More Than a Third of People With Dementia Don’t Know They Have It

What to do if you suspect your partner has the condition.

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About 36 percent of people in England with dementia are unaware they have the condition, according to a report from the Dementia Commission.

The report suggests some things health and care professionals can do to better identify early signs of dementia. But what can you do if you think your partner has the condition? And how can you broach the topic with him or her?

If you are worried that your partner has dementia, here are some useful things to know.

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Dementia is a term for a range of diseases (including Alzheimer’s) that develop over time and cause problems with memory, reasoning, and communication, changes in personality, and a reduction in a person’s ability to carry out daily activities, such as shopping, washing, paying bills, and cooking.

Dementia can present very differently, so it’s important to know what’s normal for your loved one. An organized person’s starting to unravel is very different from a scatterbrained person’s just being slightly more scatterbrained.

Grief and stress can affect memory yet not be the start of dementia. But they can also mask the start of dementia; we call this “diagnostic overshadowing.”

There are also age-related changes to cognition. For example, we take longer to learn when we get older. But a one-off event—no matter how dramatic—is not necessarily dementia. A pattern of decline is a more indicative phenomenon.

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If you see these changes happen in a short space of time (weeks or days), it is unlikely to be dementia and could be something more serious. This requires urgent investigation by a doctor.

Greatest Fear

Dementia is one of the greatest fears of our age. The horror of perceived loss of self can cause people to avoid discussing the issue, to discuss it in an unhelpful way (such as criticizing or inadvertently humiliating someone), or to discuss it with other relatives but not the person they are noticing changes in.

Over time, this can cause a lack of trust to develop. Discussing memory problems openly with the person at the point of a memory failure is best; and it’s great if he or she raises the concern. Of course, it takes courage and makes us face our own vulnerability.

Sometimes, the person will be in denial or lack insight into the memory problems (this can be a symptom of dementia but isn’t always). If someone raises a concern about his or her memory issues, you should not minimize this, as it probably took courage.

I heard a relative say to my mother: “Oh, you left the pot on the stove. I lost the car in the multistory the other day.” My mother had dementia; the relative did not.

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If he or she is adamant that nothing is wrong, this is harder to deal with. One approach is to say, “I know you are not concerned, but I am concerned, and I wonder if you would see a doctor to ease my worries.”

Also, explaining that memory problems can have reversible causes helps communicate the importance of a visit to the doctor. It may also be encouraging to say to the person, “If there is something with your memory that will get worse over time, would you want to know?” (Most people say yes.)

Most people would want to know if they have dementia. fizkes/Shutterstock

Seeing a Doctor

If your partner agrees to visit a doctor, it is helpful to prepare by filling in a diary for a week with the kind of memory (or other) problems experienced, what was happening at the time, and the effect of the memory failure. You can tell the doctor these things to help him or her understand the issues.

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When people hear even the suggestion of dementia, they are faced with the uncertainties of what will become of them, what they will lose, what they can keep up with, and where they will end up. These uncertainties are often shared with family members. However, research shows that the positive aspects of timely diagnosis outweigh fears over time.

At the same time, there are often ongoing stresses from dealing with memory impairments or confusion. With these stresses, everyday life can be troublesome, family relationships can suffer, and people can find it difficult to be supportive of each other.

Being honest and open is the best policy. Stating that we are in this together, that we want to help, or that we'll meet whatever happens head-on can help. If a person becomes resistant, it may be that there is another family member who might better assist the person.

Kate Irving, Professor of Clinical Nursing, Dublin City University

This article is republished from The Conversation under a Creative Commons license. Read the original article.