This weekend the American Psychological Association is meeting in San Francisco. While certainly not exclusively so, the meeting tends to be dedicated to the presentation of fairly trivial and limited scope, poorly designed research studies.
Psychology should be embarrassed that the focus of the meeting is not developing new and better ways of addressing psychological problems. For instance, I have dementia. So do many millions of people worldwide. At this psychological meeting, there is little focus on actually improving the lives of persons with dementia. The same is true for many other psychological disorders.
How has psychology failed persons with dementia? The following mind map presents my assessment of the situation.
Why does psychology fail persons with dementia? I believe it is because the field wants to pretend it is a science of the rigor of biology and physics, rather than focusing on becoming an evidence-based way of developing better ways of patient assessment, screening, treatment, and communication. What a waste. And remember that I am a person with degenerative cognitive and behavioral disease and I get it. Shame on psychology.
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.
Last week (June 14, 2017) I received an email from a close friend with a link to an article generated by the North Carolina station of the National Public Radio a month ago. Along with noting that the research process was not what it once was — specifically that I had received a description of a study carried out in India from a psychologist in Israel with a summary of a radio broadcast generated about five miles from my home.
The changes in how we think, process and access information, and communicate change dramatically annually (as well as monthly, weekly, daily even). But is everyone changing how they fit to match our modern world and its information use possibilities?
People of many different income, education, social, and other strata within Indian society took EEGs to study their alpha brain patterns. There were many differences between the way that their brains seemed to work as measured by EEG indicators that could potentially be explained by differences in exposure to different levels and kinds of technologies.
A summary of the work appears here and was written by the University of California, Berkeley, philosopher Alva Noe. Noe discusses how brain wave patterns may have changed as individuals are exposed to the dramatic new information access and processing annually. The original scientific research by DhanyaParameshwaran and Tara C.Thiagarajan appears here. Noe notes that one of the “problems” in our current conceptions of neurocognitive science is that virtually all of the experimental results have been derived from “WEIRD” brains, that is individuals educated in current technologies within western, industrialized, rich democracies. The Indian results suggest that there are different patterns of “NORMAL” brain waves among individual from other backgrounds.
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.
I was old enough to vote in my first presidential election in 1972 when I was 21 years old. I voted Democratic then and since then I have always voted for the Democratic candidate often as a perceived lesser of two evils. I voted for Hillary Clinton last year not because she was a good candidate or a good person (in my judgment) but she was better than Mr Trump who was the most extreme political presidential candidate since George Wallace and the most “out of it” candidate since Ross Perot. Before I could vote, I lived through the presidencies of Eisenhower, Kennedy, Johnson, and Nixon’s first term.
I have a neurodegenerative condition that makes me almost uncontrollably anxious at times, obsessive-compulsive at others, and not particular good at decision making. But more than ever, I think that Trump’s Fake Populism is a horrible way to run the USA and the World and I am pretty sure that in spite of cognitive decline my perceptions of Trump are accurate.
Trump’s behavior makes me very anxious and deeply concerned about the USA I will be leaving behind soon. A lot of Americans (according to recent polls, the majority) share my concerns that Trump is an extremely bad President.
I would personally feel much better if the USA required its presidential candidates to take non-partisan medical, neuropsychological, and psychological evaluations before assuming office and annually. My belief is that a group of actively practicing medical doctors enlisted in the Uniformed Services of the United States could make an overall assessment of an individual’s fitness to be “the most powerful person on earth” and commander in chief of the world’s largest army and largest biggest nuclear arsenal, as well as the architect and steward of the world’s largest budget. I note that medical doctors and other healthcare professionals in the US Uniformed Services have sworn an oath to uphold the Constitution of the United States. It is reasonable to expect that the medical practitioners of the United States Uniformed Services can use due diligence and state-of-the-art medical skills to ensure that an individual honored with the duties of the President of the United States is physically and mentally fit to deal with the stresses of the job. I also note that 14 members of the 115th US Congress (2017-2019) are physicians (and 2 are Democrats while 12 are Republicans) and that I have confidence that their medical ethics and competence in medicine would permit a nonpartisan panel to oversee such an assessment (even though I vote as a very liberal Democrat). Perhaps Mr Trump has a medical condition affecting his ability to perform the duties of his office or perhaps he is just a bigoted, narcissistic, incompetent jerk who is quite successful at manipulating the voters of the USA, even without the assistance of Mr Putin and his hackers.
