Conversation is hard for me now, but I’m adapting. I think it helped to have the pandemic start at about the same time I was diagnosed with a Mild Neurocognitive Disorder (mNCD), because I had some quiet time to adapt. I was able to practice with my family, and on Zoom. I’ve been open with my family and my some of my co-workers about my cognitive issues. There’s really no way to hide that I’m having trouble remembering.
Working Memory Lapses Lead to Conversation Lapses
I’ve been helping my daughter fill out forms. Often we need to look something up, and that’s when things fall apart for me. I don’t remember things like how I got to the webpage I was on two minutes ago, or what the directions I just read said. Those are working memory problems. Part of my job before semi-retirement was teaching students how to find trustworthy information. I still know how to look things up, but I can’t always remember where I am in the research process. That’s a major reason why I retired from my profession (research librarian). I’d forget what I was talking about in the middle of an instructional session. Sometimes I’d stop and ask the students questions like, “What do you think we should do next?” That was my sneaky way of finding out what I had been talking about. Sometimes I’d just choose a subject that seemed relevant to what was on the screen, but that didn’t always work. It would be obvious from the puzzled looks that I had veered off onto a different subject.
Ask For Help, or Not
Since then I’ve found better ways to keep track of conversations. The two methods I use most often are asking for help, and substituting generic words. With people I trust I’ll ask for help finding the right words, and using filler words like stuff and things works with everyone. If I spend too much time trying to think of the correct word I’ll lose track of what I was trying to say. With people I know I’ll also ask what I was talking about if I get lost during a conversation. I still struggle with what to do if I lose my train of thought with people I’m not comfortable with. Right now I either wait for them to pick up the thread of the conversation for me, or I uncomfortably stop and ask them what I had been talking about. With time and practice conversation is getting easier. I’ve learned how to keep a conversation going, so my lapses in working memory aren’t as troublesome, but it’s a work in progress.
Write Down What I Want to Say
Sometimes it feels easier not to talk. It is easier to be quiet, but it’s lonely. I feel misunderstood, and I am if I don’t speak up for myself. Sometimes when there’s something important that I need to say I’ll put it in an email. When I write something on my computer I can stop, see what I’ve already written, search for a missing word or phrase, or look up a fact. I can be more eloquent, and use my whole vocabulary rather than just filler words like “something.”
Make a Timeline
When I write it down I can reorder my thoughts. I’ve discovered that I prefer to describe things in chronological order. For instance, when I’m at a doctor’s office and I’m asked about a medical condition of mine I’ll start from the beginning. Well, about twenty years ago I started to have problems with ____. Ten years ago I tried ___ to treat it. Part way through my recitation the doctor has tuned out, and they miss when I finally make my way to my current situation. They end up focusing on something I said about last year instead of my current situation. I prefer to say things in chronological order, because that helps me remember. I can associate my symptoms with things like where I lived at that time, or who my doctor was. It’s hard for me to start with today, and then hop back and forth over time. My foot started to hurt five years ago, but my hand started twitching two years ago, and I first had trouble with this condition ten years ago. I get lost when things aren’t in order. Time is one of my biggest points of reference for remembering past details.
In an email I’ll write something out, and then I’ll usually cut and paste the end to the beginning, so I can start with the current status instead of what happened ten years ago. For doctor’s appointments I make a bullet list of things I want to talk about. If I’m there to talk about a specific condition I’ll make a timeline of things like symptoms and medications that I can refer to during the appointment. Some doctors will ask to see my list. I don’t need to spend time trying to remember if I got a pneumonia shot three years ago, or whether it was five. It’s written down for both of us. I do something similar for phone calls and Zoom meetings. I make a bullet list beforehand of things I need to discuss.
In Zoom meetings and during phone calls I jot down important details during conversations, but usually just a word or phrase. If I take too many notes I lose track of the conversation. If I don’t take any notes I also lose track of the conversation. Zoom calls are easier for me, because there are visual clues. Phone calls are difficult, because I can’t tell how the other person is reacting. I start to worry about what they think of me, and I lose track of the conversation. Notetaking can be distracting, but notes are great memory prompts. Just the physical process of writing a note helps reinforce details, so it’s easier to bring back to mind more parts of the conversation.
For instance, a medical assistant calls to give me post-procedure information. She whips off a large list of instructions. I write down prompts for myself like, Epson salts. When she stops to take a breath I’ll say, “How long did you say I need to soak in Epson salts?” At the end of the phone conversation I’ll try to recap what we discussed. I’ll say something like, “Just so I don’t forget any details, you want me to watch for redness, use ice if there’s bruising, and call if I have a low grade fever?” While I’m saying that and while the person confirms or corrects what I said I make more detailed notes. If I don’t have the opportunity to recap with people I’ll try to take notes immediately afterwards. I write down the main points while I still remember, and then I add details. For example, I write down Epson salts, bruising, fever, and then I add details like soak twice a day, ice for 10 minutes and call if low grade. I make sure I write down the main points before I forget, and then I add any details I can still recall.
Who Cares If It’s Embarrassing
It’s easier not to talk to people. I don’t make mistakes, because I don’t even try. But, people slipping into dementia stop communicating. It’s too hard. It’s embarrassing. There are too many details to keep track of, and people will expect me to remember what they said to me yesterday. It’s embarrassing. Communicating is hard work, but it’s work that keeps my mind active. I need to get over the embarrassment. My mind is a muscle that needs exercise. I recommend that everyone find their own unique ways to keep talking. Keep your independence, use it or lose it.
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