Living with Memory Loss

A guest post by Jane L. David.

“My head is full of holes. I can’t remember anything anymore.” These are words frequently spoken by my mother as she approaches 94.

Memory becomes less reliable as we age. Lots of remembered experiences and information remain stashed away in our brains but we lose the ability to access that information. That’s why going to a room and forgetting why you’re there can sometimes be recovered if you retrace your steps.

For my mom, however, declining memory is a more serious problem. She can ask a question, hear an answer, and within a minute or two repeat the question because she does not remember that she asked it or that it was answered.

For someone who spent many years as a reference librarian, this is particularly distressing. But she is among the fortunate. Unlike many with Alzheimer’s, her memory loss has not affected her personality nor recognition of family and friends. Still, it has dramatically affected what she can do. She struggles to read because reading requires following a storyline or train of thought. Similarly, she finds watching a movie frustrating and sustaining a conversation difficult.

Yet she manages quite well thanks to her desire to remain independent, systems she and our family have set up, plus scheduled activities and support at Stevenson House.

She is able to track her medications because she has a system she began before her memory was so poor. All her pills are lined up on one shelf in the bathroom with a list above for what to take in the morning and in the evening. She fills her morning and her evening pillboxes before breakfast every day and puts one where she eats and the other in her pants’ pocket so it will be with her wherever she has dinner.

Her calendar is crucial. She crosses off days to keep track of time—and uses the daily newspaper to confirm the day. With help from family, she makes sure to enter every upcoming appointment and activity in the calendar. In the evening, with reminders from family, she makes a large note for any event for the next day and posts it on a chair she will see from her bed in the morning.

She keeps her apartment keys and her purse in the same place so she can always find them and has regularly scheduled coffee and meals every day. She has posted notes with reminders about daily routines from brushing her teeth to drinking enough water.

These examples mirror findings from researchers and advice from experts. Systems and routines are essential. Family and friends can help set them up and offer reminders. More information on the causes of memory loss and what to do can be found on the National Institute of Aging’s website.

Spending time with my mother is teaching us important life lessons: how to be with someone in the moment. We are learning to avoid asking questions that rely on memory (as almost all do) and to repeat things over and over again calmly, without communicating impatience. And she is learning that it’s still possible to have fun. We listen to music, play games, and laugh—and eat chocolate.

Jane L. David is the daughter of a Stevenson House senior resident and a long-time resident of Midtown. She is slowly retiring from a career as an education researcher.

Adjusting to Vision Changes

A guest blog by Beth Colehower.

Vision is one of those things that changes as we get older. What is encouraging is that there are tools and resources available so that these changes don’t have to compromise a person’s lifestyle. My grandma was a glowing example of how low vision tools and lifestyle adjustments helped her continue to live independently.

My grandma lived in her own studio apartment above two art galleries in Taos, New Mexico, until she passed away at 91. She loved the independence of living on her own and absolutely loved her studio! It was her home in every sense. She would host rooftop parties regularly, or when weather would not permit instead would gather people around her kitchen island, the “bar” as we called it, to discuss politics, local events, global issues or anything currently on her mind. She always wanted to connect people.

In her later years, she developed cataracts as well as age-related macular degeneration. It became increasingly difficult for her to see, but she continued to make the necessary adjustments that worked for her so that she could stay in her studio. She had a number of magnifying glasses to use as needed, and made sure to keep critical information in binders she could easily get to. She also had dots on the stove and oven to confirm where the on/off positions were. Throughout her home she kept large yellow writing pads with black sharpies for her to make notes and lists she could still read. We still have a number of these, and I love sitting down to read—in her own writing—her copious notes.

One of the most beneficial resources she found was the Library of Congress. Their National Library Service for the Blind and Physically Handicapped provided her with specialized playback equipment and books, catalogs and magazines all on tape, regularly shipped to her for free! As an avid reader, this ability to choose from a broad collection of titles made the adjustment to not reading much easier. It’s a fantastic program.

My grandmother knew she wanted to stay in her home, and used whatever tools she had available to her to continue to do the things she most enjoyed. She still needed help for certain tasks and errands (as we all do), but these tools were critical to her overall independence.

