Understanding and Living with Dementia
Through improved lifestyles, diet and medical treatment people are living longer than generations past. It is not uncommon for families to contain a member who has been diagnosed with some form of dementia. This talk will cover the major types of this illness and provide strategies for managing dementia and its implications when it impacts your family.
Art Gottlieb received his undergraduate degree in Psychology in 1987 from the State University of New York at Purchase and his Master of Social Work in 1991 from Hunter College in Manhattan. Maintaining licenses as a Master Social Worker in New York and a Clinical Social Worker in Connecticut, Mr. Gottlieb has additionally earned the credential of Certified Senior Advisor (CSA). A frequent guest speaker at colleges, senior centers and independent living communities throughout Fairfield County, he maintains a private practice of psychotherapy and intergenerational counseling in Milford Connecticut.
Speaker Summary
Employing a storytelling/case study approach based on his own personal and professional experiences as a clinical psychotherapist, Art took us through an educational session on the causes, challenges, and management approaches for dealing with people with dementia. His engaging, personable, and often humorous style helped make a sensitive and potentially uncomfortable topic easier to hear about without undermining the seriousness of it.
Art explained how his work evolved from discovering a niche in local psychotherapy practices and then filling the gap working with seniors and their families and, especially, the needs of men. He reinforced what we have heard before from other speakers: that the less well-developed social networks of men make them especially susceptible to loneliness and fewer social interactions which can exacerbate illnesses like dementia.
Art talked about a “typical” patient situation and the family dynamics that often ensue including tension among children, decisions and reactions to each other and their parent’s condition/needs, and how feelings of guilt (“I need to take care of mom”) can heighten problems rather than help them. He emphasized the notion that doing the right thing for them might mean finding others to provide the help they need including an example of his own mother (who does not have dementia) who needs certain types of help that is better provided by someone other than him despite his knowledge and love for her.
A few key points Art touched on for consideration were: ensuring the patient’s dignity/not talking about them in front of them; “incurable loneliness” as the most common complaint of the elderly; and, the frustration of families looking for the “cure” for something that is incurable. Art drew an interesting analogy about life and aging to ascending and then descending a hill (in this case, “the hill of life”) and the psychological and physiological implications of that.
Art spent some time discussing the two types of dementia and some of the “causes”/precursors to them. The first type is caused by vascular damage, largely strokes (either a single large stroke or a series of smaller ones). He explained how the blockages from the stroke impact the brain, drawing analogies to cardiovascular/coronary heart disease, which is also a risk factor for this type of dementia. The second type involves degenerative brain diseases, of which Alzheimer’s is most common. These diseases are caused by the breakdown in protective fats in the brain that insulate and protect key brain components. For this type, he mentioned some of the negative contributing factors like diet. But he made a major point to mention that genetics/hereditary is one of the largest factors and nothing can be done about that other than to be aware of your risks, do the things that are best to mitigate/minimize the impact of other contributing factors, and undertake lifestyle activities that work against this disease. To this end, he talked about the importance of physical and mental activity and getting out of the house to do things to help keep the brain active and people socially engaged. He emphasized that the programs he has developed for seniors and facilities he works with focus heavily on doing this.
Finally, Art explained the process and distinction between short- and long-term memory and how/why it manifests itself in people with dementia, sharing an easily relatable example of telling someone with dementia the same thing 10 times and not understanding why they don’t remember it. They lack the mechanism to transfer the information into long-term memory. Yet they remember things that were transferred years ago when this mechanism was still functioning.
An indication of how Art’s talk resonated with the audience was the number of people who came up to the stage to take one of his business cards during and after the Q&A session.