Is my cognitive decline causing my perceptions to slip in their accuracy or are my observations accurate descriptions of living for several months in #TrumpWorld?
Click on the image to expand.
Note. None of the 14 physicians in the current Congress has formal training in neurology. Since a neurological assessment is an important part of a medical exam for a 70-year old person, independent neurologists of either political party should also be part of a supervisory and assessment panel.
Not the past, not what might happen in the future. Fuzzy, intuitive, today’s emotions. Nonlinear, visual, big picture. Attention flows toward good, bright, happy visualizations.
Opening your mind to nonlinear thinking may provide a cognitive reserve that helps you as cognitive functions start to decline perhaps precipitously into dementia. Neuroplasticity is a mechanism that the brain will use to reassign functional processing from one area to the brain as it is damaged by trauma or disease.
One very good way to encourage the development of cognitive reserve and neuroplasticity is to practice nonlinear thinking methods that can help promote mindful solutions. Should the brain become damaged, it may be able to use nonlinear, symbolic visual thinking to cope, at least for a while. And while you practice you may also experience strength in your resolve and understanding.
Do note that the above comments are speculative. There is NO formal research on mind mapping or other comments about this in the literature (other than my own). Also, this is based only on my own experience and generalizations from my earlier research on daydreaming and imagery. So do not go about thinking that this proven. Rather it is speculative.
While I theorize that mind mapping is related to mindfulness in SOME applications, even if it turns out that it is not — from the results of formal empirical studies — there are other demonstrated benefits from mind mapping, so the actual use of mind mapping should still be encouraged.
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).
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.
Click on image to expand. Estimated time to develop for a NOVICE (me) = 15 minutes. The sketchnote was drawn by a person with dementia (me).
[Note. I usually write/draw note panels like this from right to left in sections because I am left-handed and it minimizes the amount of smeared ink. There is no magic in this, so use any organization that works for you.]
Living with dementia is all about improving quality of life (QOL). Treatments to fix up your brain are still in development. They will not happen in my lifetime. But, as I always suggest in this blog, there are some ways of using simple cognitive and behavioral methods that may make your life (and that of your family) more pleasant. When you have dementia, a better day is priceless.
There are several products on the Apple app store for iPhones and iPads that claim to promote electronic communications among patients, family members, and paid caregivers. In reviewing many, I found them — as a group — to be somewhat expensive and typically fairly difficult to use (by me, a member of the patient target group with a PhD and 25+ years of software development experience).
I have carried an iPhone and iPad with me almost continually for the past 10 years. I have always considered the voice control app Siri to be something of a “bar toy” that you can ask questions like “who won the 1923 World Series?” or “what is the dollar-euro exchange rate?” My judgment had been drawn based on the earliest versions of Siri that had significant problems in voice recognition and returned “interesting if bizarre” information in response to questions.
Then recently I watched a teen sit with her iPhone and take notes, schedule, get smart answers, and generally zip through her homework. She did not seem to be doing anything “special” to enable the phone to interpret her voice. And she got terrific and accurate translation of her spoken words into written words using Siri.
Well … I decided it was time to start acting “cool” and flexible again and seem like I was having a conversation with my friend Siri. I started to talk to Siri and “her/him/it” and tell it to take written notes. I experimented with several Apple devices and found that multiple individuals (and devices) linked on the same account can easily share notes.
Free. Nothing special required. Easy. Doing a little research, I concluded that the transcription and note taking function now work far better than ever before due to enhancements in Siri, but more importantly because of recent upgrades in the Notes app included in iOS.
