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social, health, political imagery through the lens of George J Huba PhD © 2012-2017

Search results for dementia

Several times over the past six years, I have written similar posts suggesting strategies for minimizing the symptoms of dementia.

This is my current scorecard and suggestions about how to deal with the symptoms of the disease.

This is a totally new effort (I did not go back and look at the prior posts on this topic). If you want to know what I felt about my own dementia at various times since 2012, you can go back and look at my prior posts. To do so, on the left of any of my blog pages you can click on the month and year and see all of the posts from that time period. Alternately, in the search box, you can type in some keywords and see a chronologically-ordered list of my posts on that topic.

Here is a mind map of some strategies for minimizing the symptoms and effects of your dementia (or that of a person with dementia under your care).

Click on the image to expand it.

 

 

#dementia #MindMap @DrHubaEvaluator #GeorgeHuba

 

 

Dementia is a time that gets extremely complicated for a person with dementia and their spouse, family, friends, new social acquaintances, healthcare providers, and caregivers.

Probably the biggest issue is that those who interact with the person with dementia expect the PWD to communicate in a way that is diminished but still like the way a typical person without dementia communicates just now at a lower level.

It is difficult to communicate with a person with dementia because their own experience of communications is now shaped by the brain changes and other symptoms of dementia. What about your Mom who no longer smiles when you say something she has always liked or when you bring her the pistachio ice cream she has always loved? Ever consider the possibility that she thinks she is smiling but has no control over nonverbal communication such as her smile. Brain damage of various types can cause the loss of nonverbal communication abilities or control of facial muscles.

Why does your friend always get overwhelmed and say something stupid when there are lots of other people around? Perhaps they can’t focus on what you are saying because there is so much noise and motion from distracting sources?

Ever wonder why your friend with dementia comes back with an answer to a question five minutes after you asked the question? Brain changes and damage during dementia may make it hard to retrieve information or think and a loss of a sense of time may mean your friend keeps working on answering the question long after the conversation has moved on.

In dementia, a daydream may be as vivid as something in the real world, and just as distracting. In dementia, you can’t deal with too much information because it distracts you and can’t “fill in the blank spaces” if you receive too little because your “executive functioning” has been destroyed. You tend to get anxious during a conversation not only from unpleasant topics but also from worrying so much about missing a word or forgetting a name or misinterpreting a suggestion as hostile when it was just a normal joke.

The physical and psychological consequences of dementia combine to make it seem that a person with dementia is speaking a different language. They are.

And yes, those 20 or more pills the person with dementia may take daily can affect the ability to speak clearly, pay attention, be sleepy, look like they are bored when they are not, or become even more anxious.

Additional thoughts are arranged on the mind map below.

Click on the image to expand it.

Always try to remember that the person with dementia is often not disinterested or misunderstanding you or too tired to think or extremely distracted in what you think is a peaceful environment.

And if you are a person with dementia, remember that your friend is not trying to mislead you or express hostility and disapproval. They are not trying to trick you or harm you or pick a fight. You might not remember a conversation your caregiver says you had 10 minutes ago, so get over it and trust the other person. Nobody is criticizing you as a person because you can no longer tie your shoelaces or your necktie.

All parties in a conversation with a person who has dementia need to realize that the “rules” for the social encounter have changed because of the disease. Both persons with dementia and their families and friends and caregivers need to realize that is just as hard for all parties to figure out this new “language of dementia.” But it can be done and when mastered can liberate everyone to some degree.

Learn to laugh and smile and enjoy the company of each other again. The positive emotions are still there but they may have to be expressed in different ways. Learn how to express oneself when one or more parties has dementia. It’s worth the time. For everyone.

 

what makes conversation difficult for a person with dementia

 

#mindmap #mindmapping #dementia #Alzheimers @DrHubaEvaluator

After working hard (or some would say, “struggling) to continue having a good life with dementia, many (including me) find they must eventually come to the final obstacle of almost debilitating apathy and hurdle over it. It is very hard to commit the energy and time to fight back against the apathy which naturally results from knowing you will have to keep working so hard at fighting back for the rest of your life.

