the devastating piec about this disease is that you you lose that person as you once knew them.

And, you know, sometimes you get introduced to a new person It's the disease.

It's not the person.

Miss Pam.

Topic today.

Early warning signs and next steps.

Now the Alzheimer's Association identifies.

Is it 1010?

Okay.

Ca we just review those real quick?

We can.

I don't know them by heart.

So I'm just I find a glance at my notes.

I don't want to forget them.

The first one is memor loss that disrupts daily life.

And that's very important.

We'll talk about that later.

Challenge in planning or solving problems.

Difficulty completing.

Similarly.

Your tasks.

Confusion with time and place.

Trouble understanding visua images and spatial relationship.

New problems with words or speaking.

Misplacing things and th inability to retrace our steps.

That's another one too.

Unfortunately, we notice, quite a bit decreased or poor judgment, withdrawal from social activities, isolation.

That's another one.

And then lastly, changes in mood and personality.

Okay, can we kind o do not necessarily a deep dive but let's let's go a little bit underneath the surface on each one.

So let's let's just let's just go back and do the ten and let's just kind of deep dive a little bit on it or scratch the surface.

And let' so so people have a little bit better idea a little bit more context.

Absolutely.

Mark.

So the first thing that I would say is that, the second most frequent question that I get asked out when I'm out speaking and talking with folks is, how do I know the difference?

Like what's a normal sign of aging?

What could be a sign of oncoming dementia or Alzheimer's disease?

And so a lot of these thing that we're going to talk about here in the next few minutes, you could se also as a normal part of aging.

So I'll try to point out the difference when we talk about each one.

The things that you might look for that might give you cause for concern about is this dementia or you know, moving into dementia.

The other thing I'll say, Mark, is that we talk about ten warning signs but you might only notice one.

You may notice 5 or 6 of them but you only have to notice one to, you know, maybe think about, you know, talking to th physician or doctor or whatever.

So let's start with the first one, which is memory loss that disrupts daily life.

And that's really the key on this on is the disruption of daily life.

So these are things that people forget that you wouldn't necessarily think that they should or would forget, somebody's name that's very close to them, you know, spouse or child, a birthday, an anniversary, a place, you know, where they shop, where they get groceries, where they go to church.

Just that memory los that in the in the loss is gone.

They don't really can recover that memory.

We'll talk about that a little bit later in some of the other more signs.

Well, real quick is again just to help identify that is is i one of those things where it's where is it just complete lack to connect or is one of those things where you're like, you know, that person, what's her name?

Yeah.

Right.

So that's a great example, Mark.

So for you and I, we're going to be ther like, oh, oh I know that person.

It's Mark, someone who's having different changes in their brain.

They're not going to be able to pull mark out.

They're going to continue to kind of be in that stutter stop mode of, oh, I feel like I should know that, but I don't I can't recall that memory.

So like, if that do you want to look for a pattern in that or, or like boom, first time like, like that's something you should be on the lookout for.

Like the first time they, they don't do it or they're not able to pull from it.

Boom.

I need to take some kind of action.

Yeah, that is a great question.

And that is another real key when you're observin these changes in your loved one.

Is there a pattern?

You know what you and I, we forget people's names.

We forget where we leave stuff.

We we try to recall that memory.

The difference is that you and I more than likely will recall it and remember it.

A lot of times I always say when my mind relaxes, that's when I'll remember something.

And we al forget we all have those lapses.

But you're definitely looking for that pattern, that consistency of.

Well, I noticed that, you know, mom forgot that last week and she still hasn't remembered that.

Or she's we're talking about i and she's forgetting it again.

So you definitely in all o these warning signs and changes, you want to look for those patterns.

All right.

So number two, challenge in planning or solving problems.

So we kind of call thi the executive functioning key.

So if you're looking at, anything where you have to, follow a pattern, a sequence, a recipe, a formula or anythin where you're kind of processing if you're unable to do that or you experienced just some frustration or changes or you misstep or few, on something that you know, normally wouldn't be a change for you.

For example, you know, we typically will shop at the same grocery store, wil typically go to the same church.

We go to our kids functions.

Right?

So we're we're driving in the same places we're going doing the same things.

And then all of a sudden we can't remember, how do we get how do we how do we drive to church?

My next door neighbor played in a golf league, and one of her good friend followed her home from the golf course back to her house and she was sharing with us.

You know, I got out of the car and she was like, hey, so-and-so, what do you need?

Did you forget something and or what's going on?

Because they typicall would go home right after the, after the golfing.

And she was like, hey, I don't remember how to get home.

So things like that, that executive processing, you know, paying bills is another one.

Just things that, you know, where you're you're doing stuff in sequence and noticing those changes.

And again, when you see those, like those initial struggles, grab my water.

Excuse me.

Yeah.

I know, yeah I know, yeah.

So we're looking for the patterns.

We're looking for patterns of frequency.

Yeah.

How long is as this happening?

And, you know, there might be some things that are more complex, you know, so, you know, I know for my older parents just trying to track sometimes their health care and their bill and their deductibles and their, you know, we have trouble with that sometimes.

So I think to think about th complexity of the function too.

But something is, is, you know my mom and dad have been going to the same church for 60 some years.

If they forgot how to get there, I would pay attention is or recipe that someone has done forever or maybe some kin of maintenance that they've done on, like the lawn mower or something like that.

Yeah, something they could do in their sleep, right?

Yeah.

And that kind of leads into the next when difficulty completing familiar tasks.

So again, something like, you know, a playing bridge, playing gin rummy, you know, a card game, playing something with the grandkids, just doing something that, you know, normally you would just do you know how to do it?

It's very familiar something that you do regularly.

