We can learn new things at any age; it’s just a matter of being realistic and creative in the ways we do it. Think positive and challenge yourself to learn something new. Learn the information as actively as possible, and practise recalling the information at increasing time intervals. Once you have succeeded with learning something new, you might feel so good about your learning potential that you decide to teach someone else some new tricks!
Memory strategies at work
Sometimes it’s not until you change jobs that you realise there were many structures that provided memory cues in your old workplace that you had taken for granted. Perhaps there were noticeboards in the staffroom, or ‘in/out boards’ telling you when to expect your colleagues back at the office. You might have been supplied with schedules for regular meetings at the beginning of the year. Such routines and cues lessen the load on memory. When they are changed, or not practised or promoted in the new workplace, it is easy to feel all at sea. You will continue to be distracted for a couple of weeks, until you are reoriented and comfortably familiar with your new environment.
Having an organised system and a degree of routine and regularity in the workplace allows us to feel in control. It is a relief to be able to locate items you need the first time you look for them. It lessens anxiety and promotes self-confidence. We end up having more time to be creative because we spend less time searching. Of course, there is no single, perfect way to organise your workplace; it depends on your job and the way you like to do things.
Organised storage: putting things in special places
We discussed the benefits of storing things in special places in Chapter 6. Having designated locations for work-related objects makes it easier to recall where they are kept. You could store your spare paper and ink next to the printer, or your tools in your van ready for the next service call. Store the objects you use most often close to hand, and those used less often, further away. If you store items in boxes, use clear plastic containers so you can see what is in them. Colour coding can help and labelling is essential so that others will know where you have stored things too. Always make sure that you return items to their special place!
I travel regularly for my work, so I make sure I always have a jacket on that has two pockets inside it. In one pocket I put my passport and plane ticket, and in the other I put my mobile phone and wallet. This routine allows me not to have to worry about these little things, because I know they are always there. I’d be lost without this system—I even had to wear my jacket yesterday when it was 38 degrees!
Peter, 42
Filing
It had to happen soon—the piles on my desk were like volcanoes ready to erupt. In fact, one pile had erupted regularly over the last few months. With a slight nudge, the pile of papers had fallen all over the desk more than once. I had so much paperwork for various projects that I had made piles all over the floor. Only trouble was that I kept forgetting which pile was which, and I couldn’t find particular bits of information that I knew were there, but I just couldn’t locate! Finally, I decided enough was enough. I gave my office a storage makeover. I bought some new shelves, storage boxes and folders. I created labelled spots for each project on my new shelves. I created folders for all those loose bits of paper that I had collected and slowly got rid of those volcano piles on my desk. I threw out a whole box of papers that I didn’t need anymore. My memory feels like it has improved, but really all I have done is organised a small part of my life.
Ralph, 62
If you have an organised digital and/or paper-based filing system, you don’t need to rely on your memory of where files are stored. If you are not at work, your colleagues should be able to locate files in your absence. An efficient filing system has:
• clear labels that will make it easier for you and for others to find and use these resources
• files that are regularly ‘de-cluttered’, containing only significant and up-to-date items
• colour coding, if possible, for ready identification.
Ideas for categorising your files include:
• personal file—e.g. personal correspondence, résumé, performance evaluation
• current project files—e.g. courses you are attending, projects
• operational files—e.g. budget, accounts, staff meetings, newsletters
• equipment instructions file
• forms file—e.g. tax form, invoice form.
On your desk
It would be unrealistic to expect that our desks will be spotless at all times. The aim is to have a clear workspace and be able to find things when we need them. Some of the most obvious ways to keep order bear repeating, though. An in-tray where you can put newly arrived materials in preparation for sorting, an out-tray for completed items prior to distribution, and a pending tray for non-urgent items, together with a ‘to do’ list, will greatly simplify the load for your memory.
Every day at work I get phone calls on different topics, which leads to more piles of messages recorded on paper, which seem to cover more and more desk space. I’ve found it much easier to locate the messages I’m looking for after I grabbed a batch of folders and cleared the pile up.
Simon, 48
‘Pick-up’ points
It is very frustrating to arrive at work and realise that you have left the tool you need for the job in your garage, or your report at home on the dining-room table. Creating pick-up points at home and at work can help with remembering to take something from home into work, or vice versa. Many people use their work bag as a pick-up point, or a table by the door you exit from. Put what you need at the pick-up point as soon as you think of it. Get into the habit of always checking this spot as you leave.
Half the week I’m based in Australia and the rest of the week I’m overseas. I’ve learned from experience that I need to take half an hour or so, before I leave, to run through in my mind each meeting that I will be going to, and what I will need to take with me to each. I do this because I’m terrified of being an idiot in a meeting because I have forgotten to bring something.
