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We all forget things sometimes. You might walk into a room and forget why you went there, struggle to remember someone's name, or spend ten minutes looking for your glasses only to realise they're on your head. And as our parents, grandparents or partners get older, it's natural to notice little changes in their memory too. But there may come a point when you find yourself wondering:
“Is this just a normal part of them getting older, or should we be worried about it?’
It can be difficult to know the difference, particularly when changes happen gradually. Often, it is actually a family member who notices first and it is probably a family member reading this right now!
The reassuring thing to remember is that being forgetful does not automatically mean that someone has dementia. There are many reasons why memory can change, and some are treatable. However, there are certain changes that are worth paying closer attention to.
What sort of forgetfulness can happen as we get older?
Some changes in memory can happen with normal aging. Someone might occasionally:
- Forget a name but remember it later
- Misplace their keys or glasses
- Forget why they walked into a room
- Need a little longer to remember something
- Forget an appointment occasionally
- Need to write more things down than they used to
The important thing isn't necessarily that someone has forgotten something. It is the pattern of change that matters. If your mum, for example, has misplaced her glasses for the last 30 years, for example, that probably tells you much less than if she has recently started forgetting things she would previously have remembered easily.
So that makes you think, when might memory changes be worth checking?
Well, firstly, you know your family member. Sometimes the first sign that something has changed isn't a dramatic memory ‘problem’. It is simply a feeling that they don't seem quite as ‘sharp’ as they used to be. You may notice that they are asking the same question several times without remembering the answer, forgetting conversations that happened recently, missing appointments more frequently, struggling with things they previously managed easily like bills or medication, becoming confused about dates or times (or more generally). It may not even be things that seem obviously linked to changing memory, like struggling to find the right words or becoming noticeably more withdrawn, anxious or different in their behaviour.
It is important to know that these changes do not automatically mean that someone has dementia. However, if they are happening regularly, getting worse, or beginning to affect everyday life, it is sensible to investigate why.
Transparently, when people enquire about an assessment, we hear all the time “but their long-term memory is amazing”. This can be particularly confusing for families. You might notice that Dad can tell you exactly what happened on a family holiday 30 years ago, but cannot remember something you told him yesterday. That doesn't necessarily mean that there isn't a memory problem.
Different types of memory can be affected differently. In some conditions affecting memory, recent conversations and events can become harder to remember while much older memories remain very clear. So rather than asking, “Can they remember things?”, it can be more useful to ask “Has the way they remember things changed?”
Memory problems don't always mean dementia, this is really important to remember. When families notice memory changes, it is easy for their thoughts to jump immediately to dementia or Alzheimer's disease. But memory and concentration can be affected by many different things. These can include stress, anxiety or depression, poor sleep, certain medications and physical health problems. A trained clinician may therefore look at someone's wider health as well as their memory.
This is one reason why it can be helpful to have memory problems properly assessed rather than trying to work out the cause yourself.
If you are worried about memory concerns, but not ready to commit to a full assessment, you can start with a free Memory Screening with us. Begin with our short eligibility form and a member of our team will contact you to follow up.
But what actually is dementia?
If you have heard the word but aren't completely sure what it means, you are certainly not alone. Dementia isn't simply another word for forgetfulness. It is a term used for a group of symptoms caused by conditions that affect how the brain works. Memory can be affected, but people can also experience changes in things such as thinking, concentration, language, planning and their ability to manage everyday activities.
Alzheimer's disease is one possible cause of dementia, but the two words do not mean exactly the same thing. Most importantly, dementia is not considered a normal part of getting older.
A useful question our consultant, Dr Martine Stoffels, asks is, is it affecting everyday life?
One of the most helpful things for families to consider is whether the changes are starting to interfere with everyday life. For example, forgetting where you left your keys occasionally is very different from regularly putting everyday objects in unusual places and being unable to work out where they are. Forgetting the date for a moment is different from regularly becoming confused about what day, month or year it is. And occasionally forgetting someone's name is different from increasingly struggling to follow familiar conversations or find everyday words.
It is often the frequency, progression and impact of the changes that makes them worth investigating.
What if I'm noticing changes but my family member isn't?
This is very common. You may spend more time observing changes than the person experiencing them. They may also put them down to getting older, feel embarrassed about them, or simply not be particularly concerned. Try not to start the conversation with: “Your memory has got really bad.” Instead, you could say something like: “I've noticed you've been having a bit more trouble remembering things recently. It might be nothing, but I'd feel better if we got it checked.”
Keeping the conversation focused on checking their memory and general health can feel much less frightening than trying to decide what the cause is yourselves. It can also be helpful for a family member to attend an appointment with them. You may have noticed changes that they haven't, and you can help explain when they started and whether they have become more noticeable.
What happens when memory problems are assessed?
A memory assessment isn't simply a test that someone either “passes” or “fails”. A clinician will usually want to understand the bigger picture. That can include what changes have been noticed, when they started, someone's medical history, medication, mood and general health, as well as how they are managing everyday life. There may also be assessments of memory and thinking, and sometimes further investigations are recommended.
The aim is to understand why the changes may be happening, rather than assuming that every memory problem has the same cause.
To find out more about what you can expect from a memory assessment, visit our Memory Assessment Service page.
When should we ask for help?
You do not have to wait until someone's memory problems become severe before asking for advice. Your GP is usually the best place to start. Consider making an appointment if the changes are becoming more frequent, other family members have noticed them too, they appear to be getting worse, they are affecting everyday tasks, or you are noticing changes in thinking, communication or behaviour as well as memory. Or, quite simply, if you are worried - that is a valid reason to ask for help.
Why getting memory problems checked sooner can matter
It can be tempting to wait and see, particularly if the changes are still quite small. However, there are good reasons not to put off seeking advice if you have genuine concerns. Firstly, memory problems do not always mean dementia. There are other possible causes of changes in memory and thinking, some of which may be treatable.
If dementia is the cause, getting an accurate diagnosis at an earlier stage can also help the person and their family understand what is happening, access appropriate treatment and support, and have more time to make decisions and plan for the future.
For many families, the GP and NHS memory service will be the right route. However, some people also consider a private memory assessment, particularly if they would like to investigate their concerns sooner. We recognise that private healthcare can be expensive, and committing to a full memory assessment can feel like a very big decision when you don't yet know whether one is necessary.
That is why, at Phoenix Mental Health Services, we don't ask families to commit to a full private assessment straight away. Our first screening appointment is completely free. Initially, you, or a family member supporting you, can complete a short eligibility form. This gives our team some initial information about the memory changes you have noticed and helps us establish whether our Memory Clinic may be appropriate.
If appropriate, you will then have a free remote video appointment with one of our therapists. During this appointment, we complete an initial memory screening using a recognised cognitive screening tool also used within NHS services. There is no charge for this appointment and no obligation to proceed with a private assessment afterwards.
The purpose is to help us understand your concerns, carry out an initial screen and consider whether a more comprehensive memory assessment may be appropriate. If it isn't, we will tell you.
And if we think further assessment would be worthwhile, we can explain what this involves, what it costs and what you can expect, so that you and your family can make an informed decision about what you would like to do next.
If you would like more information, contact us here or visit our Memory Assessment Service page.
To get started now complete our short eligibility form and a member of our team will be in touch.