Here you can find out more about HSC's Memory Clinic pathway. The clinic aims to thoroughly assess, diagnose, treat and offer support to individuals who have ongoing memory problems.
I'm worried about my memory
- We all forget things from time to time. We must be careful therefore to differentiate between normal forgetfulness and what may be symptoms of dementia.
- Nowadays we are bombarded with information from various sources. Lives are busy. Our mobile phone enables instant connection to our friends, family, work, social media, news headlines, our calendar, music, sports results etc. There is little time to process, encode and file all of this information and it is easy to become distracted.
- Our short-term memory enables us to store about 5-7 pieces of 'working' information. It would be impossible to remember everything we see or hear as our brain would quickly become overloaded. To make something stick we have to mark it as being important and we must put some effort into remembering. If we haven't concentrated in the first place it doesn't get stored.
- There are many other reasons why memory problems may occur. Depression is quite common across all age groups and can present with symptoms very similar to dementia (slowness of thought, lethargy, diminished interest, concentration problems). Depression can be quite treatable with a combination of talking therapies, lifestyle adjustments and medication. Once treated, memory problems are likely to resolve.
- There are many medical conditions that can affect memory such as low thyroid function, anaemia, infection (especially in the elderly) electrolyte imbalance and vitamin deficiency. Certain medications and over-use of alcohol can also have a negative effect. Such conditions, in many cases are quite treatable and memory problems can resolve once addressed.
- Forgetting things is certainly frustrating but most of us manage to recall what we've forgotten shortly afterwards or we can find ways to prompt ourselves by re-tracing our steps. Getting older, in itself, causes a degree of memory decline but we should not consider this to automatically mean that it is dementia.
- Life can be very busy so here are some tips that can help you improve and organise your memory:
- Keep socially active: Human beings are essentially social animals and social activity gives the brain a thorough workout. During contact with others one needs to be receptive, not just to what people are saying but also to body language, gestures and tone of voice. We then have to process this information and communicate back to them. All of this happens very quickly, often with a dash of humour and within accepted social norms which also gives the frontal lobe of the brain a challenge. Social activity can also lift our spirits, increase wellbeing and counteract loneliness all of which can affect memory.
- Minimise distractions: Focus on one task at a time. Finish one before moving on. Multitasking merely means the brain has to very quickly switch between one task and another, thus doing neither very well. Try to minimise clutter in the house or workplace as this is another cause for distraction.
- Pay attention: If we don't receive information correctly we can't expect to make sense of it and store it. If you tend to struggle with memory or concentration ask for information to be repeated. Repeating it back to the person may help with clarification. Make sure that your hearing and eyesight are tested regularly and that any visual or hearing aids are worn to ensure that communication is maximised.
- Focus: Our brains can only remember a certain amount of information. Try to filter out unhelpful information and focus on the key messages you need to remember. Make notes if required.
- Make associations: Try to make mental pictures if you need to store information. Visual memory is more easily recalled than words alone. If for example your are introduced to somebody called Mark, perhaps think of him with a mark on his face. Molly could be pictured as Molly Malone wheeling her barrow, through streets broad and narrow. You don't have to tell them how you remember them!
- Keep a diary: Whilst phones and electronic tablets can be a distraction they can also help us remain organised. Set up a shared calendar with a family member to give you reminders of what is happening that week. If you don't use electronic devices a diary works just as well. Get into the habit of writing appointments and reminders in it and keep it with you. The act of writing something down will help in itself. Perhaps keep a monthly planner by your home telephone so you can write messages down whilst on the phone.
- Make a list: If you have many tasks to achieve make a list and cross things off as you undertake them. Most people depend on a shopping list.
- Keep to routines: It's frustrating to lose items around the house. Try to get into the habit of placing important items in the same place. Hang keys on a hook after coming in. Consider using a cord to keep glasses around your neck, especially if you use more than one pair. Try to charge your phone in the same place every day which will reduce the amount of places it gets placed. Helpful routines can be developed such as taking your medication with your first cup of tea in the morning.
- Sleep: It is difficult to function if we don't get enough sleep. If we are tired we will miss out on important information and memory will be affected. Don't fight sleep, go to bed when feeling tired and avoid using electronic devices whilst in bed. Avoid caffeine for several hours before going to bed. Adults should be aiming to get 7-8 hours sleep every night.