There is huge potential here for Persons with Dementia to take notes for themselves easily and simply by speaking into an iPhone they carry everywhere. And for caregivers and family members to leave notes for a Person with Dementia. Or to check the PWD’s notes to see what is going on. No lost notes and I bet that many people are likely to carry their phone everywhere than to carry a pencil and notepad.
If you and Mom (or Dad or your aging friends) carry iPhones, you can easily set up a system where notes can be shared in a couple of minutes.
Comments: 1. Apple is reliably rumored to be releasing Siri for the Mac in June 2016. 2. At this time I only recommend sharing notes, not calendars. Calendars are confusing. 3. Siri also runs on the Apple Watch. Hopefully well enough to also share notes. 4. Donald Trump is reportedly suing to change the name Siri because he does not want Syrians in the US (OK, so I couldn’t resist).
The mind map below organizes the basic information about this system and provides additional details.
The slide presentation breaks the mind map into pieces. It will run automatically or you can push the pause button and then use the arrow keys to move through the presentation manually.
This slideshow requires JavaScript.
Siri, take a note. Get started making electronic notes with Siri many times per day.
You can change voices for Siri [male/female and in the US Version Americanish, UKish, or Australish] easily. I prefer the female British voice (the American female version is too common, the Australian female version is too upbeat and hard to follow, and I do not want a male butler or a bossy service representative voice). Mary Poppins is quite helpful, friendly, and at times scolds you. I need a nanny.
By the way, ask Siri to take a note and say this word. It will spell it correctly.
If you use Siri, you can also find out the answer to the “argument” (discussion) you having with your caregiver about how much money Lionel Messi makes in dollars, euros, pounds, or yen.
Sorry folks. I do not use PCs anymore after 30 years of frustration and bugs or Android devices so if you do not use Apple products you are going to need to explore this area on your own.
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.
4 Custom Styles I Use in My Own Work and 4 Variations on the Same 3D Mind Map
Living independently or semi-independently with cognitive impairment and early stage dementia is an admirable goal. Remember, however, that there are many cautions and possible problems that you, your caretaker, your family, and your doctors need to be aware of and monitor.
Plan to discuss these (and other) issues with your doctors and others on a regular basis. It is an important part of trying to stay as independent as possible.
The majority of the posts on this blog are about using visual thinking methods — of which I think that by far the best is #Buzan-style organic mind mapping — to understand, explain, evaluate, and communicate about healthcare. A lot of my own thinking has focused on using visual thinking techniques to potentially improve the quality of life of those with cognitive impairment and dementia.
Tony Buzan and Chris Griffiths and their colleagues and staff at ThinkBuzan have done a very comprehensive job at getting many of Buzan’s ideas embedded into a general purpose computer program (iMindMap) which provides a general visual thinking environment, of which mind mapping is a special part. There are many computer assisted mind mapping programs, but I have concluded that iMindMap is by far the best for creative visual thinking and communication, in no small part because it fully incorporates Buzan’s theory and theoretical implementation.
Like scientists and management consultants and educators and healthcare providers and patients and patient caregivers and students and many others, illustrators struggle with how to best use visual representations to support better thinking and communications.
Which brings up this beautifully conceived and executed little book that I have found to be mind expanding and liberating in how to develop and use a series of illustration techniques and “tricks” to look at things differently when trying to make creative breakthroughs.
Whitney Sherman is the author of the book “Playing with Sketches” which provides 50 exercises which collectively will change the way you think about creating images to understand and communicate ideas.While Ms. Sherman wrote the book for designers and artists, the techniques will be just as useful for visual thinkers in science, education, medicine, industry, and other fields. The beauty of Ms Sherman’s exercises is that in showing you fairly simple ways to make hugely informative and well designed images, the tools will themselves suggest many applications to visual thinkers of all types.
And, I have found that Ms. Sherman’s techniques can be used by the severely artistically challenged (of which I am one); the techniques are ones for Visual THINKERS, not necessarily artists and designers.
I have mentioned this book before in much less detail, but in the months I have used the methods, I have found that they WORK very well to facilitate creative visual thinking. For me they have promoted a breakthrough in how I see the visual thinking canvas.