Take a deep breath. You can do it and then do it again tomorrow. Do remember that all of us who deal with dementia face the same general set of obstacles every day. And maintaining a “normal” or typical lifestyle is well worth it.

A mind map showing the major issues. Click on the image to expand its size.

Dementia Hurdle

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.

 

Being the Best You Can Be with Dementia

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).

#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.]

12thingsIlearnedabiytdenebtua

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.

LOSS OF MOTIVATION DURING DEMENTIA SOME REASONS WHY

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.

Types of Frontotemporal Lobar DiseaseDementia

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.”

Did You Create Problems Today

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.

  1. Start at the center of the diagram. Each of the topics (ideas or major branches) that come out of the center represents an issue. Important information about the main issues is given as a series of branches. The organization is in an outline or tree where large branches divide into smaller branches and smaller branches divide into even smaller branches.
  2. Think of the map as a clock face and start at the 1 o’clock position (upper right corner). Read outward from the center along the branches and sub-branches to see how ideas and information about the topics can be arranged in a hierarchical or tree structure. [If you could go up a huge fire truck ladder and look straight down, you would see a structure of tree branches that looks like a mind map. When we study or read a mind map, we are looking at a whole tree — set of information — and then seeing how small and more specific information spreads from the trunk.]
  3. Go around the map in a counter-clockwise manner (to 2 o’clock, 3 o’clock, etc.), following the branches down to their branches and their branches and finally to twigs. Remember that we are looking down at a whole idea [or tree] and its branches and their branches in order to understand how the information represented on these branches goes together and what the most important information is.
  4. The mind map is thus a picture of major ideas followed by its major subdivisions or branches and sub-branches. The “big ideas” are attached directly to the central issue.
  5. A mind map is a way of showing in an image how a set of data pieces or ideas go together.
  6. The pictures, color coding, and fonts are used to designate what is the most important information in the mind map. When you are trying to remember or organize or determine priorities, the pictures, color coding, and size of the fonts can help you store information in “visual” parts of the brain and then retrieve it by thinking about pictures, the color coding, or size-importance of the information.

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.

  • I HAD FUN.
  • I LEARNED MANY NEW THINGS THAT STRETCHED MY BRAIN INTO NEW CHANNELS.
  • I BUILT COGNITIVE RESERVE.
  • I THINK I PROVIDED NEW INFORMATION TO PERSONS WITH DEMENTIA AND COGNITIVE DECLINE, CAREGIVERS, HEALTHCARE PROFESSIONALS, AND THE GENERAL PUBLIC. I FEEL GOOD ABOUT THIS.
  • I HAD FUN.

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.

  1. Start at the center of the diagram. Each of the topics (ideas or major branches) that come out of the center represents an issue. Important information about the main issues is given as a series of branches. The organization is in an outline or tree where large branches divide into smaller branches and smaller branches divide into even smaller branches.
  2. Think of the map as a clock face and start at the 1 o’clock position (upper right corner). Read outward from the center along the branches and sub-branches to see how ideas and information about the topics can be arranged in a hierarchical or tree structure. [If you could go up a huge fire truck ladder and look straight down, you would see a structure of tree branches that looks like a mind map. When we study or read a mind map, we are looking at a whole tree — set of information — and then seeing how small and more specific information spreads from the trunk.]
  3. Go around the map in a counter-clockwise manner (to 2 o’clock, 3 o’clock, etc.), following the branches down to their branches and their branches and finally to twigs. Remember that we are looking down at a whole idea [or tree] and its branches and their branches in order to understand how the information represented on these branches goes together and what the most important information is.
  4. The mind map is thus a picture of major ideas followed by its major subdivisions or branches and sub-branches. The “big ideas” are attached directly to the central issue.
  5. A mind map is a way of showing in an image how a set of data pieces or ideas go together.
  6. The pictures, color coding, and fonts are used to designate what is the most important information in the mind map. When you are trying to remember or organize or determine priorities, the pictures, color coding, and size of the fonts can help you store information in “visual” parts of the brain and then retrieve it by thinking about pictures, the color coding, or size-importance of the information.

