Fall is often a time when families visit relatives. It is during these visits that games, stories and everyone’s favorite foods are always on the agenda. Most families have a favorite food that only grandma can make. No matter how many times other family members try to make the recipe, it never comes out the same as when grandma makes it. But, what happens when grandma prepares the favorite food and it tastes awful—something that has never happened. Sure, we all can have a bad day in the kitchen, yet what causes concern is Grandma’s confusion with the recipe, and her similar confusion about the loved ones around her. Everyone begins to wonder, “Could something be wrong with grandma’s mental state?”

It’s quite common for people to equate an elder person’s slight forgetfulness or confusion to be a normal part of aging, but when do you know if there is a serious problem, such as dementia?

Dementia causes many problems for the person who has it, and for the person’s family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms:

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but then they never remember them. They might ask you the same question over and over, each time forgetting that you’ve already given them the answer. They won’t even remember that they already asked the question.

• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.

• Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want

.• Disoriented to time and place. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.

• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.

• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can’t find these things later.

• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.

• Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.

• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people.

In the beginning family members find part-time caregivers for their loved one. At first, only a little help is needed with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24-hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the person. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care, including dressing, bathing, preparing meals and even eating a meal, eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes, a person tends to wander off and therefore a locked facility may be appropriate.

A family meeting should be held as family gatherings provide an excellent opportunity to discuss caregiving plans. The first step to holding such a meeting, and perhaps the most difficult, is to get all interested persons together in one place at one time. Perhaps a birthday, anniversary or other special event could be used as a way to get all to meet. Or a special dinner might be held. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.

The end of the meeting should consist of everyone present making his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support. Send questions to Clark Consulting, 325 Sharon Park Drive, Suite 408, Menlo Park, CA 94025, or email to clark@southcoast.net..