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

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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.

 

People who learn to take responsibility for their own actions could save me a lot of money.

They

  • have less kids born into families that cannot support them saving me money on social programs
  • are less likely to contract STDs especially HIV thus saving me money on STD prevention and treatment programs
  • graduate from high school (and college and grad school) thus qualifying them to be in higher tax brackets and save me from higher tax rates and subsidizing their living costs
  • live longer because they forgo tobacco and drinking alcohol to excess thus saving the entire health care system from huge wasted services
  • pick up their garbage and put it in trash receptacles thus saving me having to pay someone to pick up after them
  • recycle thus cutting the bill for environmental cleanup

The USA should incentivize self responsibility by granting payments to

  • every student who ever graduates from high school
  • every student who ever graduates from college
  • every student who ever earns a graduate degree
  • every 18 year old who has never had an STD
  • every 18 year old woman who has never been pregnant
  • every 18 year old man who has never fathered a child
  • every 21 year old who has never been convicted of a DUI offense
  • every 21 year old who has never used tobacco
  • every 21 year old who has a “normal” weight and is neither obese nor dangerously underweight
  • every 40 year old who has a “normal” weight and is neither obese nor dangerously underweight
  • every 50 year old who has never been convicted of a DUI offense
  • every 60 year old who has a “normal” weight and is neither obese nor dangerously underweight

Incentives would be in the form of one-time tax credits for the individual or the individual’s family. This means that incentives are only paid to workers and their families.

Oh, the government would supply free voluntary services to all residents on birth control methods including condoms freely available to all children old enough to conceive, unlimited voluntary counseling on avoiding self destructive behaviors, unlimited voluntary counseling on leading a healthy life, and unlimited voluntary counseling for reasons of family instability, mental health, child rearing, and birth control. None of these free services would include any components related to any religion. And legitimate and effective education at all levels from preschool through college would be free to any American resident of any age and with support services to ensure anyone can graduate.

If the USA were to provide fairly significant incentives for learning and exercising self responsible behaviors we could produce a citizenry that creates less problems and is less dependent upon social network and support programs for themselves and their children. This will leave a lot of money to spend on those who truly cannot deal with their own medical and psychological problems no matter what they personally do and probably leave some over for lower tax rates.

Wow. Incentives for studying, working hard, becoming a productive member of society, and paying for needed and fully effective programs for all of those who have mental or physical or developmental disease and cannot legitimately assume full responsibility for all aspects of their lives.

I’d love to see a similar set of ways to incentivize healthcare and education workers. Small increases in productivity and job satisfaction among these critical citizens saves a lot of money and produces a much more healthy society.

Oh, I know, I am a dreamer. After all, my proposal could never make it through Congress. Even though it will save lots of money, promote better lives through self responsibility, and leave sufficient resources for those who truly need medical and mental health services because of factors beyond their control, this is truly an anti-American proposal that expects self responsibility and does not let big religion bully small religions, agnostics, or atheists around.

Every once in a while we need a little revolution.

Imagine.

[Musings of a very liberal, very capitalist, individual who believes in self responsibility and taking care of anyone who cannot take care of themselves with first-rate, state-of-the-art programs.]

The mind model (aka mind map) below discusses my vision in developing the dementia focus on this website. I started to build the web site about two years after being diagnosed with a neurodegenerative condition (2012). Thus the entire blog is the work of a developer experiencing dementia while designing and preparing the content for the site. The site discusses my progression through cognitive impairment and decline into dementia. More importantly it discusses how I tried to help myself coordinate and use to full advantage the support and professional expertise made available to me by family, friends, the community, my doctors, and the general world-wide of patients and professionals the major issues.

Nothing in this blog post (or any other on blog post or page on the site) is intended to be, or promoted as medical, psychological, or any other form of treatment. The ideas in this blog are about using some commonsense note-taking and visual thinking methods to possible help you live better with dementia. I tried it on myself (only) and I am encouraged although I freely admit that full scientific study is needed.

These methods and comments will not substitute for medical and other professional treatments. They do not cure dementia. They do not slow down the progress of dementia. For me, at least, the methods have sustained and increased my quality of life and I do spend more time with my family and am more independent and in my opinion think better. But my dementia is not being treated and getting better; what I propose are methods that may make it easier to independently manage selected parts of your life, be in a better mood because you are trying to help yourself, be less of a burden to your caregivers, and report better to doctor what your experiences have been since the last appointment.

Many people are miserable almost all days when they have dementia. If simple, inexpensive cognitive tools can improve some or many of those days, the development of such techniques is a huge step forward.

I hope that others will examine the information here and use it to improve the decisions they, their caregivers, and their doctors and nurses must make about their formal medical treatment.

Here is what appears in the blog posts and elsewhere on Hubaisms.com.

Click on the image to expand it.

why-i-developed-the-hubaisms-com-focus-on-dementia

Click here to see Part 2 of My Vision in a separate window.

still-crazy-after-all-these-years

There are many problems that can plague a person with dementia. Some of these are easily detected but others may be “hidden” because of the nature of the major symptoms of the disease or “hidden” because the person with dementia (or caregiver or in some cases family members) is trying to hide some of the problems from outside observers.

For instance physical, psychological, or financial abuse will be hidden by the abuser and perhaps the person with dementia. Memory loss may make it difficult for the person with dementia to accurately report accidents.

