Early Stage Dementia and Holding on to Independence

by Samantha Jordan, Psy.D.

Being diagnosed with dementia can be devastating for you and your family. There will most certainly be lots of “how” and “what” questions regarding your independence. It is important to understand that there are three general stages of dementia (early, middle, and late), and each stage involves its own set of challenges for you and your family or caregivers to face. This involves your transitioning from doing things independently to doing things with more and more assistance and oversight as dementia progresses.

The early stage of dementia of the Alzheimer type involves mild symptoms such as word-finding problems, forgetting names when introduced to people, misplacing a valuable object, and having difficulty with planning and prioritizing. You may still work and drive but notice that you are having increased memory problems, trouble coming up with the right word in conversation, or trouble completing work tasks.

It can feel overwhelming for both you and your family to know what activities should be stopped, which ones should be continued, and which activities will need to be supervised. Driving is an especially important part of one’s independence and freedom. Most of us enjoy the privilege of coming and going as we please in a vehicle. When faced with a dementia diagnosis, it is important to speak candidly with your medical doctor about your current difficulties and strengths and determine if and how you could continue driving safely. You may be given strict limits about the distance you can drive alone and during what times of day you can drive. It is important to discuss driving with your family and, if possible, negotiate a driving plan with them. For example, continued safe driving may involve always having a family member or trusted friend ride with you in the event they need to take the wheel if you become confused, agitated, or somehow unable to continue driving. Another example of continued safe driving may involve developing a list of very nearby places where you can drive alone, telling your family which place you are driving to, calling your family member when you arrive, and calling your family member when you are headed back home.

Working in a psychotherapeutic relationship can be helpful for you and your family if you have been diagnosed with dementia to gain acceptance of the diagnosis and the ways in which life will change. Working in a therapy relationship can also help you and your family with negotiating issues of independence, come to compromises in some areas, maintain safety in areas of existing capacity for certain tasks, and most importantly, maintain your dignity at a time when you may think many things are being lost or taken from you.