A nine-part series for family caregivers and employers. When family caregiving roles conflict with work and career obligations.

Part 9 of 9: This is the last part of our discussion about forgetfulness and resistance to help, that could be better understood by looking at reversible dementias. Here is the original question:

My father seems to be getting forgetful and will occasionally think I am his sister rather than his daughter. He is very strong-willed and has traditional masculine values, though, so he won’t admit to needing any sort of treatment or help. How can I help him understand we are on the same team?

In the previous two articles, we examined possible causes of reversible dementia symptoms as one way to explore a solution for this dad. Why? Because reversible dementia could help improve his cognitive wellness. We were working through the dementia mnemonic. Today, we will learn about T, the I, and the A.

• T is for tumors and space-occupying lesions. These can cause pressure in the brain and could affect the neurological areas that are responsible for emotions and reasoning.

• I is for infections. Common infections that can cause confusion in the elderly include sinusitis, urinary tract and respiratory infections, such as bronchitis and pneumonia, to name a few.

• A is for anemias. Anemia is a condition where red blood cell counts are lower than normal. In older adults, anemia is marked by loss of oxygen-toting red blood cells that cause fatigue and muscle weakness. Anemias that are due to deficiency of micronutrients, such as iron and vitamin B12, can also cause cognitive impairment.

I recommend visiting the primary care provider for a workup to rule out other conditions that could contribute to his cognitive impairment. She could also communicate with her father with more “I” statements. If she said, “Dad, I worry when you are home alone,” rather than, “Dad, you should not be living alone, and you need help.” “I” statements demonstrate concern. If I can be of help to your loved one who is challenged with cognitive impairment, please call or email me anytime.