You know, you think about, like the, the challenges in solving problems, those are things that, you know, come up sometimes, like I said, sometimes those things you just kind of monitor because, yeah, that's kind of hard.

But this difficulty in doing familiar tasks, I think really would give you pause because it's something that you just do.

You know, so many of the things that we do during our day, we don't even hardly think about.

Right.

We just do.

Those pathways are developed in our brain.

And so you typically will see, you know, they just don't remember how to do something that's very familiar to them.

And it could be and I would I my brain just popped like hygiene issues.

Brushing teeth.

Yes.

Shampooing hair, getting dressed, taking a shower.

You know, any of those things?

Absolutely.

We've had families that one of the first things that they've noticed is, their loved one, always is very meticulous in their care, you know, they're, they're showering, applying makeup or Cologne or doing their hair.

And then the next time they see them they're just somewhat disheveled and they're like, that's very, very odd.

Does it happen once?

Maybe they just don't feel good that day, you know, and didn't want to get up and get dressed to the nines.

But a pattern of that behavior.

Oh, yeah, I just forgot or.

Yeah, I'm not really into that today would give you caus to take a look at that for sure.

Confusion with time or place.

Think about it.

You know, when we're on vacation, we'll be like, hey, what day is it?

What's the date?

You know, my husband's retired, and many times he'll ask me, you know, what's the date today like?

You know, he just doesn't track that as much anymore because he's not working, and he doesn't necessarily have to be somewhere.

But just a a generalized, confusion of, oh, oh, it's summer already or school's out or.

Oh, yeah, the holidays are approaching.

Just something that's just a little bit off, a little bit odd.

That, you know, you wouldn't, you know, as the holiday approach or somebody's birthday or graduation or a weddin and those things are coming up, and we've had them on the calendar for months, and then somebody is just very confused about, oh, what's happening?

Who's getting married you know, those kinds of things that just, again a little bit odd, a little bit different kind of behavior for that, is as someone who, has dementia, Alzheimer's disease.

And as the disease progresses, we see this confusion in time in place a lot more frequently, but sometimes this one's a little more subtle at the beginnin because people, can cover that.

Oh yeah.

Yeah, yeah, that's right.

I just forgot, you know, but again, you're looking fo those patterns in the behavior.

Yeah.

So and so that would be the way to focus in again looking looking for the patterns and and be like okay.

It's not it's the middle of the summer.

We shouldn't be thinking abou putting up the Christmas tree.

Anything that raises your eyebrow and, what I see now, that's this is one of those things that especially this particular topic, time and place, this is one of those things.

And correct me if I'm wrong where loved ones and and to be or soon to be caregivers.

This is a probably an are where frustration occurs a lot.

Maybe.

Absolutely.

Because, you think about what happen when you get a little confused.

What do you do?

You start asking questions, you start seeking out, you start well, and your caregivers, are like, yeah, yeah we that's been on the calendar.

We've talked about that.

We just had this conversation.

Think about those things that you, you would say.

It's like we just talked about that yesterday, or, you know, so-and-so called and invited u and you put it on the calendar and, you know, you're just kind of shaking your head like, what's up?

You know?

So I think, again, you're looking for those patterns.

You're looking for that frequency.

How often is this happening?

And I think to when we, we can get easily frustrated because our expectations are that this is just something you should know.

And then when our expectations don't get met.

Right we get resentful and frustrated.

So, particularly, I think, for caregivers and, like you said, soon to be caregivers.

You know, we've just had this conversation.

And I think that's another clue for peopl in any of these warning signs.

You know when we talk about frequency is how often have we had this conversation?

We've talked about this, and we're now we're talking about it again.

And I think that does lead to frustration for folks.

It's kind of like our families are when you are truly caregiving for someone and, one of the things your person may do is ask you the same question over and over again.

And, you know, I always tell folks we talked about this the last time you have to step into their reality and, you know, do some of your other skills, you know, redirect, and try not to get I just told you the answer to that.

You know, we just talked about that.

And that's really hard.

That is just it's really hard to really difficult.

You know, that is extremely difficult.

And I really I really sense that that subtlety aspect of it that you mentioned earlier is, is very, very challenging when it comes to this in particular because because when it is subtle at first and it's just kind of like, oh yeah, I forgot it.

And then you, you begin to disregard the warning sign because you get you begin to be like, that's normal behavior because they have been forgetting things lately.

So what what initially was like we just talked about that.

Oh that's right.

You know.

And then a couple weeks goes by and things seem fine.

And then we just talked about that.

Oh that's right, that's right.

And when it when there's that subtlety that subtle, it's like the warning like the warning sign becomes camouflage I would think.

Yes, absolutely.

Two things going on there.

You described the caregiver perfectly.

The caregiver becomes just used to it.

Absolutely.

The other person.

No.

In that in that dyad, the person who was who is experiencing the changes.

We know people who are living in the early stage.

They share with us that the they know something's not right.

They know they're having these changes.

So I don't want you to know that.

I don't want you to think I've got Alzheimer's disease.

I don't want you to think I'm good.

I don't want you to think I'm getting old.

So if you say to me, you know, Pam, we already talked about that.

And I was like, oh, yeah, yeah, that's right.

I may not have clue one what you're talking about, but I'm going to try to camouflage it.

Cover it up.

Yeah, yeah.

That's right.

I'm sorry.

You're right.

We talked about that.

And so you know denial is one of our most powerful coping mechanisms.

And if and if we can, all of us, the caregiver and the person living are bot in a different form of denial.

Yeah.

Yeah.

Okay.

Okay.

Yeah.

We talked about that.

This is just how she is.

And I think that' one of the things that we combat all the time at the Association is that these changes are not normal.

These changes are not just I'm getting old.

Grandma' getting old.

Mom's getting old.

It's truly something's changing in the brain.