It is important that healthcare providers, caregivers, and family members be trained to identify the hidden problems.

To some degree or another, it is likely that most persons with dementia have some of these hidden problems. For instance, I bump against things all day long, usually because I am rushing around or not paying attention because I am trying to multitask. When asked by a family member or friend where the bruise came from, I have to try to reconstruct where the accident must have happened by thinking through a lot of alternatives for a bruise half-way between my ankle and knee.

Click image to expand.

some-hidden-problems-among-persons-with-dementia

A mind model (aka mind map) on the way that ideas hit you when you have dementia.

In a group, the need to say something immediately before you forget it often takes a backseat to etiquette rules of waiting for your turn to say something and not interrupting. If you are talking to someone with dementia, consider cutting them slack and letting them jump in when they can. If the group won’t let the person with dementia break in it can lead to both a sense of frustration for all and quite frankly, the loss of some good ideas and interactions.

The current rules of etiquette do not take account of the fact that some of the participants in an interaction will have severe cognitive impairment or mental illness that pretty means that if a thought is not expressed immediately it will be forgotten.

Sometimes rules need to be stretched or curved (like a railway track) and patience exercised. This is one of those times.

f I am trying to blurt out an idea to you, believe me that if I don’t say it immediately it is going down the track far, far away from me. And it may not come back for another five minutes (if at all).

Click on the image to expand.
ideas-in-dementia-come-at-you-like-a-runaway-train

 

 

Blockheads-23

 

I have been a HUGE fan of the Olympics since I was a very little kid. In 1984 I got to go to the Olympic events in Los Angeles every day for two weeks, on many days with my father. That was the year that the Soviet Union boycotted the games because the USA had boycotted the Moscow Olympics in 1980. Heck, I thought it was great — the USA and East Germany (who came) won all of the gold medals! Months earlier when local pundits in Los Angeles said Los Angelenos were too apathetic to purchase expensive Olympic tickets especially with the Soviets and most of the Eastern Bloc boycotting as it would not be a real sporting event, I had bought as many tickets for the “finals” as I could get my hands on. Later I sold the extra tickets as Los Angeles fell in love with the games. I made so much money that the expensive tickets I had bought for the entire family of 7 that we used ended up were effectively free since the profits covered the cost of the tickets we used. Street enterprise at its best. My tickets became worth more because the Soviets didn’t come as all Americans became Olympic fans the year we won all the golds.

Winning the race to live well with dementia is like running the 10K race at the Olympics. Everybody has to pace themselves at the beginning so that they can learn about their opponents. In the final stages of the race they speed up and sprint their fasted the last 200 meters.

A mind model of the dementia race strategy is shown below. Click the image to expand it.

I think I am winning my race to live life to its fullest while having dementia. I’m getting ready to claim that gold medal. You can win your race too. Think about what you are doing and strategize like a 10K runner. Learn all you can in the beginning and then speed up later as your new knowledge kicks in.

race-2-bigger

 

3d-race

 

Blockheads-23

 

I want to illustrate two things with this post.

First, persons with dementia can have extremely enjoyable days even though they get tired, cranky, forget stuff, and sometimes act weird unless family and friends help.

Second, mind maps are a really good way to document a special day. [Note: My version of the mind map has family pictures and names which I have omitted from this version.] Click the image to expand its size.

April 4  A Day of  Living  Especially  Well with  Dementia

Oh, and yes to enjoy the day I had to take a 90 minute nap in the morning after taking my medications which cause a headache of epic proportions every day in order to sleep through the pain.

Oh, and yes to enjoy the evening I had to take a 2 hour nap in the late afternoon as the game was to be broadcast from 9 pm until 11 pm.

The periodic longish naps have a way of leveling out some of the difficult behaviors that are exacerbated by being tired and even more rigid than usual.

Naps help make it possible to have days of living very well and especially well with dementia.

Since the beginning of this blog in 2012, I have consistently — with each new version — concluded (from dozens of comparisons with other programs) that iMindMap is the single best program for developing mind maps. Period.

With version 8.0, iMindMap is no longer the world’s best mind mapping program. Rather, it is the world’s best mind mapping program PLUS additional features that make it the world’s best visual thinking environment (or VITHEN using my coined term). Period.

What makes iMindMap 8.0 so valuable as an overall mind mapping and visual thinking tool is that it encourages you to use iterative, hierarchical, nonlinear, big-picture, creative ways of generating ideas, communicating those ideas, and integrating the ideas with the data of images and statistics. There is no tool I know of that is better for these overall tasks and the building of creative models.

I use iMindMap between 3 and 10 hours per day on the Mac, iPad, and iPhone 6 Plus.

Version 8 exceeds Version 7 in that the program has been significantly speeded up both for computer processing and in general usability of all of its advanced formatting features. The increased speed with which advanced formatting can be done encourages more precise and creative visual thinking.

Did I mention it has a very good (becoming excellent) 3 dimensional display mode and provides a much better presentation tool than the PowerPoint standard? The new Brainstorming Mode (file cards on a corkboard metaphor) allows those who like to see words rather than images to brainstorm in the mode most natural to them. I’ll never use the mode but I project many will embrace it.

The iMindMap program has been the best tool I have had to allow me deal with a neurocognitive neurodegenerative disorder and continue to be productive over the past five years. The program permits me to think at a very high level which I cannot do nearly as well with other techniques or other mind mapping programs.

