Hi Debbie.

Yes, those certainly are some of the early signs.   There are some causes of
memory problems that are reversible.   Some are not, and will continue to
get worse.

Only a full gerontological workup will show whether she is suffering from
something as minor as a thyroid deficiency, or a reversible problem such as
Normal Pressure Hydrocephalus, or something like actual alzheimer disease.

I wish I could offer you some better advice about how to handle things at
this stage of the game.   I always say that the very beginning is the
absolute worst, because the person is still used to being independent, and
to take offense at the possibility that anything could be wrong.   Yet you
know very well that what you are seeing isn't right, and you are getting
concerned for good reason.

Unfortunately if your mother doesn't want to take you into her confidence,
or to get properly tested by her doctor to find out what is wrong, you may
need to wait till things get worse before you can do anything else.

Did you tell the doctor what you've told us?  He may not comply, but the
least you can do is to give him all this information and *request* that
he give her a full examination with emphasis on your concerns.  That
*might* open the logjam.

Blessed be,
Baird

What you are seeing are red flags.

The loss of ability to understand sequences is very common early in
AD. In other words, your mom is very likely losing her grasp on the
concept that 1 comes before 2, that Wednesday is after Tuesday, that
February happens after January and before March.

This translates into all kinds of practical day to day problems for
the person, and its very, very hard for a person with an intact brain
to understand that the person with the dementia really can't
understand sequences.

I'm willing to bet she's having a huge struggle understanding finances
(i.e. doing basic calculations and estimates, knowing if she's getting
the right change, or if the money in her purse is enough to cover the
groceries in the basket).

She probably has a very hard time reading a calendar (i.e. if you show
her today's date on a calender, ask her to show you where tomorrow is,
or where a week from today is). You likely would be shocked by asking
her some very specific questions like that. She may not really "get"
that 2 pm is before 3 pm - or be able to figure out that if its 2 pm,
and her daughter is coming in 2 hours, that means said daughter is
coming at 4.

For my mother in law, this meant that if she had an appointment, even
if she did get the right date and know the time, she couldn't figure
out when to get ready. If the cab is coming for you at 3, when should
you start getting dressed to go?

Her ability to produce the lovely dinners she was famous for was
impacted early by the sequence issue -she couldn't figure out how to
make everything ready at the same time, or in series for various
courses. When this first started to emerge, it was very subtle, but
became more pronounced with time. It was actually one of the very
first things I noticed - that the table wasn't completely set, that
she'd forgotten the rolls, that the vegetables were done when meat
still had an hour to go, that the pie was still baking when it was
time to eat it etc. etc. At the time, we thought it was from another
medical problem she had (B12 issues).

At the same time as people with AD lose the understanding of
numbers....they also lose a feel for the passage of time - probably
because of the short term memory impairment. They don't know what 2
hours feels like - i.e. Saying you will be there in 2 hours is
probably as meaningful as saying I'll see you in flumphy waterboots.
We noticed with my mother in law at this stage that if you left and
came back, you could have been gone 10 minutes or 6 hours, she would
have no "sense" of how much time had elapsed.

Another whammy that fell out from the sequence problem was using the
television. Now, obviously, the whole idea of getting the right day,
the right time, and the right station to see a specific show was a
challenge - but she couldn't understand the idea of the stations being
numbered in sequence - i.e. that the UP button made the TV go from
channel 6 to 7 to 8, and the DOWN button made them go 4, 3, 2, 1. To
her, it seemed totally random - the ability to grasp the pattern was
gone entirely.

Same concept for an air conditioner, where 0 is the start of the dial
and higher numbers mean colder temps (or whatever). She just couldn't
understand that at all. Think of all the appliances that work on this
principal. My MIL's solution to this was to stop using the air
conditioner and sit in a broiling hot apartment with the windows all
shut.

Problems with sequences also translate into problems doing complex
tasks that require you to complete a series of things in a specific
order - huge problem with daily living. We often use the example of
taking a bath. You have to know what you need and assemble the towel,
soap, shampoo, washcloth, you have to put the plug in, turn the water
on adjust the water temp, fill the tub, know when to turn the water
off, take your clothing off, climb in, etc. etc. etc. If the whole
idea of doing things in a very specific order goes (and each of those
things requiring the ability to estimate, make judgements and
decisions, remember, anticipate etc.)  what seems like a simple job to
you will become ever more confusing to her.

M