Yeah.

And that actually reminds me of of of something else that I would we may talk about it more, but with all of these things, again, with that subtle onset of some of these things, probably another thing we need to be watching out for are those generic answers to things, these positive, generic answers to, Oh so I've seen such a long time.

Well, it has, yes.

It.

Okay.

Yeah.

It has.

You look great kind of things where they're answers but not specific answers.

Correct.

Onto that hiding thing you were talking about.

Yeah, yeah, yeah.

Because, some folks are very, very, very good at that.

You know, they're very, it they can deceive, right?

They can they can camouflage, they can hide.

And again that that other person is just, you got to be paying attention.

There's some, you know, and so many times the spouse, the significant other that's, that's in the home.

They, as you said, they just get used to it.

And it takes sometimes the other family members who come in and say, what's wrong with so-and-so?

You know, to really kind of shake that up a little bit and, and push them to, to really face the issue.

Yeah.

And, and just a shout up to our loved ones and stuff.

That's pretty normal.

To be very normal, to begin to incorporate those things.

Absolutely.

On both sides.

Right.

Because a perso who is beginning those changes, they ma or may not have any exposure to what, mild cognitive impairment or early dementia.

They they may not have any idea what's happening to them.

Some people might have an idea of what's happening to them because they've seen it prior in their family.

Right.

We know this disease travels in families.

So if I'm a daughte and I've previously taken care of one of my parents, and now I'm beginning to to have these changes, absolutely.

You can't blame them.

Absolutely not.

And our caregivers, again, you know, absolutely not.

People, I find Mark do the very best they can, you know, and with how they'r coping in dealing with things.

Yeah.

And and just another real quick point on there.

And it's just popped in my head that that is somethin that we have to stay focused on.

Is in, in identifying these things is because probably some of that hiding or camouflaging that the individua who's suffering is experiencing is out of this fear that they're going to lock me up.

They're going to lock me up.

They're going to put me in a nursing home.

Oh totally totally.

So I'm going to skip a little bit.

I'm going to talk about withdrawa from work or social activities.

Because you gave me a great, great segue here.

We if you have someone in your life that is pretty active, pretty social, pretty just I hate using the word normal but I'll just say just normal.

And then all of a sudde you notice that they start to.

Yeah, I don't really want to go to that.

I don't I don't really feel lik hanging out with the grandkids.

No, I don't really want to go to that, church function.

Yeah.

I you start to see that withdrawal and that social isolation out of someone that that's a not a pattern of behavior, not like them.

I think that's a real clue because just for the reason that you were talking about like I, you know, a person will recognize the changes and if they don't want to, because I'll tell you, the other thing that we talk about at the Association is how exhausting it is for the person who is having these change in their brain, how exhausting their day is to keep up, to camouflage, to deflect to make sure that people aren't noticing these changes because I don't want people to notice these changes because I don't want anyone to lock me up.

So either I have to be like on my game, constantly combating this, or I withdraw.

I isolate because I'm just tired and I don't want to deal with it anymore.

And I unfortunately see this more often than not.

A lot of folks will just withdraw because they just they just don't want to deal with it.

They don't want people coming i and getting in their business.

They don't want the kids coming in and taking over their finances.

They they just don't wan to be moved out of their home.

And so I'm just going to hunker down so that that's really I think, a real telltale sign, which is also a doubl edged sword, because withdrawal means lack of social engagement, it means lack of of of, a variety of stimuli that that helps combat the issues.

You better believe it.

Yeah.

So you're findin so now you're finding yourself trying to drag that person out back out of that isolation.

So that's definitely a warning sign and something to watch for.

So thanks for letting me, skip over stuff.

Like I said, this i this is all free flow and stuff.

We just.

Whatever happens, happens.

So, this one's a little the trouble understanding visual images and spatial relationships is a little, It's a little tougher, I think, because, you know, as we get older, we have issues with our gait, with our balance, with our vision, with our depth perception.

And, you know, I I never was a graceful person, but as I get older, I'm even less graceful, you know?

And so when we when folks have these changes in our brains, it's not necessarily that there's problems with their eyesight.

It's how what people se is perceived within the brain.

So people typically will have trouble with, peripheral vision, depth perception some of those kinds of things.

You know, stepping off this step and, and you, the families will see that, typically in driving, distance vision, stuff like that.

Most of the time it's in driving.

So people are having difficulty driving because, you know, there's a lot of executive functioning and driving.

Sometimes.

Excuse me sometimes.

Oh my gosh, take a drink.

Don't relax.

Oh, I don't know what happened there.

Sorry about that.

It's more of.

Thank you.

And we're talking a lot new problems with trouble and speaking and writing.

No, we're not there yet.

So, you know, a typical age related visio change would be like a Cadillac.

Right?

So this is different.

This is really something that has more to do with the brain processing.

So you might see the, the depth perception, the the, you know, the changes with the vision.

And again, these things are a little more subtle.

And you may not unless you'r probably living with the person.

You may not see some of these changes necessarily.

But again, something that is just, you know, you've had somebody who's been a really good driver and then all of a sudden they're just having trouble navigating behind the wheel.

That might be something t to really think about with them.

Problems with words and speaking.

This is typically where there's a couple things that happen, and this is mostly in conversation.

So, You're right.

Yes.

That's it.

That's it.

So I always do that for impact.

You got you.

Yeah, I got you, didn't I?

Especiall because I was writing something.

Yeah.

Then you just looked at me, was like, oh, goodness.

She gets you Matt.

Okay.

I did my job, but that is that's a great example of what happen that people will just stop mid thought mid-sentence and just kind of, I think, you know, particularly if you know them or sometimes even if you don't you see that kind of lost look that, I really forgot what I was talking about.