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 …

Click the image to expand it.


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.

 

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.

 

Mind Map in the Style of a Rohde Sketchnote

 

 

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.

The types of visual thinking tools I use to help deal with my own cognitive deficits are mind mapping, sketch noting and doodling. All can be done manually with a pen or pencil and paper. Mind mapping greatly increases its assist by using a program such as my preferred choice iMindMap or alternatives XMIND, MindManager, or dozens of other programs. Sketch noting and doodling are typically done with a pen and paper or a tablet or smartphone and a drawing program.

Click on the mind model (mind map) to expand its size.

Before reading this post, consider reading my earlier post on the CODER algorithm for mind mapping by clicking HERE.

Click on images to expand them.

The CODER algorithm suggests developing mind maps that explicitly state information in order to …

C – Communicate

O – Organize

D – Decide

E – Explain

R – Report

The CODER algorithm specifically addresses deficits in abilities to communicate, organize, decide, explain, and report which are a significant part of dementia or cognitive impairment. I have been using the technique of mind mapping since 2010 to address issues in my own dementia, and I judge it to be extremely effective. Putting information into a visual thinking environment (VITHEN) so that it can all be seen provides a way to communicate with others, examine context, make decisions, explain ideas and conclusions to others, and report using the mind map itself.

As a note, I consider the iMindMap computer program (currently on Version 10) to be the best way to create and use mind maps or mind model (a term I created for advanced mind maps).

There are many kinds of dementia, but in many types, one huge change is that you lose partially or fully the ability control your facial expression, body posture, and other physical movements that indicate to another person how you feel, how attentive you are, sudden joy, fear, and especially empathy.

Since my diagnosis of FTD (and several years before that), I have heard statements like these from strangers, friends, and family members. Many people think I am angry, disinterested, or not listening to them.

“You never smile.”

“We’re waiting for you not to frown so we can take the selfie.”

“You don’t care what I think, all you do is look at me with a smirk on your face.”

Well, most of the time I am happy and/or neutral although I am sometimes depressed to varying degrees. I am usually interested in what most people are saying. Sometimes I have to break into conversations multiple times to say that I am confused. That confusion is, for me, more likely to indicate that I cannot decode your words because I am losing language skills, not because I was not paying attention to you. I slouch a lot, I often walk looking directly down because I easily trip over over cracks in the pavement and that sometimes leads to falls (I am currently typing using my left thumb on the spacebar because I broke my right thumb in a fall a month ago).

You cannot judge how I am feeling physically or mentally by looking at me unless you are part of my core family and see me very often and sometimes not even then.

That sucks.

Much of how we feel about people is based on their nonverbal gestures and facial expressions. Somebody like me who can barely smile gives people the impression they don’t like what is being said or are annoyed or distracted.

Most people infer negative things from my posture and face and staring that are simply not true.

This is probably a huge factor in how miscommunications often occur among persons with dementia and those they interact with. Even people who interact with me regularly and know my medical problems often misinterpret me.

The following mind model shows some issues in communicating with persons with dementia and possibly misinterpreting what they are thinking and feeling because they look at you with unintended disinterest, never smile, and look distracted. People have often misinterpreted my attempt to smile as smirking.

And if you are a person with dementia, look at yourself in the mirror or in recent photographs and see if you can make some improvements in facial expressions and posture. And if not, when you talking to people, especially friends and family, remind them that you not in complete control of your facial expressions and that sometimes when you think you are smiling or even grinning, the other person just sees a blank face. You can also make a joke out of the situation.

Click on the mind model image below to expand it.

Have a good day.

A phrase you have heard thousands of times (especially if you have lived in California as I did for 30 years). If you have dementia you may groan or the statement may make you angry or you might make a pointed comment back.

Chill, Dudes and Dudettes.

OK, I get it (well actually have gotten it for a number of years since diagnosis). There may not be a 100% good day for you anymore if you have dementia. But how about a perfect (or even good) 20 minutes having coffee with a friend or an hour solving a puzzle with a grandchild or 100 minutes watching Guardians of the Galaxy 2 complete with a refillable tub of popcorn. Yup, these periods of a good day may be followed by a period of frustration or not being able to remember something or difficulty doing a task of daily living.

