Seven Keys to Identifying Dementia in Your Senior Clientby Johanna “Jo” Booy
As a Medical Exercise Specialist (MES), you may be one of the first to notice and report cognitive decline in the senior with whom you work with on a regular basis. A family member or those very close to your senior client may not recognize the decline as it is often very gradual. In identifying areas of concern, you as an MES will also be able to assist your senior in arranging the help they need to avoid further decline and to help family members to know who to turn to in your community.
But first of all, here are the seven (7) most common symptoms which will assist you in identifying memory loss or cognitive decline in your senior client.
1. Memory Loss & Forgetfulness
Have you explained a set of exercise protocols and given instructions that your senior is simply not grasping? Memory loss and the ability to store a set of complex instructions may be very difficult. They may also not be able to recall where a piece of equipment is or the correlation between the piece of equipment and its use or function. Confusion can increase memory loss and your client will feel helpless.
2. Getting Lost in Familiar Surroundings
Have you found your client losing themselves in the familiar surroundings of your gym? Often they will wander aimlessly and not be able to connect to the activity at hand. Either they will sit and wait it out or bolt. This is a very serious problem, as many seniors do bolt when confused and then find themselves in a bigger predicament because they can’t recall where they were when they left their familiar surroundings or where they live.
3. Unusual Behaviour
Your client has always been very communicative and comfortable in your presence, but you start to notice increased anxiety perhaps about how they are going to get home, how much
longer they need to exercise, and whether they can afford coming any longer. Fear, anxiety, agitation and suspiciousness, are all very clear traits of an individual in cognitive decline. You may notice great shifts in mood and personality.
4. Speech and Word-finding Problems
This is a very common problem, in that the words that your client will be stumbling to find won’t come and they may cover their embarrassment with a joke. However, if you find that this is happening more often, do keep track and mention to a family member or spouse.
5. Living in the Past
Your client will often revert to stories of their younger years and repeat themselves frequently.Even when you are conversing with your senior in the present tense, they may lapse into a story of the past to counter yours. This repetitive ‘living in the past’ style of communication is quite indicative of cognitive decline.
You many be able to relate to this as well, however your senior client will not enjoy change and will tell you so. They won’t like equipment moved to another location, a different person at the desk, or having their trainer replaced. Change irritates them and they will show impatience and will even be more likely to quit the program due to changes that they simply cannot process.
7. Gait Pattern & Posture Changes
Shuffling steps, lack of balance and stooping are all very indicative of decline in cognitive function but usually occur in a more advanced dementia. Especially noticeable will be the shuffling ambulation pattern. You may find your senior tripping more often, or having trouble with maintaining balance. Your senior is at great risk for a fall which may lead to a fracture.
What to do when you notice these symptoms? Check out your suspicions with the supervisor at your health centre or fitness facility. They may have been told by a family member that there are indicators. Carefully discuss your findings with a family member. There are community support agencies in most areas that are affiliated with your health region. Home and Community Care may have a nurse that can perform an assessment. There are tests that can be performed by a professional to assess at what level your senior is for loss of memory or cognitive decline.
Most important, be very supportive to your client. Any agitation or confusion is elevated by increased instruction that they simply do not comprehend, or any lack of patience on your part. An individual demonstrating memory loss and dementia is highly likely to mirror your mood and your attitude. Be patient and smile, take a break, and make light of the situation – humor works very well and helps to lighten any situation and keep your client’s dignity intact.
You may reach Jo at Jo.Booy@shaw.ca