Now, again, I will tell you, a lot of times my mind is moving faster than my mouth, and I will be talking and I'll forget, but I'll be like, oh, okay, what was I talking about?

What?

What triggered, you know, I lost my train of thought.

A person who is begins to experience these changes truly loses that train of thought.

Right?

You and I, we we could recover that, but our folks won't be able to to do that.

The other, other kind of telltale signs you'll see in the conversational speech will be replacement of words.

So, I might called the table a chair.

I might call the spoon or fork, you know, things like that.

And I'm and I'll do i without even breaking a sweat.

Like I'll just be like, yeah, you know, you need to move that table over here so I can sit down on it.

Like, you know, I just I don't even get that.

I'm replace those words.

Sometimes the other thing I think I see and we hear about are people struggling to find the right word.

And again, all of us do that.

We're like, okay, what, how do I want to say that?

But again, we will eventually be able to complete that conversatio in our loved ones with changes are probably not going to be able to do that.

So these are some of the things that you see in conversational speech.

Sometimes people will just have real difficulty writing also.

And it depends, you know, w don't we'll do a lot of right.

You're doing a lot of writing right now.

But, you know, a lot of people are on their screens.

So we don't necessarily see that.

But you might see somethin there, you know, with somebody not being able to, operate their technology that that might be of concern to you.

Again, you're looking for frequency and patterns.

And, and again this one really jumps out as me out out to me as where this is one of those things that we just start automatically doing for our loved one.

We end up finishing their sentences for them.

And again it becomes normal to us or it becomes routine to us and we become blind to or the caregiver.

Our loved one become blind to the warning sign.

Yes, absolutely.

Perfect example of this.

My parents had a couple that were they were friends since high school.

So, I mean, they've been friends since they were teenagers.

And, the husband had Alzheimer's disease, but their friends, they never talked about it.

You know, these are this generatio didn't talk about stuff, right?

They're not one that are sharing these things.

And so they were at dinner one night.

And you know how the gentleman will retire to the study for the cigars and the ladies will go to the kitchen.

They didn't separate.

He stayed with her.

And you know, my mom, everyone thought that's kind of weird.

Like, why is he with their lights?

Kind of weird.

And he went into the kitchen with her.

Like she didn't go where the, you know, men were.

He came into the kitchen with her, and my mom was like, well all right, whatever.

You know?

But it was then during that conversation that my mom noticed that if he was talking, i someone did ask him something, he would get to a certain point and he'd look at his wife and she would finish his sentence.

And, you know, my mom was just like, he's just off.

That was just very odd.

And, you know, a few other things in that relationship.

But they didn't.

They finally shared the diagnosis.

But, yeah, it just and that happens.

And, and I just, just reminded me because, of my own, of my own journey when you kind of really you don't even.

And this is a thing where that's one of the things that you don't even necessarily realize that you're doing it.

Because I remember when my mom was aske by the doctor, what month is it?

And then my mom looks at me for help.

You can just tell by the look.

And it was excruciating to see her look at me like that.

Looking to me for the answer.

And I in that moment, I couldn't give it to her.

And it it is extremely difficult.

And I didn't even realize that I, I like I said, I didn't personally didn't notice how much I had been doing it myself until there was a situation where I was not allowed to because, like, I found myself ready to say, December mom, you know, just very simple.

You know I had to stop myself from my own automatic reaction of doing that.

And yeah, it's it's it's sneaky.

It's sneaky stuff.

And again, that's one of the more common signs as well.

When you are, they're looking to you to fill in those blanks for them.

Yeah.

Real real quick.

Yeah.

But let's just, let's just stop and talk about that for a minute.

Since we've got this real life example here, It's it's okay to do that as long as you'r recognizing it's a warning sign and it is something that is an actionable item.

We're not saying don't do those things correct.

We're saying recognize those things.

Still support your loved one, but take action.

Absolutely.

You have to look at where you're at with that.

Okay.

So you described your just right now.

You described your experience You were in the doctor's office.

So you've already worke past the point where you're like you and your brothers were, hey something's going on with mom.

Something's going on.

You've already got her in the physician's office.

The physician needs a clean slate, so to speak, to really assess he and figure out what's going on.

So no, he won't want you to support and answer questions at that moment in time.

But what have we said before when you were the caregiver, the family member, the spouse?

Your person can't change.

She doesn't know what month it is.

She's asking you what what month is it?

You're going to step into her reality and answer that question and and provid that love and support for her?

Absolutely, absolutely.

And even on the earlier side of that, before you went into the doctor, you you're thinking, oh, man.

Or you could be thinking, oh, man, what?

Something's going on with mom.

Yeah, mom, it's December.

I mean, you're being kind.

You're being a good son.

You're being a good spouse.

Whatever.

You're supporting your person, but you're also, like you said, you're being wise.

You're like, okay, there might be something going on here.

What else is happening?

So yes there's nothing wrong with that.

Yeah, for sure.

And there's no guilt when you realize it may be a little bit later than you should have because it's just normal.

You you okay?

Hindsight's always 2020, right?

So no, you you can't beat yourself up.

People are very, very good at covering and hiding and all these things that they do, and you know, something we're going to talk about in a minute is that, okay.

You got.

Okay.

So we'll, we've identified that mom's got, you know, five warning signs, and we need to do something about it.

I'm gonna tell you sometimes mom doesn't want to do anything about it, right.

We're going to talk about that in a minute.

This is another very, very common on we're going to talk about here.

And I get asked about this one a lot when I'm out speaking, and that is misplacing things and then being unable to retrace your steps to find them.

So we always use the example of car keys.

Right.

We misplace our car keys.

There is a particular place in my house where when I come in, I put my car keys because the next time I need them, I'm going to go there.

They're going to be there.

