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Click the image to expand it.
This morning while I was working on Twitter I looked at the bios of various followers of mine in order to see who they were and what they were doing.
One of the best bios I have seen on Twitter is that of Dr Sukant Khurana. His twitter (@sukant_khurana) and blog http://www.BrainArt.com are highly recommended.
I suspected that Dr Khurana might appreciate seeing how his bio could be turned into a mind map by a person with dementia (me) who is using visual thinking methods to continue to have a good life. Dr Khurana, your bio, twitter, and blog are inspiring.
It just takes a little time every day to learn and use advanced ways of organizing your thoughts and experiences.
It costs a few cents a day over a lifetime.
It builds cognitive reserve.
It potentially builds a mind more able to deal with the challenges of cognitive impairment and dementia.
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The Veterans Healthcare System is the most important one we have in the USA.
One thing that all of the cable news networks and newspapers agree on is that issues of veterans’ health are ones on which all members of Congress seek to achieve a consensus. An interpretation of this that I have heard from the TV pundits is that all members of Congress, whether veterans or not themselves, respect those who risked their lives to protect the United States and police the world. Another interpretation I have heard is that all members of Congress need to face constituents who value service in the military and would not vote for a potential member of Congress who does not protect those rights. I prefer the first interpretation, although I would also accept the second. Veterans have earned lifetime healthcare services and those services should be the very best that the medical and social services can provide.
I was very happy to see the strong reaction of Congress to the poor candidate nominated recently to head the Veteran’s Administration. A doctor who has managed a staff of 70 healthcare providers is probably inadequately prepared to run a large federal agency with hundreds of thousands of employees, 9 million patients, facilities across the US, and many political entanglements. Just because you are the personal physician of the US presidents and praise the current president’s health in spite of his all-fast-food diet, borderline obesity, and behavior that indicates high levels of stress does not mean that you should be rewarded with a job in charge of the quality of the healthcare of 9 million veterans. And no doctor who hands out medications on airplanes without prescriptions or having personally met with the recipient (patient) and is accused of inappropriate interpersonal behaviors is deserving of being trusted with the health of our veterans.
For once, Republicans and Democrats agree that the candidate was not qualified to head the Veterans Administration. And they achieved this conclusion by consensus.
So the nominee did the right thing and withdrew from his candidacy after a lot of pressure from the White House.
Wouldn’t you like to see our elected representatives act with similar wisdom and common sense every time they make a decision? CONSENSUS!
Tinkerbell thinks so.
And I am wishing upon a star.
Having dementia is, OBVIOUSLY, not a lot of fun. You feel bad mentally and physically and tired after just a little physical or mental activity. A couple of weeks ago when I had a six-hour professional meeting with two other people I went home and immediately went to sleep for 14 hours.
When you have dementia, it takes a lot of energy to just get through a day and figure out what you can do and how to do it. I have trouble with buttons so I find that I am leaving my preferred “office” shirts buttoned and just pull them over my head. I go to the trouble because wearing a dress shirt during the day — albeit without a tie and with the sleeves rolled up — makes me feel better.
Social interactions are among the most difficult things I have to deal with during the day. They are also the most upsetting to other people because they can see my vulnerabilities at the same time I may annoy the heck out of them.
So, one thing I try to do is to follow the 10 courses of action listed in the mind map below. I have increasing dementia after all so no matter how hard I try I doubt I get more than 80% of these things right. But by trying hard, my efforts are appreciated and reinforced by those family members, service providers, and others who have to deal with me when I am at my most stressed and tired and grouchy. And the fact I am trying lowers their stress.
Just because you have dementia, you are not excused from trying or being nice or appreciating others.
Click on the image below to increase its size.
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Made on the GapMinder.org Web Site.
If North Korea became just like South Korea, their per capita income would be TEN TIMES higher. The North Korean life expectancy could increase by TWELVE YEARS. Democracy, a battery-powered car and 2 television sets, a great education for your kids, a couple of trips to Hawaii, and 12 more years of life. Turn off the nuke production and increase the quality of life.
The #1 thing that I have learned over almost a decade of living with dementia is that thinking in pictures (images, diagrams, doodles, etc.) is much more effective than using words alone. Hedge your bet. Use pictures that associate with words rather than just words. After all, in many types of dementia, you lose your words at the end while the pictures may escape loss.
