Category: mental health

Too Many Open Browser Tabs

Whenever I find an interesting article, I leave it open on my browser because I just know it will form the basis of a spectacular blog post. I’ve always done this, but in the past I would finally just close everything and start over again because the web is, after all, an infinite source of riches. But since I challenged myself to write a blog post a day in 2015, I’ve been less eager to close all those tabs down. What if I face a day when I can’t think of anything to write about?

My browser has now become so bloated that I have to do something to make my system work faster. Instead of just closing all those tabs, I’m resorting to a collection of the very best ones here. Because I have lots of wide-ranging interests, this is quite an eclectic collection. But every one of these articles is worth attention. I guarantee it.

The Moral Bucket List

New York Times op-ed columnist David Brooks writes here about some special people:

ABOUT once a month I run across a person who radiates an inner light. These people can be in any walk of life. They seem deeply good. They listen well. They make you feel funny and valued. You often catch them looking after other people and as they do so their laugh is musical and their manner is infused with gratitude. They are not thinking about what wonderful work they are doing. They are not thinking about themselves at all.

Brooks distinguishes between two types of virtues, the résumé virtues and the eulogy virtues:

The résumé virtues are the skills you bring to the marketplace. The eulogy virtues are the ones that are talked about at your funeral — whether you were kind, brave, honest or faithful. Were you capable of deep love?

He goes on to say that a while back he set out “to discover how those deeply good people got that way.” In the rest of the article he describes what he found out.

It’s a good article, and I encourage you to read it. But I’ve left this browser tab open for a while now because this article reminded me of a former friend of mine. She could, at times, act caring and loving, but I always detected the tiniest disconnection between her inner workings and her outer behavior. For example, one day after she had spent a long time describing how each of her three children had recently hurt her feelings, she paused for a second while looking at me, then asked, “How’s your daughter?” During that second I could see the gears working inside her head: “I’ve talked about my kids, so I should now ask about hers.” I knew she wasn’t truly interested, so I said, “She’s fine” and left it at that. She visibly exhaled with relief.

This women always blamed other people for any problem in her own life. Everything was always the other person’s fault. She even developed a convoluted philosophy of life—it involved a person’s True Center of Pure Being (her caps)—that allowed her to avoid having to take responsibility for her own actions. When one of her children made her feel down on herself, she would explode and scream at me, trying to make me feel just as bad about myself as she felt about herself. When I told her, several times, how hurtful her behavior was to me, she said that I should understand that she was under a lot of pressure. “I’m not what I do,” she said.

This woman is the opposite of the people David Brooks describes. One can’t simply invoke one’s True Center of Pure Being. She is what she does. We all define ourselves by what we do and say. And this is why she’s a former friend, not a current one.

Sex, Dementia and a Husband on Trial at Age 78

This article brings up one of those issues that’s so complex and deeply personal that I have trouble figuring out what I think about it. In Iowa, Henry Rayhons, age 78, has been arrested for having sex with his 78-year-old wife, who had severe dementia, in a nursing home. The couple was married in 2007 after each had been widowed.

The top-level issue is whether Mrs. Rayhons was capable of giving consent for sex. But the lower-level issue is the question of who gets to decide whether Mrs. Rayhons was capable of giving consent: her husband, nursing home administrators, her doctor, her children?

This case suggests that someone must take the initiative in setting guidelines:

Sex is one of the most ambiguous areas in the scientific understanding of Alzheimer’s. While there are established methods of measuring memory, reasoning and the ability to dress, bathe and balance checkbooks, no widely used method exists for assessing the ability to consent to intimate relations.

Furthermore, dementia symptoms fluctuate. What may be appropriate on one day may not be appropriate on another day. Even more confusing, what may be appropriate in the morning may not be appropriate in the afternoon of the same day.

I’m glad I’m not sitting on the jury for this case.

Parsing Ronald Reagan’s Words for Early Signs of Alzheimer’s

Lawrence K. Altman, M.D., reports:

Now a clever new analysis has found that during his two terms in office, subtle changes in Mr. Reagan’s speaking patterns linked to the onset of dementia were apparent years before doctors diagnosed his Alzheimer’s disease in 1994.

