A 75-Year-Old Mother Keeps Forgetting to Turn Off the Stove: A TCM Assessment Approach to Dementia Warning Signs

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Ms Lee’s 75-year-old mother has recently begun repeating the same questions, mixing up her medication, and even forgetting to turn off the stove. Is this ordinary forgetfulness, poor sleep, or an early warning sign of dementia? This article shows how TCM can assess such a situation step by step through the lenses of safety, cognition, vascular risk, sleep, constitution, and caregiving.

Ms Lee’s mother is 75 years old and used to cook, buy groceries, and take medication independently in a very orderly way. Over the past six months, however, Ms Lee has started noticing clear changes. Her mother repeatedly asks, “Will you come home for dinner tonight?” and asks again ten minutes later. There are repeated grocery purchases in the fridge. Most worrying of all, she has forgotten to turn off the stove twice after making soup, and the family only noticed in time by chance.

Her mother feels that “memory naturally gets worse with age” and is somewhat resistant to seeking medical advice. Ms Lee, on the other hand, is increasingly worried: is this simple forgetfulness, or could it be an early sign of dementia?

When an older adult has memory problems and starts forgetting to turn off the stove, Aspira TCM does not jump straight to “brain tonics”. The assessment starts with safety, then cognition, then the wider body, sleep, vascular risks, and constitution.

Step 1: Distinguish “Forgetfulness” from “Functional Impairment”

Many families get stuck on the same question at the start: is an older person’s memory decline still normal? Occasional forgetfulness is not always alarming. The key issue is whether everyday function is being affected.

Family observation	More typical of ordinary forgetfulness	More concerning for dementia
Misplacing objects	Temporarily cannot find keys, then later finds them	Puts objects in unreasonable places and suspects others of stealing them
Asking questions	Occasionally repeats a question	Repeats the same question within a short time and still does not remember after reminders
Cooking	Occasionally forgets to buy one ingredient	Forgets to turn off the stove or no longer knows what step comes next
Medication	Occasionally takes it later than intended	Repeats doses, misses doses, or confuses morning and evening medication
Going out	Needs company in a new place	Gets lost in familiar places or does not know how to get home
Money handling	Calculates more slowly	Pays twice, buys things irrationally, or becomes easier to deceive

In Ms Lee’s mother’s case, forgetting to turn off the stove is no longer just poor memory. It directly affects home safety. Even if the eventual assessment does not show dementia, it still deserves prompt attention.

Step 2: Address Safety First Rather Than Waiting for a Diagnosis

When caring for an older adult with memory decline, action does not have to wait until a formal diagnosis is made. Once high-risk behaviour appears, the priority is to reduce the chance of harm.

For stove-related risk, families can start with practical measures:

• Switch to an induction cooker or timer with automatic shut-off
• Avoid letting the older person manage soup or open-flame cooking alone
• Use short, clear kitchen reminders rather than covering the walls with notes
• Simplify routine cooking steps by fixing cooking times and using familiar cookware
• Reassign cooking responsibility if forgetting to turn off the stove has already happened multiple times

For medication, a weekly pill organiser, a weekly family check, and a photographed medication list can help prevent missed or repeated doses. Extra care is needed if the person is taking diabetes medication, blood pressure medication, anticoagulants, or sleeping pills.

Step 3: Clarify the Timeline of Change

When Dr Chan assesses this kind of case, some early questions are especially important:

Question	Why it matters
Did the memory decline appear suddenly or gradually?	Sudden confusion raises concern for infection, stroke, medication, or metabolic causes
Has there been any fall, head injury, or hospital admission in recent months?	Head trauma or post-illness decline can worsen cognition
Is there a history of hypertension, diabetes, high cholesterol, or stroke?	Vascular risk affects brain health
Has sleep worsened or become day-night reversed?	Poor sleep can worsen daytime confusion and may also reflect cognitive decline
Has mood changed, such as low mood, anxiety, or suspiciousness?	Depression, anxiety, and dementia can all affect memory
Have hearing or vision worsened?	Reduced sensory input can lower stimulation and be mistaken for memory decline
What medications and supplements are being taken?	Polypharmacy or side effects may affect mental state

If an older adult becomes suddenly confused, drowsy, unsteady when walking, unclear in speech, feverish, or develops painful urination over a few days, this is not a routine TCM regulation scenario. Western medical review or urgent care should come first.

