This week I have been quite disoriented because Christmas was in the middle of the week.  There really needs to be a law!  Holidays should happen on Fridays, Saturdays, or Sundays, with Mondays off for a recovery period.  Months should always start on a Monday.  Years should end on a Friday.  In my newly re-ordered, organized and predictable world, I could easily hit “Reset” and the digits would revert to zero.

Alas, it does not seem to work that way.  The older I get the more my experience of time changes.  “Once more around the sun!”, “Another turn of the seasons.”, “Birth of a new year!”  These idiomatic descriptions do not do justice to the extremes that exist in my inner world.  Over the past few weeks I have spent time going through old papers with old_papersthe intention of tossing things.  Instead, I was catapulted into the past, both near and far, and suspended in the emotions triggered by those memories.

The papers themselves were unremarkable – employment documents, receipts from trips, half-hearted diaries started with good intentions but ended dissolutely as something else captured my interest and attention – but the voyages they sent me on were fantastical.  It seemed so easy to drop into the past through the doorway of these slips of paper.  In rooting around I found happiness, sadness, and quite a bit of evidence that some of my thoughts, feelings, and ideas were of merit and worthy of keeping.  Still, on returning to this present moment, those artifacts found their way to recycling, yet more evidence of time passing.

Returning to the present was effortful.  I am not sure whether this is due to current circumstances, a preference I have for times now long-gone, or indications that my cognitive functioning is eroding.  There is much about this moment in time that seems to indicate continued conflict and confrontation.  These are not encounters I enjoy although I have certainly acquired skills to manage them.  I would much prefer to return to simpler times and just reside there for a while until I can get my energy back.

Barring that, I prefer to stay in my well-appointed world where I have access to books and music I like, food that is nourishing and plentiful, and friends and colleagues who bring me joy and entertainment.  Still, there is that nagging experience of time passing.  There is potential that I am missing out on something important as well experiencing low-level anxiety that I have forgotten a task or appointment.

I have often heard retired people say that they lose track of what day of the week it is or what the actual date is.  They may remember the month and year, but the day?  Doesn’t matter much unless there is a deadline of some sort.  The irony to me, as someone who regularly evaluates cognitive functioning in older people, is that one commonly used measure of functioning is knowing these facts.  What does it mean when we are unable to name the day of the week or the date?

Naomi_FeilOne of the early pioneers in understanding and providing care to people with dementia was Naomi Feil.  In her years of working with older people who had memory problems, she observed that many were experiencing their “present” in the past.  She called this “malorientation to time.”  Those of us who are cognitively intact share an experience of present, past, and future that may not be available to those with Alzheimer’s. We expect them to be able to time travel just as we do, but for many with dementia, particularly dementia of the Alzheimer’s type, this time travel no longer works.  They reside in a past that is present to them.  And those of us who love them reside in a present that for them is only a physical state, not an emotional or cognitive one.

While going through my papers, I came across a note sent to my mother by the daughter of a dear friend.  She was letting my mother know that her mother had Alzheimer’s and was now quite happily existing in a time when she was much younger and living on her family farm.  She let my mother know that her mother wouldn’t be able to carry on a conversation that included my mother because my mother hadn’t known her then.  The note was tender and informative.  It was also a precursor of what my mother would go through just a few years later, as her dementia progressed.

As more and more of us Boomers navigate our 60s, 70s, 80s, 90s and beyond, it is inevitable that many of us will cognitively return to earlier times while our bodies continue to live in a world where time passes according to calendars and time pieces.  It is not so clear how we will be cared for, since Western culture continues to focus on childhood and youth.

Snr_HousingObvious needs for housing, trained caregivers, and on-going medical care are daily pushed aside by even more pressing concerns about the environment and the economy.  Resources are already stretched to the max.  Providing care for increasing numbers of aging adults who no longer have the capacity to care for themselves will put a huge burden on our children and those who follow, as well as on society.  These are uncomfortable truths that increasingly insert themselves into conversations.

For those of us who have been immersed in caring for our parents, spouses, sisters, brothers, and extended family members who have these kinds of cognitive impairment, this information is neither new nor helpful.  The conversation needs a new audience.  It needs attention from elected officials, from health care providers and administrators, from insurance companies, from social media and the press.

I had to look at my appointment calendar today to tell what day it was.  I am hoping that my malorientation to time arises from solar calculations that have 2019 ending mid-week and 2020 starting on Hump Day, and not from a decline in my cognitive functioning.  I suspect I am OK.

Trouble is, I won’t know.

calendar-page-turnThe Center for Aging and Values is committed to improving the care of all aging adults.  We invite you to explore what it means to live in an Elder-Friendly community.

Thank you for reading and commenting on this blog.  Wishing you and yours a very happy 2020!