Dementia: Areas of Concern

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When a loved one has Alzheimer’s disease or another type of dementia, activities that involve more complex thinking skills are likely to become more of a concern. In addition to concerns about handling finances and medications or issues around driving, families and friends are often unsure about some of the changes they may see. Is it normal aging or is mom or dad just slowing down? For those who live out of town, sometimes coming home for celebrations, holidays or other major events means seeing some changes but not aware of the implications.

There are areas I will assess when working with my home health clients as a speech-language pathologist so recommendations can be made for not only modifications but usually include safety recommendations and caregiver education.

Things to think about:

These all require higher level thinking skills including problem solving and organization.

1. Meal planning – shopping – cooking
Sometimes it seems like these patterns are changing because someone is older, has less of an appetite or has difficulty getting around. Changes are not unusual but perhaps there are more frozen meals, snacking on less desirable food options and skipping meals. Maybe the person is not wearing their dentures or they fit poorly. Many times a person will stop drinking liquids to reduce trips to the bathroom. My suggestion is to just observe what is going on over a period of time. These can be red flags and there are many positive things that can be put into place as needed.

2. Traveling
Life in the 21st century has changed traveling. It is more fast paced and complex. Families will often state it is okay for their parent to drive because they do not go far from home or they drive only during the day. They may know the way and then there is the detour or a time or two when they returned hours later from what was supposed to be a short trip. Reaction time and cognitive skills are important and those occasionally small dents do mean something. Airline travel includes last minute changes and announcements and short intervals to change planes. Even those who have been extensive travelers years ago may find many challenging circumstances that may become a major problem. When there is a hearing and/or vision problem and someone is traveling alone, it is the security requirements, announcements, and gate changes and cancellations that can put a person on cognitive overload.

3. Fraud – Just when you think you have heard it all, yet another story comes along that tells of someone becoming the victim of a financial scam. Elder fraud is one of the fastest growing crimes in the country. As baby boomers approach their retirement years, it could become even more problematic since the world of technology opens up a whole other set of concerns.  Older adults are more trusting, may be lonely and then there are the hearing, vision and cognitive issues which can broader the concerns.

Tips to consider

1. Meals – Meals delivered to the home is a possible option for those that need some assistance eating healthier choices and are unable to shop often, don’t cook much or are not safe using the stove.   Here are a few options to explore but it is important to follow-up on what they are eating and if they keep leftovers too long. Perhaps a friend in the area can check on the status if you do not live nearby.

2.  Travel – There are so many things to consider. One concern I have is when a family will buy a GPS for an older adult who is still driving and gets lost once in awhile. It is a distraction for anyone but for someone who has never used one before or perhaps has a hearing or vision loss, safety becomes a major issue. More details on travel and holiday concerns.

3. Fraud – If your loved one has Alzheimer’s disease or a related dementia and is not supervised on an ongoing basis, the chances of a fraud issue arising increases. Sometimes they will answer the phone while someone else is home and provide details that could put them at risk.  Or they are playing computer games or checking emails and respond to an alert that seems so real. Be observant and learn more about some of the most popular scams so you can put some safety checks into place.

When you are concerned about a loved one, the scope of things that may become an issue is rather extensive. It is important to become more informed so that appropriate proactive decisions can be made when changes are noted.  Aging Parents:When to Step In provides more details on these areas of concern and Critical Conversations offers strategies on ways to approach these topics.  This entire “Memory Matters” for ALL Ages cable TV and corresponding blog series was created to supplement my materials and products to help you walk the journey with a loved one as I did with my mother.

TO DO THIS WEEK: Contact Kathryn ( if you are interested in details about her geriatric consultation services. The Alzheimer’s Association is another excellent resource. It may be advisable for an older adult with changes in some of these areas to have a complete physical or a geriatric assessment so that a plan can be put into place based on their findings and recommendations.

“Have patience with the thoughts and concerns that remain unsolved in your heart. Don’t hide; live in questions as you slowly uncover the answers you seek. Replace your fears with an understanding that settles them.” Author unknown

About Kathryn Kilpatrick

Kathryn Kilpatrick received her Master's degree in Speech-Language Pathology in 1968 from the University of Massachusetts. She has worked in a variety of settings, primarily in Ohio, including hospitals, rehabilitation centers, and for decades in the area of home health care. Kathryn is president of Memory Fitness Matters ( and Communication Connection( She offers memory coaching for all ages and has a geriatric consulting practice. She is a national motivational speaker and author of more than 30 products to enhance communication and connection as well as a Memory Fitness Toolkit. Kathryn brings her decades of experience as a speech-language pathologist to all those wanting to enhance their quality of life, particularly when there are communication, memory and cognitive challenges. Her websites offer information on a wide variety of topics related to elder care concerns as well as memory fitness and successful aging.
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