Step 4: Look for Early Dementia Warning Signs

In medical assessment, dementia is not judged by memory alone. It may affect memory, understanding, language, learning, calculation, judgment, and daily function, and can also bring emotional or behavioural changes. Families can observe the following:

1. Recent memory
   Does the person forget what just happened, what was just eaten, or what was just said?

2. Executive function
   Has it become harder to manage familiar chores, cooking, bills, or transport?

3. Orientation to time and place
   Does the person get lost in familiar places, confuse morning and afternoon, or mix up dates?

4. Language and communication
   Does the person often struggle to find words, speak vaguely, or fail to follow longer instructions?

5. Judgment and safety
   Does the person forget to turn off the stove, eat spoiled food, or fail to notice danger?

6. Mood and personality
   Has the person become more withdrawn, anxious, suspicious, irritable, or socially disengaged?

In Ms Lee’s mother’s case, repeated questioning, duplicated grocery purchases, and forgetting to turn off the stove already reach the threshold for further assessment. This does not prove dementia, but it should no longer be dismissed as ageing alone.

Step 5: TCM Assessment Looks Beyond “Memory”

TCM does not assess an older adult’s forgetfulness by asking only whether they remember things. Many factors that drag down concentration and memory are hidden in the person’s wider physical state.

Common questions include:

• Sleep: difficulty falling asleep, waking easily, vivid dreams, day-night reversal
• Appetite: poor intake, bloating, strong fatigue after meals
• Bowels: constipation, loose stool, or bowel motion only every few days
• Urination: frequent night urination, urgency, or frequency
• Energy: fatigue, low voice, low motivation, daytime heaviness
• Mood: anxiety, low mood, irritability, suspiciousness
• Pain: low back pain, headaches, neck and shoulder pain, reduced mobility
• Vascular risk: whether blood sugar, blood pressure, and lipids are stable

This is then combined with pulse, tongue, and overall TCM pattern differentiation, such as kidney essence deficiency, spleen qi and blood deficiency, phlegm turbidity disturbing the head, blood stasis, or poor nourishment of the spirit.

TCM pattern	What may be seen in older adults	Treatment direction
Kidney essence deficiency	Weak low back and knees, tinnitus, night urination, low energy, memory decline	Nourish the liver and kidneys, replenish essence
Spleen qi and blood deficiency	Poor appetite, fatigue, pale complexion, weak concentration	Strengthen the spleen, boost qi, nourish blood, calm the mind
Phlegm turbidity disturbing the head	Heavy-headedness, chest oppression, obesity, excess phlegm, brain fog	Strengthen the spleen, transform phlegm, improve metabolism
Blood stasis obstructing the channels	Headache, dark tongue, numb limbs, poor circulation	Move blood and unblock the channels, after acute issues are ruled out
Poorly nourished spirit	Insomnia, vivid dreams, palpitations, anxiety, being easily startled	Nourish the heart, calm the mind, stabilise sleep

These patterns do not replace Western diagnosis. They help the practitioner understand why the person’s overall condition is declining, what modifiable factors may be present, and what should first be referred onward.

Step 6: When Should Western Medical Review Be Recommended?

At Aspira TCM, the following situations would prompt advice for timely Western medical assessment or memory testing:

• Ongoing decline in memory and daily functioning
• Recurrent forgetting to turn off the stove, getting lost, or medication confusion
• Sudden confusion, unsteady walking, or unclear speech
• Cognitive decline after a fall or head injury
• Hallucinations, delusions, aggressive behaviour, or serious safety risk
• The family can no longer maintain safety through reminders alone

Depending on the situation, doctors may arrange cognitive testing, blood tests, medication review, brain imaging, or specialist referral. Dementia diagnosis requires history, functional change, and appropriate examination findings. It cannot be made by a single online test.

What Can TCM Contribute in This Situation?

Once acute problems have been excluded, or while formal assessment is pending, TCM may support care in several ways:

1. Improving sleep and day-night rhythm
   Poor sleep at night can make daytime confusion, falls, and mood instability worse. TCM may regulate insomnia, vivid dreams, irritability, or night urination according to constitution.

2. Improving appetite and bowel function
   Poor intake, constipation, and bloating can lower both energy and alertness. In older adults, better digestion often supports a steadier day-to-day state.

