Cognitive health is one of the most pressing concerns facing seniors and their families. From trying to determine if someone is dealing with normal forgetfulness or an actual cognitive disorder, to deciding when the time is right for full-time memory care, it’s a fraught, emotional process.
We have an interview here with Angie Frantz, the Expressions Product Manager with Prestige Senior Living. Angie started with Prestige over a decade ago and became an award-winning executive director at a memory care community, and today she oversees the entire Expressions memory care wellness program across all Prestige communities.
What are some of the early signs of memory decline in seniors that people need to take note of?
Angie Frantz: “Certainly forgetfulness, but that’s not always a sign of cognitive decline, we all forget things. But forgetting to do normal daily tasks like shutting off the water or shutting off the stove or maybe leaving the house and leaving the door open, or forgetting to pay some bills. Maybe getting lost when someone is out driving or just struggling with finding their way around generally, or maybe going out for a walk and getting lost…it could be forgetting words, like they might’ve lost their car keys, but they can’t tell you that they’re the car keys. They can’t find that word any longer. And that tends to be something else that we see quite often.”
When should you be concerned that it does go beyond normal forgetfulness and may be a deeper problem?
AF: “I think back about my mother-in-law, she would sometimes pay bills three times because she forgot she paid them originally. And then issues with people calling and trying to financially compromise you, and not having that cognition about decision-making. If you see someone is making decisions that are inappropriate or they’re befriending people that you’re concerned about.
I know we’ve had some communities where people have moved in because they were allowing people into their homes they didn’t even know because it was somebody to talk to. They were lonely and loneliness certainly feeds memory issues. We do see that quite often as well when there’s not that brain stimulation on a daily basis; not just watching TV, but actually having conversations with people and learning those facial cues when you’re having a conversation.”
You mentioned loneliness, and over the last year and a half with the pandemic and the various lockdowns, it’s had probably a huge effect on cognitive health for many seniors.
AF: “Part of cognitive decline is about socialization. So when you’re not conversing with someone, you tend to lose words. And so you start to not only lose words, but you lose eye contact, you lose that ability to understand people if they’re joking or if they’re sad, those kinds of things…One of the things with being lonely is no one’s asking you things anymore. You’re just doing things. And so you’re not using your voice, you’re not using your mental capacity to think of things and figure things out and to answer questions from people outside. And so you kind of shut down and become kind of in a cave or a cocoon. And it’s when you get out in those social instances again that maybe it’s hard to express yourself, and they lose that. We see many of our residents that come into us that have lost that verbal capability. And it’s not just because of a physical situation, they’ve just forgotten how to converse with people in general. And so that makes it really tough.”
A lot of adult children may struggle to bring up the subject of cognitive decline with a parent or loved one. What would you tell them?
AF: “It’s important to journal those things when you see them, but don’t harp on them right away because generally people that are having a decline in their cognitive abilities know it’s happening and they’re trying to compensate for it…Like maybe you want to go in and say, ‘Well, the laundry is not getting done. Mom’s forgetting to do the laundry so I’m going to do the laundry.’ Well, it’s better to do it alongside them and involve them in the activity of doing it rather than taking something away from them. We have to be really cautious about trying to take over, but do it in a way that still preserves their dignity and not cause them to feel like you’re trying to take everything away from them.
With cognitive decline, that’s one of the things we hear with in memory care is, ‘Oh, my daughter or son, they’re stealing from me and they’re taking everything away and I don’t trust them.’ And so you have to continue to walk that fine line of keeping that trust. And so involve them in the process and talk to them and say, ‘You know, I noticed you forgot to do this today, is this something I can help with?’ It’s also important to include the family physician in the conversation when making decisions – allow them to be the person recommending no longer driving or a moving to memory care or assisted living.”
When does it become time to really sit down and have that conversation about having a loved one move into a memory care community?
AF: “I think when it begins to disrupt your day and it’s really causing a disruption in the life of your loved one. I think that’s when you need to sit down and maybe have those conversations. Maybe it’s not about moving into a community, maybe it’s having someone come in and be a companion for a while, or maybe you need to adjust your day. And that’s harder to do if two people are working outside the home. That’s tough. So being able to ask for help and knowing where to get help is one of the big things.”
A lot of times when it comes to families who discuss memory care or assisted living, guilt comes into play, as far as feeling like they can’t care for someone anymore. What would you say to people about the guilt aspect of assisted living or memory care?
AF: “There’s always an emergency that comes up and the guilt that goes along with that, because I didn’t do something sooner. And so safety is what we have to keep in mind when we’re making those decisions. I’ve seen so many situations being an executive director in our communities and it’s the call that you get that says, ‘My mom just fell and she’s in the emergency room and they say she needs memory care. What do I do about it?’ And they end up having to make a decision immediately, and it’s better if you take the time to research it and not having to be an emergency but be prepared for it…I think it’s easy to put it off until later and say, ‘Oh, it’s not so bad’, but you’re getting to that place where you realize this could cause a big issue in the future.”
If the time is right to consider memory care for a loved one, contact the Prestige community nearest you for more information or to book a tour.