best rated beverage refrigeratorsWhy should you practice living with an illness as dreadful as Alzheimer’s? Because, according to NIH statistics, one-in-ten people over 65 will develop this most common form of dementia, and by 85-years-of-age, one-third of us will be struck. We have a choice: ignore the statistics, quake in fear, or prepare. The purpose of this series of articles is to help you use senior moments to get ready.
WHY SENIOR MOMENTS SHOULD NOT BE DISMISSED
The brain is a marvelous organ. It not only controls everything in our bodies, but it provides an early warning system for cognitive problems in the form of senior moments. These embarrassing events may not just be aging quirks, but the equivalent of your car’s flashing “Low Oil Pressure” light.
Think of senior moments as mild coming attractions of what you might encounter in five, ten, or fifteen years. Forgetting an old acquittance’s name may sprout into being unable to recognize your grandchildren’s faces. The momentary confusion you experience driving to an unfamiliar location may slip into disorientation while walking through your neighborhood. The inconsequential forgetting of an item in a familiar recipe may develop into not remembering how to make scrambled eggs.
HOW TO USE SENIOR MOMENTS
I always teach clients with progressive illnesses strategies they will need in the future, not just those necessary for today. Research has shown that learning a new technique before it is required yields better results than waiting until it must be used. For example, learn a disorientation strategy before getting lost on your way home.
Advance learning not only produces more successes, but it can result in a less traumatic emotional adjustment to a life where structure is allusive. Learn now how to adapt to dementia, and you will be less anxious if it develops. And the downside if you never experience dementia? None. Practicing will enhance your normal cognitive abilities.
WHY CAN’T I WAIT FOR AN ALZHEIMER’S DIAGNOSIS RATHER THAN ANTICIPATING IT?
I’ve often heard the refrain, “If I’m prone to developing Alzheimer’s, I don’t want to know about it.” An off-shoot is the fear of practicing for something frightening that may never develop. The assumption is by waiting for a definitive diagnosis, you can lead a life unencumbered by scary scenarios.
Fair enough. I get wanting to live fully now. But what happens if you roll the dice, and up comes “snake eyes?” The average life expectancy following an Alzheimer’s diagnosis is eight to ten years. That’s a long time to live in a confusing and frightening world, one in which learning how to adapt becomes more difficult.
So let’s say the data convinces you to prepare. What should you do? Begin by identifying types of memory problems you label as “senior moments” and link them to proven helpful strategies.
TYPES OF SENIOR MOMENTS
Senior moments can be lumped into at least four behavioral categories, none of which is necessarily tied to a theory of memory loss. Basically, what appears below is what we do.
Very-Short Term (e.g., forgetting what you want to ask your husband minutes after you form the question.)
Short-Term (e.g., forgetting something that happened during the day before you go to bed at night.)
Long-Term (e.g., forgetting an occurrence of something that happened at least one day ago.)
Executive Functioning (Working Memory) (e.g., forgetting how to create something you’ve made for many years like chicken soup)
HELPFUL STRATEGIES FOR MEMORY PROBLEMS
There are two types of strategies that can be used for memory problems: general and specific. In future articles, I’ll provide examples of both along with suggestions for how to use them for yourself or your loved ones. If you want to be notified when they are published, please join my mailing list.
General. General strategies offer some help for a broad-spectrum of memory and retrieval problems. Conventional approaches include not crossing emotional and physical thresholds, reducing stress, eliminating multi-tasking, slowing down, thinking more linearly, and increased attention, among others. Consider them as “supplements” to specific strategies, since few by themselves are sufficient to remedy a memory problem.
Specific. There are particular strategies for each type of memory problem. For example, difficulty in remembering names (long term) is addressed by a strategy of making them “sticky,” as the memory is created. Being confused in a new neighborhood (working memory) can be reduced through the use of “external mapping.” Not remembering why you went to the kitchen (very-short term) can be remedied by using “visual recall.”
MEMORY LOSS: THEORY AND PRACTICE
Neuroscientists think of memory loss in terms of where in the brain the problem originates. There have been significant advances in our knowledge of memory loss. Yet, most conclusions are theoretical. Those that have any certitude, rarely are helpful to a person, for example, who continually loses her train-of-thought in a noisy restaurant.
An old Arab expression is, “Don’t ask the doctor if the medicine works, ask the patient.” Unfortunately, I’m both the doctor and the patient when it comes to memory loss. After fifty years of sleep deprivation and seventeen years of drugs to control prostate cancer, every day I feel as if a three-hundred-pound NFL linebacker head-butts my brain.
