Overthink (2)

Scraggy, wet feathers

I’ll try not to mislead any of you this morning – I am calling this Overthink part 2 as yesterday I had planned to write about this but lost my way.

It is wet again.

Going back to last week’s conference and Professor Ian James from the UoBradford, another comment he made which I thought quite profound, related to thinking and dementia.

Those of you who have read previous blogs on the subject might have encountered my attempt at Latin; yes, I am no Latin scholar, but the dictionary helps. Dementia – which is derived from ‘out of one’s mind’ is not necessarily useful, particularly when we are trying to understand another’s experiences.

Indeed, the only people I know who I suspect are out of their minds are Brexiteers and Capitalists.

Sorry.

No, the professor’s point related to the thought processes of people living with dementia.

If, say, I am taken in my sleep to location X – might be a hospital, could be a detention camp, and, eventually I wake-up, it probably will not take me long to work out where I am and start planning what to do. (Depending on the movie this could be longer or shorter).

This process requires complex brain pathways and interactions whereby I determine i) This isn’t my bed ii) I don’t know where I am iii) Those bars on the window are unfamiliar iv) The people on the other side are watching me.

From there I will hopefully work-out what to do, even if the only thing I can do is wait for something to happen.

This all requires a healthy brain. One which has a short and long-term recall function, an ability to process, to convey messages to and from my emotion centre, involving my frontal lobes – all in a kind of magical way that no-one yet fully understands (if ever viz. Pascal).

For someone who has dementia and, as previously described, there isn’t ‘dementia’ but infinite individual variations based upon the person’s life history, experience, physiology and, well, pathology.

The function of getting to a point where I can accept that nothing is happening and no one is coming to help me, at least for the moment, is disrupted and then begins the overthink.

If your short-term memory is impaired; to orientate, you might repetitively be asking yourself, ‘Where am I?’ or, ‘How did I get here?’ ‘What is next?’ – endless permutations that I perceive are like being in free-fall.

I can sit and watch the TV and enjoy the programme; at the end I know where I am and what is next; in dementia this can be disrupted. I might enjoy the programme, yet, as it comes to an end, so too does the process of self-orientation.

Add to this, perhaps, sitting in a care home with 40 other strangers around you, poor lighting, regimented meal times and difficult to navigate corridors and walk-ways and you can imagine why the whole thing might become exhausting and terrifying.

This I perceive is the overthink.

Imagine having to constantly re-orientate yourself to where you are and what is happening, if not, again, the free-fall.

How can we support people in this situation?

Well, the first step might be to understand that this is a possibility, that the person sitting or standing before you might be perceiving the world very differently to you and, because of a disease process, this is potentially less effective and efficient than it might otherwise be – this must be exhausting – imagine trying to travel at speed in first-gear; wheels spin and your engine overheats.

Beyond understanding are the usual tropes.

Give time and space;

Be kind

Smile

Empathise

Tolerate

Listen

Hear

Imagine yourself to be in their position.