Use the Force, Luke.

Good moments can be great moments if you let them be. They may last only for few minutes or an afternoon, but given that your brain is “sick” they are a huge gift and blessing. Focus on what is happening to you now, try to not let the bad upset you unduly, and try to enjoy every moment for every second possible.

You may master the Force. You may feel better. Is there a better use of your time?

Focus on what is, not what was.

Click the image of the mind model (mind map) to expand it.

When I try to more than I can, I often get myself into trouble. You should try to do as much as you can but never at the expense of your family, caregivers, friends, and healthcare providers. Elite athletes call this “staying within yourself” while I call it plain common sense. At any rate, your experience of dementia can be made much better by staying within your CURRENT limits, not those of prior times before you started cognitive decline.

Click the image to expand it.

Nothing in this blog post is intended as medical or psychological advice. Should you wish to understand the issues in cognitive training as they pertain to you, consult with your doctor, psychologist, or another licensed healthcare provider. I am neither suggesting that you use cognitive (brain) training or alternate methods of thinking although I have made such a choice for myself. The intent of this post is that you understand the issues with these methods should you be making a choice. 

In the past three decades, methods of cognitive training have been developed by many companies. Services are offered by online companies, individual healthcare professionals, and some psychological testing companies.

The developers-owners of cognitive training methods make many claims about how these methods can improve or maintain GENERAL cognitive (brain) functioning for typical adults, those starting cognitive decline, and those entering the faster decline of dementia.

In most cases, costs associated with receiving cognitive training — especially under the supervision of a licensed professional — can be quite high.

As the term is used, cognitive training consists of repeatedly taking cognitive tests developed usually in psychology research studies and typically presented on a computer. Look at a complex picture flashed on the screen rapidly and say where a selected object (thing, person) was shown on the screen. Look for sequences of numbers and letters. Ignore distracting stimuli when looking at the computer screen. In many cases, these tests look like “old time” computer games like Tetris.

These cognitive training procedures are supposed to make you better at thinking by training your brain in certain types of ways that then improve the ability to do a very general and large set of tasks in attention, judgment, planning, and other cognitive processes. It is assumed that learning to perform well ON THESE SPECIFIC TASKS will help you think better in a general way. Unfortunately, it appears after decades of studying cognitive training, it is found that the training on a test will help you get somewhat (and it is a small somewhat) better at taking THAT TEST ONLY and not in similar cognitive tasks more related to day-to-day activities. Yes, you might get better at identifying flashing letters when they appear on the screen, but there is little, if any, replicable evidence that becoming good at the test generalizes into being good at exercising attention in real world situations.

Just what you always think when you think about psychology. Psychologists study “dumb” tasks that look little like real world situations and then claim that getting good at those tasks will change your life. You usually laughed when you read this stuff in news outlet stories. Nonetheless, cognitive training continues to sell and expand and advertise. Money can be made selling cognitive training to individuals concerned with their current and future ability to think well and remember and maintain independence. Many claims are made that the methods work and the glossy, high-priced advertising is convincing, but the statistics are not. And yes, the companies that sell cognitive testing products claim that the training works if THEY conduct the experiments and evaluate their own products. However, ongoing INDEPENDENT RESEARCH suggests this is NOT the case.

Did you really expect the ethics of cognitive training companies to exceed those of pharmaceutical companies? The false claims to be less? Big money, big pressure to prove that these things work.

Independent psychologists who evaluate the effectiveness of programs and assertions of others do not find much if any, effect of cognitive training on improving general cognitive functioning, thinking, and performance in real-life situations faced by aging adults.

The most important INDEPENDENT EVALUATION appears in a journal of the Association for Psychological Science of which I am a Fellow. APS is one of the two major psychological associations in the USA and designation as a Fellow comes only after a thorough peer evaluation of competence.

