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Carol W. Berman, M.D.

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How to Tell If a Loved One Has Dementia

Posted: 01/23/2013 2:09 pm

I lost my husband to dementia six months ago. Since I'm a medical professional, a practicing psychiatrist specifically, you would think that I would have been prepared. Of course, I wasn't. The emotional impact was like a knock-out punch. I'm still reeling even though I lived with my husband's condition for five years and had ample time to prepare myself. Anyone who has seen the film Amour has a snapshot of what it is like living with someone with dementia.

There are many types of dementia: Alzheimer's, vascular, Lewy body, dementia due to HIV or Pick's or Huntington's. My husband had Lewy body dementia, which is like the worst of Alzheimer's mixed in with Parkinson's-like features such as muscle stiffness, tremors, and hallucinations. He went from an IQ of 140 to 80. I witnessed it all.

If you suspect that a loved one might have dementia, here are the 10 signs to look for that are common to most types:

1. Loss of words. My husband was a brilliant attorney, but when the dementia process started he no longer could remember certain words that he used every day, such as "brief" or "process."

2. Loss of trains of thought. A person with dementia might be talking about a subject, but then become disorganized and either talk about something else or stop talking completely.

3. Failure to recognize and identify common objects. In my husband's case, he couldn't remember the words for "pen" or "briefcase." He would just say the "thing" or "bag."

4. Failure to recognize friends and family members. At the onset of the condition, a person with dementia often fails to recognize co-workers or neighbors. In my husband's case, he failed to recognize those we had known for years in our office building. At the end, he even failed to recognize me.

5. Lack of planning ability. People with dementia often lack the ability to initiate activities, whether it be scheduling a day or planning a weekend trip.

6. Inability to carry out chores. My husband routinely washed the dishes and set the table. Suddenly, he couldn't organize his thoughts enough to do his regular chores.

7. Disinterest in learning new information. When dementia begins, people often lose their curiosity and love of learning. Whether it's a new computer program or scrapbooking technique, new information is rarely sought out.

8. Inability to abstract. My husband could no longer interpret the proverb: "People who live in glass houses shouldn't throw stones." In the past he would know that the meaning was, "Don't criticize others if you are also vulnerable," but when dementia set in, he just mumbled about houses and glass.

9. Inability to count or do simple mathematics. My husband had been an engineer before he was an attorney. He had shown me how to do calculus, but he lost the ability to count his change after he went shopping.

10. Avoidance of new or complicated situations. Like many people, before dementia my husband loved to discover new restaurants or travel to new places. Afterward, he wanted to go to the same place to have lunch once a week. He avoided trips that we had planned and was reluctant to try anything new.

I learned through therapy and practical experience that when a loved one has dementia, many people close to the person are in denial at first. We might rationalize the condition and say, "It doesn't matter that she can't remember her niece's name." Only when the conditions get worse -- she forgets where she lives and goes wandering around the neighborhood -- do we begin to seek help for our loved one.

If you find yourself faced with these 10 signs of dementia, please get help for your loved one. And seek help for yourself too, so that you can deal with your loved one's illness effectively.

Carol W. Berman, M.D., is a writer, psychiatrist and artist who lives and works in New York City. As an undergraduate she attended the University of California at Berkeley; she went to medical school at NYU Medical Center. Presently she is an Assistant Clinical Professor at NYU. Her two books, "100 Questions and Answers About Panic Disorder" and "Personality Disorders," have helped thousands of patients and their loved ones deal with mental disorders. She is at work on a memoir about her husband's struggle with dementia. To find out more, read Dr. Berman's blog on Red Room.

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