Late last year I had the opportunity to hear a (surprisingly) amusing lecture by David Tullar, a neurology expert specializing in memory. Now, who would expect to chuckle and even laugh out loud during a talk on Alzheimer’s Disease (AD) and other dementia issues? Especially puzzling to enjoy the humor as we ourselves age.
Yet, that was the situation as Dr. Tullar gave practical advice on how to deal with those having memory problems. (Hint: sticky notes have limited success.) He considers the two most difficult challenges for caretakers to be:
- The never-ending question(s).
- Did the person remember to take their medication?
While neither of those were the subjects spurring me to write this post, I will mention some of the Doc’s answers briefly. The first, is simply answer the question (over and over and over and over). Don’t bother to say it was just answered. I must admit I thought to myself, maybe the approach should be to amuse yourself with different answers. Ok, no, not nice.
The second issue about taking medication is simply don’t expect the person to remember to take their own medications. It may no longer be in their capacity to track it. Your own expectations must change.
What about Capacity and Memory Impairment?
Dementia? OK – we are notoriously forgetting where we left our infamous keys, or what we had for breakfast or the name of the person we JUST met. But we don’t (yet) have dementia, right? True, and we probably don’t have substantial memory loss.
Our cognitive capacity needs to stay above cognitive workload. If we are overwhelmed but handle it nevertheless, we don’t have dementia. For an AD patient, that’s no longer true and we need to REDUCE their workload. Simplify their life. So simply their life. Oh yes, I just said that.
Dealing with Anger
Caretakers, Dr. Tullar said, need to think not about behavioral problems but about behavioral ‘communication.’ What is someone’s behavior trying to say? They are frustrated? They are misunderstood? They feel disrespected? All of the above? Taking the blame for not communicating well with them goes a long way to diffusing a situation or an angry outburst.
Don’t expect once resolved it won’t happen again. That’s the disease. Reasoning may be slipping from their capacity.
The Caregiver
We have all heard that often it is the caregiver suffering much more than the patient. The latter can often be happy-go-lucky most of the time. Not so for the caregiver.
They are worried, tired, conflicted over treatment, confused on the options, feeling guilty over their own feelings, stressed in general or hesitate about where to turn for help. This memory care specialist wanted to point out that this is not just secondary. He proclaimed that:
A DIRECT goal of Treatment
of the person with Alzheimer’s Disease
is to take care of the Care-Giver.
NON-Pharmaceutical Options Available for Care
While the lecture did cover pharmacological categories, such as cholinesterase Inhibitors, memantine (blockers of NMDA) and new drug categories like Aducanuman (Aduhelm), his simplest point about such medications was about weighting the risks. None of them work for everyone, or totally cure these diseases, but when you are considering what is right for a loved one – look at the risks, look at the possible benefits. After reading and deliberating with the patient’s own doctor, weigh it out carefully.
Readers of Aging with Pizzazz know that most of the time I don’t deal with pharmaceuticals, (something never my specialty). But I always keep my ears open for other, non-pharmaceutical, options. That wasn’t hard to do during this lecture. Tollar described his belief that there are 3 things (OTHER than taking care of the caregiver) that ALL of us should do now. Whether we are in perfect health with good ‘memory,’ or we are showing signs, or have been diagnosed with impairments, the three things are the same. AND inexpensive.
3 Tips to Improve our Brain Health
As was said about pharmaceuticals, nothing fully stops memory impairment. As we age it is natural to lose some of this capacity. It’s not necessarily a given, but incredibly common. Still, it’s Tollar’s findings, and he points to the many clinical studies about memory impairment to prove this, that we can do at least 3 important things to help ourselves (or encourage those we take care of or love).
They won’t sound new or surprising in terms of general health, but maybe a bit unexpected in terms of memory health.
- Exercise.
- Good diet (specifically something like the Mediterranean Diet).
- Keep, increase and encourage social connections. Avoid isolation.
Two other smaller issues he mentioned are also in one’s control. Namely, avoiding excessive (maybe even moderate) alcohol use. And secondly, avoid frequent use of Benadryl, whether for sleeping or allergies.
Read Sufficiently Before Making Decisions
It’s never too early to understand these issues. And if a loved-one is demonstrating unusual behavior (for them) and you wonder about what lies ahead – take a step.
Read about things like AD from professional sources (some of it IS in English vs. medical-ease). For example, Tullar suggested referring to Clinical Trials.gov. Check out all you can if you’re considering a particular medicine for a loved one. The risks may outweigh the benefit.
There is a myriad of books on Alzheimer’s. Currently, I don’t have a suggested list, but will only say, check the source, just as you would online. If miracles are guaranteed, it’s probably fantasy.
Final Thought
While much time has passed, I first wrote this article just days after the lecture. Then, I hoped that I would remember to post it.
Considering that the 3 tips about Brain Health are ones already in my own portfolio, I’m optimistic. I trust I’ll stay within my capacity for now, and hope for a lot more years of Aging with Pizzazz. You too?
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Picture credit: Photo by Tara Winstead: https://www.pexels.com/photo/skeleton-hands-on-skull-8386715/
(Did you think was a pre-Halloween post?)
Good tips, and timely, having a dear one just recently pass with the primary cause dementia. Nice to have those non-pharmaceutical options reinforced too, since there doesn’t seem to be much clarity on the pharmaceuticals for treating dementia yet.
Thanks for sharing. AND very sorry to hear of your lost loved-one. Such loses are more frequent as we age and a difficult thing to do with pizzazz. I agree that the options are nice to know about, and to consider doing now. Thanks Darrow.