And I'm not wasting my time looking for my keys.

You could replace anything in this equation.

Not just keys but this is the most common one.

And, Well, I go to that place.

They're not.

They're.

Oh, crap.

Okay, what did I.

Where do I leave my keys?

Okay.

They could be on my desk.

They could be in one o the thousands of bags I carry.

They could be on the kitchen table.

When's the last time I had my keys?

Oh, yeah, I went to Bowling Green.

Okay.

What did I do after that?

So I'm sequentially moving backwards to figure out where I left my keys.

And honestly, this is embarrassing.

But the last time I lost or misplaced my car keys, I found them on the floo in my car on the passenger side, because they had fallen out o one of my many humongous bags.

I don't think you can put that on you.

So that's the difference.

I was able to retrace my steps and figure out whatever it is that I misplaced.

Where was a person living with dementia?

We're seeing those changes.

They're starting this you know, having the impairment, they would have looked at the keys on the floor in the car and and would have said something like, well, who put my car keys here?

How did my car keys get here?

Or someone hid my keys.

Someone hid my keys.

Have you been hiding my keys again?

You know, and they just.

And it can be anything.

It can be, your wallet.

It could be, something.

An ingredient you're looking for to cook.

Anything that they've misplaced, that they can't find, and they're unable to retrace steps to find it.

That is a huge clu and a warning sign for people.

And that is a little bit more common.

And again, this one is one of those subtle ones and extremely frustrating.

Extremely frustrating.

You know, my my thought process with it is, is like, let frustration be a red flag.

Let frustration to be a red flag for you.

If if you are getting frustrated in areas you have not gotten frustrate historically, that's a red flag.

Yeah.

And in terms of that frustration, I know we're talking about the warning signs, but when those things happen, there are products out there where you can put little tags on things, put them on your keys put them on your remote controls so they make little beep sounds, right.

It'll help.

That's all I'm saying is it'll help.

So for caregivers, you just got some great tips from Mark.

Just a little extra, little extra.

There too.

Because I think that, you know, in Mark also that's really that's really valuable on this side of the diagnosis, right?

When you have those warning signs.

But it's also a great strategy on the other side because, you know, we know that, over 80% of people who are diagnosed and live with dementia or some who are not even diagnosed, but are living with dementia, are living at home.

And so those are that's a great idea for caregivers to, you know, we also know that six out of ten people wander.

So if you've got a person that's wandering, you know, something like that to help yo figure out where they might be, where their stuff might be, absolutely.

Great idea.

Well, just the like you said, the just in general, if you can decrease the frustration on both sides caregiver and loved one, it' just a better quality of life.

And it's, it's management of, of what is this disease.

And, and it just increases th quality of life on both sides.

So I agree I agree.

Would totally, totally agree.

A couple more will finish up decreased or poor judgment.

And again these are things like we typically see the, the decision making.

The decision making is just you're just shaking your head.

A lot of times our families will find this poor decisio making in financial decisions.

So, you know, maybe you happen to see some mail on the table and you see a collection notice, and you're like, you know, my dad pays his bills every month.

I mean, there's just what's happening here, and dad's forgotten to pay a bill, or dad's like, well, we don't we don't have cable TV.

But I'm not paying this bill when indeed they do.

Or it could b the other extreme where they pay the same bill three times in one month.

Same bill.

They're paying three times.

So a lot of times this is there may be other, you know, poor decisions going on, but a lot of times families will first see this evidence in the financial decisions.

So just anything that just again seems very odd or out of the ordinar in any kind of decision making.

And then the last one is tha change in mood and personality.

And, you mentioned jus a minute ago that frustration, you might begin to see huge frustration in your loved one because they're struggling to keep up.

They're tired, they're fighting that, you know, where did I put this?

What am I doing today?

What's on the calendar?

What day is it?

Who is that?

You know they're there.

This takes a lot of energy.

You know, I walked in here today.

You're like, hey, Pam, you know, hi, Mark.

And we're just on about it.

A person living with dementia.

Did they have to expend so much energy?

Okay, that's Mark.

I'm here to record a program.

I need to do X, Y, and Z to get there.

That causes frustration.

Maybe they're really tired and just, just a change in their f in their affect.

I mean, that' just something that it's again, it's just out of the ordinary, you know, maybe your person is just really easy going and all of a sudden they are just hyper or typically we unfortunately, we don't see people who are kind of gruff.

You become all nicey.

I see, we typically will see people, you know, go the other way just because they're tired and frustrated.

And what's happening to me, you know, and this, I mean, this with all due respect, it's like, a version of hangry.

It's, you know, it's it's literally their system inside is, is is suffering and that anger and frustration or gruffness or that's I just think I use that ter because I think that's something everyone can identify with.

Absolutely absolutely hangry.

Know I really I was hangry yesterday.

I think too this is where we see the depression.

So if, if I'm very early on I'm noticing some changes.

I might go over here to my iPad and what does this mean?

What's happening to me?

And I might read about Alzheimer's disease, which is progressive, fatal, no cure.

This is what I have.

So I might become very depressed.

I might give up.

I know I deny that's the most powerful.

But a person may also become more anxious.

I mean, I think jus the isolation, that withdrawal, you may se a lot of different things here that are just very abnormal or very out of the unusual for your person.

And this is also one especially, like you said, if you have someone who usually has a very sunny disposition all of a sudden becoming angry, confrontational, again, obviously a red flag.

But as the loved one, as the family member, this is on where you have to watch out that that the this don't come up, that it's like you're not going to talk to me that way.

It's like, whoa, whoa, whoa, wait a minute.

And again, it's natural.

It's natural.

But but this is again one of those areas where if we cannot identify it as a warning sign.

We take it personally.

Yes.

And we react personally.

Yes we do.

