flags waving

This is the hardest part of all. Whatever response you have should come from a place of love. It may be time to get mom or dad conserved through the California courts, but perhaps a heart-to-heart talk could achieve the same results. Should you need to initiate conservatorship proceedings, first develop a plan with an attorney who is experienced in handling such matters.

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Conover & Grebe, LLP
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