Facing Aging

If you are wondering what this topic of Facing Aging has to do with our trial consulting world, I’ll state right off the bat, not much. Except that, when we’re living with these issues among family and friends, it does impact our lives. It hits very close to home! And, some of the issues impact Melissa and me on a regular basis. But, the point I want to make in this post is that, to me, it seems a better path is to face the realities of aging, and specifically, memory or dementia issues, head on and not avoid them in hopes they will go away or, worse, get better. They won’t. I raise this issue a week after going for another round of cognitive testing with a family member. It was the 3rd test over 4 years and each one after the initial baseline indicated a decline. As I discuss these tests and my efforts to get them done with friends, I have often heard things like, “well, Dad seems to be declining a bit with his memory…” or “Mom asks the same question repeatedly.” To which I respond – the red flags are being waved – get them tested. What do you have to lose? It is not physically painful to do this, though I admit it is emotionally difficult for all. The upside is that, while there is not a cure for dementia, there are treatments that slow the process down just as applying the brakes slow a bus. Without the brakes applied, that bus becomes a runaway bus careening down a mountain. With medication, and perhaps other therapies, the decline slows and a better quality of life is maintained longer. Interesting, in our own experience, my parents’ family doctor did not do, or even want to do, this testing. He knew what he’d find. I’ve heard this same issue from others. But, as I have observed the testing with my parents, I realize what he was missing in his approach. With properly conducted testing, the first assessment creates a baseline. It may or may not indicate a serious issue. Subsequent tests conducted over time indicate the speed of the decline, such that adjustments can be made in care, support, treatment and planning for aging. Is the person living in the right, safe, environment? Is the person capable of making medical, legal, or financial decisions? Is there a need to find caregivers to provide oversight on a regular basis? All of these things become informed decision points when testing is brought into play. If it is your parents, or other loved ones, get it done. Again, what have you got to lose? If you slow down the process, even a little bit, you have done someone, and yourself, a favor.

My friends and I have reached the age when we are facing many maladies, both physical and mental. When various friends of mine lament about their ailments, I remind them that we either get older or we don’t. There are only two alternatives and one is death. With the other, getting older, there exists the possibility that our health will decline. Who among us feels like we felt in our 20s? My dear sister-in-law, Sandy, told me that she feels the same age inside, about 25, as she always has, however, when she looks in the mirror, the person staring back at her is a long way from her 25th birthday! It is a sad, but true, fact of life that many people will succumb to cognitive decline, including one of the several forms of dementia, as they age. This cognitive decline can result from one of several factors, or a combination of factors: (1) heredity; (2) a medical condition, such as Parkinson’s disease; (3) the effects of long term alcohol or other substance abuse; (4) a head injury, such as a concussion; and (5) aging. Dementia takes several forms and no two people experience identical symptoms. For example, my late mother passed away from a form of dementia known as Frontotemporal dementia, commonly called Pick’s Disease. Pick’s Disease is more rare than Alzheimer’s Disease and the symptoms are vastly different between the two types of dementia. One of David’s family members suffers from a hereditary form of dementia that, unfortunately, strikes people in their 50s and 60s and is related to Parkinson’s Disease, while the other family member suffers from age related Alzheimer’s Disease. Although each of our loved ones manifests their cognitive problems in vastly different ways, the common thread among them is that, once they were diagnosed, they were provided treatment that slows their decline and in doing so, provides them with a higher quality of life than they would have had if their disease was left untreated. In my mom’s case, my brother, Frank, told me some disturbing things about her behavior that, when added to my own observations of her personality changes, told me she had dementia (at the age of 86). I rushed her to the memory care clinic in my hometown, Fort Myers, Florida, where we were told Mom was the first patient they had ever had whose family member cared enough to have them tested, diagnosed, and treated at the first sign that something was wrong. (My Ph. D. in psychology has really paid off, in so many ways.) Mom was able to live a happy and full life for several years, declining relatively slowly, until she passed away in her home. David’s family, in contrast, refused to heed my advice, preferring instead to “lock the barn after the horses were out,” thus, delaying necessary treatment until the point that things became wildly out of control. In my opinion, most families adopt the latter, reactive, approach, instead of the former, proactive approach which delays their loved one’s treatment and ensures a more rapid decline. As with many things in life, one can accept reality, take control of the situation, and do something to help someone who can no longer help himself or herself or sit back, do nothing, and watch things get a whole lot worse. The point of this post is, when, not if, you notice cognitive decline in someone you love, do something to help.

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