Communion Of Dreams

The choices we make.
July 27, 2008, 9:50 am
Filed under: Alzheimer's, Health, Hospice, Science, Scientific American, Society

The human mind is a remarkable device. Nevertheless, it is not without limits. Recently, a growing body of research has focused on a particular mental limitation, which has to do with our ability to use a mental trait known as executive function. When you focus on a specific task for an extended period of time or choose to eat a salad instead of a piece of cake, you are flexing your executive function muscles. Both thought processes require conscious effort-you have to resist the temptation to let your mind wander or to indulge in the sweet dessert. It turns out, however, that use of executive function—a talent we all rely on throughout the day—draws upon a single resource of limited capacity in the brain. When this resource is exhausted by one activity, our mental capacity may be severely hindered in another, seemingly unrelated activity. (See here and here.)

Imagine, for a moment, that you are facing a very difficult decision about which of two job offers to accept. One position offers good pay and job security, but is pretty mundane, whereas the other job is really interesting and offers reasonable pay, but has questionable job security. Clearly you can go about resolving this dilemma in many ways. Few people, however, would say that your decision should be affected or influenced by whether or not you resisted the urge to eat cookies prior to contemplating the job offers. A decade of psychology research suggests otherwise. Unrelated activities that tax the executive function have important lingering effects, and may disrupt your ability to make such an important decision. In other words, you might choose the wrong job because you didn’t eat a cookie.

Read the whole thing.

* * * * * * *

Almost a year ago I wrote this:

There’s a phenomenon familiar to those who deal with Alzheimer’s. It’s called “sundowning“. There are a lot of theories about why it happens, my own pet one is that someone with this disease works damned hard all day long to try and make sense of the world around them (which is scrambled to their perceptions and understanding), and by late in the afternoon or early evening, they’re just worn out. You know how you feel at the end of a long day at work? Same thing.

* * * * * * *

We cared for Martha Sr for about four years.  Well, we were here helping her for a couple of years prior to that.  But the nearly constant care giving lasted for about four, growing in intensity during that time, culminating with nearly six months of actual hospice care.

That was a long time.  But my wife and I had each other, and it could have been longer.

That same day, a hospice patient named Michelle passed away. She was only 50 years old. She’d been battling MS for over 20 years. Debra is dispatched to her home.

The little brown house is shrouded by trees. Stray cats eat free food on the rusted red porch. Inside, Michelle lies in her hospital bed with her eyes slightly open. Debra’s there to help Michelle’s husband Ross. He quit his job in 2000 to take care of his wife.

“So eight years,” Debra says.

“She was permanently bedridden,” Ross replies. “This is the way it’s been. But like everything in life, it all comes to an end I guess.”

His voice sounds steady when he speaks, but his eyes are full of tears as he remembers his wife.

“I’ve never seen a women fight something like she did,” Ross says. “She spent years on that walker because she knew when she got in a chair she’d never get out. The pain it caused her.”

Ross talks for more than an hour. Debra listens and commiserates. It’s at these moments, even more than when she’s providing medical care, that Debra feels her work is appreciated.

Appreciated, indeed.

* * * * * * *

Jim Downey

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