Very normal.

That spirit.

Of course you do.

Why wouldn't you.

You know.

And so that's where you know, part of my why is making sure that people are educate and understand what they could potentially be dealing with and, and just have that knowledge that, you know, it.

It's hard not to take it personally, but it really may have nothing to do with you.

It's what's happening in the person's brain.

You know, we tell people on the other side of the diagnosis as they're learning what the new normal is and to try to plan for the future and what behavior and communicatio and changes are going to happen that, you know, it's you don't know what to expect.

It could be different every day.

You just have to understand that it's the disease.

It's not the person, but it's hard.

It's hard.

Of course you're going to take it personally.

It's hard.

Yeah.

It's, those are all the points, that's all.

Ten.

Okay, a couple follow ups.

Since we touched on all of them, I do all those things.

So again, let's just reiterate the difference between just today, lack of sleep, stress versus those two things.

Yes.

And they, they all jump in there.

They are in the top ten brain habits though.

Yes.

They, decrease stress plenty arrest and, but, you know, in all seriousness, it's, We're having this conversation right now.

I'm recognizing that I do those things.

I know that, I have a loved one.

My mother, who is experiencing Alzheimer's and dementia.

I know that it's par of the family history as well.

There's a certain level of anxiousness that I have just having this conversation right now, having as much experience that I've had up to this point with things like this, I'm even more sensitive to, i there something wrong with me?

So, again, can we just kind of just do an overview of of what is what is healthy observation and what what is the difference between the two is everything that we've talked about in the last few minutes, people who are not having changes in their brains related to dementia.

We all experienced that at one time or another.

We're hangry.

We're stressed.

A lack of sleep.

That's a good another good one.

Did things come up?

Stressors come up in our lives.

We all forget things.

We all misplace things.

We all get moody.

Wow.

What?

Yeah.

We all do that.

The difference is a person who's havin these changes in their brains.

It's going to happen more often that because we know that dementia is a progressive disease we know that the changes occur 15 to 20 years in the brain before we get a diagnosis.

It we're looking for patterns, frequency, things that are just odd, that are off.

It I think after a while that particularly if it's a spouse that's living with someone, you just realize that that memory of whatever that is just isn't there anymore.

And that's your red flags.

That's your warning signs.

That's what you really want to pay attention to.

And you know, the people that live with you, interact with you on a frequent basis.

They're going to notice changes.

So, you know, I think again, you're you, you add people that you personally, you and people educate themselves about what's happened to their loved one.

What does this look like?

What is what could it mean fo me as a person in their family?

You know, we have, an opportunity to go get a blood test.

Now, that may help us in that diagnostic path.

You know, you could there' there's things that you can do, but it's it's mostly thinking about what's happening to me.

And in that education about what to look for and should I, should I get upset if I forget something now and then, Probably not.

But if you do have it in your family and we know that family is one of the risk factors, I think being aware, understanding what you're dealing with, having that knowledge, is important, but it shouldn't control your life and drive you crazy if you forget something.

A couple of things I want to follow up on that.

The concep of proximity popped in my brain.

Is that this?

This is probably most effective to identify warning signs in a team environment, so to speak.

Yes.

It's like, hey, I'm the loved one.

Look, I'm here all the time.

I'm noticing these things.

And then on the flip side, it's like I'm an outside observer.

I'm noticing this, and you're finishing their sentences all the time or these other things.

And so to, it's it's really is a two way street in some of those situations when you agree.

Absolutely.

I'll go back to my friend, my next door neighbor.

Who, who her friend came home after golf.

It was interesting because my next door neighbors and I also knew this lady.

She lived in our neighborhood as well before they moved.

And, you know, she said I said, well, what did you what did you do other than get her home?

You know, get her taken care of it, you know?

And she said, you know, I told her husband what had happened.

And he said, yeah, I've been noticing, blah, blah, blah.

So it's it is important for those observers to to speak up because you might be noticing this and you might be noticing this over here in the spouse o the person maybe who lives with them is noticing this is like, geez, you know what?

We can't we can't deny this anymore.

Something is happening and we need to take the next step.

Okay, so speaking of next steps, I'm not sure.

Can I just call the Alzheimer's Association and say, this is what my loved ones experiencing?

What what what what do you suggest?

What do you recommend?

Absolutely.

Call us.

We'll we'll tell you what to do.

We'll help you figure out a solution to that issue.

And you do you actually do consultations for actually do care consultations.

And you can call us directly at our office and one of us will respond, or we have our 24 over seven helpline.

And we also have counselor and helpline staff there who can also walk you through that.

So let's say you're just, you know, you're just like something happened and it's Saturday afternoon and you know, you really want an answer now or you really are at the point where I really need to.

Now's the time, right?

You can call the helpline and we can take care of that now, or you can talk to us and we can talk to you from the office as well.

Okay.

So let's, let's, let's demystif what a, what a consultation is.

Let's demystify what those because fear denial all those things are real.

And I'm I'm I'm I don't want to call because quite frankly, I'm afraid of what the answer is.

If I call am going to have to do x, y, and z?

Does this mean that again, the locked up thing is, or they're going to put me away kind of thing.

So let's let's demystify what a care consultation is.

So people are 100% comfortable with calling eithe the 24 seven line or setting up, a more, something local, something local.

Yeah, yeah.

Okay.

So first of all, just know that we have people calling us for all kinds of things.

So it might seem like very scary to you.

And in whatever.

But we're we're very well trained.

This is our work, our passion.

So our goal is to when we are done with that conversation, our goal is to make sure that you have the information you need.

First of all, it's completely confidential.

It's completely free.

We're not going to tell you what to do, but we're going to provide som options and possible solutions.

Education.

