Friday, March 12, 2010

Caregiver Brain Changes

Much has been written about the brain issues of aging parents. Less has been written about the brain issues that impact middle age adults. Given that the majority of caregivers of aging parents are middle age, it is important to know how middle age brains are changing and how this impacts the demands of caregiving.

The most significant change in the middle-aged brain is a decrease in “executive function.” Executive function is the hub of multitasking and occurs in the frontal brain. It is responsible for prioritizing and keeping track of long lists of complicated, interconnected transactions. As this capacity begins to wane, it becomes harder and harder for middle-aged adults to keep “everything together.”

Complicating this setback in multitasking capacity is a concurrent decrease in the brain?s “staying on task” function. The impeccable filtering of distractions that comes so easy in youth begins to give way to the irresistible pull of distractions in middle age. The result is that middle-aged adults suffer from a failing attention span. Things get put in the wrong place, scheduling errors increase, “why I did I come in here” moments are more frequent, and “retrieval time” of information slows. This unwelcome and annoying distractibility has qualities that mimic ADD and make it harder and harder for middle-aged adults to “stay on task.”

Both of these brain changes complicate the job of caregiving for middle-aged adults where keeping everything together and staying on task are essential.

What can make this better?

1. Consider a “one-list” system Multiple “to do” lists can lead to disaster. It is more effective to work off a single, dynamic list that is constantly annotated, revised, rewritten, and reviewed. It becomes the focal point of a “keep track of things” system that is always identifying the most important short-term priorities and then quickly repositioning these items to the top of the list.

2. Fight the urge to “binge” multitask Binges of multitasking only exacerbate distractibility and prove inefficient and unhealthful. With the natural tendency of middle age brains to wander or lose their location “threads,” it is better to focus on a the task at hand and “turn off” as many distractions as much as possible (music, cell phone, email dings, etc.).

3. Optimize the continuum Mind-Body health is an interconnected continuum. The simple but powerful things that optimize bodies, optimize brains. Exercise, prayer, music, meditation, writing, dancing, being with friends, healthy food, support groups, and large does of humor open caregiver hearts, and, as importantly, give caregivers the creativity they need to build a new partnership with their middle age brains.

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1 Comment

  1. Comments  DermaWorksStaff   |  Friday, 23 January 2009 at 11:01 am

    I have been caring for an aging parent for 4 years now. Although it feels good to know that I am taking care of my mom, it does take a toll. I definitely have more wrinkles on my face, bags under my eyes, and these are only changes on the outside!

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Aging Parents Insights, hosted by David Solie, is a blog radio show that provide listeners with "new ideas and strategies” for understanding and communicating with aging parents.

No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link http://www.dsolie.com/articles/reframing.html will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this.

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.