Click here to see a short summary of the research that examines all of the research over several decades on cognitive training. The full report is 83 pages. I still understand most of the mumbo-jumbo in the full report. You will have to pay to purchase the full report if you are not a member of APS. My judgment is that the summary is very accurate in presenting the results of this research through what is called a meta-analysis and I doubt that most people need read more than the 1-page summary.

OK then, so cognitive training probably will not turn out to be the big fix for what ails your thinking as you age or you have a neurodegenerative (neurological) disease. Maybe improvements will be made in future decades but right now the effects appear to be tiny at best.

What’s the alternative?

I have argued for a number years that learning alternate ways of thinking and expanding the types of information your brain can effectively process can be very useful throughout your life. While learning such strategies in childhood is best, you can keep learning new ways to think up until the day you die and expect to get some significant return for your work.

What kinds of activities have been shown to increase brain function? Learning additional languages, studying a musical instrument, learning math, creating art or stories, and many others to which we all have access, typically with a minimum expense. These are real-world activities and many are a lot of fun.

As I progressed through cognitive decline and dementia I have come to believe that learning what are called visual thinking methods — arranging information into pictures that organize major ideas and show the “big picture” — can help you in many ways I have documented throughout this blog (Hubaisms.com). Of course, my findings are based only my own observations of myself and not on formal studies. I note, however, that sometimes observations are better sources of information than research studies, especially from individuals touting products they have invested millions of dollars in developing.

I think that the fuzzy research on cognitive training and the fact that mind mapping is seen as effective at most Fortune 500 corporations, many universities worldwide and by millions of users worldwide at this time suggests that learning alternate WAYS TO THINK probably is much more effective than cognitive training (akin to playing a 1980s computer game).

My suggestion is that if you are concerned that your ability to think will decline or you are already experiencing cognitive decline, you take some time (1-8 hours will help you evaluate this) and determine if visual thinking is useful for you. You can read my work on this blog or work created by Buzan when he popularized mind mapping in business and education or look at many other authors who write on this topic such as Nast. Major summaries and videos are available online. If you would like to see someone with dementia use mind mapping, you can click here to watch a number of short videos of my mind mapping process in a new window.

Alternate visual thinking methods that I find useful are SKETCHNOTES, doodles, cartoons, and graphs.

You can try mind maps, sketchnotes, doodles, cartoons, and graphics with a few pencils or pens you already own and a piece of paper (A4 or 8.5×11 in landscape mode).

Later you can buy computer apps to make the visual thinking look better if you want but you need not do so.

Look at the image below to show the way I think about the information in this post visually using a mind map.

If you want me to understand something or remember it, DRAW ME A PICTURE. I’m a lot smarter than you might think if you just talk to me. Oh, and you need not be artistic at all to use the techniques in visual thinking so don’t use the excuse that you have no “talent.”

Click on the image to expand it.

ObamaCare revised/enhanced?

Trump/RyanCare another draft not submitted to Congress?

Within the extant and mythical healthcare plans, additional dementia care services need to be included. Most are cost-neutral or may actually save money while providing better patient outcomes.

Case Management makes existing healthcare services (doctor visits, medications, emergency care) work better. At a very small cost that should actually SAVE money, case management can provide better total patient care, cut unnecessary emergency room visits, and achieve better medication outcomes. What isn’t there to like?

Dementia Caregivers are most often UNPAID, female family members forced to juggle their own jobs/finances, families, and general lives to care for a loved one. Support is required for Dementia Caregivers in the forms of training, support, advice, and FINANCIAL COMPENSATION for their services. They do the work, they should get paid for their time. An upgraded system of paid family caregivers should make DementiaCare more effective and reduce other costs in the healthcare system to such a degree that it will be cost-neutral. An unnecessary hospital stay or emergency room visit can cost as much as $10,000 — $20,000. A family caregiver could be paid for 500 hours at $20 per hour for $10,000. Train family caregivers, pay them, and you have a cost neutral system. What isn’t there to like?

Mental Health issues often lead to huge patient distress, anxiety, and medical management problems. They can frustrate caregivers and lead to nonadherence to medication recommendations. Therapy and counseling can help patients and caregivers as well as cutting overall medical costs. What isn’t there to like?

