For those who suspect dementia or Mild Cognitive Impairment in themselves or a loved one, many are in need of resources, services, and strategies to address their needs. Recommendations, including clinical needs, safety needs, and resources and services available specifically in Central Texas, are detailed below.
Clinical/ Medical Services:
- Establish and maintain care with a neurologist.
- If indicated, seek out a neuropsychological assessment. Some insurance plans require a physician’s referral for this.
- If concern is present about driving safety, a driving evaluation such as that offered by the St. David’s Adaptive Driving Program in Austin can be very useful, including recommendations about under what circumstances driving is safe. This service requires a physician’s referral.
- If depression, anxiety, or other mental health concerns are present, seek out psychotherapy and / or psychiatry consultation. Depression and anxiety can cause distractibility, forgetfulness and “mental fog;” treating these adequately may help improve attention span and memory, as well as assist with coping with changes related to aging.
- When significant snoring, sleep apneas, restless sleep, excessive daytime sleepiness, and other sleep changes are observed, a sleep study may be sought. Untreated sleep disorders can affect cognitive health.
- When hearing impairment is suspected, audiology evaluation should be sought. Hearing impairment, if left untreated, can contribute to cognitive decline.
Safety and Behavioral Health Needs:
- When concerns about safety of advanced activities of daily living arise (including medical management, medication administration, transportation, and financial management), supervision is recommended on at least a periodic basis (and more assistance may be needed over time).
- If the person is still driving, ride with them to observe their ability.
- Check that bills are on autopay, and supervise bill-pay periodically.
- Watch for signs of victimization due to scams/ fraud.
- Ensure that medical needs are being addressed, and that they are making and keeping medical appointments.
- Ensure that medications are placed in a weekly pill strip, loaded accurately into the pill strip, and taken as prescribed, without missed doses.
- Medications that can affect cognitive functioning include Benzodiazepines (which treat conditions including anxiety, sleep impairment, and seizure disorders), Anticholinergics (which treat conditions including urinary incontinence, motion sickness, and asthma), Antihistamines (which treat allergies), Opioids (which treat pain), and Proton pump inhibitors (which treat gastroesophageal reflux). Please use caution with these medications and use them only under the direction of a physician who understands your health history and cognitive risk factors or diagnosis well.
- Research findings suggest the following, to promote optimal cognitive functioning: maintaining healthy weight, cholesterol, and blood pressure; following a diet that promotes a healthy heart including a full complement of fruits, leafy green vegetables and other vegetables, whole grains, foods containing antioxidants, lean protein, limiting red meat and processed meat, no more than one serving of alcohol per day, limiting fast food/ processed food and fried food, and limiting pastries and sweets; regular exercise (daily if possible); a strong and vibrant social network; a focus on harm and risk avoidance; reduction of anxiety; engagement in relaxing activities that bring joy; reduction of negative social interactions; and engagement in stimulating social and cognitive activities (in the community whenever possible) on a regular basis.
Home and Community Resources:
- AGE of Central Texas is an excellent resource for those concerned with cognitive decline, in themselves or a family member. Services include adult day care, caregiver resources and education, early memory loss support, health equipment lending, and peer-based computer classes, as well as a published newsletter. Offices are in Austin and Round Rock, TX. For more information, please see: http://www.ageofcentraltx.org/.
- The following books may be useful:
- The Memory Book: The Classic Guide to Improving Your Memory at Work, at School, and at Play, by Lorayne and Lucas
- Living with Mild Cognitive Impairment: A Guide to Maximizing Brain Health and Reducing Risk of Dementia, by Anderson, Murphy, and Troyer
- Coping with Mild Cognitive Impairment (Mild Cognitive Impairment), by Jordan
- The Complete Family Guide to Dementia: Everything You Need to Know to Help Your Parent and Yourself, by Harrison and Forester
- The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease and Other Dementias, by Mace & Rabins
- The Anxiety and Worry Workbook: The Cognitive Behavioral Solution, by David Clark and Aaron Beck
- Mind Over Mood (Second Edition), Change the Way You Feel by Changing the Way You Think, by Dennis Greenberger, Ph.D., and Christine Padesky, Ph.D.
- Feeling Good: The New Mood Therapy, by Burns
- Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence – A Hazelden Guidebook, by Colleran and Jay
- Social and special interest opportunities may be needed for improvement of quality of life, such as the following:
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
- University of Texas at Austin Osher Lifelong Learning Institute: https://olli.utexas.edu/about
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
- University of Texas at Austin Osher Lifelong Learning Institute: https://olli.utexas.edu/about
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
- University of Texas at Austin Osher Lifelong Learning Institute: https://olli.utexas.edu/about
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
- University of Texas at Austin Osher Lifelong Learning Institute: https://olli.utexas.edu/about
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
- University of Texas at Austin Osher Lifelong Learning Institute: https://olli.utexas.edu/about
- Austintexas.gov, Austin Senior Services Hub: https://www.austintexas.gov/page/austin-senior-services-hub#:~:text=The%20Austin%20Senior%20Services%20Hub,and%20engaging%20senior%20living%20activities.
If you are concerned about cognitive decline in yourself or a loved one, you may want to explore additional posts on my Neuronews Blog. If you are interested in assessment for cognitive decline or dementia, you can learn more on my page about, Neuropsychological Assessment. Please feel free to contact me from that page or by email at amy@amyblackmonphd.com.