Consultant’s Corner – January 2020
by Carolyn Lukert, MBA, CGCM,
PAC Consultant and Mentor
Dear PAC Consultant,
My family and I just returned from a week of visiting my parents for the holidays. We actually stayed at their house this time (we usually stay in a hotel, but we waited too long to make reservations, so nothing was available). All I can say is – wow! A lot has changed over the last year. They are in their mid-80s and are generally in good physical health – I mean, no major medical issues. But, I think something is going on brain-wise – at least with my mom. I was shocked at the mistakes mom was making when doing what she has always been able to do well. Like baking cookies, for example. The very same cookies she has made pretty much every Christmas. She struggled with being able to follow the recipe, and would have left some ingredients out had I not been there to help. And, when I noticed she hadn’t wrapped any of her gifts, I suggested we have a little wrapping party. You know, turn on holiday music, drink a little cider, and have a festive time. Well, that was a disaster. She just couldn’t do it. She got frustrated, and then said she just would put them in gift bags and skip the wrapping. Come to think of it, we have been getting our birthday gifts in bags this past year, so I am wondering if that is why.
The other thing that really got my attention is that she seemed to lose her temper much more often – and with more intensity - than in the past. My two young children became the targets of her outbursts. She used to be so good with them, but now she has no patience. And, she gets flustered with even the smallest amount of chaos. She is better in the morning, but as the day goes on, she gets more and more irritable. And lastly, she was up frequently late at night. I could hear her pacing around the kitchen, talking to herself. I got up to check on her a few times, and she seemed to snap out of it and go back to bed. But, she was pretty tired for our entire visit.
I have to say – I was quite shocked. I didn’t say anything to her about what I noticed because I wasn’t sure what to say. And I didn’t want to ruin our vacation, quite honestly. I figured she would get defensive, and then it would be all over.
So, I am now back home and I live 2,000 miles away. I am an only child, so I am pretty much it. What should I do?
Shocked from Starkville
Wow, so that must have been quite a surprise, and not a good one! And being 2,000 miles away is likely weighing heavily on you. I can only imagine. I get the sense that – when you have visited your parents in the past - maybe you haven’t had the opportunity to get a complete picture since you don’t usually stay overnight. A few around-the-clock visits in the same physical space can really be an eye-opener. I am wondering – is it possible that some of these symptoms have been brewing for a while? Or, are these symptoms brand new and sudden? Perhaps your dad could shed some light. He may be able to provide some accurate reporting, and his answers can provide you with clues.
Oftentimes, we jump to conclusions when we notice changes like the ones you are describing. The thought that dementia may be in the picture comes to mind quickly. But, in actuality, there can be a variety of causes. It could be dementia, but it might not be. So, the question becomes – how do you find out? A full medical workup to include lab tests to screen for infections, thyroid issues, vitamin deficiencies, cardiovascular disease, along with other conditions, is usually a first step. And, screenings to include family history of cognitive illnesses, including depression, are often part of the exam.
You may be wondering how you go about getting your mom to agree to go to the doctor, and yes, this can be tricky. Lots of variables, beginning with – how aware of the symptoms is your mom? Does she realize these changes are taking place? I know you said you didn’t want to point out when she was doing something wrong (or different than you expected) – but did you notice if she seemed to notice? Is this a question you could ask her – in a caring and concerned way? It might start like this – “Mom, when I was visiting last week, I noticed something different. It was when we were wrapping gifts. I am wondering, did you notice anything?” That may open the door to a conversation to explore further, with an expression of concern, and a next step of going to see her doctor, for example. And, perhaps your father could play a role in this conversation, as well.
If your mom isn’t aware, the idea of going to get checked out is going to take a different shape. Some variables to consider include:
- your relationship with your mom (does she trust you)
- her reaction to being told something she isn’t noticing in herself (is it anger, sadness, or something else)
- her relationship with her doctor or the medical community in general (does she generally like to see her doctor, or does she have an aversion to doctors overall – or somewhere in between)
As you can see, there is no one-size-fits-all answer to how to go about these next steps once you notice something is different. And, the path you choose will set the stage for whatever comes next.
If you would like to explore strategies together, please do not hesitate to email us. We welcome the opportunity to have a phone conversation to help you consider some options and determine what might be the best next step for you.