If your loved one is in their 70s, 80s, or older, you may notice changes in how they think.
Even if they’re healthy, older adults may have subtle changes in thinking or behavior that are a normal part of aging. They may develop mild cognitive impairment or dementia. This can affect their day-to-day life.
One of the most common age-related changes is a small decline in memory. Older people may also experience changes in language and visual perception. These changes usually happen gradually.
Changes may include:
Cognitive slowing. It may take your loved one longer to process details. They may not be able to think quickly. It may be harder to grasp information like a phone number, on the fly. The slowdown may affect their driving and increase their risk of getting in a car accident.
Lower recall. For people over 70, it’s common to have problems recalling information. They may have trouble remembering someone’s name or a specific word, even if they know it. It may feel like it’s on the tip of their tongue. They may recognize the word as soon as they hear it or they may remember it later.
Decline in working memory. Your loved one may find it hard to remember different things at once. This type of processing is called “working memory” and it may decline with age. A slowdown in working memory makes it harder to do things like calculate a restaurant tip in your head.
Attention changes. Your loved one may have trouble paying attention. It may be harder to focus on more than one thing at once, which makes multitasking tricky. This may affect their driving.
Changes in visual perception. It may be harder for your loved one to understand spatial relationships, especially if they’re over 80. They may misjudge the distance from a curb or how to turn the car when they’re parking. If they try to find something they lost, changes in visual perception may make it harder for them to spot it.
A dip in higher-level thinking. It may not be as easy as it used to be for your loved one to think through problems, make good decisions, plan well, or act on their plans. Mental flexibility and decision making, which is called executive functioning, often declines in your 80s. This may put your loved one at risk for becoming a victim of fraud.
Behavior changes. If your loved one has dementia, you may notice changes in behavior like agitation, aggression, psychotic symptoms, or changes in mood. If your loved one has Alzheimer’s, they may experience sundowning. This is a set of challenging behaviors that come up when daytime turns into nighttime. Signs include confusion, anxiety, and mood swings that get worse in the late afternoon and evening. Scientists aren’t sure what causes this, but it may be related to the brain changes that come from Alzheimer’s.
Mental health challenges. As your loved one gets older, they may be at risk for mental health issues. More than 2 million older American adults have depression, which may be triggered by personal loss, chronic illness, lower functioning, or heavy alcohol use. But depression is very treatable. If you notice symptoms of depression for more than 2 weeks, talk to their doctor.
Symptoms of depression include sadness, anxiety, loss of interest in activities, feelings of hopelessness, increased fatigue, trouble concentrating, irritability, thoughts of death or suicide, and changes in sleep, appetite, or weight.
Tips to Manage Challenges
Try these tips for managing these challenges.
- Follow a daily schedule.
- Allow extra time for tasks.
- Be flexible.
- Find activities that match their needs.
- Encourage them to get more sleep.
- Work with your loved one instead of against them.
- Notice what works and what doesn’t, and make changes based on what you find.
- Resist the urge to change them.
- Keep them involved in decision-making.
- Get help from your support network.
- If your loved one needs care but they don’t want help, talk to your loved one’s doctor.
Remember that the need to communicate doesn’t stop if your loved one has cognitive issues. But it can be harder. Your loved one may not be able to function as well when distractions are present. If you need to talk about something important, do it in a place where you can be alone with them. Cut out distractions like the TV or radio. This will help both of you focus better and stay calm.
Being social and active may help your loved one’s cognitive health. Studies suggest that doing things they enjoy, being with friends, and having an active lifestyle may prevent age-related cognitive decline and dementia. It may also help your loved one to feel like they have a purpose in life.
How to Plan for the Future
If your loved one has dementia, it may be harder for them to think clearly as they get older. Try to plan ahead so you can make decisions together and be ready when things change.
Health care planning. Talk to your loved one about advance directives, or legal documents that outline their preferences, like a living will and durable power of attorney for health care.
Your loved one may decide what to do if something happens to them. They may want medical orders like a DNI (do not intubate) or DNR (do not resuscitate) order. They may decide to be an organ, tissue, or brain donor.
Long-term care planning. Your loved one may need more care if they continue to decline. If they have Alzheimer’s or dementia, they may need long-term care in their home or at a nursing home or assisted living facility.
Talk to your loved one’s doctor about options. You can also get help from a geriatric care manager.
Financial planning. Talk to your lawyer about preparing directives for your loved one’s financial preferences and decisions. This may include a will, durable power of attorney for finances, and living trust.
Stay organized. Keep your paperwork in one place. Share the location with a family member. If things change, remember to update the paperwork.
Make copies of everything and share them with their doctors. Ask your loved one to give their lawyer or doctor permission to talk directly with you.
Start talking openly with your loved one. Do it early. It’s best to do it before symptoms get worse.
Photo Credit: Tara Moore / Getty Images
Clinics in Geriatric Medicine: “Normal Cognitive Aging.”
CDC: “The State of Mental Health and Aging in America.”
Dana Foundation: “Cognitive Skills and the Aging Brain: What to Expect.”
Mayo Clinic: “Caring for the elderly: Dealing with resistance.”
Morningside Ministries: “Family Caregiver Guide: Caring for a Senior at Home.”
NIH: “Planning for the Future After a Dementia Diagnosis.”