Contradictory Advice in Dementialand

I was recently talking to someone who worked at the Alzheimer’s Association about some of the challenges of working with families and individuals affected by dementia. I mentioned that I feel like I give people contradictory advice. First, I tell them to live in the moment. Second, I tell them to plan for the future. Sometimes I give those two pieces of advice in the same sentence or on the same Powerpoint slide.

“But isn’t that what we really all should be trying to do?” said the woman I was talking to. “Whether we have dementia or not, shouldn’t we enjoy the moment but also prepare for the future?”

It occurred to me that she was absolutely right—life is about balancing the short-term and the long-term. Your short-term self wants to have a piece of cake and enjoy the moment. Your long-term self wants to consider your health and avoid the cake. Enjoying the moment too much could potentially be a detriment to your plan for the future, but if you’re always planning ahead and never have any fun, what’s the point of life?

I’ve sometimes struggled with the balance between enjoying the moment and planning ahead. I remember telling friends in college that I couldn’t go out one night because I had to work on a paper. They asked if the paper was due the next day. Nope. It was due in three weeks. I just wanted to get a jump on it. (I wasn’t very much fun in college. I’m a lot more fun now, actually.) Yet, as a college professor, I see a lot of students who error in the other direction in the balance between enjoying the moment and planning ahead. The point is that it’s a balance. You want to have fun in college, but you can’t have so much fun that you screw yourself over in the future.

Living in the moment has always been easier said than done for me. I don’t live much in the past. I don’t spend a lot of time replaying and regretting my decisions. It’s not that I’ve always made the right choices. It’s just that looking back can be a waste of time, and I don’t like to waste time. However, I’ve tried to live in the future. I’ve played the “I’ll be happy when….” game. I’ll be happy when I finish this marathon. I’ll be happy when I finish my PhD. And, spoiler alert, after both of things were accomplished…I was no happier. It has been my journey in working with people who have dementia that has taught me to live, laugh, and love in the moment–or at least to take a big step in that direction. I’m still a work in progress.

But there is a risk to always living in the moment. In order to maximize the possibility of success in the future, we sometimes have to do stuff that doesn’t bring us much joy in the moment. We have to pay bills when we want to spend our money on things that make us happy NOW. We can’t eat what we want all the time…or we end up fat and unhealthy. We have to go to work because if we don’t go we will get fired. If we all did exactly what we needed to do to enjoy every moment to the fullest, we’d all be broke, fat, and unemployed. It’s about immediate gratification versus delayed gratification. It’s about what we want to do versus what we should do.

Everyone has that one friend who is a lot of fun. They may be the life of the party. Maybe they drink a little too much. Maybe they don’t always make the best decisions (e.g., cheating on a partner, taking a few too many “liberties” with their job). Their life is sort of a train wreck. If you think about it, they live in the moment a little too much–without thought to the consequences. If you knew me in college, you may have seen me sitting awkwardly in the corner at parties admiring this person…thinking they seemed pretty cool and wishing I had their moxie. Now, more than a decade later, I’m thinking maybe my envy was a bit misguided. I guess life is all about balance.

A family negotiating dementia walks a fine line. My advice to them is all over the place. Find something to smile about. Start researching local nursing homes. Don’t be afraid to laugh. Talk about end of life decision making. Go over your finances. Plan some fun things to do together. Figure out what’s available from local agencies for respite care. I’m sure sometimes they want to punch me. I don’t blame them.

A family that focuses too much on living in the moment might be unprepared for the challenges ahead. They may have to choose a sub-par nursing home because they didn’t have a plan. They might have to make decisions about care in crisis mode. A family that focuses too much on preparing for the future might regret missing out on joyful time that could be spent together because they are dreading the decline of their loved one.

And I have to be honest here… If you have dementia or have a loved one who has dementia, there will be moments of joy and hope. However, there will be moments where you can’t find that joy and hope, even when you look as hard as you can possibly look. Those are the moments you just gotta survive. You have to make it to the next moment–where maybe that joy and hope will be within reach again.

There are days when you can smile and laugh. Then there are days where you just gotta hope that tomorrow is a little better. That’s the thing about living in the present….living in the present is great when you can find joy in the present. When you can’t find joy in the present, it’s okay to look to the future a little bit. And maybe that future is only five minutes away. Perhaps there’s something right around the corner that’s going to make you smile and laugh. You have to believe that.

I am working summer orientation right now. I do advising for incoming freshmen. The more I think about it, I realize that I give similar advice to individuals and families impacted by dementia and to college freshmen. I state it a little bit differently. I tell freshmen to have fun but not so much fun that they have to go back home and live in their parents’ basement. I tell those affected by dementia that they need to focus on the moment but set themselves up for success (and as little stress as possible) in the future.

But we all need to enjoy the moment while we prepare for the future.

As for me, I no longer opt out of fun events to work on things that aren’t due for another three weeks. In fact, I’ve gotten better at procrastinating. It’s all about balance.

3 thoughts on “Contradictory Advice in Dementialand

  1. This has been a stressor for me for a long time. (Can you tell I’m binge-reading?) I’ve always felt I needed to pick one or the other — now or the future. One day someone said, “You see everything as black and white. Why don’t you spend a little time in the gray?”


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