The visit that changed how I see my mom
I see my mom once a year. She lives in Tucson, Arizona, and I recently spent some time with her this past week.
I knew she was struggling with her memory. She had not been remembering things for a while. I had quietly filed that under “getting older.”
Then she fell for a scam. It put the money in her bank account at grave risk.
That one scared me. My mom spent her career as an accountant and Comptroller. Numbers were her whole life’s work. Now she struggles with day-to-day financial tasks.
I noticed something else during my visit. She was short-tempered and impatient. Could that be part of dementia too?
That question sent me down a research path. I am not a doctor. I am a daughter with a finance background who wanted answers. Here is what I learned.
Dementia is an umbrella, not one disease
I used to think dementia and Alzheimer’s were the same thing. They are not.
Dementia is an umbrella term for a loss of memory, thinking and problem-solving that interferes with daily life. Many diseases cause it. The two most common are Alzheimer’s disease and vascular dementia.
Alzheimer’s disease
Alzheimer’s causes 60% to 80% of dementia cases. Two proteins build up in the brain, forming plaques and tangles. Most experts believe they block signals between nerve cells until the cells die.
The damage usually starts in the brain’s memory centers. So the classic first sign is trouble remembering new information. People ask the same questions again and lean more on notes or family. The decline is usually gradual, over years.
There is no cure. Two newer drugs, lecanemab (Leqembi) and donanemab (Kisunla), are FDA-approved to slow early Alzheimer’s. That is one more reason to get answers early.
Vascular dementia
Vascular dementia comes from problems with the brain’s blood supply. When brain tissue does not get enough oxygen and nutrients, it is injured. Strokes are one cause. Damage to tiny blood vessels is another.
The early signs often look different from Alzheimer’s. Mayo Clinic notes that early symptoms tend to affect the speed of thinking and problem-solving. Watch for trouble with planning, decisions, concentration, and walking or balance. Mood changes are common too.
The type I believe my mom has
One form caught my attention: subcortical vascular dementia. It happens when small blood vessels deep in the brain’s white matter are damaged. Cleveland Clinic explains that this form comes on gradually, without the sudden drops that follow a stroke. Early symptoms tend to involve attention, planning and movement more than memory.
My mom has not had a stroke or mini-stroke that we know of. But she has Type 2 diabetes and high cholesterol, and she is not active. Those are major risk factors for blood vessel damage. Her biggest struggles are with money and patience, not only memory.
This is my guess as her daughter, not a diagnosis. Mayo Clinic notes that some strokes are “silent,” with no obvious symptoms. Only a doctor and a brain scan can say for sure.
Here is the hopeful part. Risk factors can be treated. The Alzheimer’s Association says managing blood pressure, cholesterol and blood sugar may postpone further decline.
Alzheimer’s and vascular dementia side by side
| Alzheimer’s disease | Vascular dementia | |
|---|---|---|
| Share of cases | 60% to 80% | 5% to 10% alone, often mixed with Alzheimer’s |
| Cause | Plaques and tangles kill nerve cells | Reduced blood flow from strokes or damaged small vessels |
| First signs | Trouble remembering new information | Slower thinking, poor planning and judgment |
| Progression | Gradual, steady decline | Steps down after strokes, or gradual with small-vessel disease |
| Treatment | No cure; two drugs slow early decline | No approved drug; treat blood pressure, cholesterol and diabetes |
Many people have both types at once. Doctors call that mixed dementia.
Money trouble is often an early sign
Doctors have an old saying. The first place to look for dementia is in the checkbook.
A Johns Hopkins study of more than 80,000 Medicare recipients backed that up. Missed bill payments started six years before a dementia diagnosis. Credit scores fell below 620 about 2.5 years before.
Scams fit this picture. A 2024 University of Southern California study linked scam vulnerability to brain changes tied to early Alzheimer’s. The lead researcher cautioned that falling for a scam does not prove dementia. Still, it is a reason to look closer.
