Years ago, I had an internship in a psych ER. A patient was brought in and the psychiatrist asked the patient who the president was. "It's election day doc, we're just gonna have to wait to find out" was the response.
Those questions are asked to determine a patient's orientation to place and time. It's not really about getting it "right". It's about knowing what you don't know.
Not remembering what day or the date I think is common with people who have been retired for awhile. Every day seems like the day before.
My Dad had that problem, in the past what helped him was looking at the date of the daily newspaper.... worked great until he was getting slower and slower with reading the newspaper and the papers would pile up... then he had no idea what day it was.
I bought my Dad a "day clock" which only has one hand and it points to the day of the week. Dad said that day clock was very helpful.
I did notice in my dad that the first thing he lost was the concept of time. And by that I don't just mean the day, but also the month or the year (although the month is a tiny bit easier for him because he looks out the window to see -- we live in MA where the four seasons help him determine the approximate month). But not only just know what day it is, but also time...what does 4pm mean? does that mean its early morning or does that mean its time for dinner? He also had a really hard time reading a standard (non digital) clock and interpreting what it meant. From my observation time, and the concept of time are indicative of the early stages of dementia.
What kind of doctor did he see? Sometimes, a person's performance on a test like that can vary depending on the day and time of day. Some days are better than others when it comes to their memory. Has he been referred to a neurologist? Has he had other tests, like brain scan? Do you know what has caused the suspected dementia?
I suppose that the things that go vary by the person. With my cousin, it was her lack of judgment that went first. She seemed to not understand how hygiene was important. She didn't wash hands often and didn't handle kitty litter appropriately. She also seemed to grow more isolated, lost her appetite and grew confused as to how use her tv remote and to drive. Later came the repeating and then memory loss, including what day it was. So, I'm not sure there is any one order the losses come in.
I found this happened after I quit working. Work had provided such a structure and orientation for me, and when it no longer became a part of my life, I had to make more of an effort to keep oriented.
Now I find I have more trouble remembering what day it is when I'm semi-awake in the morning, having to go through orientation of what was done the day before, what obligations exist for the next days, etc.
Patsy, I would continue watching for other signs, but don't let it upset or frighten you too much as it might just be a temporary disorientation.
I also think that this could easily occur to people living in remote areas, with little contact with others, or with people out camping in remote areas.
ff: I am retired and every time I go to the doctor, esp. my neurologist, I have to look at the news to see the day, date, and even year. There is just no reason, for me, to keep up with that kind of stuff any more. Unfortunately, the days seem to melt together, so time passes much too quickly. Once I said it was March instead of November. (In my own defense, we had just been talking about March, but I don't suppose that made any difference to him.) Hey ho. Whatever.
GA: About a hundred years ago, my ex and I saw Nureyev at the Met Opera House. I hadn't liked him when I saw him on TV -- his facial expressions put me off. But live at the Met? He had so much charisma he just blew me away. I think it was Sleeping Beauty and I think he had taken Karen Kain under his wing then. Whatever -- it was as if a mighty wind had overtaken me and I could hardly stand to give him the ovation he so rightly deserved.
When Mum was first diagnosed with Alzheimers she, like many others didn't know the current day or month but unless she had a digital clock she lost the ability to tell the time. However she is on Donepezil now which suits her (it does not suit everyone I might add, not by a long mark, but she can now manage quite well things like time. What she can't do is follow a conversation so TV is something she watches avidly but never remembers so repeats are never a problem because it would take her watching it 5 or six times before she could remember it!
Patysretired: The typical memory questions asked at the doctor (or even when a person has reached Medicare eligibility) is "what is the day, date, month, year; who is the President; where are you currently?" A person's "score" is then recorded. So, okay, let's say your husband doesn't leave the house much...that's where the problem comes in...the days just all flow together and they are left without a clue as to what day it is. But...since your husband failed four items (year, day, date and month) that should have raised a red flag to the doctor that something is amiss.
When I had a car accident and appeared to have some scratches and bruises coming up from the air bag, the EMTs wanted me to go with them; but, I didn't feel it was necessary. So, they started the questioning. I was working part time then. When they asked the date, I knew the month, but not the date. When they asked the day of the week, I said it isn't Monday or Wednesday because I work on those days. I told them I was retired and only knew things that were not readily available in my phone, to which they grinned. When they asked who was president, I said, "UNFORTUNATELY, ..." They all laughed and decided I was fine and released me on my own signature to ride with the tow truck that took my husband's car home. :-( As some of the medical people have pointed out, it isn't getting the answers right that matters. They just want to observe your thought processes. It was a good point about being questioned in one's first language, though. The patient might not understand the questions or might not be able to express the answers properly. FYI Knowledge of a foreign language, if any of you want a diversion and have to be at home with LOs, is supposed to postpone the onset of dementia and some other forms of mental illnesses. It increases with the third, fourth, etc. language. So, maybe some of the free sites online or language learning sets might be something of interest and short mental escapes from your caretaking duties? Do I have to add it can be fun, especially with a buddy or if your LO happens to speak the language?
Those questions are asked to determine a patient's orientation
to place and time. It's not really about getting it "right". It's about knowing what you don't know.
My Dad had that problem, in the past what helped him was looking at the date of the daily newspaper.... worked great until he was getting slower and slower with reading the newspaper and the papers would pile up... then he had no idea what day it was.
I bought my Dad a "day clock" which only has one hand and it points to the day of the week. Dad said that day clock was very helpful.
Angel
I suppose that the things that go vary by the person. With my cousin, it was her lack of judgment that went first. She seemed to not understand how hygiene was important. She didn't wash hands often and didn't handle kitty litter appropriately. She also seemed to grow more isolated, lost her appetite and grew confused as to how use her tv remote and to drive. Later came the repeating and then memory loss, including what day it was. So, I'm not sure there is any one order the losses come in.
Now I find I have more trouble remembering what day it is when I'm semi-awake in the morning, having to go through orientation of what was done the day before, what obligations exist for the next days, etc.
Patsy, I would continue watching for other signs, but don't let it upset or frighten you too much as it might just be a temporary disorientation.
I also think that this could easily occur to people living in remote areas, with little contact with others, or with people out camping in remote areas.
Whew ... going to lie down with a cold cloth now.
See All Answers