Memory Loss
As we age, some of us become more forgetful or have more difficulty remembering things. These changes are usually signs of mild forgetfulness, not major memory problems. But because memory loss is not an inevitable part of getting older, it's important to differentiate between what's normal when it comes to memory loss and when it is not. The first step to staying mentally sharp is to understand the difference between typical forgetfulness and serious memory problems.
Difference between short term and long term memory loss
There are differences between short-term memory and long-term memory as we function day-to-day and as we age. Short-term memory differs from long-term memory in the following ways:
- Short-term memory has a somewhat limited capacity and can hold information for only short periods of time while long-term memory can store unlimited amounts of information limitlessly. The more that short-term memory information is employed or repeated, the more probable it is to become part of the long-term memory.
- People must relearn items continuously to keep them in the short-term memory vault, but the long-term memory is relatively passive and is not easily distracted by interruption.
- Short-term memory and long-term memory are different in the way forgetting happens. The way short-term memory works is if information is not rehearsed or processed immediately, then the memory fades rapidly and the item is permanently lost. In contrast, the way long-term memory works is if information is permanently recorded then the ability to retrieve it depends on an appropriate trigger.
- Short-term memory and long-term memory are managed by different parts of the brain. Short-term memory is mainly a function of the frontal lobe of the cerebral cortex. In contrast, information stored in long-term memory is first held in the hippocampus and then transferred to the areas of the cerebral cortex involved in language and perception for permanent storage.
What is normal memory loss for older adults?
Forgetfulness is a common condition among older adults. You start to talk about a television show you watched recently when you realize you can’t remember the name. You’re talking with someone and lose your train of thought. You walk into the kitchen only to forget why you went in there in the first place.
Lapses in memory can be annoying, but most of the time they aren’t a reason to be concerned. Age-related changes in memory are not the equivalent of dementia.
Signs and symptoms of memory loss
The word "dementia" is a term used to describe a set of symptoms, including memory impairment, diminished reasoning or judgment and other cognitive skills. Dementia begins gradually in the majority of cases, deteriorates over time and significantly impairs a person's capabilities to communicate and rationalize.
Frequently, memory loss is one of the first or more-recognizable signs of dementia. Other early signs may include:
- Asking the same questions over and over
- Forgetting common words when communicating
- Mixing words up
- Taking longer to accomplish familiar tasks, such as following a recipe
- Misplacing things in inappropriate places
- Getting lost while walking a familiar route or driving around a known neighborhood
- Experiencing sudden changes in mood or behavior for no obvious reason
- Becoming less adept at following directions
When to seek help
Cognitive and memory impairments can change how a person thinks, acts and feels. These changes often present a unique set of circumstances for families and caregivers. For example, an ordinary conversation can be quite trying when your loved one has difficulty remembering from one instant to the next what has been said.
Individuals with moderate to severe memory loss or another cognitive impairment often require special care, including 24-hour supervision, specific communication techniques and management of difficult behavior. They may also need help with activities of daily living, such as eating, bathing, moving from the bed to a chair, medication management and administration, going to the restroom or other personal care.
Individuals with cognitive impairment may experience a variety of behavioral problems that can be challenging for caregivers. These might include verbal communication difficulties, repetition, aggressive or impulsive behaviors, paranoia, fatigue, forgetfulness, incontinence, poor judgment, the frequent need to wander, exit seeking behavior and sundowning. The word "sundowning" refers to a state of confusion towards the end of the day and into the evening. Sundowning is not a disease, but a collection of symptoms that occur at a specific time of day or night that affects people with dementia, such as Alzheimer's disease.
Some people may develop behavioral problems early on, while others go their entire illness with only minor complaints. Most cognitively-impaired people tend to have a little of both consisting of good days and bad days. It is important for caregivers to anticipate that there will be ups and downs and to maintain patience and compassion. If a caregiver is prepared for these symptoms, it will help them cope more effectively with difficult behavior. It’s important to remember that it’s the disease, not the person, causing the behavior.
Helpful suggestions for managing these problems include communication techniques, such as keeping words simple and straightforward and asking one question at a time.
If your loved one begins to wander, has impaired judgment or experiences the effects of sundowning that may signal the need for 24-hour supervision.
It is important to remember that not all residential care homes have night staff or what is referred to as an “awake staff” so be sure to clarify if this service is offered or not. Additionally, assisted living facilities are not licensed to provide an awake staff unless the family hires a private caregiver to come into the facility. Memory care facilities have 24/7 staff including which typically includes an awake staff. Assisted living facilities and nursing homes may not be appropriate models for those with advanced memory loss or dementia as they may not equipped with an awake staff.