Sometimes you know, sometime people will call and say, well, we heard about such and such and such and such and we can say, yes, we'll get you linked up with them, or here's somebody to call o depending on what the issue is, a lot of times people start out with they just want some education.

They just want to know what's coming.

What should we do?

I will tell you that any there for us, any type of, we're not a crisis line.

So we're more focuse on education, future planning.

Although depending on how the conversation goes, a lot of times I will address any safety concerns like right up front.

So, you know, safety for the person in the caregiver is important.

Education is important.

Do you need help getting the person to the doctor?

That's another big this is going to shock you, Mark, but most people don't want to go into the doctor and get a diagnosis of Alzheimer's disease.

And to that point, this conversation that you have with them, it's not a diagnosis.

It's directions.

It's directions that they can go.

Yeah, here's some suggestions.

So we have we call them tip sheets.

We have tip sheets on everything.

We have a tip sheet on how to have that conversation with your loved one.

On on getting them to the doctor.

We have a tip sheet on.

Once you get to the doctor, here's the things that we might suggest you ask the doctor.

So we're really looking at a care plan is a familiar term to most people.

So we're really looking at helping that family.

That caregiver set up that care plan.

What are some things they need to think about?

What are some things they might need to do?

You know, I always say when I'm talking to my staf and other people that sometimes people need to talk to somebody, they're not related to them, right?

That they just, I have one family that I've worked with for almost the whole time I've been at the Association, and it's the story of there are five siblings, but one sibling is the one that's carrying the backpack.

And so we talk about with her.

We talk about how mayb she unloads some of those pieces of the backpac on some of the other siblings.

And so there's all kinds of family dynamic that we can help sort through.

Getting the clear plan, getting those resources, getting that education.

And we're just going to provide those things.

We're not going to tell you what to do.

It's not about you should or you need to.

Here's what you could do.

Here's some resources.

And and it's not always a one and done.

Hey, you want to go sometimes.

Sometimes we'll give a lot of stuff because people have a lot of questions and I'll be like go home, process this, you know, talk to your other family members, think about this.

You can call us back.

We can set up a time three weeks down the road and get together again.

It's not was not necessarily one and don or this family that I work with, you know, they'll call with some questions, we'll get them situated and then I might not hear from them agai for maybe another 6 or 7 months.

But we kno this is a progressive disease.

The needs may change that first phone call.

You may not be able to anticipate everything you're going to need.

That's why we're here for you.

Ongoing.

So let's let's scratch the surface a little bit about that blood test that you mentioned to.

Let's, let's so let's just can you describe that.

Yeah.

Yeah.

So it just recently was approved by the FDA earlier this year.

And this is the year 2025 and this is 25.

So this is just earlier this year was approved.

What.

It's a blood biomarker test.

And what it does is, it's specific for Alzheimer's diseas because in Alzheimer's disease there is a buildup of beta amyloid protein in the brain.

So this blood test looks for that protein, that, abundance of protein in the blood.

If a person has that increase in the blood test shows that it does.

The Alzheimer's Association and many of the great minds in this, in this field have said, you know, that's great.

That's a great clue.

But it's not a standalone diagnosis.

So just like many times when you go get your blood sugar checked and your blood sugar is sky high, that doesn't necessaril mean you have diabetes, right?

You there's, it's it's not in a vacuum, but it is a very not.

Well, it is invasive but less invasive, less costly and certainly quicker wa to help some people understand.

Am I at risk of this or do I have it?

And so they're recommending that you take the results of that blood test and then you, the physician, will work you up in different ways to get to that diagnosis.

But it's it's definitely a game changer.

It's a step in the right direction and will really add to what we are always beating our drum about, which is early detection, early diagnosis, get it, get it caught early so you have the potential to intervene for treatment.

And just briefly, since you brought that up, really, what are the benefits of that early detection?

The biggest benefit now is well, there's lots of benefits.

Prior to a couple of years ago when we did not we the biggest benefit no is that we have two medications that treat the underlying cause of the disease.

They don't cure it, bu they treat the underlying cause.

The first time this has happened, two medications that has those medications have to be given in the early stages.

So huge benefit there.

The other benefit of early diagnosis is the knowledge and helping the person i the family plan for the future.

Because so many time when the person is not diagnosed or it just progresses quickly and families have to make decisions, it's really hard because they don't know wha their person might have wanted.

They're not in capacit to make those decisions anymore.

It's just tough.

You know, I promised dad I' never put him in a nursing home.

Well, dad is too much for you to handle at home, right?

So it's those kinds of things.

So it's that planning.

But really, truly, now it is more of the fact that we actually have a treatment that that coul potentially impact that person.

And that blood test is something you could just request from your doctor.

So it's it's becoming more mainstream.

It's we're very early on, even though we're in 2025, it's very early on.

I would imagine that it will get easier and easier to go in and request that blood test.

I think that for right now, it is.

It's definitely being used in clinical trials, and we will begin to see it filter out into the broader population.

I'm not sure 100% that that's happened yet.

And then there's that issue of who's paying for it and, you know, all those fun things that come behind, you know, the new stuff.

That's that's that's what I say, puts the UN in fun.

Yes.

But it's a reality.

And we'll talk about all that stuff at some point as well.

The last thing that I want to touch on with these ten signs.

Is to look, these signs are going to be exhibited by the person that you love.

And it's heartbreaking.

It is frustrating and it is scary.

Can you please talk to the point that it's not the person, it's the disease.

Yeah I mean you just said it.

It is the disease.

It is not the person you we are unable to control.

The changes that are happening in our brains.

Now, we also know that the ten healthy habits, reduce our risk and have a great positive impact on prevention.

So there are things that we can do, and we know that through the science, there are things that we can do to prevent the disease, perhaps delay the onset.

And reduce our risk.