3. Managing pain and inactivity
   Knee pain, low back pain, and neck or shoulder pain can reduce outings, social contact, and activity, indirectly affecting mental and physical function.

4. Supporting vascular risk management
   Poorly controlled diabetes, hypertension, and high cholesterol increase vascular and brain health risk. TCM may help constitutional support, but medication changes must be made by the treating Western doctor.

5. Helping caregivers stabilise daily routines
   Fixed routines for sleep, medication, outings, and simplified household steps are often more effective than blaming the person for being “forgetful”.

Eight Things Families Can Do Right Away

If an older family member has already started forgetting the stove or mixing up medication, the following steps may help:

1. Record specific events from the past three months, including date, time, what happened, and the consequence
2. Photograph all current medication and prepare a medication list
3. Check open flames, gas, power points, and floor clutter at home
4. Use a pill organiser instead of mixing multiple medication bags together
5. Arrange a general health check or memory assessment
6. Keep daily routine and activity timing more stable
7. Preserve safe and manageable household tasks rather than removing all independence at once
8. Divide responsibilities among family members for appointments, medication, cooking, and finances

Caring for an older person at risk of dementia should not rest on one person alone. Earlier division of roles usually means fewer conflicts later.

How Can Families Bring Up Assessment?

Many older adults strongly resist the word “dementia” because it feels like a label. It is often better to avoid leading with that label and instead use gentler language:

"You have not been sleeping very well recently, and there was that incident with the stove. Let us go together and see whether sleep, medication, or general health might be affecting things. It would be more reassuring to sort it out earlier."

"This does not mean you definitely have an illness. Let us just do a memory and health check to see whether anything can help you feel clearer and sleep better."

The key is to frame assessment as a way to find causes and improve daily life, not as proof that something is “wrong” with the person.

Aspira TCM’s Assessment Priorities

For a case like Ms Lee’s mother, Aspira TCM would focus first on three areas:

• Safety risk: whether cooking, medication, going out, falls, or finances already involve danger
• Medical risk: whether stroke, infection, medication side effects, unstable diabetes or hypertension, or other internal medical problems must first be excluded
• Constitutional state: whether sleep, digestion, qi and blood, liver-kidney balance, phlegm and stasis, pain, or mood are dragging down overall function

If TCM regulation is appropriate, Dr Chan will tailor the plan to the person’s constitution. If Western medical review or memory assessment is needed first, this will also be explained clearly to the family. For older adults, the most important goal is not rushing to a label, but stabilising safety and general health as early as possible.

FAQ

1. If someone forgets to turn off the stove once, does that already mean dementia?

Not necessarily. A single event may be related to fatigue, distraction, poor sleep, or emotional strain. But if it happens repeatedly, or comes together with repeated questioning, getting lost, medication confusion, or disorganised cooking steps, assessment should be arranged promptly.

2. If the older adult refuses Western medical care, can TCM be the first step?

Yes, TCM can sometimes serve as an entry point. But if the practitioner judges that there is acute risk or clear concern for cognitive decline, Western medical assessment should still be recommended. TCM should not replace necessary cognitive testing, blood work, or brain investigation.

3. Does dementia always worsen quickly?

Progress varies greatly depending on type and individual circumstances. Early diagnosis, management of diabetes and hypertension, better sleep and nutrition, ongoing activity and social contact, home safety planning, and caregiving support can all help preserve quality of life.

4. Should the family immediately stop the older adult from cooking?

That depends on risk. If forgetting to turn off the stove has happened multiple times, the person should stop using open flame alone. But that does not mean all independence must be removed. Safer stoves, accompanied cooking, or lower-risk kitchen tasks may still be possible.

5. How soon might TCM regulation make a difference?

That depends on what is driving the problem. If poor sleep, weak digestion, constipation, or chronic pain are major contributors, some people feel more alert in the daytime once those factors improve. If dementia is already present, the goal is usually more about stabilising function, improving quality of life, and supporting caregiving arrangements.

Disclaimer: This article is for health education only and does not replace individual consultation, cognitive assessment, or treatment advice. If an older adult develops sudden confusion, stroke symptoms, head injury, severe hallucinations, or immediate safety risk, seek medical care immediately.

Article note: The case example in this article has been anonymised for health education purposes and does not contain identifiable personal information.