All seven maps shown here are identical except for their format.

[I intentionally did not use any clipart because I did not want distract from the basic creative thinking and model development-presentation functions of iMindMap that are the real core of the program. With any of the variations of this map, if you spend 10 minutes adding selected included clipart or icons, the map will be even more visual.]

The remainder of my review is — appropriately — presented as a mind map.

Click images to expand.

Three styles provided with the iMindMap program.

1iMindMap 8.02iMindMap 8.03iMindMap 8.0




4 Custom Styles I Use in My Own Work and 4 Variations on the Same 3D Mind Map

gh1Imindmap 8.0gh2Imindmap 8.0gh3Imindmap 8.0gh4Imindmap 8.0

Imindmap 8.0 3D4Imindmap 8.0 3D3Imindmap 8.0 3d2Imindmap 8.0 3D

 










bolero cover 3 parts FINAL

 

I frequently tweet about neurological diseases, sending out links to US government and major foundation web sites. These tweets are among the most retweeted and favorited of those I distribute.

As you may have inferred as you look at the fact sheets distributed, there are commonalities among many of these diseases above and beyond the fact that these are all diseases of the nervous system.

Very few of these diseases have treatments. Most of these diseases are rare and often not detected by primary care physicians or even related specialists like psychiatrists. Medications are frequently used off-label for controlling symptoms like depression, anger, tremor, and many others but these treatments are rarely effective for a long time, if at all, for most patients. Because these are rare diseases and neurological research itself is quite expensive, a small portion of the US medical research budget is spent looking for cures or effective symptom control.

The following mind map shows some of the commonalities among the neurological diseases. Click on the image to expand it.

neurological diseases features common to many conditions

The next mind map is identical to that above. The formatting has been changed so that you (and I) can judge if an alternate format is more useful for certain audiences.

neurological diseases features common to many conditions2

Here is a technique I would try with someone with cognitive impairment. It might also work well with a child, an elder, or anyone else in-between who needs a little help with organization and planning. A caregiver can prepare a mind map or you can prepare one for yourself.

I find the size of standard business envelopes (#10 in the USA) to be just about perfect as a daily information catcher. You can write your schedule on the front and slide the envelope in a pocket, small bag, or the inner pockets of most men’s jackets either unfolded or folded. And since this is an envelope, throughout the day as you pick up receipts, reminder cards for your next appointment with the dentist, a flyer about a concert and all the other little tidbits of life that get lost in your pocket and end up in the clothes washer you can insert them into the envelope and have a good chance of not losing some important information.

Using a mind map instead of a list on the front of the envelope can engage the user, permit color coding, and makes it easier to remember the content.

Takes a couple of minutes.

Yup boss, I have the receipt from lunch.

Notes:

  1. I printed the mind map on an actual business envelope and then scanned it. The green paper was just a background for the scan.
  2. You can use any style you like for the mind map. I chose a font designed for individuals with dyslexia just to illustrate tailoring the content and style of the map to the individual using it.
  3. This mind map was designed in iMindMap. If you wish you can add clipart or photos to the branches; typically I would not just because of the small size of the envelope. Bright colors can substitute for images to engage attention and color code sections.
  4. One can change the map simply by crossing out information that has changed and making notes on the map with a pen.

I think that this can be a very good technique for a paid or family caregiver of someone with cognitive impairment. Prepare the envelope in the morning or preceding evening and go over it with the patient when it will be used (mornings are preferable). I did not put the person’s name on the envelope since the front or inside may contain private information (names of doctors and similar information like medication reminders). I would not put medications in the envelope as they fall out too easily. It may be useful, however, to carry a small amount of paper money in the envelope. Also a standard card with the the caregiver’s first name and telephone-email may prove helpful should there be a health or other problem.

Click the image to expand it.

Scan2014  26

 

Recently I have had a number of discussions with Tony Buzan (@Tony_Buzan) about how the relationships between art and creativity and dementia support the conclusion that mind mapping may be useful in helping those with cognitive impairment. I believe that my my conclusions are supported by a sufficiently large scientific literature of credible studies to make the assertion of the probable link and to suggest that additional research should prove to be fruitful.

Here is how I access credible scientific research in the fields of medicine, healthcare, mental health, and related fields. Note that in addition to my searches, the same system works the same way with searches for information about cancer, heart disease, ADHD, autism not being related to vaccination, and organ enhancement of various kinds. Patients, scientists, and those who make medical claims late at night on informercials may want to consult this database. Especially informercial producers who disseminate inappropriate, biased, and wrong health information and claim it is medically-proven.

Click to expand.

Scientific Literature  on Dementia,  Art, Creativity

 

Part 1 of this series of posts can be accessed in a separate window by clicking here.

Art therapy is fairly well established as a non-medical intervention that can be made for those living with dementia in order to improve certain aspects of quality of life.

My hypothesis is that if individuals with dementia or other levels of cognitive impairment can be taught to use (and possibly create) ORGANIC mind maps, it is likely that the patient will receive more than just the benefits of standard art therapy. Major cognitive refinements from mind mapping such as maximizing creativity, memory processes, organization, and visual thinking can be added “on top of” the creation of one’s own drawings or paintings. At one level, mind mapping is disciplined and expansive creation of art. It is likely that at least some of those living with cognitive impairment can use the visual thinking tools offered by Buzan-style ORGANIC mind mapping to improve their optimism and creativity and other aspects of quality of life.

