Many changes happen to a person's body and bodily functions as they age. One of the most noticeable is memory decline. As young individuals, we have a razor-sharp memory. We can cram before an exam and remember details exactly as they are written in our notes and books. We memorize lists and formulas with a little effort. Older people, however, tend to remember fewer details. To compensate, they analyze things better than when they were young.
A change in recall skills may happen as we age, but worsening memory loss and other symptoms that disrupt daily life is not a normal part of aging. They are signs of dementia, the most common of which is Alzheimer's disease.
CNAs will almost always care for older patients as they work in hospitals, facilities, and nursing care homes. Because they interact with patients more than any other staff, they must know how to spot the difference between signs of possible early-stage dementia and normal aging.
Normal Aging: A patient forgets the details of an event that happened a few years ago or the names of acquaintances they've met in the past. Occasionally, they cannot remember appointments or where they last put items. Some memory glitches happen, like forgetting the day of the week, but they quickly remember with some attention. They are also aware of these changes in memory.
Dementia: A patient cannot recall what happened recently, like where they’ve been after going out or what they ate for breakfast. Their inability to remember details of recent events becomes more frequent. They not only forget the day of the week, they are confused about the date, time, and place, too. And, they seem to “misplace” things all the time and cannot retrace the steps for how they “lost” the items. People with dementia are not readily aware they are having memory problems.
REASONING, JUDGEMENT, AND PROBLEM-SOLVING SKILLS
Normal Aging: As part of normal aging, older people make occasional mistakes with decisions and tasks, but they usually know how to work out a plan to correct the errors.
Dementia: People with dementia will experience increasing difficulty with planning, like being suddenly unsure how to organize a simple meeting. They also increasingly struggle with budgeting, a task that was familiar and easy for them in the past. They handle finances poorly and lose a sense for the value of money. They can spend savings on very unwise purchases and quickly fall for deceiving scammers.
Those with dementia have trouble solving simple math problems, like how much change to expect for a hundred-dollar bill after buying an item costing $21. Following step-by-step instructions from a simple recipe also becomes challenging. They may also have difficulty focusing and take a longer time to accomplish routine tasks than before.
Normal Aging: Patients experience some age-related vision loss such as cataracts, but after correction with glasses or surgery, their perception of distance and color contrasts as well as their ability to recognize images remain intact. They may sometimes say they cannot “find the right words.” Other than that, they do not have problems with speaking or writing.
Dementia: They may also experience age-related changes such as cataracts, but are also frequently are involved in accidents because they could not perceive the depth or distance. For example, they trip and fall when going down stairs because they thought the step was much steeper than it really was. They lose their balance because of wrong visual perception. When they pass by a mirror, they are unable to recognize their own reflection. It won't be a surprise if they ask about the “guest” or unfamiliar person in the house.
Patients with dementia will also have newly experienced problems with speaking or writing. They usually struggle to join or follow a conversation. They may be speaking and suddenly stop, because they have forgotten the topic of conversation. They also have increasing difficulty finding the right words for ordinary things so that they give them new descriptive names, such as calling a ring a “gem for the fingers.”
BEHAVIOR, MOOD, AND PERSONALITY
Normal aging: Older people often develop a specific and strict way of doing things, and they want their system followed every time. If they don't get their way, they can get irritated easily. They sometimes feel tired of work and socialization. They may show frustration with certain things and occasionally feel sad or reflective, but the sullen mood does not linger.
Dementia: Patients with dementia may show signs of mood and personality changes. Those who know the patient personally may comment that their loved one is not their usual self. Patients with Alzheimer's disease, for example, become overly cranky, suspicious, or anxious. At times, they feel depressed or fearful. They withdraw from social interactions and activities. They may not show up for their favorite social events or skip working on hobbies and projects altogether. They prefer not to keep in touch with family and friends. They may also show signs of confusion and their memory loss prevents them from finishing tasks and projects.
Nursing assistants who care for older patients play a big role in observing for changes in older patients’ mental functions. Knowing the difference between normal age-related changes and signs of dementia can significantly help patients receive the proper care.
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