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Music Lessons from Tony

For people with dementia, everything happening now is unfamiliar, because the way they process visual, auditory, tactile, and emotional data is damaged by dementia, and so nothing seems as it once did. What is familiar is what was happening, where they were, and who they were with when they were in their cognitive peak – when they had command over their minds, their bodies, and their lives.

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Say this, not THAT

...a person with dementia simply cannot remember, asking you repeatedly, “When are we going to the dentist?” Short term memory is usually the first cognitive function to betray them. To the person with dementia, every time they ask is the first. So responding with “Don’t you remember?” is useless...

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Wheel of Cognitive Function

It can be so difficult to tell the difference between normal "senior moments" and the signals of cognitive decline. There can be several reasons for this. Off the top of my head...

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When Professional Help Is Needed

The best answer to that question is it depends. You must first evaluate the overall situation. Where should an aging senior live? There are many factors that you should look at to make an informed choice. Let's explore the options for yourself or a loved one.

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Holiday gift ideas: What to give a person with dementia?

My caregiving clients have been asking, What should I give my loved one as a holiday gift? You might be wondering the same thing. Here are some guidelines, some idea sparks, and some examples to help you make informed choices for a loved one with dementia as you make your gift list this year.

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Dementia-friendly decorating

For a person with dementia, the visual stimulus of the holidays can be too much. Overstimulation can cause disorientation, confusion, and agitation…especially as the day wears on. Here are some decorating suggestions to help keep everyone’s spirits bright and calm throughout this holiday season.

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Like a scratched record

Repetitive reminiscences are usually a sign of dementia. When a loved one tells you the same stories over and over, it can try your patience like a scratched record. But once dementia caregivers understand WHY people with dementia do this, it becomes easier to manage.

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Boundary setting: The mother-in-law suite

For family caregivers, their relationship to the person with dementia will be forever changing and forever changed by dementia. Although it may be hard to break the old patterns, they often don’t work anymore.

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Why did I come up here?

It happened again last night. I went upstairs during a TV commercial to get something from my bedroom, but when I reached my bedroom door, I couldn’t remember what I’d come all the way up there for. I scanned the room. Maybe I would see the thing I meant to retrieve. Once, twice I combed the contents of the room with my eyes.  Nothing.  I gave up. Why does this keep happening? Was this a glimpse into the future I pray I do not inherit from my father?

Why does this keep happening?

No! It’s actually quite normal for this to happen – especially as we age. So if you, too, can’t remember why you stopped what you were doing to go get something or do something in another room – and you only remember what you wanted when you return to the place where you decided you wanted it – you are completely normal. Here’s why.

“Why did I come upstairs???” – explained

Visual data is the most important sensory data to our survival. We rely a great deal on our hearing, but we most prefer to process the world around us, and respond to it, based on what we see.

It’s not really true to sa that we see with our eyes. We receive visual data through our eyes, but it is in the occipital lobe that we process that data. It is way back in the back of our skull where we see that round, red object as a kickball, or that open, black circle as a tire. It is in the occipital lobe that we detect form, color, depth, motion, light, and shadow. And it is the occipital lobe that heavily embeds code into our new memories.

Near the center of the skull lies the hippocampus. This is where new memories are formed. This is where I created the new memory that there was a chill in the October air, and a fleece would be nice – better than turning the furnace on. When I formed the memory that I would get my fleece jacket from my bedroom during the next TV break.

Encoded in that memory were the images of the television in front of me, the wood paneling behind it, and the black and white photo hanging above the screen. But when I left the room to climb the stairs, the imagery changed.

The threshold effect.

Because I am not young, my working memory is past its peak. For most people, many aspects of working memory peaks in our 20s or 30s.[i] But for me and most my age, we can’t hold as much information in working memory as we used to hold. So our brain arbitrates which information stays and which is determined to be no longer necessary. The hierarchy is based in part on time[ii], so recency is highly tied to relevance. This creates a sort of threshold effect; when we leave a room, we discard certain bits of data.

So as I was navigating through my house, thinking about what I’d just watched on TV, remembering to move the clothes from the washer to the dryer, recent bits of data were getting shuffled around. Coupled with the fact that my fleece memory was missing bits of visual data, I could not recall the purpose of my trip to the bedroom.

Did scanning the room help?

No! What would have been really helpful would have been the missing data. This is why I could only remember the purpose of my trip upstairs when I sat back down on the sofa and in front of the TV.

Perhaps I could have recovered if I instead had closed my eyes, imagined myself sitting on the sofa, looking at the TV screen, seeing what I was seeing when I decided to get the fleece in the first place. I will try this next time. These days, my stairs are more like a StairMaster® than I would like…

Try this instead.

I bet this happens to you, too, if you are beyond a certain age. While you are standing at the bedroom door, don’t scan the room. Try rewinding to the moment you had the thought to go get something from somewhere else. Visualize what you were looking at when you had the thought. What visual imagery surrounded that? Scan that room. You just might remember why you left and save yourself an extra trip.

[i] Hartshorne, J. K., & Germine, L.T. (2015, April). When does cognitive functioning peak? The asynchronous rise and fall of different cognitive abilities across the life span. Psychological Science. 26(4), 433-443.

[ii] D’Esposito, M. (2007). From cognitive to neural models of working memory. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 362(1481), 761–772. doi:10.1098/rstb.2007.2086


The Dementia Caregiver Compass, Explained

Caregivers have the best intentions at heart. We all want to savor those parts of the relationship with our loved one that we’ve known for decades. But when a loved one has dementia, the disease interferes more and more often, hiding the person we remember. It can be so frustrating to ...

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