You might want to consider acquiring visual thinking skills before you have the onset of possible cognitive impairment as you age.

Click on the mind map image to expand.

Hypothesis  Mind Map = Art Plus  for those with  cognitive impairment

To understand the mind map better from the clinical experiences of the patient, family, and healthcare providers, you may wish to …

view this trailer …

or this excerpt

https://www.youtube.com/watch?v=qqQ6JNnNiNg

Search the Internet to buy the whole video or the book as pictured below  …

bothcovers

 

The book and the video have complementary information and both should be studied.

Aaahh … “hard science double-blind” research designs.

How do you apply such a design to determine if visual thinking-art therapy-visual cognitive remapping strategies help those who live with cognitive impairment? Do you put a paper bag over the head of the patient and over the head of the healthcare provider-art therapist-social worker? Or blind them.

I don’t think so. Even scientists who bow to the Science God (often noting the relationship to Thor) are not that dum or stoopid. Scientists willing to accept “softer” data and designs like clinical observations, case studies, interviews, and knowledgeable peer judgments are willing to accept the relationship found for some people showing mind mapping is an effective (and cost-effective) way of making some situations less stressful and more productive and life quality enhancing for those living with cognitive impairment.

However, try searching the scientific literature with Google or PubMed for studies of mind mapping and cognitive impairment-dementia. Not a lot of “hard science” results to be found. I see this not as a failure of the efficacy of the method of mind mapping but rather the fact that the brick walls of hard science are not broken down by the sound of trumpets or the roar of a lion. There is a missing link and probably many studies that indirectly demonstrate that mind mapping works well with cognitively impaired patients but are not labeled as such.

Last week I read what I judge to be a highly credible and careful study by two neurologists and an art therapist that was published in April 2014. I think they found the missing link and data supporting it, although they did not call the intervention technique mind mapping for those with cognitive impairment. Instead they called the intervention-life skill to be ART THERAPY for those with Alzheimer’s disease and other dementias.

There is a LOT of literature showing that Art Therapy increases social interactions, understanding, motivation, enjoyment of life, associations, and perhaps memory among those living with dementia, and even for those in the latter stages of the disease.

What is Art Therapy? Applying color, form, creative ideas, social interactions (with a teacher and other participants) and positive psychological states to try to understand the world better and communicate the perceptions of the artist.

What is ORGANIC (Buzan-style) mind mapping? Applying color, forms, creative ideas, interactions, and positive psychological states PLUS radiant, hierarchical, and nonlinear organization to try to understand the world better and communicate the perceptions of the artist.

Is this conceptualization of mind mapping with and by the cognitively impaired as an enhanced formulation of ART THERAPY (conducted by a professional, family or friends, caregivers, the patient her- or himself) to help individuals use visual thinking strategies to navigate their world a break through one? I think it is the scientific missing link and we can bootstrap from the findings that Art Therapy is a good intervention for dementia to ORGANIC mind mapping may be a good intervention for dementia and perhaps will achieve a greater effect than less focused “art.”

Here is a link to the paper. Click on it to retrieve the article.

screen_0050

As a technical note, the authors’ use of meta-analysis to combine the results from a number of independent studies selected for their methodological soundness is an accepted one which has become popular in the past three decades.

I want to see much more research on this topic. BUT, I think that we are currently moving in the correct direction in a “leap frog” way with great speed.

Keep both eyes open and click on the image below to expand it.

When you are done, part 2 can be accessed in a new window by clicking here.

Missing Link  Reducing the Effects  of Dementia with  Mind Mapping  (Huba's Theory)

 

Back in 2012, I published a mind map on this blog suggesting that giving people one chance to learn (as in, you only get one taxpayer-subsidized educational opportunity) or to receive free treatment for drug abuse (as in, if you can’t quit the first time you are morally undeserving because you do not have the moral strength) or to receive specialized behaviorally-related healthcare (as in, you let yourself get fat or nicotine-dependent or out-of-shape so you pay the consequences) is an obscene abuse of other individuals,

It’s just as true now as it was then. I know more about mind mapping now and am even more irritated by those who want to balance the budget by not helping others enough, or even at all. So I thought I would revise my mind map and make this a post a lot more angry that we do not give people second (or even eighteenth chances).

Show me a drug abuse treatment  provider who says you can go through treatment one time and it will “stick” and I’ll show you a snake oil salesperson who is trying to sell services to 18 year old entertainment industry billionaires surrounded by a media feeding frenzy. Do you really want to deny additional free education to someone who realizes in their 30s or after going to prison or after achieving a stabilized life without drugs or while serving our country in the Armed Services that they need more education to get good jobs and be successful and much better citizens? Mental health services should not be denied or limited to tossing people pills because someone lost the genetic lottery and has a life-time disease or experienced trauma (like a rape victim or maybe somebody unlucky enough to have lived in an earthquake or hurricane zone or in a dangerous neighborhood or in an Armed Services encampment in Afghanistan, Iraq, or Vietmam).

Enough said. The picture will tell more than 100,000 words ever could. And if one fails after 18 chances?

