Your mum lends a hand with the washing-up, but when you go to put it away you notice it’s not clean. The next day she appears in a top that’s got a stain. Help! It’s just not like her.
Having people to stay with you rather than visiting them for the day can make you more aware of changes in their behaviour. But don’t be too hasty to make judgments, warns Lesley Carter, clinical lead, health influencing at Age UK, who has a wealth of experience as a dementia nurse specialist and former director of nursing.
‘It’s all too easy to leap to conclusions – quite likely your mum just needs her eyes tested rather than showing early signs of dementia,’ says Lesley. ‘Seeing parents becoming older and slower makes us feel uncomfortable. We think we’ve got to fix their problems for them, but sometimes we may be doing it to make us feel better. Remember too, your relatives are in a different environment rather than their own home and may react differently.’
Your first step is to isolate what the issue is exactly and what you’re worried about.
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Could it be depression?
‘Low mood brings on anxiety and anxiety brings on depression. Older people have nearly always experienced bereavement, so may have a constant sense of loss,’ explains Lesley, who has written a paper on the topic for the University of Bath Institute for Policy Research.
According to the NHS, depression affects one in five older people, but it can be hard to tell when feeling fed up or low tips into depression, especially as the physical symptoms such as tiredness, weight loss and problems sleeping are more common as we age. Depression and anxiety can also affect memory and cause confusion.
‘The families of older people are often not good at recognising depression, which should always be checked out by a GP,’ says Lesley.
How to spot depression
Is loneliness a factor?
There’s still a stigma around loneliness despite the fact that we are increasingly recognising how pernicious it can be for our wellbeing. Loneliness is as bad for our physical health as smoking 15 cigarettes a day, says the Campaign to End Loneliness, a registered charity.
Spending time with family over the festive season can mean the post-Christmas period is hardest to bear, as a return to solo living sparks an acute sense of loneliness.
‘We see an increase in calls after Christmas because suddenly people are back to a home on their own and the sense of contrast just makes them feel worse,’ says Sophie Andrews, CEO of The Silver Line, the helpline for older people started by Esther Rantzen, and Saga’s national charity partner.
Talking about loneliness with family members is tricky. It’s a trip switch for guilt for parents (‘I don’t want to be a burden’) and for children (‘I should be doing so much more for Mum/Dad’).
Fiona Phillips experiences what it's really like to live alone
Memory blip or dementia?
We’re all fearful of dementia, but commonplace conditions can also cause confusion, points out Kathryn Smith, chief operating officer, Alzheimer’s Society. Urine infections, constipation, thyroid disorders and dehydration are all possible causes. So how to tell the difference between normal ageing and early-stage dementia?
‘We all go upstairs and forget what we went up for, but walking into a room and not recognising the room or not being able to locate the bedroom can be a sign,’ says Kathryn. ‘Other indications can be repeating the same phrase, repetitive behaviour or no longer showing any interest in something they used to enjoy.’
If you notice changes in your relative, don’t raise the subject over Christmas. Instead visit them a week later in their own home to see how they are. Asking if they have noticed any changes in themselves is a way of starting the conversation.
Diagnosing dementia is both complicated and slow, and typically people have to see their GP three times before they get a referral to a memory clinic, says Kathryn.
Alzheimer’s Society estimates 200,000 people in the UK with dementia haven’t had a diagnosis, so can’t get the right support.
6 common causes of forgetfulness
On the road
Noticed scrapes on your relative’s car or stamped on an imaginary brake too often when you’re a passenger? Discussing competence to drive can be a minefield: to avoid family arguments the Institute of Advanced Motorists’ mature drivers’ assessment gives a dispassionate view.
Last year, 400 people aged from 50 to over 100 booked one. It costs £49 and is easy to arrange. A local assessor comes to the house; there’s no pass or fail, but areas of concern are highlighted in a report and the assessor can suggest that someone should stop driving, says Rodney Kumar of the IAM (iamroadsmart.com/courses, 0300 303 1134). NB There’s no legal age limit for drivers, though from 70 onwards licences have to be renewed every three years.
Driving past 70: renewing a driving licence and more
Any degree of hearing or sight loss makes life more difficult. These are the easiest checks to arrange.
Eye tests are available free every two years from the age of 60, or more frequently if recommended by an optician or doctor – or if your relative notices changes in their vision. Eye tests can detect general health problems, such as high blood pressure and diabetes, as well as monitoring eye health and sight.
For more info, see The Royal National Institute of Blind People website www.rnib.org.uk.
Hearing loss affects 40% of the over-50s; in the over-70s that rises to two-thirds, says Action On Hearing Loss. There is also growing evidence that it may increase the risk of dementia. Your relative’s GP can refer them to an audiologist or Action on Hearing Loss has an online test actiononhearingloss.org.uk.
Julie Taylor Hassell, 58, is married with two children and one grandson, and lives in South Reddish, Greater Manchester. Here she talks about noticing changes in her mother, Audrey, 84
Mum was a very astute, organised person. She had worked in fashion retail and was good at finance, but she began to say she owed me money when she didn’t. She had lived alone for 20 years and was also adept practically. When she told us the boiler had broken down, we found she was turning the thermostat the wrong way. Then the hairdresser rang to say she’d arrived on the wrong day. Neither did she remember we’d just been to the opticians.
Her personality also changed. She had been reserved, almost prudish, but she became cheeky and rude, using innuendo. She saw the GP twice and he actually said, ‘You can tell your daughter you don’t have dementia.’ It was only when I wrote a letter listing specific changes and went with her that we got a referral to a memory clinic. They diagnosed Alzheimer’s and vascular dementia. It was scary, as well as sad.
The clinic put us in touch with an Alzheimer’s Society Dementia Adviser. She was wonderful and gave us so much advice and information. Mum still lives alone and has a few other health issues too, so I’ve given up my job to be with her during the day. We go to three Dementia Cafés, which are great as I can talk to other carers too, and one day a week we have my two-year-old grandson, Lucas. That’s the highlight of the week for my mother – as well as for me.’
Download a free care guide from Saga Care
Where to get help
Age UK offers support and information on a host of topics. Local groups run befriending schemes, friendship centres and Call in Time, a weekly phone call (ageuk.org.uk, 0800 055 6112).
The Silver Line is the UK’s only free confidential 24-hour helpline for older people thesilverline.org.uk, 0800 470 8090.
Alzheimer’s Society offers information, support and advice alzheimers.org.uk, 0300 222 1122.
Dementia is the UK’s biggest killer; someone develops it every three minutes. It affects 850,000 people, set to rise to one million by 2021.
The Royal College of Psychiatrists’ Depression in Older Adults has good tips.