Get the book, try some of the techniques (pick a random one here and there to start), discover that great artistic talent or aptitude is not required, and see how the techniques fit the information you study in search for better healthcare or disease prevention or decision making or facilitating creative group processes.
In partnership with Tony Buzan’s techniques for organic #mindmapping and Mike Rohde’s framework for #sketchnoting, the techniques codified by Whitney Sherman provide very powerful visual thinking tools.
I will be posting some examples of using the sketching techniques of Ms. Sherman to developing assistance and communication techniques for those with cognitive impairment or early-mid stages of dementia.
This mind map is an enhanced version of a mind map I first published about a year ago. As is well recognized in the literature and discussed previously on this web site, individuals experience the progression of dementia in a number of ways depending upon the specific underlying disease or condition that causes the dementia symptoms to appear, existing psychological resilience factors independent of the neurological issues, and one’s psychological and physical resources.
You CANNOT diagnose yourself as having cognitive decline, cognitive impairment, or dementia from the information in the mind map. People without neurological OR psychological illness, problems, and issues may experience these feelings.
The map does provide an overview of some of the feelings and views that individuals whose cognitive health is declining may feel.
Sometimes the following trick helps me both code notes (or task lists) and grabs my attention when the ignored task list is floating around on my desk or becomes part of the wad of notes, receipts, and other small pieces of paper that accumulate in my pockets. I review the wad of paper regularly (hopefully finding it before I put the pants or shirt in the laundry and being transformed to lint in the dryer). This little trick is used by people who make sketchnotes for a living (see the wonderful books by Mike Rohde on sketchnoting). Sketchnoters — because of their business and professional audience — tend to use a more subtle and artistic version of what I do (after all their audience is wearing suits while my audience is me wearing shorts and an old T-shirt). Same principle though.
[Star Trek may have incorporated the following idea into some of its episodes.]
The thick-thin pens are called Fude de Mannen by their manufacturer Sailor and fairly inexpensive. A much more elegant and expensive option that does the same thing is any Sailor fountain pen with a Zoom nib. You can also do the same shift between thick and thin inexpensively with a Noodler’s flex pen or many calligraphy pens (the Japanese ones are best and brush pens work even better) or much more elegantly and expensively with either a Pilot Falcon pen or any Pilot pen equipped with an FA nib. I have no commercial relationship to any of these companies. The odds of finding any of these pens in a brick-and-mortar store in the USA are fairly low but they are available widely on the Internet with many coming directly from Japan (yup, they ship anywhere).
I use different writing implements to vary things, color code, and even slow myself down (like the decorative fonts do) in order to increase the time for memory encoding, to build in uniqueness that grabs attention, and to amuse myself (I am easy to amuse).
Many of these “tricks” are the same as those as used in mind mapping without the most important feature of structuring, restructuring, and formally associating many ideas.
The next logical step after these kind of notes is mind mapping which I strongly endorse. On the other hand, some people just want to takes notes and may not want to take the time to carefully think through them or organize their thoughts, and for those folks at least remember this.
&&& the purpoSe of noteS is to REmemBER in parT because the noteS are MEMOR(Y)able and you pay more attention to them ***
While I cannot prove this, it is my guess that these techniques will also be useful for those with memory and attention problems like normal aging, cognitive impairment, dementia, Alzheimer’s, and ADHD. But all of these conjectures require empirical research to substantiate and are just WAGs (Wild Ass Guesses) on my part at this time.
Most other web sites that rank mind map apps carry advertising from at least several different producers of these programs while I do not. This may or may not explain my greater willingness to differentiate sharply between the apps.
Your idea of what a great mind map app should be may differ from mine resulting in different ratings. Mine are particularly relevant for scientific, health, education, and personal use rather than corporate outline formatting. In fact corporate outline formatting in “mind map” programs does not really produce true mind maps, but most corporate customers do not know the difference. Learn why Buzan-style mind maps will perform far better than the “formatted outline” maps produced by many of the best selling programs before committing to one model or the other.
The programs continuously change (most copy each new version of iMindMap after its release) and my ratings change fairly often.