- Stay hydrated: Drink plenty of water throughout the day. Your brain is 75% water and it takes only 2% dehydration to shrink brain tissue and cause a temporary loss of concentration and memory.
- Diet: You wouldn't use cheap fuel in a fine sports car, so don't feed your brain with junk food.
- Keep active: It is easy to get bogged down in day to day life to the point where we can't think clearly. Having a walk or some exercise is good for our circulation and gets the blood flowing to the brain. Having a walk is also calming and allows us a chance to relax, clear our mind, take in nature and generally improve wellbeing.Look after your health: Keeping generally healthy can impact positively on memory. Physical health issues should not be ignored but should be investigated and treated by your GP.
- Alcohol: Whilst alcohol in moderation can help us relax we should remember that alcohol is a depressant and it can impact negatively on memory. In excess it can cause long-standing memory problems. Some studies have shown that an occasional glass of red wine can be beneficial but we should still aim to have 3-4 days every week where we don't have any alcohol.
What should I do if I'm still worried?
- If the shortfalls in your memory are occurring regularly or if they are interfering with your ability to manage your day-to-day life then they should be explored further. If your memory is causing you to struggle with things you once did well such as:
- Finding the right words
- Managing money
- Keeping appointments
- Managing household chores
- Keeping on top of bills
- Getting lost
- Remembering names of close family and friends
- You should go and speak to your GP. It may also be helpful to ask a family member or friend to go along with you for support.
What will my GP do?
- Your GP will ask you some questions about your memory and how this is affecting your daily life. The doctor may also ask you to undertake a brief memory test.
- Your doctor will want to undertake some basic blood tests. This is to find out if there are any treatable conditions that might be affecting your memory. You will probably be asked to have an ECG to check your heart rhythm. You may also be referred for a CT scan to see if there are any changes occurring in the brain that may be affecting your memory.
- Your doctor should also ask you some brief questions about your mood. Depression can have symptoms very similar to dementia. It can slow up your thinking, cause you to forget things and affect your concentration. This may be quite treatable.
- Once your doctor has received all the test results he/she may want to treat any medical causes that may be affecting your memory. The GP may then refer you for a more specialised assessment at the Memory Clinic. The doctor will ask your permission for this to occur.
What happens at the Memory Clinic?
- Within about 2-4 weeks of receiving the referral, a member of the Memory Clinic team will send you an appointment and arrange to come and see you at home. They will explain the process to you. With your permission they will gather some background information about you and ask you about your daily activities and how your memory is affecting your daily life.
- Once the team have got an overview of your situation you will be invited to come along to the Memory Clinic at the hospital, usually with a family member. There you will have a more detailed assessment of your memory using some tests. With your permission your family member will also be able to contribute to the discussion.
- Once all the assessment is complete you will be offered an appointment to see a specialist doctor at the PEH who will discuss the test results with you and aim to explain the probable cause of your memory problem. They may make a diagnosis and prescribe some medication to help your memory. If the diagnosis is not clear we usually ask to see you again in about 6 months to monitor your situation.
- If you receive a diagnosis of dementia you will have the opportunity to discuss with the doctor what this means and the implications it may have for you in the future. We usually try to include your family member in these discussions so that they can offer you support and ask any questions they may have.
- If you receive a diagnosis a team member will visit you at home about 2 weeks afterwards. You may have questions you want to ask. You will be provided with information about your diagnosis and offered advice about support groups and practical help if needed. You will be seen again after about 6 & 12 weeks. After 12 weeks you may be discharged from the clinic or offered ongoing support if required.
- Your GP will be provided with all the information from the Memory Clinic and if you are prescribed medication it will eventually be added to your normal prescription which you collect from the GP practice.
What support can I get after a diagnosis?
- After you have been diagnosed and given information about your condition you will be given advice about support groups run via the voluntary sector and The Committee for Health & Social Care. These groups are also helpful for anyone who supports you. See details below.
- If you need ongoing support or advice you may be allocated to a member of the OACMHT or a Social worker. The key worker will be able to advise you on issues around benefits, support networks or about planning ahead for the future.
- Alzheimer's Society (Guernsey), 01481 213367, firstname.lastname@example.org
- Guernsey Alzheimer's Association, 01481 245121, email@example.com
- Both groups above provide some ongoing support for people with dementia and their carers. The groups include talks from professionals as well as peer support, music groups and can sometimes provide financial help to people in a caring role.
More information on the support groups is available by ringing 725241 ext: 3515