In my line of work, I encounter many families who are concerns that their loved one has suddenly become impaired and may be showing signs of dementia. One of the most common times that this happens is when the whole family gets together for the holidays. In reality, the person in question most likely has not suddenly developed impairment. Rather, they have been declining subtly over time, but they aren’t in situations that highlight the impairment often enough for the family to take notice of the changes that have happened. The holiday season tends to draw out signs of impairment for a variety of reasons. For one, the holidays can be complicated. Between travel, arriving on time, and lugging gifts around, there are many opportunities to get confused. Holidays can also be busy, which means more noise, more people in the environment, and more conversation. If you have an aging loved one in your life, the holidays are an important time to keep an eye out for signs of dementia. Here are five signs to watch out for:

They Seem Out of It

One of the first things that is looked at when assessing someone for a dementia condition is called orientation. Orientation simply refers to your awareness of yourself, your environment, the time, and the situation. It is normal for a person who is retired to care a little bit less about the date, but if your loved one is confused about why there are so many people gathered, that may be a sign that they are unaware of (or forgot about) the holiday. Keep an ear out for any conversations that your loved one takes part in that involve current events. Do they seem aware of recent news such as political scandals or natural disasters? If they generally seem to be in a haze and answer questions in a very general manner (or are less responsive in general) this would be something to keep an eye on.

They Don’t Use Names

When considering if someone has started to decline in their thinking abilities, it is important to think of what may suggest a change from their previous level of functioning. I have never been good at remembering names. There were some quarters teaching college classes where I probably only remembered 15% of the names in class. Therefore, it would not be unusual for me to also be bad at names when I become an elder. However, if your loved one is somebody who has always had a sharp memory for names of family members, spouses, and family friends, but you find that they are now seeming to avoid using names, it may be cause for concern. Often it is not as obvious as the person using an incorrect name for a very close family member (although that would be quite concerning). Rather, they may avoid using names entirely when there are more extended family members, spouses, or grandchildren. Instead of greeting by name, they might say, “Oh hey, you! Good to see you again.” You may also hear them use other terms for people whose name they can’t remember. For example, they might say, “So where is the… uh… the little one?”

They Don’t Remember Recent Events

During conversations at family gatherings, it’s common to talk about other recent occurrences such as birthdays or vacations. One major telltale sign to watch out for is your loved one forgetting that they have recently seen someone. A person who is beginning to develop memory issues might express excitement at seeing a family member and say that it has been a long time when in reality they visited with them within the month. Likewise, if there was an important event such as a milestone anniversary, birthday, or graduation, they should have some awareness of it. During early memory loss, it would be typical for the person to remember the recent event when they are given a little hint or once someone starts reminding them of the details. As memory loss gets more significant, they may have no awareness of the event.

They Are More Irritated or Agitated

This is another factor where we are looking for change from a previous style. Some people are grumpy and irritable throughout their life and that’s fine. There are also some changes that can happen with aging and certain dementia conditions that make people less patient and more irritable. Watch for your loved one’s interactions with family children, waiters at restaurants, and their behavior while in the car (especially in traffic). If they are reacting in ways that seem over the top to you, based on their typical behavior, you may be seeing a legitimate issue caused by changes in their brain. When dementia conditions affect the frontal lobe of the brain, they can impact someone’s abilities to make good decisions and their ability to hold back inappropriate behaviors. If your loved one makes off color jokes around kids or comments on things they should be keeping to themselves, that may be a sign of change. These sorts of changes in behavior can happen before memory impairment takes place, so they may seem otherwise normal.

They Are Less Social

One of the most common changes that someone in the early stages of dementia will develop is decreased interest in socializing. There are various factors that can play into this. Sometimes hearing is an issue. As someone starts to become hard of hearing, it makes it more difficult to keep up in conversation. Even with hearing aids, when there are multiple speakers in the same setting, the person might just shut down and not meaningfully participate in the conversation. There are a couple other factors that compound this issue as well. Many neurological issues can cause a decrease in processing speed, which is basically just how quick someone is to think and respond. Disorders such as Alzheimer’s disease also impact someone’s ability to fully process and comprehend language in the same way. If you see a normally social loved one sitting off to the side or nodding without adding in their own responses to a conversation, you should pay attention to how they seem to be processing language in other, less busy settings as well.

When in Doubt, Get Checked Out!

These are just a few of the most common signs of dementia that you might encounter in your loved ones over the holidays. None of these issues are enough to diagnose a dementia condition. Rather, they should be a starting point for getting your loved one assessed. Keep a notebook of any issues that are concerning you and bring those to their doctor. If you’d like more information about the assessment process, please see our recent blog post detailing exactly how it happens.

If you’d like to learn more about the difference between dementia and normal aging, please consider reading our new book! We wrote it as a straightforward guide for families and loved ones.