Archive for June, 2011

Caregiving takes an enormous emotional and physical toll even when it is a labor of love and/or obligation. In the case of caring for someone with progressive memory loss, a spouse or child often has to parent their partner or parent. This sets up a natural and sad antagonism. The caregiver must set limits and enforce rules (nag and be bossy) and the care receiver isn’t aware that they need the guidance as they forget that they forget and resent and resist rather than appreciate the efforts on their behalf. Take for example the case of a caregiver (partner or child) who is caring for her very forgetful but very bright husband/father. He is so forgetful that he cannot monitor how much money he spends in any given month and is prone to overspend. His partner/daughter has to put him […]

What Engagement Therapy for Memory Loss When Wednesday, July 27, 2011 2:00pm – 2-4 pm – All Ages Where Arden Courts (map) 15950 McGregor Boulevard Fort Myers, FL 33908 Other Info2-4 pm Tailoring activity to abilities Engagement therapy Living life to fullest despite memory loss « Back to the calendar


What Breakfast with Bill When Wednesday, July 6, 2011 9:00am – All Ages Where Arden Courts (map) 15950 McGregor Boulevard Fort Myers, FL 33908 Other Info9-11 am « Back to the calendar


What Coping With Guilt When Thursday, June 23, 2011 6:00pm – 6-7:30 pm – All Ages Where Arden Courts – Wilmington (map) 700 1/2 Foulk Rd Wilmington, DE 19803 Other InfoStages of memory loss and role of caregiver Caregiver role changes Coping with the feelings 6-7:30 pm « Back to the calendar


What How to Identify and Treat Alzheimer’s Disease When Thursday, June 23, 2011 12:00pm – 12-1 pm – All Ages Where Arden Courts – Wilmington (map) 700 1/2 Foulk Rd Wilmington, DE 19803 Other InfoCommon myths Memory loss vrs normal aging Treatment options « Back to the calendar


I was giving a talk about assessing memory the other day and I was asked a question that I have been asked often – “When will there be a cure for Alzheimer’s disease?” It is a difficult question to answer. I don’t want to sound as if there is no hope but I also don’t want to give false hope. I would be very pleased to be wrong about my belief that there will not soon be a cure for Alzheimer’s disease, cancer, heart disease, etc. First, consider that Alzheimer’s disease is a complex and progressive degenerative disorder of the brain. It is not the only complex progressive brain disorder. Other progressive brain disorders include but are not limited to Parkinson’s disease, multiple sclerosis, Lewy body disease, Pick’s disease, Huntington’s chorea, and primary progressive aphasia. All are subtle in onset, […]

How old is too old to work? It used to be easier to answer this question. Prior to 1900, you worked until you could no longer work. The social security act changed things. In 1935, older workers could draw benefits and retire at 65. When I reached the age of 65 and much to my surprise, I was often asked when I was going to retire. I have no plan as retirement is a process that unfolds over many years. Age is not the critical factor in the decision to quit working. The question of being too old to work is not answered based on chronological age. Rather it is answered based on financial resources, desired life style, need for engagement in challenges, and functional (physical and mental) abilities. I had several clients doing well into their 80s and beyond. […]


We all confront the major myth of brain function which is that our brains work best in our youth. Even as early as middle age (40-69?) we are confronted by changes. Our brain slows as we get older. But we can’t run as fast or hit a ball as far either. The brain becomes more distractible as it ages. We can’t multitask as well and memorization takes more effort. As the brain ages (as early as 40), it has more difficulty with names and nouns. None of these changes compromises competency or the ability to learn. The truth is that the brain not only preserves its youthful skills but also develops new strengths well into middle age and beyond for many. The middle and old aged adult brain can rewire and elaborate itself. The catch phrase for this ability is […]


Many who later develop significant memory disorders and dementia start with mild changes that are difficult to distinguish from the normal changes of aging. Ronald Peterson at the Mayo Clinic described such cases as Mild Cognitive Impairment in about 2000. A number of factors may cause Mild Cognitive Impairment: Alzheimer’s disease, vascular disease (i.e., small strokes), Parkinson’s disease, Lewy Body disease, Primary Progressive aphasia…. The important word is mild. Persons with Mild Cognitive Impairment are not demented. They live independent lives. Many do not become demented. However, the risk of becoming demented is much greater for those with Mild Cognitive Impairment than those who never show these changes as they age. The new diagnostic criteria for Alzheimer’s disease include Mild Cognitive Impairment. Accordingly in Mild Cognitive Impairment: • The person or family members express concern about changes in memory or […]


As infants, we need assistance to survive. As we develop and master the world about us, we need less and less assistance. We become independent. Progressive dementia follows the course of development backwards. With dementias such as Alzheimer’s disease, there is a gradual loss of independence that requires outside assistance. The principle works according to the pattern of first in, last out. Last in, first out. Treating progressive dementias requires a forward looking plan that provides assistance where needed in a systematic fashion before dementia sets in. At first, we can provide our own assistance. Short-term memory makes new learning more and more difficult over time. We assist ourselves at first by fortifying our calendar and checking it often. We use post-it notes. There are a multitude of external memory supports. The more complex skills weaken first. We need to […]

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