There are a number of residents at Stevenson House who have experienced a range of changes to their vision. We work at making adjustments to the apartments and the community to enhance the functionality and support independent living. These include using contrasting colors where possible to increase visibility, lighting considerations and other universal design elements. Through the generosity of the Palo Alto Host Lions Club we have been able to provide a state-of-the-art low-vision reader in one of our libraries that enlarges print and manipulates the presentation based on a user’s needs and preferences.

An exceptional resource we have locally is the Vista Center for the Blind and Visually Impaired. I can’t say enough good things about the staff and volunteers at Vista Center! They fully embrace their mission of “empowering individuals who are blind or visually impaired to embrace life to the fullest by serving individuals of all ages who are threatened by loss of independence due to moderate or severe vision impairment.”

With their two locations in Palo Alto and Santa Cruz, they serve people living in San Mateo, Santa Clara, Santa Cruz and San Benito Counties. I recently visited their Palo Alto center near California Avenue and was impressed by the wide variety of products that provide practical solutions for adapting to life with vision loss. My grandmother would have loved the bold-line pads of paper and easy-to-read 20/20 felt tip pens that don’t bleed through like her sharpies use to. They have talking clocks, large print calendars and address books, “bump dots” used to mark keys on a computer keyboard or the on/off buttons on household appliances (like my grandma used), a wide range of magnifiers, large print games and a number of other smart tools.

Their website offers a wealth of information about all their programs and services, including their low vision clinic, health library and active youth group. You can call them in Palo Alto at 650-858-0202 or Santa Cruz at 831-426-6233 to see about meeting with an experienced social services staff member, either at your home or in a mutually convenient location, to get connected with the appropriate Vista Center services. During this visit they can also inform you about community resources that can assist you. I wish I could have shared the innovations I found at the Vista Center with my grandma, and am grateful that they are able to help others in our community learn about living modifications that can be made to support a person’s independence despite low vision.

Beth Colehower grew up in Palo Alto, and has been working with Stevenson House for the past few years.

How Do You Keep Elderly Parents from Falling?

A guest post by Jane L. David.

Many of us worry about aging family members falling. Even those of us in our 60s begin to sense changes in balance. I often find myself banging a hip on a doorframe that seems to have moved into my path or tripping and just catching myself.

For many older seniors the consequences of falling can mean the end of independence. That’s why doctors and caretakers and senior residences pay so much attention to minimizing the risk of falling. Grab bars in the bathroom, emergency response buttons, good lighting, no throw rugs—these all contribute.

My 93-year–old mother who has lived at Stevenson House for 5 years had not taken a spill at all until last Christmas. Stevenson House goes out of its way to ensure that all possible fall prevention practices are in place. But last Christmas my mother was at my house, not in her apartment.

I’ve observed two kinds of falls. One I call the slow tumble, which can result from bumping into something and will produce bruises or worse if hard objects are encountered on the way down. These falls are less likely to result in a broken hip but can still leave seniors unable to get up by themselves.

The other is tripping. When you trip, you hit the floor hard before you even know what happened. On her way to set the table (leaving her cane behind), my mother tripped and landed with a loud thump on the hardwood floor covered by a 5’x7’ rug that had become invisible to me. Even with a non-skid pad beneath, the edge of the rug was a disaster in the making.

My mother was lucky. After a night in the emergency room, doctors concluded her hip was badly bruised but not broken. Perhaps her early years as a dancer helped.

I drew three big lessons from this. One is that family and friends of seniors who host them in their homes need to be as careful about fall prevention as Stevenson House is for its seniors. My dining room rug now lives in the garage, and we remove smaller rugs when Mom visits.

Another is that someone who uses a cane should not carry things in both hands. My mother now uses a walker, which provides more stability than her cane did. But she still believes she can go short distances with both hands full. So a third lesson for me is vigilance—making sure Mom always has one hand free for holding on to a cane or something solid.

None of us can protect against every threat to balance, but some precautions are easy. The Center of Healthy Aging has some handy checklists and other resources.

Do you have your own tips or stories to share?

Jane L. David is the daughter of a Stevenson House senior resident and a long-time resident of Midtown. She is slowly retiring from a career as an education researcher.