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 spend increasing time managing mail, bills, and checkbooks. Technology becomes a struggle. As short-term memory and complex thinking decline, there is less and less initiation or increasing apathy. We need more assistance to do complex things and to stay involved with those activities we enjoy and do well.

The ways to integrate assistance are limitless. Our spouse and/or family provide one form of assistance. This is informal assistance. The problem here becomes that they can’t do everything and they can’t manage for 24/7/365. They need breaks. Friends provide another form of assistance. Friends may call us to go to a play or a ball game if we forget.

Assistance may also come from outside persons or organizations. There are organizations that provide care for those with mild memory loss. There are places like the Millennium House (992-5513), Ardent Manor (435-9526), and the Care Club (353-1994) where those with memory loss can go to participate in formal activities with others. These are places one goes for stimulation and enjoyment. They provide a break for your spouse and engagement for you.

There are also more personalized programs. I call them “day care without walls.” This kind of assistance is based on your unique interests and skills. Personalized assistance is provided by friends or family or can be found at CompanionPlus (370-7130). CompanionPlus’ mission is to get you to activities you love to do but forget to go. If you golf, you have a companion with whom to golf. If you love to go to art class, you have someone with whom to go to art class. If you love to fish, you have someone with whom to fish. If you love to go to plays, you have someone with whom to go to plays. Programming is built around your desires and interests. I once had a client who loved electronics. The “program” was to have him go to Best Buy (without a credit card), make a wish list, and do lunch with a buddy.

It’s so sad for me to see so many with mild decline become so isolated when they don’t have to. It is sad to see overwhelmed caregivers try to do it all. There are options to have a good life even if you are very forgetful.