Caregiver Guide: Memory Problems

Understanding the Problem

In our busy lives, all of us forget things at one time or another.

As we age, this can happen more frequently and can be a natural part of the aging process. Some older people have little or no change in their memory, but, in others, forgetfulness can begin to interfere with their lives in a noticeable way. This might involve leaving bills unpaid, stoves on, or doors open—all of which can create serious safety concerns.

Short-term memory (remembering recent events) is the type of memory that becomes impaired most often with aging. This might include planning, organizing, and following through with current events and activities. Often long-term memories of childhood or young adulthood remain vivid, even in the case of Alzheimer’s disease.  So it is short-term memory that is important to assess when there are concerns about a possible decline.

In the case of Alzheimer’s disease there might be many years of gradual change such that spouses and family members slowly take over responsibilities or daily duties that the individual had previously managed (for example, paying bills or making meals). When it becomes evident that the person is no longer able to do these tasks, an evaluation for possible Alzheimer’s disease or other memory disorder is needed.

On the other hand, many people notice memory loss but are able to continue to manage their household and monetary affairs without difficulty. While it is always good to seek an evaluation for someone if there are worries, in this group it is likely that the person simply has mild memory loss that is normal with age. Many healthy older people do not have any significant changes in their memory as they age. While slower retrieval of information is a frequent feature in these people (such as the “her name is on the tip of my tongue” phenomenon), they otherwise keep good memory function.

An abrupt change in mental status is called “delirium” which is different from dementia. Delirium is a state of confusion that can happen over just a few days. Causes of delirium might be a urinary infection, pneumonia, dehydration, heart attack, or a response to medicine. Persons with delirium have trouble paying attention. They might not be oriented to the place and time, and they can have trouble carrying on a logical conversation. Older persons with delirium might appear excessively sleepy and confused.

It is important to recognize delirium since people with memory problems are especially prone to having episodes of delirium if they become ill. The healthcare provider should be notified immediately.

Once the medical problem is treated, the delirium might improve and the person will be less confused, but the memory problems from the underlying dementia will still be there.

Memory problems can be due to many other conditions besides Alzheimer’s disease.

These conditions include Parkinson’s disease, large and small strokes, depression, and thyroid disease, for example. A detailed review of medicines is essential, since prescription, over-the counter, or herbal remedies can contribute to memory problems.

Some of these conditions can be treated or managed so that symptoms improve or stabilize. This is why it is important to schedule a medical check-up for the older person if you notice memory problems, particularly if they go along with other problems such as a change in weight, loss of appetite, gait instability, loss of urine control, or other new physical symptoms.

What are typical age-related memory changes?

Some changes in memory are related to aging, but do not indicate serious memory problems. Here are some examples:

  • Sometimes forgetting names or appointments, but remembering them later.
  • Making occasional errors when balancing a checkbook.
  • Occasionally needing help to use the settings on a microwave or to record a television show.
  • Getting confused about the day of the week but figuring it out later
  • Sometimes having trouble finding the right word.
  • Making a bad decision once in a while.
  • Sometimes feeling weary of work, family and social obligations
  • Developing very specific ways of doing things and becoming irritable when a routine is disrupted

Your goals are to:

  • Be alert for signs of short-term memory loss
  • Be aware that memory changes often turn up as changes in daily functioning such as planning, organizing, and making decisions
  • Make sure that memory changes are thoroughly evaluated by a doctor or nurse and that all appropriate treatments have been considered
  • Keep a detailed record of all medicines the older person is taking, including prescription, over-the-counter, and any herbal remedies. This will help the doctor or nurse to decide whether these could be contributing to the problem
  • Understand that delirium might occur in persons with dementia
  • Learn techniques for helping reduce the emotional stress and burden of memory loss

Click on each of the topics below to read more.

Last Updated July 2015

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