Sharon, 53
I keep a digital copy of all my files in an online file-sharing application, so that I can work on a file at any of my work sites.
Nassim, 45
Maintaining good organisation
All these ideas sound good in theory, but in practice they can be hard to maintain, especially if you are sharing an office or workspace.
Joe doesn’t think he is messy, but he is. I can never see any bench space, and it drives me mad. Twice a year I clean out all the files and put them in order, but he thinks it’s a waste of time.
Rita, 54, Joe’s wife
You will only continue to use a system that suits you as an individual, so set it up in a way you like, that fits your needs at work. Some people like clean surfaces; others work quite happily with their work space covered with objects. Build a regular 10–15 minute time slot into the end of your day to clear the top of your desk, or if you are not in the office each day, it might suit you better to do this once a week.
Writing things down
Writing things down is the most common technique used to help us remember things, as discussed in Chapter 6. At work, a paper or digital diary is an important written memory aid in which you can note down important information to remember. Keep your diary system streamlined—don’t be tempted to write reminders in too many different locations, otherwise you will waste time trying to recall where you wrote that important note!
A few weeks ago, a friend in my team told me about a new place to buy some equipment for work. I typed the name and address of the warehouse into my phone, but now I can’t find where I typed it, and I want to go there today. My phone is full of random notes and reminders in different apps! I’m going to have to work out a simpler system so I can get my hands on information when I need it.
Maani, 63
A digital diary can be programmed to provide timely reminders. If you prefer to use
a paper-based diary, leave it somewhere you will see it often, and check it regularly for appointments, meetings and project deadlines. Put reminders in on the appropriate days. For example, if you are presenting some information at a particular meeting, write a note in well before this date to remind you to start preparing what you will present. A secondary wall calendar or yearly planner can be helpful for remembering future projects and planning for their deadlines.
I have several projects on the go, which I used to manage in my head, and I often couldn’t remember which job needed to be done first. Now I write them in my diary in order of importance. I find I can devote more time to my work, rather than trying to remember what to do next.
Anna, 56
A ‘to do’ list helps you remember things that you need or would like to do that day, or even in the next few days, such as returning a phone call, writing an email or preparing the agenda for a meeting. Of course, it is not a list of everything you do each day, as this would be far too long—but it acts as a reminder of things that you may forget to do, and it helps with prioritising your jobs. Keep your ‘to do’ list somewhere you frequently see it, for quick reference. Digital ‘to do’ lists can be programmed to provide reminders at specified times. You can ask a colleague or friend to assist with maintaining your ‘to do’ list, and to run through the list with you on a regular basis.
I have an A4-sized diary with a page to a day. I jot down my daily tasks into my diary and cross them out when I have done them. At the end of each day I write the things that I didn’t get done onto the next page.
Tony, 39
A memory-wise work environment
Constant change in our workplaces, and an increasing proportion of older workers, means that we need to actively promote more memory-wise work and learning environments. Practical changes should be introduced to reduce the demand on memory and to maximise the likelihood that new information can be learned. Workplaces need to acknowledge memory problems. If it is not okay to talk about memory difficulties, this can lead to anxiety, which in turn can exacerbate any memory problems.
A memory-wise workplace does the following:
• simplifies work processes and work instructions
• arranges for work instructions to be available in written and verbal formats
• highlights and repeats important information
• avoids information overload
• allows time for questions, clarification and practice
• gives permission for people to be reminded
• creatively uses aids to reinforce memory, particularly visual aids
• controls noise and other distractions
• encourages people to disclose memory concerns.
Challenge your workplace: how seriously does it take being memory-wise?
We have a high turnover of casual staff at my work, and it has been difficult to remember all of their names. A bright spark at work came up with a great solution to this problem. All staff now have their name, role and photo displayed on the work intranet, arranged by departments. I don’t know why we hadn’t done this earlier—it has made such a difference!
Vanda, 66
Key points WORKING AND LEARNING
• Constant changes in our workplaces mean an increased load on everybody’s memories, no matter what age we are.
• Older people at work may need to use strategies to compensate for mild changes in their memory abilities.
• Being more susceptible to distraction is often a frustration for older people, and working on ways to reduce possible distractions becomes a necessity.
• We can learn new things at any age if we adapt our learning by being strategic.
• Having an organised system and a degree of routine and regularity in the workplace allows us to feel in control.
• We need to promote more memory-wise work and learning environments.
CHAPTER 8
What if it’s dementia?
When I went to visit Audrey, a 72-year-old woman, her geriatrician had just told her that she had dementia. Together with her husband Tom, we talked about what this news meant to them as a couple. Tom said that on the way home from the appointment with the geriatrician, he had said to Audrey, ‘Today is just another day; we are no different from yesterday, we just have different knowledge from yesterday.’