Well, there’s always a 19th chance or a 36th chance waiting. [And a special ring in hell waiting for those who would only offer people one chance at happiness or productivity or health. Or the politicians who supported this position to get (re)elected.] Oh, and if you were one who denied others a second chance, you have a second chance to act in a more moral and supportive way and give others that second or 18th chance.

Click on the image to expand. Then think about whether we should invest in people and families or in creating the wealthiest uber-class in the history of the United States?

18th Chance 2014

 

 

The golden rule of using mind maps in healthcare settings is to provide information to a patient, the patient’s family, or another service provider. It’s all about customizing any “standardized” templates used to fit the patient’s needs, beliefs, behaviors, priorities, and background. Click mind map to expand.

FINAL Mind Mapping for a Patient  from the  Patient's Perspective  It's All About Me,  Stoopid

2015-04-07_11-33-24

stop making publicizing your disease your end goal. You and the other 350 or 3,000 or 25,000 or 199,999 people with the disease will hardly be heard above the shouts of those advocating for funds for cancer, coronary disease, diabetes, HIV/AIDs and other diseases affecting many medically and/or politically.

And in the current system of new drug development, Big Pharma is going to be more interested in developing treatments for gastroenterological disease (heartburn), STDs (avoidable), erectile dysfunction, safer birth control, cancer, heart disease, and obesity.

Get smart.

Your 5,000 sufferers should collaborate with the 350 individuals with another disease and the 199,999 with another and all of the rest of them to be a large and huge advocacy group for encouraging change. Your illness group may not be the first to get attention if changes are made, but somebody will be and as treatments are developed for one rare disease they might also be applicable to other related rare diseases.

This is clearly a situation in whch cooperating with those with other rare diseases will ultimately yield better results for all than screaming ME FIRST on the Internet in social media.

The existing laws and administrative rules probably do not go far enough in encouraging drug companies to develop pharmaceuticals for rare and orphan diseases. Advocate for better incentives and decreased bureaucracy for developing new pharmaceuticals to treat a few thousand. Maybe even the staid Nobel Prize committee will even make an award to somebody who makes a huge research contribution that advances the development of treatments for a rare disease and top research universities will create endowed professorships for high talented physicians and others who study a rare disease.

Click image to expand.

ENCOURAGE MORE RESEARCH  ON RARE AND ORPHAN DISEASES

PART 1 discussed my view that a world wide memory is available to supplement an aging (and especially cognitively impaired) person’s biological personal memory (a.k.a. the brain).

Seems obvious, but is it?

I contend that even though Google and the huge information database contained on the Internet have been around for a while, it is only just now starting to be understood that this information can be “mined” and reorganized for individuals.

It’s not just about Facebook  either although Facebook is an important part of it. As are all of the other social networks, the stuff for sale on the Internet, the old stuff on your computer, and the old stuff on the computers of your extended family.

It’s all about visualization, visual information processing, and rearranging that visual information for the individual. Like your Uncle Fred who is “losing it” or your Mom who has lost it or yourself. Or leaving behind visualizations for your kids and grandkids or your spouse (who even after decades will not know how you view all of the things that shaped you and are important).

In the spirit of visualization, lets go to a mind map for explaining visual thinking.

Please click to expand.

CREATE THE  PERSONAL INTERNET  TO SUPPLEMENT  YOUR MEMORY

Or same map, slightly different format …

2CREATE THE  PERSONAL INTERNET  TO SUPPLEMENT  YOUR MEMORY

I’m getting old. Show me some pictures of Yankee Stadium two blocks from where I lived as an infant in 1951. Or remind me about those kids I knew in High School. Whatever ever happened to my office mate from grad school? Where could I get a copy of my college yearbook? The 1984 Olympics in Los Angeles were great (I went everyday for two weeks), how about some pictures? What does the home I grew up in look like now (apparently almost exactly like it did after my parents’ deaths, although the guy who bought it from us obviously does not know how to take care of shrub beds). Neighborhood looks almost identical, just the trees are bigger.

Don’t have photos or descriptions of some place or event you went to. The Internet does. Want to make sure the tales you have told for 30 years about freezing your ass off in Minnesota in ’76-77 were grounded in reality. Yup, the stat charts clearly indicate that was the case.

Look up something you seem to have forgotten. Browse information about events and places and you may find that you (with or without the help of the hyperlinks in Wikipedia) can remember even more things.

Are you a caregiver or healthcare provider for an individual with cognitive decline? It’s pretty easy to use the Internet as a big box of memories and pictures and even context to help the patient retrieve memories or relive parts of the past.

Given how I typically feel about the billionaire Darth Vader Juniors over at Google who trample individual privacy in the unending search for more liquid currencies, it’s going to be tough to say, but …

Just Google it.

Find out about your life or your parents’ or retrieve memories or recreate associations.

[Just remember that the world’s memory will also record what you just asked about so as to try to sell you yearbooks, genealogy services, or New York Yankee collectibles.]

Having a fairly accurate, very comprehensive collective world memory will potentially help many who are losing their own biological cognitive functions. It could very well help in caregiving and helping patients maintain or even increase their quality of life. Darth Vader Junior might even make it back from the Dark Side by providing funds and other resources to use the accumulated information of the Internet to help those with aging memory banks and CPUs.

Click on the image to expand it and see how these ideas go together. Form some new associations. The mind map in which the information is presented will help you do that.

Click here for Part 2 of this discussion.