The findings of the study by Arizona State University researchers were published in The Journal of Alzheimer’s Disease. Altman points out that these findings “do not prove that Mr. Reagan exhibited signs of dementia that would have adversely affected his judgment and ability to make decisions in office.”

But the findings do suggest that alteration in speech may one day be used to predict the development of Alzheimer’s and other neurological conditions long before clinical symptoms appear. Earlier detection could lead to earlier treatment, which in turn could help reduce or at least slow damage to the brain.

This research used the same computer algorithm that other researchers have used to analyze changes in writing by novelists, which I have written about here:

Canadian researchers have reported that analyses of syntax in novels by Iris Murdoch and Agatha Christie indicated early signs of dementia (Ms. Murdoch died of Alzheimer’s; Ms. Christie is suspected to have had it.) The same analysis applied to the healthy P. D. James, who died at 94 last year, did not find signs of dementia.

Scientists not involved in this study caution that much more research is necessary before analyses such as this can confidently be used in examining for Alzheimer’s disease.

Film Review: “Still Mine”

‘Still Mine’ Adds to Movies on Aging

Paula Span reviews this new film:

Not long ago, I could name the really excellent recent movies about aging on one hand. Now I’m running short of fingers, which I hope reflects filmmakers’ dawning recognition of the way this global demographic shift affects all our lives. The latest entry, a Canadian movie called “Still Mine,” opened in New York, Washington, Phoenix and several other cities last month and will arrive in Denver, Atlanta, Seattle, Charlotte and more locations today.

And, just as rain is the standard symbol for Seattle, dementia has become a standard trope for aging:

Interesting, isn’t it, how many of the best films about aging zero in on dementia? On my personal favorites list (adding “Still Mine” to “Amour,” “The Iron Lady,” “Iris,” “The Savages,” “Away from Her” and “About Schmidt”), all but the last incorporate a central character suffering from this disease. Screenwriters, and novelists like Walter Mosley and Alice LaPlante, can’t seem to resist its intrinsic here-but-not-here drama.

“Still Mine” is clear-eyed about this phase, not nearly as brutal as the masterful “Amour,” but more grounded than “The Best Exotic Marigold Hotel” and “Quartet,” both of which featured charming British actors in fluffy screenplays that carefully evaded most realities of advanced age.

This film doesn’t, but it is gentle, more gentle than life can be.

 

A Dark View of Assisted Living

A Dark View of Assisted Living – NYTimes.com

the hourlong “Frontline” documentary “Life and Death in Assisted Living,” airing Tuesday night on PBS stations across the country, doesn’t really break new ground on the subject. But it is important nonetheless.One reason is that families, who make most of the decisions about assisted living, don’t pore over gerontology journals or state regulations as they are looking for a place that is not a nursing home.

So they don’t always realize that these reassuring-looking residences may have no nurse on the premises most of the time, that health care in assisted living frequently consists of a 911 call, that the average length of stay — according to the Assisted Living Federation of America — is less than two years.

Canada’s elderly at high risk of suicide, can’t afford mental health care: experts | The Lethbridge Herald – myLH.ca

Canada’s elderly at high risk of suicide, can’t afford mental health care: experts | The Lethbridge Herald – myLH.ca

TORONTO – Studies show that Canada’s elderly are at a much higher risk of suicide than adolescents, and there is growing concern among mental health experts that psychological care may be out of reach for most seniors.

Dr. Marnin Heisel, a clinical psychologist and professor at the University of Western Ontario, says lack of public awareness of the issue is a key problem that affects not only the elderly, but their families and the public in general.

Although this article reports on the problem in Canada, depression among older adults is by no means confined to that country.

As pointed out here, there is a need for public awareness about the issue of older adults and depression. Family and friends should be aware of what signs to look for and should not hesitate to discuss the issue with older friends and family members.

One interesting point here is the observation that suicide might sometimes pass for death by natural causes in this age group unless coroners, alerted by reports of depression, know to look specifically for signs of suicide on autopsy.

Concerns About Dementia Screening

Concerns About Dementia Screening – NYTimes.com.

