One of the challenges in providing care to loved ones with Alzheimer's Disease (or even mild cognitive impairment) is figuring out when the loved one is "covering up" for their lack of memory. It's this loss for words (or a response or original thoughts in relation to a particular conversation) that tend to be a real signal that something is wrong; yet if missed, these early signals may cause the loved one and the family to delay getting a diagnosis and treatment that can slow the onslaught of this terrible disease.
I remember that a doctor once told us that Mom was an expert in looking like she was in control of the situation (and all her mental faculties). She'd figure out numerous tricks in order to hide her memory loss. Mom might ask the person to repeat the question and then answer on a tangent. She might pick a fight in order to take the conversation off track. She might leave a pregnant pause so that one of us would fill in the blanks without realizing that she couldn't answer the question. As a retirement community nurse told me, "Your mom is crazy - crazy like a fox"
Mom desperately wanted (and still wants) to fit in and not be considered "crazy." She continues to maintain the pretense of mental control even as her memory fades. For instance, Mom had a hospital stay in January. Mara, a friend of mine, happened to be in town and agreed to accompany me to see Mom. In order to entertain Mom, Mara started telling stories about her dog, Loki. For instance, she recounted that Loki loves to "borrow" socks and other pieces of clothing from his beloved humans (and their guests) at inopportune times in order to instigate a chase.
Mom smiled as she listened to Mara's story. A few moments later, Mom mimicked Mara's story verbatim: "My dog likes to steal socks." It was Mom's attempt to carry on a conversation, but it also was a giveaway about her mental state. I know for certain that Mom's dog doesn't have that playful streak and has never stolen a sock in her life.
So how do you find out if your loved one is "covering up" for a diminishing memory? Here are some suggestions:
- Ask more and deeper questions about the topic to see how much the loved one can recall.
- Come back to the topic a few minutes later and see if the loved one can resume the thread of the conversation.
- Let the pregnant pause keep going instead of jumping in with an answer.
- Always - ALWAYS - do these three steps kindly. Your loved one already probably knows that memory loss is happening and is probably on the defensive. Causing an angry outburst isn't going to help anyone; in fact, it can cause hurt feelings and the delay of getting medical attention.
It's never easy to help a loved one realize that they are in a losing battle to the aging process, especially when it involves losing their mind. Helping them to deal with the loss - and to not cover up for their lack of memory - is an important task for caregivers. It will allow you and the medical community to assess where your loved one is in fighting this disease. By knowing your loved one's status, you can work with them to make the proper decisions to slow this disease.