People often remind each other of appointments, words, what to buy, and names. For example, at work there are administrative assistants whose job it is to remember for and remind others. These memory collaborators serve as the backbone of organizations. At home, partners are our memory collaborators. So often my wife helps me find words for which I am searching, reminds me of appointments, helps me recall times I have enjoyed, and what to pick up at the grocery store. She also reduces my memory load by managing the checkbook and finances. As with many married couples it is a symphony of collaborative efforts that makes both of our lives easier as neither of us has to remember everything on our own.

For those with memory disorders, the need for memory collaboration is no longer a convenience but becomes a necessity. As memory disorders progress, there is an increasing need of external support for memory, especially for those who forget that they forget. Those with partners will do much better than those who live alone. With mild memory loss, the partner becomes the source of reminders for appointments, sending birthday cards, or taking medications but routines such as chores or going to play golf remain. As memory increasingly fails, the partner becomes more and more important (but not necessarily appreciated) for remembering. They need to be sure the bills are paid, that the checkbook is correctly balanced, that the laundry is done, etc. In more advanced stages of memory loss, the partner has to help remember when it is time to attend to personal care such as when to shower or when to change clothes.

It’s no wonder that partners of those with memory disorders are often tired, frustrated, and stressed. They have to increasingly remember for two in addition to the myriad of tasks they have to take over such as shopping, the checkbook, or driving for those who cannot. The collaboration becomes one sided. I recall so clearly the frustration of a husband who brought his wife to see me about back pain that kept her in bed for an extra several hours each morning. By the time they saw me in the afternoon her pain had subsided. He asked her to describe the pain to me and she merely said, “What pain?”

We need to keep the collaborating spouse in mind when working with those with memory loss. For medical appointments self-report is no longer reliable. Assessments need to include the partner as an active participant in all phases. The partner also needs to understand the outcome of assessments and be included in treatment planning and execution. Finally, the partner also needs attention, guidance, support, understanding, and training. Treatment of memory disorders is a collaborative process that must engage all partners.