Group Adult Daycare can provide needed respite for family caregivers as well as important social and recreational experiences for patients, thus enhancing their lives and to some degree ability to function independently. What isn’t there to like?

The following mind model provides some details. Click the image to expand it.

 

I get in trouble when I make mind maps about Donald Trump. This is a mind map about processing repetitive TV cable news (on CNN and MSNBC and FOX) about the most televised story — Donald Tackles the USA and the World — at this point in late April 2017.

Mr Trump is just completing the first 100 days of his Presidency having accomplished less — according to the fact checkers from numerous news organizations — than any President since the index has been tracked from the beginning of Franklin Roosevelt’s Presidency in the 1930s. Mr Trump believes he has accomplished more than any president ever studied in his first 100 days.

I am a lover of news stories where the President gets bashed on TV. In the 1970s I watched (and read about) all the hearings focusing on Richard Nixon and Watergate. In the 1980s I watched huge amounts of TV about Reagan and Iran-Contragate. In the 1990s, I watched the hearings about Bill Clinton and the blue dress and impeachment and not inhaling. Nothing of a comparable nature occurred during either Bush presidency or that of Barack Obama. I almost didn’t know what to do with my spare time.

Now, I am watching numerous hours of TV/video on the major USA news channels (including CNN, MSNBC, Fox, CBS News online, New York Times, Washington Post, and of course the best news outlet for all news worldwide, BBC). And even ESPN has had a big Trump story about star players declining invitations to the White House to meet POTUS.

My dementia has been progressing at an ever increasing speed in a downward spiral during the past months. I remember (recall) less from current events and “work” and daily tasks. When I can retrieve information I do so very S—L—O—W—L—Y. Judgments are tougher, understanding sequences are harder, and writing down what I think is very slow as the length of my current journal entries (and al of the wurds nat spelled wrongly or too bigly) is increasing grately. Handwriting does not come with A spel chkr.

The current trend in cable TV news on MSNBC and CNN and others is to have one-hour shows where a moderator/commentator discusses all of the “important” news of the day with 2-5 different “self-styled” experts ranting from all political persuasions.

7 hours of liberal rantings about Trump is available on MSNBC and to a lesser degree on CNN; Fox News has 7 hours of conservative rantings about how terrible it is that the liberals are ranting about Trump.

I have repeatedly argued that inexpensive (or even free) visual thinking/mind modeling methods can help a person with dementia “rewrite the operating system” on that storage device we call the brain and think better, albeit in a different way.

As I was making the following mind model (AKA mind map) about Trump’s first 100 days yesterday, I was struck by how rapidly I could create this fairly complex model. I think it shows that the intrinsic interests and REPEATED exposures to structured, summary information can be well captured using visual thinking methods by a person who has lived with dementia for more than half a decade after diagnosis. While I understand that 40% of USA voters will find the content WRONG because it is very liberal rather than very conservative, I do propose the hypothesis that developing a fairly complex, fact-based mind map of current news shows the value of mind mapping for someone with dementia basing this conclusion only on my own experience. And it works no matter what you think about Trump.

I hope that as many conservatives as liberals will use these methods to study the facts of issues and their own conclusions and evaluate the completeness of what they know.

Examine your memories and conclusions in mind models. Political leanings and party do not matter because your mind model is for YOU as much as my mind model is for ME.

Should you find my political points to be in error, just use this as a template about what you would like to say about, for example, Hillary Clinton or a Democrat in Congress.

But remember that models like the one can be developed by a person living with dementia like me.

And most importantly, I hope that we — whether your political views are similar or dissimilar to mine — can come to an agreement that cognitive methods for supporting thinking for those with or at risk for dementia belong in the next version of ObamaCare or TrumpCare along with training, support, and respite services for unpaid dementia caregivers and especially COVERAGE OF COMPREHENSIVE HEALTHCARE FOR ALL AMERICANS.

Click on the image to expand it.

Oh … and let’s make sure that no President of any party ever uses the nuclear option. I hope we can all agree on that.