Try it. You will probably like it. Creating visualizations of important events, ideas, feelings, and other information can be FUN.
I’ve been using visual thinking methods for the past 10 years. They work (for me).
Click the image to expand it.
In March 2018, @USNews and @AetnaNews published key results from their study of approximately 3,000 US counties. Each of these counties received a total score as an index of how healthy the community is as well as scores on 10 component parts of being a healthy community. Eighty indicators of community health were developed from standard, well-constructed, and valid datasets.
The Healthiest Communities rankings are based on well-collected longitudinal survey data from US government databases and those of well-established, not-for-profit organizations.
My professional conclusion is that the study is valid, reliable, and relevant. The index scores are based on a combination of expert judgment from independent professionals and data sources that are among the best available. Statistical analyses appear to be appropriate and expertly applied. Of course, as with all such studies, over time additional analyses can be made, interpretations can be added by experts of many disciplines not limited to health, and supplemental quantitative (numerical) and qualitative (judgment) data can be collected.
The report on America’s Healthiest Communities provides a summary of the top 500 communities. The remaining rankings are not revealed as the intent is to identify excellence and study it to establish models for other counties that are also working to improve the quality of life for their residents.
Data available on each community includes well-constructed indices of the following characteristics listed in the mind map below. Click on the map to increase its size.
I spent more than 25 years in my post-doctorate career studying the health of communities throughout the USA, including a) small “frontier counties” too small to be considered rural where there were 5 times as many cows as people and the trip to a doctor was more than an hour for more than 50 percent of the population; b) the fourth largest U.S. county in a location on the Mexican border; c) large-city neighboring “bedroom” counties; and d) healthcare systems in more than 100 other U.S counties. My work (in collaboration with my business partner Dr. Lisa Melchior and our staff at The Measurement Group) was primarily focused on developing high quality, effective, and accessible care and treatment for people with mental health problems, drug and alcohol abuse and addiction, HIV/AIDS, extreme poverty, unstable families, inadequate or housing, poor education, immigration status, criminal justice system involvement, dependence on public-supported health- and social-care systems, and legal unemployment with a subsequent dependence upon “illegal employment” such as selling drugs and sex work in order to support themselves and their minor children.
As we worked with health systems and clinics, what I concluded was that a very comprehensive service system with widespread support among residents, service providers, and elected officials was necessary to make a community healthy. It was clear that all of the major stakeholders in the system need to communicate clearly to the other stakeholders about what they could and could not do with available resources. Stakeholders needed to learn to how to leverage their resources with those of other stakeholders to provide better services for a lower cost. A permanent system of making decisions and sharing resources and improving services needed to be formed and nourished.
The basic components of our work included assembling data from sources such as surveys, focus groups, interviews, and public databases. We presented these data to groups of stakeholders and facilitated discussions on how various systems such as healthcare, public housing, law enforcement, and education-training could work together and share resources. Progress was monitored and evaluated and new cycles of data gathering, communicating, discussions, and program alterations were conducted.
The following diagram shows the steps our process went through in order to build a self-sustaining system of interdependent services and joint decision-making in order to make a community more healthy. Click on the mind map to increase its size.
It is often said that “it takes a village” to plan and implement long-lasting improvements in a community. It does, but it takes a few other things also as well. Click on the diagram to increase its size.
#13) The diagram below is a sketchnote, a new method for recording information developed by Mike Rohde about 10 years ago.
In my personal experience (using it to deal with my dementia) this works far better than a “regular To Do List” for helping me remember and stay motivated.
It would take you 10 minutes to try this yourself whether or not you have cognitive impairment.
[Go buy some erasable markers.]
Click on the image to expand its size.
A caregiver looking at a person with (advanced) dementia can easily conclude that it is impossible to motivate them to do tasks that are “easy” (washing dishes, taking the garbage to the recycling bin, calling and making their own doctor appointment, or cleaning out the garage).
