How should I approach having my parent screened for early Alzheimer's?
Question: For years my Dad and mother have had a ritual of an evening “happy hour.” Dad always makes mom a martini, but lately he is making mistakes. He puts in tonic water. He gets the proportions wrong. My mom makes a face and asks, “What did you put in this?” and he gets all defensive. He’s been slipping up on many small things recently, and this is too big to ignore. Could this be early Alzheimer’s?
I am a terrible mixologist and my imbibing is generally limited to red wine (good for the brain!), but it sounds like your father has had his martini recipe down for years.
I do think your concerns are valid.
Whether it’s making a martini or tending the garden, making mistakes while doing something one has done for many years is a perfect example of an Alzheimer’s-like symptom or behavior.
A good evaluation by a neurologist will give you some answers. A good evaluation typically includes blood work, a brain scan and a thorough neurological exam. Sometimes the physician will order a neuropsychological exam, which tests your dad’s memory, thinking and judgment. A common task during a neuropsychological test might include naming as many animals as he can in 30 seconds, drawing abstract objects, or word recall tests. We know enough about Alzheimer’s disease and the other dementias to be highly confident of our diagnoses.
But it sounds like getting him there might be tricky. One option might be for you or your mother to call his regular doctor and share your concerns privately. Responding to a request from his doctor keeps your dad in control and doesn’t set you up as the “bad guy”.
A well-groomed, reasonably with-it person can easily “pass” a short appointment. To urge the doctor to go deeper, follow up your phone conversation with a letter detailing recent incidents. Bounced checks, getting lost, forgetting the martini recipe—put any incidents of concern down on paper.
Once you are at the physician’s office, be sure to stay with your dad for the examination. That way you can hear the doctor’s recommendations and get a first-hand report. If you stay in the waiting you’re your dad may come out and report that all is well! He may not have understood the doctor’s message or have forgotten key parts of the conversation.
Hopefully the physician will discover a reversible issue, such as a B-12 deficiency, a medication issue, or depression. If it is Alzheimer’s disease, consider the dementia medications and focus on keeping your dad as active and engaged as possible.
Some research suggests that a little bit of alcohol is good for the brain, whether it be red wine or the daily martini. Let him continue to be the official bartender, with a bit of assistance from you or your mother to help him maintain this enjoyable past ritual. If his dementia worsens, you may want to consider switching to non-alcoholic beverages or encouraging dad to adopt a healthier, simpler ritual, like making a pot of sensory rich, comforting, and enjoyable herbal tea.