Dementia and Time Management

Today I’m coming to you from O’Hare Airport in Chicago. Specifically, I’m at Chili’s on terminal H, drinking a glass to Riesling and deciding if I need an appetizer. I do, don’t I? Probably something fried. Cheese curds. Onion rings. I wonder why I put on weight when I travel? Any ideas?

I flew here on a 1:14 pm flight from Waterloo, Iowa, and now I await my flight to Atlanta for a work-related conference.

Let’s back up a few hours.

My flight departed at 1:14. In Waterloo, you don’t exactly worry about long security lines, so I knew I had to be at the airport 45 minutes early…so that’s 12:30-ish. Yep…45 minutes is plenty. To give you the back story on the Waterloo airport, I once I happened to be the last passenger to arrive at the airport for my flight (three flights to Chicago leave each day–that’s all the departing flights!) and the guy working the American Airlines desk exclaimed “Elaine!” as I walked in–kinda like “Norm!” from Cheers, right?

I know it takes about 12 minutes to drive from my house to the airport. I knew I need to leave home about 12:15. (If you regularly fly out of an airport like Chicago or Atlanta, I apologize if I am making you jealous. Keep in mind that I haven’t flown anywhere direct in over ten years. I’m the jealous one.)

Let’s back up a bit more.

I knew I wanted to run and lift weights before catching my flight today. I also knew I needed to leave time for a shower after my workout, and it would take me about 30 minutes to shower, dry my hair, put on a little makeup, and get dressed. I’d need to make sure I was in the shower by 11:45am.

So….if I was going to run 5 miles…that would take about 45 minutes. And lifting weights? Maybe 20 minutes. I would need to start my workout by 10:40ish at the absolute latest.

Now–1:14pm was the original goal. I needed to be at the airport at 1:14. However, there were a lot of time benchmarks I would need to hit to make that 1:14 goal happen.

And I did. But I must admit it took a little thought and planning. And the stakes are pretty big for something like this. I’m not really sure what happens if you miss your flight, and I don’t want to find out.

Over the last few years, I have come to realize just how challenging getting somewhere on time can be for people in the early stages of dementia.

A friend with younger-onset Alzheimer’s recently told me about a challenging situation she has been encountering. Her husband would tell her that they had dinner plans with friends at, say, 7 pm. He would swing by at 6:30 after he finished work to pick her up.

And there she would be–sitting on the couch. Not dressed for dinner. Still needing to touch up her hair and makeup.

“Dinner is at 7, honey,” he would say, frustrated that they were going to be late.

“I know dinner is at 7, and it’s only 6:30 now,” she’d respond.

It was as if she were so focused on 7pm that it did not register that some action would have to take place before 7pm to make a 7 pm arrival a reality.

After several instances like this led to arguments between my friend and her husband, they came up with a new plan. He would write the time she needed to start getting ready on a dry erase board.

5:45pm Pick out dinner outfit and change clothes

6:00pm Brush and curl hair

6:15pm Put on make-up

6:30pm Dave will pick you up for dinner

Another friend with younger-onset dementia puts everything on her calendar. One night she was expecting company. She needed to clean house during the day, but she didn’t just write “clean house” on her calendar.

She wrote:

1:00pm vacuum

1:30pm Swiffer the kitchen floor

2:00pm wipe down counters

Writing down specific tasks and a more definitive timeline can be helpful to all of us. However, I don’t want you to think we should all turn into overscheduled robots with no flexibility. Maybe it doesn’t matter if you go to the grocery store at 3 pm or 5 pm. You’ll get there when you get there. Perhaps there are days you have nothin scheduled and you can head to the gym at any point.

But sometimes we need to be at a certain place at a certain time. And I don’t think we give people with dementia enough credit for the mental energy it takes to make that happen.

Think about everything Grandma has to do to make it to Christmas dinner on time. Picking up the last minute items she was asked to bring. Getting all of the presents packed up and ready to transport. Finding the Christmas sweater she hasn’t worn since last year. And mentally organizing all of those tasks so she can arrive exactly at 4 pm.

Is it any wonder her brain is tired by the time she gets there?

Time management issues can mean that people living with dementia show up early. Someone recently told me that their neighbor with early-stage Alzheimer’s was going to stop by one evening to visit. They received a call at work that day from their neighbor who wondered where they were.

The friend said, “I might be a few minutes early, but I’m wondering if you’re around. You might have forgotten that I said I was coming at 6.”

It was 3:30 pm.

A while back, I had a chance to talk to a family doctor who counted individuals living with dementia among his patients. We were discussing how to give a person and their loved ones a diagnosis of a dementia-causing condition.

Of course, I’ve never actually done this since I’m not a medical doctor but still felt he’d probably value my input. Okay….that’s not true. He was probably wishing I’d shut up. And I knew that at the time but kept talking anyway.

I mentioned that I wished there was more education about how to live with dementia. I gave a few examples–one of which focused on using more memory aids and listing out specific tasks on mediums like white boards. I explained that we should focus on breaking down tasks a bit more. Instead of “get ready for the day,” we can use “brush teeth,” “put on clothes,” and “use deodorant.” (If I am being honest, I also do better when I write a to-do list with specific tasks I can check off rather than a large general task.)

The doctor responded, “Yeah, but stuff like that doesn’t work forever.”

And it’s true. Dementia is progressive. There will come a time when people living with dementia can no longer read a list. There will come a time when they don’t know what deodorant is anymore. I get that.

But that day isn’t today. And it could be a long way off.

Use strategies until they don’t work anymore. Then find new strategies.

 

 

 

 

 

10 thoughts on “Dementia and Time Management

  1. Great, great, great!! I couldn’t agree more. Strategies don’t have to fit the entire progression of the disease. Thanks for another powerful post.

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  2. I always adore your blogs Elaine, and always share them with my Young Onset Group and as widely as I can.Carry on your fantastic work x

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  3. Really helpful post – especially the tip on breaking out the process into the actual steps, and putting them on the whiteboard. I get caught a lot, as caregiver, saying too much at a time, not realizing that a “simple” sequence of 4 or 5 things gets stalled out because holding one thing in mind while taking in another thing is getting harder and harder for my spouse.

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  4. Dear Elaine, this is so right. The reason why Speech Therapy is not offered commonly to those with Primary Progressive Aphasia is because “it’s progressive”. What about quality of life and mood improvement, both improved according to recent research. Neurologists diagnose the disease, but often don’t work to mitigate the symptoms but say “ there’s no cure so go and live your life” living well with dementia needs strategies and where do people get them from if the M.D. doesn’t signpost the possibility.

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  5. Also, I think it’s important to have multiple strategies and tools at the ready to manage different sets of circumstances and events, any one of which might work or not at any given time. For example, music might help someone to feel calm today, but not tomorrow when baking cookies might make them feel better. Music might be effective the day after tomorrow and the following day, but not the day following that. Flexibility and creativity are important.

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