Motivation from the standpoint of the person with dementia such as myself is a much more complicated phenomenon. If you don’t have dementia you may not see it the way I do. Most people who have dementia will not articulate these issues in the way that I do (I have had 30+ years as a psychologist and this medical-psychological language is natural to me). I am convinced, however, that most people with dementia feel some of the things that I describe below. I not that I object to cleaning the garage but rather that in order to clean the garage I have to overcome dozens of fears and anxieties and find different ways to do simple things because I can no longer remember the order of the steps needed to do what seem to be simple tasks.
Please click on the mind map to expand its size.
If this is more than the second time you have ever read a post on my blog, you know that Donald Trump is not “well received” on my blog site.
Here is the worst tweet he has ever posted.
Trump is so obsessed with his “button” working that he has ignored and hidden the fact that his brain is not.
And here is a tweet from Lindsey Graham who has recently become Trump’s chief sycophant.
Mind maps are extremely useful for expressing an opinion or conclusion. Along with my conclusion that Donald Trump should be forced to resign, I also espouse full human rights for all without regard to the cost, banning all weapons of mass destruction held by ALL countries, and the full array of universal human rights specified by the United Nations. I also support allowing the figure-skating, Olympics-qualified couple from North Korea to attend the 2018 games in South Korea and enjoy the kindness of the host country and the support and friendship of the athletes of the world.
The President and his sycophants like Senator Graham need to be evaluated for their fitness to hold public office.
Modern terminology for Frontotemporal Dementia (FTD) has been expanding. Now, FTD is included within a larger group of neurodegenerative conditions including Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), FTD with Parkinsonism, and FTD with Atrophic Lateral Sclerosis (ALS). The combined set of diseases including FTD behavioral variant and PPA is referred to as Frontotemporal Lobar Degeneration (or Dementia).
At the present time, a variety of factors (including the research literature, the interests of advocacy groups for individual diseases, and prior medical practices) continue to the nomenclature and typology of these diseases inconsistent in different places.
Donald Trump promised America no more Happy Holidays but instead a Merry Christmas for all Americans (even those who like me who are not Christians a group which includes also includes Ivanka, Jared, and their three young Jewish children). He also promised to cut taxes for the poor and middle class. He calls this the greatest Christmas present you have ever received. He has once again told a lie, and this one is a real doozy.
Trump says he is Santa Claus. Instead, Trump (Santa) and his two elves (Paul Ryan and Mitch McConnell) are pretenders and have been very bad boys and helped super-rich donors and friends grab all of the money. They have also told middle-income Americans to deal with it, suck it up, and pay-off the $1.5 TRILLION debt that will result.
The richest 1% of all Americans will receive 83% of the reductions in taxes. Santa will probably just bring you a piece of coal.
Santa Trump deserves to be impeached and/or in jail. Today.
VEDTEFS has come to public health, or more accurately erased from public health “thanks” to the Trump administration.
The brilliant comedian George Carlin had a routine in the 1970s about “10 words you can’t say on the radio.” Carlin’s schtick has of course been made irrelevant in the 21st century since you can now say all of those words – and many more similar ones – on top 40 radio and on TV.
As reported in the Washington Post, those pathetic and mean clowns in the White House have now developed a list of seven words you cannot use in official reports at the US Centers for Disease Control, one of the world’s premier medical and healthcare research and public health agencies.
THOSE SEVEN WORDS ARE CRITICALLY IMPORTANT TO DESCRIBE A SCIENTIFIC APPROACH THAT LOOKS FOR TREATMENTS THAT HAVE GOOD OUTCOMES. SERVICES SHOULD BE MADE AVAILABLE TO VULNERABLE POPULATIONS, OF A DIVERSE NATURE, AND INCLUDING SERVICES FOR THE HIGH NEED ISSUES OF TRANSGENDER INDIVIDUALS AND FETUSES. STATE-OF-THE-ART HEALTHCARE AND ACCESS TO IT SHOULD BE ENTITLEMENTS AND A UNIVERSAL RIGHT FOR ALL THOSE IN THE USA.
Effective now the CDC is banned from using these words and web pages are coming down. Of even greater importance, apparently since the CDC is banned from using these words in their official reports and therefore they cannot seek to fund work on these topics as they cannot list them in such official documents as their proposed budgets. All seven words are part of the working vocabulary of most healthcare professionals in most countries.
