Where Did I Put the Keys, Again?

Mrs Lakshmi, seventy-eight, lived with her son Arvind and his wife in Chennai. For the last year she had been repeating questions, leaving the gas on once, and getting lost on the lane to the temple she had visited for forty years. She covered it with jokes, but she cried when she could not recall her granddaughter's school.

Her family argued. Arvind said, 'She is just old.' His wife thought it was attention seeking. Then a neighbour found Mrs Lakshmi standing confused near the main road, unable to say where home was.

They took her to the family doctor, who listened to the story and also asked about mood and sleep. Mrs Lakshmi had been low since a friend died, was sleeping badly, and rarely left her room. The doctor said depression can mimic dementia, so proper assessment mattered. Blood tests, a memory screening and a visit to a neurologist were arranged.

The results showed early Alzheimer's disease, with depression sitting beside it. The family felt grief, but also relief at having an explanation. They treated the depression, started cognitive stimulation with photo albums and cooking, wrote the home address on a card in her bag, and put a safety lock on the gas. The first sentence the doctor said to Arvind was, 'Early diagnosis still helps, because there is a lot you can do.'

How to recognise it

Progressive trouble with memory, such as repeating questions or missing recent events.
Getting lost in familiar places, or confusion about time and place.
Difficulty with words, calculations, or judgement affecting daily life.
Mood change, withdrawal, or sleeplessness alongside the memory problems.
Decline over months rather than a single bad day.

What this story explains

This story shows the chapter's point that memory change needs assessment, because depression can mimic dementia, and that early diagnosis and safety planning still improve life when dementia is real.

Probable root causes

Alzheimer's disease, the commonest cause of dementia.
Vascular, Lewy body or frontotemporal causes, or a mixed type.
Depression, which can look like memory loss.
Other medical problems such as thyroid, vitamin deficiency or medicine effects.
Age, family history and heart or blood-pressure risk factors.

What to do

Note examples with dates: missed bills, lost routes, repeated questions.
Visit the doctor together, with a list of medicines.
Ask for a check of mood, blood tests and a memory assessment.
Make the home safer: gas, stairs, doors, identity card with address.
Keep routine, cognitive stimulation and social contact.
Plan early for the future, including legal and care decisions, while she can take part.

Whom to consult

Family doctor first, for general health, mood and blood tests.
Neurologist, psychiatrist or memory clinic for diagnosis of memory decline.
Clinical psychologist or neuropsychologist for memory testing.
Emergency service or hospital if she is lost, injured, or suddenly very confused.

Do and don’t

Do	Don’t
Do get an assessment early.	Don't assume it is only ageing.
Do check mood and medicines too.	Don't test or quiz her repeatedly.
Do keep her routine familiar.	Don't hide the diagnosis from her without reason.
Do include her in decisions.	Don't argue about facts she has forgotten.
Do plan safety at home.	Don't leave dangers unaddressed.

How to behave and communicate

Speak simply, one idea at a time: 'Amma, let us have tea now.'
Be patient with repeated questions and answer as if for the first time.
Avoid 'I just told you'; say 'Let me tell you again.'
Face her, make eye contact, and use a warm voice.
Include her: 'What would you like for lunch?'