I communicate with some of the app developers (as well as other independent reviewers) via email. I try not to let these interactions with nice people and arrogant people and people with crummy business models (and crummy customer support) and development geniuses color my ratings.
These ratings apply only to Mac software. I do not use any of these programs on a PC. After 25 years of 40-80 hours of PC use per week, I switched to a real computer and use Macs exclusively.
I will release separate ratings for iPad apps, but in general those programs that are especially good on the Mac tend to be especially good on the iPad. Note that while I do not believe that the Mac version of Inspiration is a particularly good app, I think that the iPad implementation is among the very best.
The apps I review are full commercial versions. I have yet to find a free mind map app that is even close to the best paid apps in quality and usability.
Virtually all of the paid apps have free evaluation periods. Most periods are 30 days which is plenty of time to form your own judgment. Make use of the opportunities provided by the developers and vendors.
And yes, the three programs that I intend to use 90% of the time or more are iMindMap, iMindQ, and iThoughtsX. My use is about 85% iMindMap and 2.5% each of the others. I spread the other 10% of my usage around, often experimenting with other programs just to see if they better fit specific uses or types of users.
This mind map that follows is the same as that above reformatted for “3D” presentation.
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.
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.
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:
I printed the mind map on an actual business envelope and then scanned it. The green paper was just a background for the scan.
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.
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.
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.
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.
To understand the mind map better from the clinical experiences of the patient, family, and healthcare providers, you may wish to …
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.
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.
Google Glass can almost immediately be used as a technology to help those living with dementia and cognitive impairment recognize faces and associate names and other information, know their location, and make associations between environments and their own life experiences. The software needed to be used along with Google Glass is, in most cases, existing and needs to simply be modified for individuals.
Click image to expand.
Blog posts and other information about the use of Google Glass with those living with Alzheimer’s as well as other types of dementia can be accessed by clicking here. A new window will open with current suggestions from a Google search.
This YouTube video shows the national award winning science project of four sixth grade girls. The future of Alzheimer’s care is in good hands.
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?
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.
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.
There are more than 7,000 rare diseases in the world, almost all of which lack any type of medical treatment. Were every religious congregation in the world to “adopt” a disease and do what it can to help find and provide a cure for that one disease, it is quite possible that the hundreds of millions of people (in aggregate across all rare diseases) could be helped in small and large ways.
I think that it is very possible that organized religions can put away their ideological differences and work cooperatively through information sharing, advocating, raising monies, and demanding progress from governments and corporations to fight rare diseases. After all, most of these diseases are genetic in origin and more than 50% of those who suffer from rare diseases are children. And, central values in the organized religions are showing compassion, helping, and supporting those in need.
I am not naive enough to believe that religions, religious leaders, and religious congregations working together in small ways is enough to solve religious bigotry, the hot points in Jerusalem, or prevent future ethnic-religious cleansing by horrible people deceiving their own citizens. But let’s at least try to start in the small ways of learning about one or two rare diseases and pooling creativity, resources, and prayers for the energy and stamina to find cures. Religious congregations and their energy directed by the desire to help are almost unstoppable forces.
February 28 is Rare Disease Day.
It is also a day when the religious peoples of the world can unite to plan to make small and large steps to acknowledge and cure at least some of the rare diseases.
I pray that it will happen.
And should you not believe in organized religions, I hope you will nonetheless join in an organized search for effective treatments.
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.
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.
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.
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
Caregivers may find that visual information recorded in mind maps provides a good way for the caregiver and the client to start discussions.
Caregivers may find that clients can express themselves better with pictures, drawings, doodles than in words.
Caregivers may find that their own notes from each day are more useful if captured in the format of mind maps.
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.
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.
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.
***
Preparing a Mind Map (with the help of the client or family members) of the Client’s Religious Beliefs.
***
Preparing a Mind Map (with the help of the client or family members) of Things the Client Especially Enjoys.
***
Preparing Mind Maps from the Warning Brochure that Comes with Each Prescription Refill.
OR
***
Preparing a Mind Map of Each Day for Your Use and That of the Client.
***
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.