But at the same time, we don't get into our brains.

And, you know, we don't turn those screws.

And, you know, we can't we just can't do that.

So when this happens to us, it happens to us.

And unfortunately which is the devastating piece about this disease is that you you lose that person as you once knew them.

And, you know, sometimes you get introduced to a new person and you learn things about them and other times you just don't understand where that person went.

They just sort of disappear.

It's the disease.

It's not the person.

And it's it's really hard when you're a 24 over seven caregiver and the perso is asking you the same question minute after minute, or they're doing something that is not safe and you have to redirect them and redirect them again and again, or they get up during th middle of the night and wander, and you have to get up and get them back to bed.

You have to, you know, for as tired as they get, you get even more tired because you are doing whatever.

And even if it it's determined that perhaps a memory care or a more supervise living arrangement is important.

The caregiver still has a lot of responsibilities for that.

And so it's just it's just different.

But it's always really important to remember that it's the disease talking what they're doing, how they're acting or not acting.

And it's hard it's hard fo the caregiver to remember that it is.

And I swear, I always think that looking through something from a different lens or rephrasing or reframing things, really, it doesn't solve it.

But it does make it a little bi more helpful when you're like, okay, this disease is like asking someone with a broken arm to carry two suitcases.

That's a great analogy.

Yeah.

Which they can't do, which they cannot do, they cannot d they cannot do physically do it.

Yeah.

And you can't get mad at the person because their arm is broke.

Correct.

And so why are you going to get mad at them.

Because they can't remember what day it is.

Because they can't.

Just like with the arm is broken they can't carry the heavy load.

And let's just be honest that's what makes this disease so difficult is because it manifests itself through someone that you love.

Yes.

Sure does.

Anything else that you want to touch on that we have not touched on?

Considering this topic?

No, because I think when we get doctor Lee, we can talk more about gettin the person to the doctor, okay?

Because that's the other kind of the other piece of the ten warning signs is having that conversation.

But he I think that would be a great thing to incorporate in that.

Well, if you want to.

Yeah.

Let's but you know, I'm glad you said that because that does make me have another question.

You know, again, let's just again, it goes back to that demystifying the phone call to the Alzheimer's statio or or that your doctor is like, you're still in control.

The association, your doctor are going to give you options.

And a diagnosis is not 99.999% of the time, not an immediate sentence of some kind, whether it be lock up, a death sentence or anything.

Like you said, there are some people that call you here and it's not for another few months that they'll they'll talk to you.

What can you say to people to kind of just let them take a breath about taking some kind of action when they do identify these ten signs, okay.

I think the important thing to remember is that when you identify these signs and now we we know there's a bit of a urgency to get a diagnosis.

If you're early on because you have the potential for treatment.

Okay.

So there is that, there is that urgency there.

Now, unfortunately, what a lot of people tell us is that there's still a lon wait to get into the physician, to see them, to get the diagnosis.

And, you know, we we all as a society need to continue to work with that.

I think once a diagnosis is made and once that that everybody takes a breath and it's like, all right, this this is definitive.

This is what we have.

We have a diagnosis of Alzheimer's disease.

What are we going to do now?

What what do we do now.

And and a lot of times people will tell us that they don't really get a whole lot of information from their provider at that point in time.

And so that's where that call to us is important.

Because here's the thing.

You may or may not have to do something immediately.

You know, if your person is early on and there's an opportunity for treatment, you want to have that conversation with your doctor and your doctor there.

I think our physicians are becoming more and more aware of the treatments and the options and and the fact that that conversation needs to happen.

Other than that, you really probabl want to just sit for a minute, give us a call, we'll get you scheduled.

We can talk about some things, kind of point you in the direction of wha maybe do you need to think about there are a lot of families who already have a son.

I'm just going to speak legal and financial for a minute.

Okay.

With my parents, we already have a person who's power of attorney and financial and health care power, which we've already taken care of.

That.

So if the diagnosis would pop up, we already had that piece done.

So I think that you ca come into this with different.

Different things, you know, like maybe your love one is already sold their home and they're living in an apartment.

You know, because there's always those pieces of if we have to transition, what are we going to do?

None of that needs to be done right that second.

I think a lot of times what I see with our families is just reaching out for that education because they don't know what to expect.

They they've heard about they've heard about what's going to happen, but they don't really know.

And they don't know how to plan, what to plan for.

What are some things they need to think about?

You know, for me, it's always safety.

And, you know, we probably ought to get started thinking about the financial house in order.

Because you're persons living at home, it can be very expensive.

If they're living in memor care, it can be very expensive.

So what are those plans again?

Nothing that needs to happen that second, because, Mark there's going to be some grief.

There's going to be some period of I just got this diagnosis.

I need some time to process.

I need some time to grieve.

We don't really label it as grief, but it is.

And and so then how do we how do we walk through that?

How do we adjust to that?

And what I love to tell people is you do have to adjust and walk through it and accept and all that stuff, bu you don't have to do it alone.

There are people that can help you along.

That pathway will hel you figure out what you need to do, will help you build that village.

We can help you with all of those pieces.

So we're good called to make, and then we can hook you up with other resources that you need.

Maybe you need adul respite or day respite services.

Maybe you need some services through the area office on Aging or home Care.

Well, we'll get you started on that in those pathways.

So what I'm hearing even though I'm afraid to call because you are going to make real what I suspect which is why I'm afraid to call there's really empowerment on the other side of that phone call.

There certainly is, because it gives you an opportunity to direct and control and and have some say and involve your loved one and get ahead o what's going to happen to you.

Either way, you can you can educate yourself and be prepared or not.

Either way, it's going to happen and yes, there is empowerment on the other side of that.

There's going to be other things.

But again, you'll have the friend in us to help you through that.