At 74-years-of-age, I don’t have time for science to identify the source of my problems. And even if researchers could, I doubt the knowledge would help me remember why I went into my workshop after leaving my office minutes ago. An intervention pathway for me and millions of others involves matching types of memory problems with proven helpful strategies, something that will be done in subsequent articles.
ACCEPTANCE AND ADAPTATION
Acceptance of memory problems doesn’t mean becoming an addled senior willing to be treated like a six-year-old. Instead, acceptance means acknowledging you need a bit of assistance in doing what you automatically did ten years ago. It’s like driving uphill with a ton of stones in your pick-up. There’s nothing wrong with using a lower gear. Likewise, relying on memory strategies isn’t shameful.
Using memory strategies when you may not need them now, serves as a deterrent for confusion and anxiety if you need them later. It’s similar to purchasing a burglar alarm. Your primary purpose is not to catch and punish bad buys. Rather, it’s to deter crime.
As powerful as these strategies are, their effectiveness is dependent upon the acceptance of a new cognitive reality and willingness to use adaptive techniques. Will any of these strategies stop Alzheimer’s and other forms of dementia? No, but to paraphrase an old Buddhist saying, ‘You may not be able to cover a thorny road with leather, but you can wear shoes with good soles.”
Stan, I love this, too. As a daughter of an Alzheimer’s patient, I am anticipating my possible diagnosis, should I be lucky enough to live that long, and am also already making accommodations for my “senior moments”. I have never seen this written about before, and I think it will be immensely helpful for fearful people. Preparation is empowering.
Thank you for your kind words Sharon. I’ve always felt knowing what to expect from a potentially terrible situation is better than living in ignorance and frantically trying figuring out what to do when your world has already imploded.
We have never met in person, Stan, but have become distant friends through our cancer. Some of us are fortunate in those we meet when we realize the depth of intelligence, experience, and expertise present in those me meet wherein we find we can learn new things from them. Fortunate for me, you are one of them!
When I think I have learned so much from you, you come up with the authoring of new, important issues, we all should be aware. I admire that you haven’t slowed down in that regard.
After 27 years following surgical removal, salvage radiation, then 23 years of treating recurred prostate cancer, that cancer has finally been totally eradicated. I learned everything I could about this men’s cancer that can become deadly for some so that I could always entertain the hope that medicine and science would one day find methods to bring about a cure for me and others. And so that has become so for me. A new isotope/radiotracer to be injected in order for newer imaging to locate the area of continued cancer cell activity became available locally last year, and even better, Medicare covered the cost of this imaging using the product “fluciclovine (brand Axumin)” in 18F PET/CT imaging. The imaging identified a tiny area of cancer cell activity in soft tissue alongside the anastomosis that had eluded me all these years but that I had obviously kept under control with the androgen deprivation medications I had come to know were best to maintain that control. With targeted radiation to that specific location the cancer cell activity has disappeared. I never lost hope. But, sadly, over these past years of aging (I prefer to use Chronologically Giftedness), once I turned 70 years of age, several other “health issues” have beset me that included pulmonary embolism to both lungs at the same time on two occasions (blood clots) that meant blood thinner medication for the rest of my life; rectal bleeding – again on two occasions – that required trips to the ER to stem; two bouts of heat stroke requiring hospitalization and some rehab; then recently to my surprise blockages to five areas of my heart requiring stents that have left me exhausted and experiencing continued weakness as well as difficulty in walking/balance requiring a walker or wheelchair. Yet, I cannot help but be thankful that both my wife and I, in our “chronologically giftedness” (am 87 years of age and my wife of nearing 66 years is 92 years of age), remain on this earth to enjoy our extended family, our friends, and the beauty of the world that surrounds us – the colors of the flowers, trees, bushes, sunrises, sunsets; the births of life in children entering this world to take over from us – ah, we are truly blessed!
Sorry, Stan – your writing inspires my mind and I easily get carried away reminiscing.
As usual Chuck, your words humble me. I’m honored to be considered a friend. That’s more important than any writing accolades I’ve received. Your courage and fortitude in dealing AND LIVING with cancer is inspirational to everyone on the same path.
Stan, I LOVE THIS! What a wonderful new approach. i intend to share it with everybody I know who is as they say, “of a certain age”. Call me sometime! xo Audrey
Thanks. I’ll give you a call when I stop listening to the hearings.