Apparently Trump has been paying attention to Stalin, Hitler, and Putin, all of whom have banned words, books, and plays to control and brutalize their populations. And they have increased conflicts among citizens by allocating services to only the richest and most powerful people in their countries.
I rearranged the words in the order VEDTEFS so that you have an acronym to help remember what Trump wants you to forget.
Click to expand the image.
George Carlin’s famous X-rated monologue on the 7 words you can’t say on television greatly influenced my generation. One of the high points of the career from a comedian who did much to make us reassess cultural boundaries and censorship.
Carlin’s monologues are obscene by many people’s definitions. Don’t click on the videos if you are upset by extreme obscenity like that in the top 40s songs of the 21st Century.
From where I sit, Trump’s list of forbidden public health words at the CDC is just as obscene that presented by Carlin.
Note. The word ban at the CDC was extensively discussed in the worldwide media on December 16, 2017. If you would like to see the media discussions of the ban, a simple Google search will yield hundreds of results.
I have a series of mind maps that address the ways that I — as a person with dementia — should self-reflect on my own functioning and that I create or shape among others.
Most importantly, I try to ask myself what I learned for tomorrow. And then — by putting it in a mind map — remember what I hope to achieve. If I don’t map it, I probably won’t remember it Or gain from my insights.
Dementia is strange like that. It doesn’t necessarily keep you from having deep insights into issues… it just prevents you from remembering what they were if you don’t write them down. I’d contend that using a visual thinking method like mind mapping is the best way to “write them down.”
XMind was one of the original open source programs on the PC and Mac for mind mapping. A high percentage of the “simple” mind maps you have seen online were generated with that program. As time went on, a Chinese company used the open source code as the basis for a commercial product which has many advanced features while still being easy to use and very fast. An enhanced version of the original program is still available on the website and has been promised to continue to be circulated for free.
This week XMind was released for the first time as an iOS (iPhone, iPad) app. It is currently being offered for free on a limited time basis.
My initial impression of the app is that it is one of the two best mind mapping programs for the iPhone and iPad (iMindMap continues to be #1). XMind is especially well adapted for the small screens of the iOS devices and is very usable on an iPhone. XMind employs a “keypress” user interface which is generally more accessible for most users at the beginning stages of use.
What XMind iOS lacks — and what I suspect will end up as an additional feature you have to pay for — is the ability to add images to the mind map. For most maps where one wants to use images throughout the diagram, this is a limitation. I expect you will see another version very shortly. XMind iOS mind maps can easily be imported into other mind map programs to add images and advanced formatting. In exporting images, the app is limited to only medium resolution.
This version of the program will suffice for most basic note taking and simple brainstorming applications. Many might find this the only mind mapping program they need.
For now, the initial version is free. Available on the iOS app store for Apple products. More information here.
Donald Trump is an incompetent president and it is just a matter of months before he is removed from office or resigns. With the current succession order, the future looks almost as dark as the present. Click on the image to expand it.
For every case of dementia, mind maps can potentially be used to improve the quality of life of the patient, caregiver, and family. Many people in the later stages of dementia are confused at times, frequently unresponsive, have minimal access to their memory, and can be aggressive and otherwise difficult to deal with. In spite of this, the care of almost every dementia patient, even one at a very late stage dementia, can be improved by mind maps and other visual thinking tools and better care will almost always produce a better quality of life.
Mind maps and other visual thinking methods are better ways to capture, store, manipulate, share, and understand an individual case. Image that. A method that costs pennies per use can improve the efficacy of $200 doctor visits, $20 pills, $3000 emergency room visits, $150 of home healthcare, and $1000 consultations because at the end of all the fancy stuff, mind mapping is an intuitive, easily understood method of communicating among and coordinating among the many parties that collectively are the care system for an individual person with dementia. No, simple mind maps will not substitute for medical treatments, but they can make the individual healthcare system developed for a person with dementia more efficient and help cut service redundancies and unneeded tests and treatments resulting from poor patient-doctor-family communications.