Replace your aging memory with the world's knowledge

Every year around this time, I go out and buy a new external hard drive, copy all of my computer files onto it, set the file to “read only,” and then archive it. The drive contains my memos, years of email, 14 drafts of manuscripts from 15 years ago, data from projects long completed, jokes I receive by email, contact information for hundreds of business acquaintances I will never hear from again in my retirement. It also contains copies of all my photos (many duplicates and out-takes) in a very disorganized state.

I invest in religiously saving this information even though a high percentage is junk that should be eliminated from the digital attic. I think there is some value in preserving this stuff, if only to reduce my anxiety that something got lost.

My personal insights, feelings, events big and small, interactions with people, history, memories of Mom and Dad, and all of the stuff that makes life worthwhile and important. HHhhmmm. Doesn’t need to be organized because I will remember all of that really important stuff.

IDIOT. If there is anything that should be backed up it is ME, not a bunch of outdated and stoopid memos.

Some ideas about archiving ME. Think about archiving YOU. I suspect this will be a very valuable exercise for both of us even if the “Big D” (dementia) is never an issue. Why not fight back against the possible Big D?

Click on image to expand.

ANNUAL MEMORY BACKUP

This post does not contain medical advice. None of the methods described are known to be therapeutic. What is described are possible note-taking or information-sharing models for patient-client-self management.

For the past few months, I have been focusing on the use of mind maps to assist people with dementia, cognitive impairment, or cognitive decline deal with various issues that arise as they work hard to maintain independence.

You can access those posts simply by using the search box at the bottom of each post with keywords like “dementia” or “cognitive.” Several dozen blog posts will pop up with most very recent.

But the reality is that as dementia or other cognitive problems progress, many patients will require increasing amounts of supervision and care. Mind maps may prove to be useful in assisting a caregiver to help in a more effective, and cost–effective, manner.

  1. Just as those with cognitive decline may be able to remember, plan, express themselves, and document their lives in maps, caregivers may be able to use these techniques themselves to provide better care and client management. Mind maps may potentially help the caregiver recall the preferences of the client, as well as the client’s life history, important events, significant people, and life style
  2. Caregivers may find that visual information recorded in mind maps provides a good way for the caregiver and the client to start discussions.
  3. Caregivers may find that clients can express themselves better with pictures, drawings, doodles than in words.
  4. Caregivers may find that their own notes from each day are more useful if captured in the format of mind maps.
  5. Caregivers may find that mind maps may be used for brainstorming by themselves, with healthcare providers, with family members, and with the client ways to organize daily events, select food and clothing, remember medications, and organize social events.
  6. Caregivers may find it useful to record their own feelings in mind maps as a way of dealing with the emotional and physical stress of caregiving.
  7. The daily calendar — including doctor visits and other appointments and visitors — may be easier to prepare as a mind map and much more useful to the client.

There are dozens of other ways mind maps might be useful in caregiving. I am going to write many posts on this topic in the next months. For now, here are a few examples with many more to come.

Click on each of the images to expand it.

Preparing a Mind Map (with the help of the client or family members) of the Client’s Preferences.

Preferences  Hypothetical  Individual

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Preparing a Mind Map (with the help of the client or family members) of the Client’s Religious Beliefs.

Religious Beliefs

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Preparing a Mind Map (with the help of the client or family members) of Things the Client Especially Enjoys.

SPECIAL TREATS

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Preparing Mind Maps from the Warning Brochure that Comes with Each Prescription Refill.

possible  side effects winter

OR

SEg

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Preparing a Mind Map of Each Day for Your Use and That of the Client.

Today  Tuesday  November 12

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Technical notes. The sample mind maps here were all prepared in the computer program iMindMap, which I strongly prefer both for the way it facilitates mapping and the way it typically produces maps that can be very useful. There are alternate programs that can be used, although perhaps not with the same level of good results possible with iMindMap. Because the maps will be used by caregivers and clients, they will tend to be most effective if colorful, “bold,” graphically interesting, and with large typefaces all of which are easily done in iMindMap. Acceptable alternatives to iMindMap would be iThoughts, Inspiration on the iPad (but not on the PC or Mac), MindNode, and XMIND, although each of the alternatives will be more difficult to use to produce maps for clients with cognitive decline than is iMindMap. There are free mind map programs available or free demo versions. This is a case, however, where paid versions are far more cost-effective than the free versions or most free programs. There is a second type of mind mapping program more suitable for business purposes (the major one is MindJet MindManager and also MindDomo and MindMeister) than those caregiving applications discussed here.

THAT (clip from information sheet attached to prescription refill)

horizontal warning

OR THIS (pictures could be added, fonts could be changed, colors could be changed, style could be changed)? [I am NOT advocating any specific design without pilot testing although I tend to like some of the designs near the top and near the bottom better, especially since I believe they will communicate more effectively to all ages but note that this has not been proven. And, note that a professional designer could undoubtedly do a better job on the artistic elements and a neurocognitive specialist would be quite valuable as a reviewer to maximize impact.]

Click on any image to expand through several levels of zooming.

SEd

SEf

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SEd

possible  side effects simple

possible  side effects SIMPLEPIC

possible  side effects winter

possible  side effects

possible  side effectsBEST

possible  side effectsBOXES

possible  side effectsSIMPLEPC

possible  side effectsBEST

possible  side effects

possible  side effectsD

possible  side effects6

cpossible  side effectsC

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In the past I have blogged about my suggestion that Public Health students learn to use methods like mind maps and other visualizations to make health brochures and posters more informative and compelling to the public. Here I am going to show some examples.

