7 Signs Of Early Alzheimer's In Your Loved Ones And What To Do

When we think of dementia, what usually comes to mind is someone sitting in a room, not knowing where they are, nor the identity of any of their visitors. We have probably watched movies featuring dementia patients, such as Julianne Moore in Still Alice or Meryl Streep as former British Prime Minister Margaret Thatcher, portraying her mental decline from dementia in The Iron Lady.

In Singapore, dementia is an illness that affects one in 10 people above the age of 60. In 2018, this number was 82,000 but will grow to 152,000 by 2030. Alzheimer's disease is the most common form of dementia. This happens when your brain's nerve cells are destroyed and your brain substance shrinks. While there is no known cause of Alzheimer's, it is believed to be a combination of genes and lifestyle factors. And, because Alzheimer's is a progressive disease, it gradually worsens over time.

Christina Loh, head of nursing at Allium Healthcare, explains that typically, Alzheimer's begins with changes in the part of the brain that affects learning. As the disease progresses through the brain, it can cause increasingly severe symptoms including disorientation, mood and behaviour changes, confusion about events, time and place, unfounded suspicions about family, friends and caregivers, serious memory loss and behaviour changes, and difficulty speaking, swallowing and walking.

“It can be challenging for individuals experiencing memory loss or other potential signs of Alzheimer's to recognise that they have a problem,” she adds. “However, dementia symptoms may be more apparent to family members or friends.”

The early signs

If you're concerned about your loved ones developing Alzheimer's, here are some early signs you can look out for:

Memory loss

This is one of the primary indicators of Alzheimer's disease. In the early stages, this manifests as memory loss that affects daily life, such as forgetting newly-acquired information, important dates or events, and repetitive questioning.

“As the disease progresses, individuals may increasingly rely on memory aids or assistance from loved ones for tasks they were once able to manage independently. It is normal to sometimes forget names or appointments as we age, but usually, we can recall them later,” says Christina.

Difficulty with familiar tasks

If you've found your loved ones struggling to drive to a familiar location, organising a grocery list, or remembering the rules of a favourite game, it could be an early sign of Alzheimer's.

Language problems

Christina explains that as expressive and receptive language skills decline, your loved ones might have difficulties finding words, are repeating phrases, or losing track of conversations. They could also have difficulties in communication, whether in speaking or writing.

“They may experience challenges in participating or following a conversation and may suddenly stop without knowing how to continue,” she shares. “Additionally, they may find it difficult to recall certain words, struggle with vocabulary or use incorrect names for familiar objects, such as referring to a watch as a 'hand-clock'.”

Disorientation

Your loved ones could experience confusion regarding time and place. For example, they may find it difficult to track dates, seasons and the passages of time. They may even forget their current location or how they arrived there. While we could get confused about what day of the week it is when we get older, individuals with dementia may have more difficulty figuring it out later.

Poor judgement

Some early signs of Alzheimer's include poor judgement when managing money or neglecting their personal hygiene. They could also have uncharacteristic lapses in decision-making, make irrational choices or have poor financial management.

Misplacing items

Sure, it's normal to forget where we've kept important items sometimes but if this is happening to your loved one more frequently, it may be an early dementia symptom especially if they're unable to retrace their steps to locate them. As the disease progresses, they may even begin to accuse others of theft, says Christina.

Changes in mood and personality

This includes mood swings, heightened anxiety, irritability and withdrawal from social interactions, due to neurological changes. Your loved one could also get upset in familiar surroundings – when with friends, for example – or when they are out of their comfort zone.

Preparing for what comes next

Some of these symptoms may sound like things you expect your parents to do as they get older. However, if these signs are unusual and persistent, you should consult a doctor.

“Arrange for a comprehensive assessment to determine whether these symptoms are indicative of Alzheimer's disease or other related conditions,” Christina advises. “Early detection can facilitate better management and planning for the future.

“You may consider contacting hospitals or nursing homes that provide Alzheimer’s or dementia care, such as Allium Healthcare, as they typically offer integrated care plans that support the unique needs of each individual. This approach may prove to be beneficial and effective in addressing the situation in a holistic and integrative manner,” she adds.

It's also important that you are prepared for what will happen in the future. You might be faced with challenges you won't be able to handle so you need to be aware of what the next stages of Alzheimer's entail. Challenges may include an increased dependence on others for essential activities like bathing, dressing and eating, or dealing with behavioural changes such as agitation and aggression.

Also, verbal communication may become more complex, making non-verbal cues and gestures more important for understanding their needs and emotions. Plus, there could be safety concerns such as your loved one wandering off, so you need to prepare for heightened vigilance and preventive measures.

Christina warns that, in advanced stages, individuals may become bedridden and require round-the-clock care, which may require transitioning to a specialised care facility.

“It is also recommended that you start discussions early with your loved one so they can be involved in decision-making,” she says. “And obtain permission in advance to talk to their doctor or lawyer, if needed, to get necessary information about care, bills or health insurance claims.

“Legal and financial matters, in-home care options, long-term care and funeral and burial arrangements should also be considered. Learning about your loved one's disease will help you anticipate what to expect as the dementia progresses and how you can best support them,” she adds.

Tips for dealing with early Alzheimer's

As a caregiver, you should educate yourself to ensure that you're able to provide the best possible care for your loved one while also taking care of your own well-being. Get a comprehensive understanding of the disease and the different stages involved, as well as the various caregiving techniques that can be utilised. You'll be better prepared to deliver high-quality care for your loved one while also taking care of yourself, says Christina.

She shares other tips such as establishing a routine as having a structured daily routine can offer a valuable sense of predictability that may assist in reducing feelings of anxiety and confusion. It's also crucial to approach the situation with patience and understanding.

“Keep in mind that any challenges they may face are a result of their illness and not a deliberate action on their part,” Christina says. “Before you react, take a moment to consider your response and ensure that your non-verbal cues are consistent with your message. To effectively communicate, start by engaging their visual senses and then proceed with a verbal message, followed by a comforting touch.”

You also need to look after yourself, as prioritising your own well-being is crucial when caring for someone living with Alzheimer's. Practising self-care, seeking support networks and considering respite care are all important steps in ensuring that you can provide the best care possible.

“Caring for someone with dementia can be a challenging responsibility, and if you're feeling emotionally or physically drained, it can be difficult to provide the care your loved one needs. Taking time for yourself is not selfish – it's essential for maintaining your own health and well-being,” says Christina.

Singapore has an initiative of identifying dementia go-to-points (GTPs) – these are 'safe return' points in the community, where you can bring someone who appears lost and is unable to identify themselves or where they live. These GTPs are equipped with staff who are able to reunite these individuals with their caregivers and also serve as resource centres for information on dementia. Allium Healthcare is officially registered as a GTP.

For dementia caregiving resources, please visit Dementia Singapore or Dementia Hub.