Among other ways, mind mapping and other visual thinking methods can be used even with patients with advanced stages of dementia. While people in advanced stages might be limited in their ability to draw maps, they may be still quite skilled in reading them and picking up on associations. Whether or not patients with dementia can draw (or even read) mind maps at the end, caregivers, doctors, nurses, families, and others may use these visual methods of communication to easily share information among themselves. If the patient has created a “pre-dementia” set of diagrams for her or his life experiences, there will be a useful baseline for healthcare providers to better understand the individual case.
Good communication. Good coordination. Knowing the issues. Applying the best thoughts of all people in the care team (including the family, caregivers, and patient). Using the best treatment methods useful for the individual with dementia. And all because mind maps (compelling visual methods of producing insights into complex issues in a simple way) make communications clearer and more reliable, allow a patient to take part in her or his own treatment, and do so at a low-cost that makes the care team more effective and the patient and family happy about the quality care the patient is receiving.
Sounds almost too good to be true. It isn’t.
Click on the mind model (mind map) shown below to expand its size.
I know that a simple version of the outlined model has worked super well for my (dementia) care. It could also work super well for you or a person with dementia for whom you provide care.
If you have not read the Introduction to this series of posts, it is important that you read it before this post. Click here for the Part 00 Introduction. This post is part of a series of more than a dozen posts.
I worked on understanding health and social service programs, especially for the disabled, poor, disenfranchised, and traditionally underserved as a program evaluator for about 25 years. I was very good at it and worked with hundreds of programs spread over most US states.
In writing about my activities to achieve stability in my dementia and maximize my quality of life, I am going to employ the tools of program evaluation to describe what I was trying to achieve, what I did to achieve my goals, why I did various activities, and which parts of my interventions seemed to help me the most. No, not in this post but in a series of more than a dozen posts.
In this post I will start by describing the activities I designed for myself and did throughout my period of diagnosed dementia over six years of living with the disease. In subsequent posts, especially Posts 02 and 03, I will discuss the outcomes of my activities. After that, I will address some of my activities — and especially those that “worked” extremely well for me — and describe them in depth, show how other individuals might use these methods, and how dementia caregiver and healthcare systems might be built around them.
The image below is a mind map. Should you not be familiar with how a mind map is drawn and read, please search this website for posts on mind mapping using the search box. Or, go to the home page by clicking here and look at the list of pre-defined searches.
A very simple set of rules for reading a mind map is as follows.
Click on the mind map to expand its size and zoom to various portions of the map.
As you can see, I tested app after app after app on my Mac and iPhone to see which could help me. I read all about how to mindmap and draw sketchnotes and I practiced and practiced. I learned to read “dog” and taught my Newfie to understand “people.” I doodled, watched the news, built a highly-rated social media following of more than 140,000 individuals interested in healthcare, dementia, visual thinking, and 100s of other topics from around the world. I went to concerts, watched movies, and cheered for the two local universities with huge sports programs. I engaged some new parts of my brain. I thought in pictures.
Stay tuned, the interesting stuff starts next.
In 2010 I was diagnosed with neurodegenerative brain disease with the initial diagnosis being supranuclear palsy which was later amended to the highly related frontotemporal dementia, behavioral type. Some believe that PSP and FTD are variants of the same disease.
I started to examine Mac and iPhone/iPad apps that might be useful early in 2010. After I retired in 2011 I started to use a number of the apps for such things as calendars, task lists, alarms, reminders, and other business-like functions. The business-like apps failed to motivate me to use them continuously nor could they address executive functioning problems that were at the core of my disease. As early as late 2011 I had concluded that mind maps and other visual thinking methods could be very helpful.
As I read about every mind map book around by dozens of authors and bloggers, including the majority of those written by Tony Buzan who makes the claim he is the “inventor” of mind mapping (it is a silly claim no matter who makes it), I rapidly discovered that virtually all visual thinking work focuses on lucrative management consulting that few who use it have strong background in substantive areas like medicine, healthcare, psychology, and related disciplines. What little work exists in mind mapping and other visual techniques within the health and medicine areas indicates a total lack of understanding of visual thinking and is generally painful to read.
I wasn’t scared off by the fact that there was no clear guide to what a person with cognitive impairment and later dementia could do with visual thinking procedures and computer apps to try to improve the ability to cope with dementia. I had, after all, spent 35 years of a successful career as a (nonclinical) psychologist and much of my career had focused on developing new applications of psychological knowledge to addressing medical, psychological and social disorders. And much of the 35 years were spent studying the service care system for those who were least connected with society and traditional healthcare.