This article describes a patient who benefited from early diagnosis of a rare form of Alzheimer’s disease. But for most people, early diagnosis of dementia only provides knowledge of a problem for which there is no effective treatment.

the push for ever-earlier dementia screening raises troubling questions for patients and their families. When the diagnosis is early Alzheimer’s disease, the medical profession has little treatment to offer. This month, researchers at an Alzheimer’s Association conference in Boston urged policy makers to think hard before recommending wider dementia screening, saying studies have found no evidence that early detection improves outcomes.

And the experts said that little, if anything, is known about the potential risks of early detection. The diagnosis may cause stress, anxiety, depression and even suicide in patients, and can have implications for employment, purchasing life and long-term care insurance, and one’s overall quality of life, sense of autonomy and self-image.

While there are no easy answers, the article concludes with an encouragement for older adults and their family members who begin noticing signs of cognitive impairment to get a thorough medical examination:

The physician should take a history, do a thorough exam, and rule out a number of potential causes of mental impairment: depression; thyroid, kidney and liver function; vitamin B12 levels; infections; and dehydration and electrolyte disturbances. . . . The physician should also do a careful review of medications, since many drugs can have adverse effects on cognition. . . . Reassuringly, many people who experience mild cognitive impairment do not progress to dementia, and many even return to normal, some studies suggest. A study of primary care patients seen at Wishard Health Services identified 130 patients with mild cognitive impairment. A year later, most were stable, and nearly one-third had reverted to normal.

 

Dementia’s Signs May Come Early – NYTimes.com

Dementia’s Signs May Come Early – NYTimes.com

Studies presented Wednesday at an Alzheimer’s Association conference in Boston showed that people with some types of cognitive concerns were more likely to have Alzheimer’s pathology in their brains, and to develop dementia later. Research presented by Dr. Amariglio, for example, found that people with more concerns about memory and organizing ability were more likely to have amyloid, a key Alzheimer’s-related protein, in their brains.

And, in a significant shift highlighted at the conference, leading Alzheimer’s researchers are identifying a new category called “subjective cognitive decline,” which is people’s own sense that their memory and thinking skills are slipping even before others have noticed.

This article reports on a new interest in Alzheimer’s research, the subjective reports of aging patients, known as “the worried well,” who sense their cognitive abilities changing before standard testing procedures reveal definite signs of dementia:

leading Alzheimer’s researchers are identifying a new category called “subjective cognitive decline,” which is people’s own sense that their memory and thinking skills are slipping even before others have noticed.

However, it’s important to note that:

Some memory decline reflects normal aging, they say, and some concerns reflect psychological angst. People who forget what they wanted in the kitchen or the names of relatively unfamiliar people are probably aging normally. People who forget important details of recent events, get lost in familiar places or lose track of book or television plots may not be, especially if they have more problems than others their age.

European studies find dementia rate down sharply | Nation & World | The Seattle Times

Finally, a bit of good news:

European studies find dementia rate down sharply | Nation & World | The Seattle Times

A new study has found dementia rates among people 65 and older in England and Wales have plummeted by 25 percent over the past two decades, to 6.2 percent from 8.3 percent, a trend researchers say is likely occurring across developed countries and that could have major social and economic implications for families and societies.Another recent study, in Denmark, found that people in their 90s who were given a standard test of mental ability in 2010 scored substantially better than people who reached their 90s a decade earlier.

 

Retiring later may stave off dementia | Nation & World | The Seattle Times

Retiring later may stave off dementia | Nation & World | The Seattle Times

Baby boomers, take note: For every year you put off retirement, your chances of developing Alzheimer’s disease or other types of dementia are cut by 3 percent.

The findings are the result of a massive French study, which looked at the records of 429,000 workers. The scientists presented their results Monday at the Alzheimer’s Association International Conference in Boston.

. . .

The findings underpin the often-repeated advice to prevent mental decline: “Use it or lose it.” Doctors have said that keeping the brain mentally challenged is one way to prevent dementia and related diseases.

 

Depression & Seniors: 5 Ways You Can Help | World of Psychology

Depression & Seniors: 5 Ways You Can Help | World of Psychology.

Depression can be easy to overlook in older people for a number of reasons, as this article explains.

If you know someone who might be depressed, don’t let that person brush off your concern. Here are some ways you might be able to help.

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