Anne
Tom’s words reminded me of a past catch-cry of our local dementia support organisation: ‘Life doesn’t stop when dementia starts.’ Indeed, life doesn’t stop with a diagnosis of dementia—there is plenty more living to do. This chapter provides information about dementia—what it is, how it is diagnosed, and the latest on medical treatment. Being memory-wise when you have dementia involves looking after your psychological and physical health, as well as supporting your memory with practical memory strategies.
What is dementia?
One way to think about dementia is to see it as evidence of a progressive change of brain functioning. Dementia is an illness that can cause memory loss, together with decline in other areas of thinking ability and emotional processing. These changes impact upon your ability to function in everyday life. We hear many words used to describe the existence of progressive memory loss, which can be confusing. Terms you might have heard are ‘dementia’, ‘Alzheimer’s disease’ and ‘vascular dementia’.
The brain change involved in dementia can have many different causes, just as a high temperature is a sign of body change that could stem from a variety of illnesses. There are several causes of dementia, and the most common is ‘Alzheimer’s disease’. Up to 70 per cent of all cases of dementia involve Alzheimer’s disease. So, when we say the words ‘Alzheimer’s disease’ and ‘dementia’, we often mean the same thing.
What causes dementia apart from Alzheimer’s disease?
Vascular dementia is the next most common cause of dementia, accounting for approximately 15–20 per cent of dementia cases. It arises from problems with the circulation of blood to the brain. Vascular dementia is typically caused by a succession of minor strokes, which people often aren’t aware of having, and changes in memory, thinking abilities and emotional processing can occur. Many people with dementia have a mixture of both Alzheimer’s disease and vascular dementia. In a much smaller number of cases, dementia may be related to other conditions, such as fronto-temporal dementia, dementia with Lewy bodies, Parkinson’s disease, Huntington’s disease, long-term alcoholism, HIV/AIDS and rare degenerative diseases of the brain.
This chapter will concentrate on Alzheimer’s disease because this is the most common cause of dementia, and the focus of much anxiety in people concerned about memory loss.
What causes Alzheimer’s disease?
The symptoms of Alzheimer’s disease are caused by brain cells becoming disconnected, malfunctioning and ultimately dying. Scientists are becoming increasingly sure that this is at least in part due to the presence of an abnormal toxic protein, known as amyloid, which accumulates in the brain.
Scientists still don’t really understand why some people develop Alzheimer’s disease and some don’t. It is likely due to a combination of inherited genetic risk factors interacting with non-genetic factors. This is similar to the way in which inherited factors make some people more likely to get heart disease or breast cancer than others.
Having a close relative with the disease, such as a parent, is seen as an inherited risk factor, and may increase your chances of getting Alzheimer’s disease by a small amount—but it doesn’t mean you are destined to develop it. In a small number of cases, Alzheimer’s disease occurs because of a genetic mutation (that is, the illness is inherited from an affected parent). This rare inherited form of early-onset Alzheimer’s disease (‘autosomal-dominant Alzheimer’s disease’) accounts for around 1 per cent of all people with dementia, and typically develops when people are in their forties or fifties.1
Researchers have identified several health and lifestyle risk factors that may make Alzhe
imer’s disease a little more likely for some people. Risk factors at midlife include high blood pressure, obesity and hearing loss, and risk factors during later life include diabetes, smoking, depression, physical inactivity and social isolation. By contrast, a protective factor identified is spending more time in education during childhood.2 (For more information about reducing the risk of developing dementia, see Chapter 5.)
At what age are you most likely to develop Alzheimer’s disease?
The proportion of people developing Alzheimer’s disease increases with age, but the majority of older people do not develop the disease before their lives end. Approximately 3 per cent of people aged 70–74 develop dementia, as compared to 18 per cent of people aged 85–89.3 Women are more likely than men to develop dementia in their lifetimes. One reason for this is that more women live to an advanced age than men, and new research is investigating the role of certain hormones in the development and progression of Alzheimer’s disease.4
How is dementia diagnosed?
There are many different pathways towards an assessment for possible dementia. The most usual procedure (it will vary from state to state, country to country) involves consultation with your doctor, who may then refer you to a specialist in the diagnosis and management of memory and thinking problems. Such specialists include geriatricians, psychiatrists, neuropsychologists and neurologists.
Other conditions that can cause changes in memory functioning include anxiety, depression, stroke, tumours, vitamin deficiencies, infections, thyroid disease and many other illnesses. Investigations performed to check for these include a clinical examination, blood tests, and brain scans such as CT (computerised tomography) or MRI (magnetic resonance imaging). Doctors will sometimes arrange more specialised brain scans, such as SPECT (single-photon emission computerised tomography) and PET (positron emission tomography), or amyloid PET imaging (usually through clinical research trials).
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