I am writing a series of posts (currently more than a dozen) evaluating my experiences during the last six years with a progressive brain disease. Each will focus on a specific test of methods and outcomes I think were achieved.
My studies are one-subject research (often called N=1). I will present results that I believe can be inferred from specific indicators. However, what I discuss is DERIVED FROM MY EXPERIENCE AND MY INTERPRETATIONS OF THE OUTCOMES OF WHAT I DID. I do not claim that any of what I write about is applicable to all people or that what I did should be considered to prove anything as opposed to simply observing it in myself validly or not. And, I see no evidence that the outcomes from what I did have done suggest I found anything to treat or cure or slow the progression of dementia: I never expected them to do so. What I do believe that I have demonstrated for myself is that these methods have helped me maintain a much higher quality of life. Not more days in my life, but many more good days while having dementia. I feel blessed to have received those extra good days.
Most of my “writing” is in pictures. That’s the point of visual thinking.
The following mind map is a general introduction to my work over the past six years. I call it Part 00. Starting with Part 01, I am going to start to present both observations and objective indicators of what happened for me.
Should you not be familiar with how a mind map is drawn and read, please search this website for posts on mind mapping using the search box. Or, go to the home page by clicking here and look at the list of pre-defined searches.
A very simple set of rules for reading a mind map is as follows.
Click on the mind map below to expand it and let’s start the process of understanding of what visual thinking methods help me to do.
In case you were wondering which topics might be selected for mind maps to help patients and their caregivers with cognitive disabilities or dementia …
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And, yes you are correct, this is the same diagram as in the prior post with just the title changed from sketchnotes to mind maps.
I think that is the exact point I am trying to make.
Use what works.
In case you were wondering which topics might be selected for sketchnotes to help patients and caregivers with cognitive disabilities or dementia …
Click the image to expand it.
I have come to the conclusion that the process of mind mapping forces a structure onto the brain that can help it deal with some of the problems of dementia. Mind mapping — at least for me — seems to force a structure for attempting organized thought that engages different (undamaged?) parts of the brain. I have no proof: there have been no brain wave studies of individuals while they are using visual thinking methods. My experience of five years has led me to believe that is why my mind mapping works. I await some formal studies which will reassure others if not me.
Click the image to expand it.
I often post about a trio of visual thinking methods that I use (I believe successfully) to deal with my own dementia.
Yes, this is one more post on the “trio topic.” This differs from the earlier posts in that it tries to use a commonsense and nontechnical language to explain how and why these methods seem to work.
Click the mind map to expand it.
Click here for my partner post on merging mind maps and sketchnotes. The post opens in a new window.
Buzan-style mind models are great (for me) in dealing with the cognitive issues of my dementia. Rohde-style sketchnotes are great (for me) in dealing with the cognitive issues of my dementia.
Q: What happens when we combine the strengths of both approaches? A: A little bit of magic.
This diagram was created in the superb program iMindMap Ver 10.
Click the image to expand it.
Mike Rohde’s seminal work on #sketchnotes is a brilliant contribution to the knowledge base on communicating and using visual thinking methods.
I have recently done much work on using mind map methods to assist those with typical aging, dementia, and cognitive planning for their futures which may include cognitive decline with age or after brain trauma.
Mike #Rohde and his disciples say to hand sketch when using his visual thinking model. I am moderately good at simple sketchnoting. See here for early posts on hand-drawn sketchnoting (with examples) for those with dementia (by someone — me — who has dementia).
But how might you use a computer program to generate a sketchnote? Here is an example prepared with the superb mind map program iMindMap of my guidelines about how to combine strengths of mind mapping and sketchnoting.
Of course, I prepared this as a computer-assisted sketchnote with iMindMap.
Within my application space of developing visual displays for those with typical aging or dementia or brain trauma or concerns about future cognitive decline as they age, I think the best applications of sketchnoting would be instructions for various methods and issues, historical records, and visual thinking for people who usually acquire new information through written or verbal media (conversations).
Click on the image to expand it.
More information on sketchnotes is found on the Sketchnote Army web site.