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14 Changes - Phil Hardt
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14 Changes That Could
Signal Concern In HD
by Phil Hardt,

1. Memory Loss that affects job or personal skills. It is normal to forget
an assignment, deadline or a colleague's name, especially when under
stress. However, frequent forgetfulness or confusion at home or in the
workplace over an extended period that is not typical of the person with
HD and may signal concern.
 
2. Difficulty performing familiar tasks. Busy people pause occasionally to
think about what they are doing, or how to finish a project. However,
concern is raised if tasks, which used to be completed in two hours, start
taking all day, or if getting ready to go somewhere takes an hour instead
of ten minutes.

3. Problems with speech and language. Everyone has trouble finding
the right word sometimes, but a person with HD may forget simple
words or substitute inappropriate words, such as, "place the pie in the
toilet," instead of saying "in the oven." Speaking may be slow, with
pauses between words and responses.

4. Disorientation to time and place. Anyone may momentarily forget the
day of the week or what is needed from the store. But persons with HD
can easily become distracted and completely lose track of time and tasks.
They may remain disoriented until it is brought to their attention. They
may get lost driving home, to work, or even to a familiar store.

5. Changes in mood or behavior. Everyone experiences a broad range
of emotions- it's part of being human. However, persons with HD may
exhibit rapid mood swings for no apparent reason. These moods may
be uncharacteristic changes from their usual temperament. They may
show reduced or inappropriate emotional responses to any given
situation.

6. Poor or decreased judgment. Everyone has gotten upset when they
received a traffic ticket. However, a person with HD who is stopped
and falsely arrested for being drunk may become extremely angry
and insult or even hit the policeman because of poor judgment or
lack of consequential thinking.

7. Problems with abstract thinking. Balancing a checkbook can be
challenging for anyone, but for someone with HD, recognizing
numbers or performing calculations may be extremely difficult and
stressful. Diminishing concentration, focus and sound decision-
making may signal problems if they continue for no apparent reasons.

8. Misplacing things. We all misplace a wallet or keys from time to
time. However, a person with HD may put items in inappropriate
places and not remember doing so, such as placing a carton of milk
in the cupboard or a wristwatch in the sugar bowl.

9. Changes in personality. Personalities often change with age.  A
person with HD may experience uncharacteristic changes in their
personality. For example, someone who was generally easygoing may
become angry, paranoid or fearful and someone who was outgoing
may become withdrawn from social interaction.

10. Loss of initiative. It's normal to tire of housework, business
activities or social obligations. But for most people, this feeling is brief
and enthusiasm and interest return. The person with HD may become
apathetic and become indifferent towards activities which used to
bring them satisfaction and happiness.

11. Depression. Tragedy saddens us all but the person with HD may
not recover- they may show increased irritability or crying and may
express feelings of hopelessness or guilt. They may lose interest in
ordinary activities, such as sex, and may even experience disturbances
in eating and/or sleeping patterns. Severely depressed individuals
may even talk openly of suicide, saying things like, "I'm not needed
anymore," or "Things would be better off without me."

12. Loss of social inhibitions. It is normal to change beliefs or values as
you age. A person with HD may uncharacteristically start cussing, gambling,
lying, cheating, stealing or being sexually inappropriate- things they
would have never done before.

13. Loss of visual-spatial coordination. Anyone might misjudge a turn or
hit a curb. However, a person with HD may lose the coordination or reflexes
to avoid an accident, back out of a driveway, or shift the car. They may
hit their elbows while walking through doorways or bump into a wall
while simply walking down a hallway.

14. Slowed comprehension. Everyone occasionally misses the punch line
of a joke but a person with HD may have poor or slowed comprehension
so they cannot grasp the meaning of a story or conversation. There may
also be slowed interpretations or misinterpretations of facial expressions,
such as approval or disgust, causing inappropriate responses and
misunderstandings. 
 
PLEASE NOTE: The changes noted above, subtle to severe, should be brought
to your doctor's attention if they begin happening unexplainably or are not
characteristic of your usual behavior or normal abilities. Since some of these
warning signs are so personal, only you or someone close to you, can help
determine if they indicate areas for concern or are simply a result of stress or
illness. What is typical for one person my not be considered "normal" for
someone else.
 
I wrote 14 Changes That Could Signal Concern In HD  to inform and teach
about the softer symptoms of HD in a manner that can be easily understood,
allowing everyone to recognize their subtleties early on so they can cope positively with them, instead of letting them ruin their lives. In addition, I got tired of everyone saying to me   (when I would try to describe what was happening to me)- "I always forget where I leave my keys", or "Everyone does that!"
 
This will hopefully show that real HD-affected problems are much deeper than most realize, when compared with normal forgetfulness, emotions and behavior. The idea came from an Alzheimer's handout I read, however, the examples have all been changed to fit those early cognitive, emotional and behavioral symptoms of HD.
 
My goal was not to create mass hysteria with these 14 Changes, but to help
eliminate so much of the bleeding in the trenches I see daily. 
Phil Hardt, HD Warrior 16-May-02