Broadcast Retirement Network’s Jeffrey Snyder discusses how family members and caregivers can connect with loved one’s with dementia with University of Alabama Birmingham’s Andrew Duxbury, MD.
Jeffrey Snyder, Broadcast Retirement Network
Joining me now is Dr. Andrew Duxbury at the University of Alabama, Birmingham. Doctor, so great to see you. Thanks for joining us this morning.
It’s a pleasure to be here. I am so excited because dementia is prominent in our society. And I want to take a step back and ask, in terms of relating to people with dementia, I would imagine it’s pretty difficult for caregivers, for family members to have that interaction with a loved one that’s kind of going in and out of their memories.
Andrew Duxbury, MD, University of Alabama Birmingham
Well, the thing that I always try to teach families in regards to communicating with someone with dementia is that their reality is different than ours because their brain works differently than ours and reality is strictly what our brain tells us it is. Therefore, our worlds intersect, but they do not overlap. And therefore, the important thing is to try to figure out how to stay as much as possible at the intersect together as you can, but that when they’re in their part of their world that you cannot visit or you’re in our reality that they cannot visit, that it’s okay.
And it’s just a matter of trying to come around to where the intersect is present again.
Jeffrey Snyder, Broadcast Retirement Network
So it’s really important to have those expectations going in. I would imagine, doctor, this is really hard for families because they’re so used to seeing their loved ones as they were, not as they are.
Andrew Duxbury, MD, University of Alabama Birmingham
That is absolutely correct, that people develop long-term relationships with someone over many decades and they construct who that person is and how they will react. And when that person no longer fits that construct, it can cause a lot of friction and a lot of trying to push people back into the construct with which they are comfortable and familiar, even though that individual no longer fits and is not capable of inhabiting it.
Jeffrey Snyder, Broadcast Retirement Network
So we’re essentially meeting the patient where they are. How do we do that? I mean, how do we reframe it for ourselves?
But what kind of strategies should we undertake? There are probably numerous Americans out there, numerous family members who are dealing with this. What’s the first step?
Andrew Duxbury, MD, University of Alabama Birmingham
Well, the first step is to understand that life has always changed and that the biggest problems happen when we try to remain static, that we try to hold people in one place or we try to hold life in one pattern or we try to force people into a life pattern that they constructed for themselves in the past that they no longer fit. We’re really good at understanding these changes in younger people. A five-year-old, a 10-year-old, a 15-year-old and a 20-year-old are all very different beings, even though they’re only five years apart from each other.
But we’re really terrible about understanding that these same kinds of changes and these same different or these very large differences can happen in the same kind of speed later in life. And so you have to always understand, you have to look forward, you have to understand that you have to move toward whatever way things are changing and not try to hold back in what is no longer appropriate.
Jeffrey Snyder, Broadcast Retirement Network
And so, you know, in terms of tactics, I’ve been reading a lot up, reading up a lot on dementia, reading a lot on music to stimulate some of those memories. Does that help kind of get the ball rolling? If a loved one loved a certain theater production to go into one of your hobbies or they liked a certain sound of music, would that help kind of stimulate?
Andrew Duxbury, MD, University of Alabama Birmingham
It absolutely can. We lay down our understanding of culture, particularly kind of pop culture, in a very specific band of our lives between roughly the ages of 12 and 25. Everything that we come to understand as being right about music, television, movies, is all created for us when we’re going through that particular maturation process.
I read somewhere that the key year in regards to music is the year we are 14. Whatever we are listening to that year is what we define as being good music for the rest of our lives. So for people with dementia, because music is processed in a very different way in the brain than language.
And this is why, for instance, like all of the great epics are written in poetry, because we can not transfer orally prose language in large chunks, person to person very well. But we can transfer lyric and song and poetry person to person in large chunks much more easily. We lay down those poems and those songs and that and we always remember them and we all know this phenomenon because we’ve all been in the car listening to the radio and some song comes on that we haven’t heard in decades and we’re singing along.
Jeffrey Snyder, Broadcast Retirement Network
Doctor, in terms of the environment, thank you for that, in terms of the environment that we’re in when we’re communicating with our loved ones, should it be less stimulative, meaning quieter environment where you can look at the person one-on-one, there’s not these distractions, for example, you’re not in the mall, you’re not in…
Andrew Duxbury, MD, University of Alabama Birmingham
Absolutely. Our brains have a finite capacity for processing information. And in a young healthy brain, that capacity is pretty large and a young person can be in a party and yelling and shrieking and music is blaring and you can hear someone say your name across the room and you can all of a sudden focus in on that conversation and drop out all of the other noise.
But older brains just can’t do that. Older brains also have to deal with the fact that hearing decreases some as we age, it happens in everybody, and because we don’t hear as well, we start making up with that with other cues and we all start reading lips as we age in terms of understanding spoken language. So in order to really clearly understand someone, we have to see the face and we have to have not too much extraneous noise that the brain could pull into sound processing as somehow being part of the spoken information.
At my age, in my mid-60s now, I realized that if the lawnmower or something’s going outside the window, all of a sudden the person talking to me from the other room is like they’re speaking Swahili because other noises are just getting into that stream of information and I don’t understand it as well.
Jeffrey Snyder, Broadcast Retirement Network
Well, doctor, I’ve got about a minute left and I want to ask you, I want you to touch on the latest, the future of research, but also could you talk about integrating technology? There’s a lot of new technology out there. People that go to the Consumer Electronics Show know there’s a lot of technology that’s being demoed for people in our age demographic.
Andrew Duxbury, MD, University of Alabama Birmingham
Well, it’s because there’s so many people in our age demographic. We have roughly somewhere between 8 and 10,000 people a day having their 80th birthday for the next 20 years and that’s just the baby boom and what has happened with our society. I don’t know exactly how AI is going to build into all of this and how we age and how we process information.
My guess is there will be devices that will come online that will allow us to better understand the streams of information we need to and that AI will be able to help us eliminate those which are distracting. How that’s going to work, I have no idea. That’s way over my head in terms of understanding technology.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, well certainly, it’s iterative. We’re sure there are people in the field that you’re in or trying to take the data sets, trying to analyze them and try to get that research done more expeditiously. Dr. Duxbury, we’re going to have to leave it there. Thanks so much for joining us and look, we look forward to having you back on the program again very soon, sir.
Andrew Duxbury, MD, University of Alabama Birmingham
It will be my pleasure.