The information in this post derives from very credible web sites. [As a note, much of the information about Alzheimer’s disease and “normal” or typical aging appears to be accurately derived from the public domain information put online by various departments of the US government.]

For each image, click to expand.

The American Medical Association has this very informative page on its web site.

Voila_Capture91

I believe that the following mind map is better for explaining the information.

Typical Aging or Dementia

[I acknowledge the fact that various mind map “artists” can make this map more visually appealing and I see this as a first draft.]

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The Alzheimer’s Association has posted this professionally valid information on its web site designed in a way as to be compelling through its high density of high quality warnings.

screenshot9

The “problem” with this brochure is that it is “too dense” for me (and probably anyone else without a professional background in medicine) to be able to understand and remember the information. How about including this graphic as a third page (ideally as the ENTIRE page 2) in the brochure. I would bet that the outcomes from the  extra understandability and memory retention for this critical information would prove to far offset any additional printing costs.

10  Warning  Signs of  Alzheimer's  Disease

[I acknowledge the fact that various mind map “artists” can make this map more visually appealing and I see this as a first draft.]

Here are links to some earlier posts about events, people, reactions, and other information you might wish to document as you age so that you (or a caregiver or younger family member) will have the information later. Each of these posts illustrates combining text and images. These examples are ones that can be done by you before you have any cognitive problems as a self history as well as with a caregiver after problems occur. Any whether you ever need to use to help you if there is a cognitive decline, these are great ways of passing down information from generation. I wish I knew much of this information about my parents and other family members. Click on links to see examples.

Beliefs and Values

Diary

Traditional Timeline

Symbolic Timeline

Stories

Letters

Data Visualizations

Career in Perspective

Social Media

Favorites

Some Things to Document as You Age

In the past few days I have posted about using mind maps and similar tools to “fight back” against cognitive impairment and then in a follow up post discussed some of the tools that can be used to potentially improve your ability to deal with cognitive impairment.

Today I am posting about paying some attention to the methods you use to communicate and remember and make decisions and express approval and make other appropriate reactions to others. What will YOU do If your mind fails due to a degenerative condition, a disease, the luck of the genetic draw, or because you are so dumb you refused to wear a helmet while riding your bicycle or motorcycle, or even due to playing football and huge traumatic blows to the brain while wearing a clearly inadequate helmet over the course of decades.

You are told (but probably tune it out like I do) that you should plan for disasters ranging from total disability or an earthquake or a hurricane or the election of a Tea Party President to such things as the day your dog needs hospitalization.

Did anyone ever tell you that you should considering learning some alternate ways of thinking and organizing your memories and planning than the ones you have used for most of your life.

What’s more important to you, having a few bottles of water in your basement in case there is a hurricane or earthquake in the neighborhood or learning new ways of thinking or remembering or making decisions that you might want to use now or after your memory starts to fail.

Consider yourself being told to look into this before somebody hits you with a car while you are weaving through urban traffic on your bicycle without a helmet or you learn that you lost the genetic lottery and have early stage X or Y or Z or xx or yy or etc.

I am not suggesting that you abandon the way you have thought for the bulk of your life if that style ia effective for you. I am suggesting that in case you have brain trauma from an accident or sports involvement or disease or start cognitive decline due to a brain anomaly, you know some alternate ways to think and store–retrieve information and make decisions using simple techniques.

I have a very well developed set of skills that has allowed me to have a great career. If one of those parts of my brain that produces good results for me is damaged, I want to make sure that I can switch out the bad memory drive (symbolically) in my head for another one. Or I can replace the logic program that got corrupted by damage to certain parts of the brain with a different method of doing the same thing utilizing other parts of the brain.

So here’s the deal. Take a look at the mind map below and see if it helps you recognize that you should start to take stock of all that wonderful data and hardware for processing it that lies in your brain and figure out how you are going to change the logic board and memory drives if you are unlucky and you need to try to make repairs.

Click on the image to expand it.

why you might want to start using cognitive-behavioral tools now and not after significant cognitive decline

Missed patients appointments represent a major wasted cost within the healthcare system.

Huge amounts of resources are wasted when patients miss appointments. Expensive healthcare providers in expensive medical office space with expensive equipment and expensive staff are not utilized to their fullest resulting in a loss to the overall system.

To deal with missed patient appointments, clinics often schedule a few more patients than they have time slots in order to compensate for the number of patients who may not arrive or may arrive later than scheduled.

If everybody actually shows up at appointments in the compensatory, over-booked environment, several things happen; doctors and staff get stressed because they have to squeeze patients into the schedule and patients get pissed off their doctor cannot be in their examination room on time or earlier.

So the system needs to get patients into healthcare clinics on the correct day at the correct time. A number of strategies are typically used.

Do you think that the average elderly or cognitively challenged individual (and caregiver) understands and remembers those reminder messages left on their voice mail or those short telephone communications from an obviously harried staff member?

Do you think that the small type, too many words, black-and-white business letter does the trick? Do you think the letters get opened? Do you think that aging folks can all read small fonts or understand a packed letter without white space?

