Living well with cognitive changes… Picture by: Ambro
“People often hold on to what they remember as an ideal holiday from years gone by, and are unable to reproduce it.” “There are also expectations around the holidays that everything must be perfect, and perfection is, of course, rarely obtainable.” Changes in abilities and grief can at times over ride what is possible. Different minds can find common ground. Set realistic goals and build togetherness. Memories come back to us at this time. It is important to give time for all the feelings and not get stuck in any feeling.
The experiential self: Is in the moment. It is a direct evocation of interacting with the flow of current events. Seeks moments that are enjoyable as they are lived.
The narrative self: Is the story of one’s life. The narrative self typically comprises a few key moments of major life change and the rest of the memories are relegated to the great blackness. The narrative self seeks happiness through the ideas of success, conforming to social expectation and the imagination of how an event will play out in the larger plot of one’s life. Neurocognitive changes often push into the raw ability to have experiential happiness.
Two forms of memory: Declarative (memory for facts) Procedural (memory for emotions, and skills) Procedural memory is intact in a wide array of neurodegenerative disorders even Alzheimer’s Dementia. Declarative memory is often impacted in those with dementia particular
Water Maze Study: Mice with dementia like brain injury when dropped into a water maze will figure it out but will not remember the solution at first. If given enough trials they do. Emotions lingered in individuals with dense amnesia long after the ability to remember the event that caused the emotions.
The brain is very plastic (can change itself). The brain has “preferred” ways to do a job. If the preferred way is damaged the brain with use other areas to get the job done. The none-preferred area will get the job done but it takes more work to do it.
Moral model: This model views disability as a moral failing. Medical model: Views disability as an illness or deformity to be fixed. Disability rights model: Recognizes differences and notes that social systems hold biases that can impede the ability of the individual to adapt.
Alzheimer’s dementia: Memory-based disorders (forgetting). Movement-based disorders including Parkinsonian dementia and Lewy body dementia. Frontal-temporal disorders including Picks disease, primary progressive semantic dementia. Vascular dementias: Reflecting changes in areas of the brain effected by strokes.
The changes our loved one go through can create grief in us that stops us from having the relationship they are capable of. People are still present even in late stages. Do not get caught on your loved one remembering your name. Other relationships: Non-verbal relationships, being together, finding things you two can enjoy together.
Depression is a common reaction to changes in functioning. Depression accelerates functional disability from dementia. Depression present in about 20-40% of dementia patients. Myth: Depression is rare in people with dementia because they can’t remember. Fact: The rate of depression is about 4 times that of the normal population. Myth Behavioral interventions and Therapy is ineffective in elders with dementia. Fact: Through a solid treatment plan that includes exercise, increased positive activities, problem solving difficult behaviors and supportive therapy for individuals and families people can heal from depression through behavioral interventions.
Treatment for depression and anxiety in elders with dementia requires Re-enforcing emotional states incompatible with depression Changing the interaction between caregivers and clients. “Even though individuals with dementia do not learn new (DECLARITIVE) information they do benefit from therapy.” “This is not to say that individuals with dementia learn new skills, but rather their behavior (in this case affect) responds to the environment.”
Anxiety is common for elders with dementia. Anxiety leads to increased symptoms of dementia. Anxiety leads to a lower quality of life. Along with depression events that can be perceived as live threatening increased anxiety. Anxiety is related to: High amounts of social contact. Problems in the relationship with care givers. High levels of physical dependency.
Caring for elderly people with dementia can lead to emotional distress, health symptoms and mental health symptoms and loss of emotional wellbeing. Emotional distress from care providing increases with: More sever behaviors. Higher levels of impairment. Number of care hours per week Number of tasks. Declining coping and support resources. Self-care is vital: Remember to take brakes, laugh at the difficulties, keep connected to your community, build a support team. Positive activities list.
Have family time just with the children. Help children see the relationship possible with elder. Use simple clear language, normalize the elders behaviors. Let your children talk about their emotional reactions. This can be difficult because often as adults there are similar feelings.
Savoring is the opposite of judging. It is seeing life as it is and finding one thing that you enjoy and focusing on that. We can learn to savor the relationships we have with our family members. Despite changes our loved ones face there are moments of deep connection. Savoring a Skill: Find one thing that is positive around you. Pay more attention to that. As you pay attention to the thing you enjoy also notice how it makes you feel inside. Shift your attention from the thing that you are savoring and the feeling and back again at your own pace.
Three skills to de-stress through out the holidays. Breathing with a pause – Breath in slowly through your nose and our through you mouth. Just before you breath out take a small pause (the count of three). See or listen to three things that you like… Look around the room and notice three things that you like or listen to three sounds that are good. Stop judging thoughts! In the holidays we want things to be perfect. Our or attitude makes a big differnce to how we feel. Notice any negitive patterns of thoughts and then find a more kind and real thing to think.