Watch for unpaid bills, new trouble with numbers, and poor judgment about spending or giving money away.
Short temper can be a symptom too
The Alzheimer’s Association lists changes in mood and personality among its 10 warning signs. A person may become suspicious, anxious or easily upset. Cleveland Clinic lists irritability as a symptom of vascular dementia.
Common triggers include pain, poor sleep, a noisy room, or too many questions at once. That last one stopped me. As I worked with my mom on some computer issues and asked questions, that was when she got really short tempered and snapped.
What helps? Stay calm, speak slowly, focus on feelings rather than facts, and take a break when you need one.
Normal aging or something more?
| Normal aging | Possible sign of dementia |
|---|---|
| Missing a monthly payment | Problems taking care of monthly bills |
| Making a bad decision once in a while | Making poor decisions a lot of the time |
| Forgetting which day it is, then remembering | Losing track of the date or season |
| Getting irritable when a routine changes | Becoming easily upset, suspicious or anxious |
Sources: National Institute on Aging and the Alzheimer’s Association.
What you can do next
1. Write down what you see
Keep dated notes. On a visit, look for unopened mail, unpaid bills, spoiled food and missed medications. Ask neighbors what they have noticed.
2. Talk gently, one-on-one
Try something like, “You haven’t seemed like yourself lately. How are you feeling?” Offer to go to the doctor together. Expect more than one conversation. The Alzheimer’s Association has 10 steps that help.
3. Push for a full evaluation
Medicare’s yearly wellness visit includes a cognitive check at no cost when the provider accepts assignment. But the check is often brief. The Mini-Cog asks patients to recall three words and draw a clock. Many seniors are ready for it, and it says little about paying bills at home.
So bring your notes and a full medication list. Ask about a complete evaluation, including blood tests and a brain MRI. Blood tests can find treatable look-alikes, such as thyroid problems or vitamin deficiencies. An MRI can show blood vessel changes. Ask your parent to sign a release so the doctor can talk with you.
4. Treat the risk factors
Ask whether blood pressure, cholesterol and blood sugar are under control. Ask whether any medication could affect memory or mood. For vascular dementia, this is the main treatment.
5. Protect the money
After a scam, call the bank right away and report it at ReportFraud.ftc.gov. Then add guardrails: account alerts, automatic bill pay and a trusted contact on investment accounts.
This is the finance professional in me talking. Put a power of attorney for finances and health care in place while your parent can still sign. Do not wait.
6. Build a local team
I live far from my mom, so this step matters to me. Ask neighbors to check in. Call the Eldercare Locator at 800-677-1116 for local meals, rides and help at home. For questions day or night, call the free Alzheimer’s Association Helpline at 800-272-3900.
What I am taking home from Tucson
Her impatience is not about me. Her money mistakes are not carelessness. They may be symptoms, and symptoms call for help, not arguments.
If you see these changes in your parent, trust what you notice. And be gentle with yourself. Watching a parent change is its own kind of grief.
This post shares my own experience and research. It is not medical, legal or financial advice.
Frequently asked questions
Is a short temper a sign of dementia? It can be, especially alongside other changes. Pain, poor sleep and depression cause it too, so ask a doctor.
Can someone have vascular dementia without a stroke? Yes. Damage to small blood vessels deep in the brain can cause it gradually, with no obvious stroke.
Does falling for a scam mean my parent has dementia? No. Scammers fool people of every age. But it is a reason to look closer.
Further reading
- National Institute on Aging: What Is Dementia? covers types and diagnosis in depth
- National Institute on Aging: Managing Money Problems for People With Dementia is the closest match to your mom’s story
- National Institute on Aging: Managing Personality and Behavior Changes goes deeper on mood and irritability
- National Institute on Aging: Difficulty managing bills may signal early dementia summarizes related research
- JAMA Internal Medicine published the original Johns Hopkins study on November 30, 2020, led by Dr. Lauren Nicholas
- Alzheimers.gov is the federal government’s hub for dementia information