Do you want to increase the rate of patients showing up for appointments? Look at this general framework and the example I provide below.

Use a mind map, improve patient care and help make the service system more efficient.

Click on images to expand.

Reminder  [optional use of name]

Reminder Jill Brown

chapel hill ambulatory

A clerical staff member should review the completed form with a patient or caregiver.

Personally I would send the mind map home (or in the mail) with a few brightly colored refrigerator magnets (with my phone number on them) suggesting that the patient or caregiver put the appointment mind map on the door. I would also send a second copy to be put wherever these things usually go, or to share with the caregiver. Refrigerator magnets are very inexpensive and if printed with your name and phone number will increase the number of times patients will call to reschedule rather than just skip the appointment because they cannot find your phone number (and guess what percentage of elderly or cognitively challenged or disabled or practicing physician adults might not be able to find the business card and did not enter your office phone number into their smartphones?).

Oh, and even if the form slips off the refrigerator and is whisked off to recycling by a rushed and harried house cleaner, the refrigerator magnets will still be there so the patient can call to get the scheduling information.

Try something like this. If it works you save a lot of wasted time and loss of income and frustration. Your patients get better healthcare because they remember to see you when it is medically desirable to do so. The caregivers will like it because it makes their jobs easier.

And if it doesn’t work better than the same-old, same-old, you have only lost a few hours of clerical time spent implementing a system of mind map appointment reminders.

Banks and online merchants use fairly sophisticated algorithms to identify probable cases of financial fraud and then protect themselves from the consequences of lost or stolen credit cards, etc. One of the most prevalent forms of elder abuse is financial. Aging adults are attacked by predators trying to get them to refinance their homes with reverse mortgages at exorbitant rates; make huge gifts for “kindness” from strangers; and one scheme after another. Sadly, much of the financial abuse is perpetrated by family members. And predatory financial scams are often targeted at aging immigrants to the US. Instead of just checking credit card records for fraud so as to protect themselves from liability, banks could use the same types of algorithms to scan withdrawals from savings and brokerage accounts as well as charges to credit cards to determine if they are atypically large for someone in their 80s.  (At least in California) Banks are mandated reporters (to law enforcement) of suspected financial abuse of elders. Wouldn’t it be nice if banks used the algorithms they already use to protect themselves (at the expense of your privacy) to at least protect older individuals (at a loss of the privacy they already gave up when they opened accounts) from the scum who try to separate cognitively impaired or depressed seniors from their lifetime savings? Wouldn’t that be nice …..

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When I start to work with technical research information, I find that size of the maps quickly grows.

There are limits to the brain’s processing of complex information and the computer’s ability to display image details at a size you can see.

Here are a few different models for presenting the same mind map. Which model do you think is best?

Click images [once or twice] to expand.

Model 1: “I hope you have a big display and sharp eyes”

d style 1

Model 2: “Big Bang — Universe of Information”

d style 2

d style 2a d style 2b

Model 3: “Stand in Line for One at a Time”

d style 3

d style 3a

d style 3bd style 3c

D STYLE 3D

[ADD REMAINING SINGLE BRANCH VARIANTS … AND THEN TOTAL SHOWN BELOW]

d style 1

My conclusion is that Models 2 and 3 are best for large maps, but that the selection between of these models needs to be made considering the overall size of the full map, the audience, and the topic. Model 3 is the more traditional, but Model 2 may be the best for either web or live presentation applications.

I prefer Model 1 for small maps presented online.

One of the dumbest things that I have seen in the mind mapping literature — primarily written by “professional” mind mappers typically from a business background and with huge hourly billing rates — is that writing in mind map for others is not possible for most people because it is too personal.

Bullshit.

If you have real content to present and use reasonable syntax and semantics, you can develop mind maps that others can learn to read, critique, remember, and use. Better. Stronger. Faster. And as Buskes points out, the sooner we develop common semantics-syntax for mind maps, the sooner we will all be able to read each other’s maps at least as easily as paragraphs. Buskes favors empirical studies to determine the best semantics-syntax as do I.

Judge these assertions from my blog and that of Hans Buskes. If you have real content (not bullshit theories developed from the half-baked understanding of someone else’s work) and employ semantic-syntax constructions designed to communicate to the majority of folks you can find that mind maps offer greater understanding than paragraphs of dense text.

But you gotta use real data and logical thoughts and actually want to communicate with someone else. This is not rocket science, just using skills you should have learned in elementary school by grade four. (Or if you are in the failing American education system by grade six.)

Don’t listen to the nay-saying gurus who have a vested interest in convincing you that you cannot write in mind map (as they can) so that you will pay their large consulting fees.

I believe Hans Buskes and Tony Buzan when they write-demonstrate that good mind maps can be written so that they can be universally understood. And that the skills of successful mind mapping can be developed by most adults and virtually all children. And that the resulting maps can be informative, well-researched, creative, and extremely interesting (see the online work of Dr Buskes). I also believe that communicating through mind mapping can make technical and life skill information more accessible to many more people including those with declining cognitive skills and learning disabilities and mental illness and allow them to better expressive themselves. And that visual data displays and writing tools are now fully supported by computer technology.

The best mind map is an accurate one that the most people can understand.

Not rocket science at all.

A few recent examples are given below. There are 100s of such maps in my blog posts.

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what neurologically-impaired individuals might gain from mind mapping