Hope and Health: Navigating Dementia and Depression with Compassionate Care

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Coming up on this episode of the
healthy, wealthy, and wise podcast.

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Let's say a quick word about depression.

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Um, because again, I want
to make the distinction.

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Remember, um, when I talk about dimension,
talk about how we think, um, uh, and

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when I talk about depression, I'm
talking about how we feel, how we feel.

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Um, one, one, uh, medical, uh, definition

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of depression is welcome to the healthy,
wealthy, and wise podcast with Dr.

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William T.

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Choctaw, MD.

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This podcast will provide you with
tools and actionable information

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you can use to help live a more
healthy, wealthy, and wise life.

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It's powered by the over 50 years of
medical experience of this Yale university

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medical school trained surgeon, who is
also a Western state law school trained

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attorney with executive experience being
a former mayor of Walnut, California,

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as well as the current chairman of
the nonprofit servants arms and.

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And as president of Choctaw
Medical Group, Incorporated.

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This is the Leadership Masterclass
Edition, already in progress.

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Uh, number

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two, difficulty remembering tests,
remembering, performing regular tests.

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It is normal to make, um, the wrong
term in the case of when driving, you

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know, um, I'm driving, coming to church.

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From Walnut and I'm thinking about
something or listening to music,

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and I is, I'm, I should have
turned right, but I turned left.

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That that is not an illness,
that is not a disease.

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Um, that is, that is normal.

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Uh, someone with dementia
might have regular difficulty

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driving a familial route.

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So if, if I'm driving to church and I
turn, um, I don't know, left on Walnut,

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instead of turning right on walnut.

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That's okay.

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Um, uh, if I'm driving to church and,
uh, uh, instead of turning on Walnut, I

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keep straight and go all the way down to
Hacienda and turn, uh, by mistake, uh,

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that may be a sign of early dementia.

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Does that make sense?

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Um, disorientation, no
problems with language.

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Uh, many people occasionally
have trouble remembering, um,

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uh, finding the right words.

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You ever been in a conversation where,
where you want to say something,

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but the word you're looking for
is not on the tip of your tongue.

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And so you said, well, you know, it's,
it's so and so or you, you remember her

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name, it was, you know, the little lady
who's blah, blah, blah, blah, blah.

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And then somebody said, Mary.

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Yeah, yeah, yeah, yeah, yeah.

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Mary.

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That's what I was trying to think.

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That's normal.

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That's normal.

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Dementia, uh, would be, um, uh,
sometimes with dementia one might

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have difficulty, um, uh, starting a
conversation, or may use the wrong words.

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Now that's a whole different thing.

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If I'm talking about
Mary, but I mentioned Joe.

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So, but I thought you would tell me
about this lady, Joe's not a lady.

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What do you say that that
could be early dimension.

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Uh, next example, um,
disorientation of time and place.

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It is normal to forget, uh, It
is normal to forget, um, uh, to,

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um, be confused about the time of
day, of what, what is appropriate

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to do, uh, on a particular day.

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Dementia, on the other hand, is
where you, you mix up a whole day.

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Let me give you an example.

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Uh, you're supposed to have
a cheeseburger for lunch.

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Uh, but you confuse lunch and dinner,
you understand what I'm saying?

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So you say, Oh, okay.

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Oh, I got to have my cheeseburger.

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And your wife said, but it's
six o'clock at night, you

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know, I'm, I'm fixing dinner.

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So Oh, but I thought it
was noontime or whatever.

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You can see the difference in the,
in the, in the, in the understanding

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about what, what, what it is.

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A decrease of poor judgment.

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Many people, um, Uh, poorly, uh, think,
uh, make decisions, uh, but a person with

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dementia might make a decision frequently,
uh, and start paying attention.

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Um, uh, in terms of, uh, making
poor decisions, you start noticing

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that the way they dress, is not
appropriate for what they're supposed

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to be doing, if that makes sense.

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Um, it's Sunday morning and you, you
think about going to church, um, and they

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normally wear X, Y, Z to church, but,
but they, they, they don't remember that

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they, they, they're dressing differently.

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And that, that's just another
suggestion about, uh, dementia.

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Okay.

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Other examples of dementia, we're
still talking about dementia.

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Dementia.

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is a, a, a abnormality or a dysfunction of
how we think, you know, there's what you

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believe, that's what you think, there's
how you feel, and that's how you act.

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So we got to go over in those,
those, those four different areas.

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So we're talking about how you think.

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Okay.

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With dementia, the short term memory
loss, There might be difficulty with

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communication, um, difficulty in
logical reasoning, um, um, trouble in

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performing familiar tasks, uh, difficulty
in some voter function, depending on

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how old you are, um, confused sense of
direction, um, um, uh, impairment in

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judgment and problem dealing with change.

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One of the things about dementia also
is Many times there can be psychological

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symptoms and you say, well, okay,
well, what's the psychological symptom,

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um, um, uh, dementia and a thinking
thing we've been talking about a

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psychological symptom is how you feel.

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That's how you think.

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And then there's how you feel.

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Okay.

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So let's say I'm having a conversation
with my wife, uh, but I can't carry the

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conversation that I want to carry on
with my wife cause I keep forgetting

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stuff and it gets frustrating for me.

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Right?

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And, and, and the more frustrated,
frustrated I get, I said, well,

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I'm just not going to talk at all.

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I just, you know, I just, this
just drives me crazy or whatever.

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And I get sad about it or I
may get sad and then ultimately

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get depressed about it.

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Depression is how I
feel, not what I think.

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So that's what you believe.

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That's what you think.

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That, that, that's what you, you feel
and then that's how you act, okay?

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And when I'm depressed, I'm
going to act a way where I just

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don't want to deal with anybody.

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I just want, just leave me
alone, let me sit in my room or

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whatever, whatever, whatever, okay?

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Yes?

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Yeah, yeah, yeah, yeah, yeah.

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But, yeah, it's, um, 180 plus?

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Yes.

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Yes.

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Now, keep in mind, aging can be, can
start for some people at, at at 30, right?

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Uh, because even, because remember I
said everybody's a little different.

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Uh, I choose 50 and older because
that's easy to understand,

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but it doesn't have to be 50.

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They have 30 year olds who
may have some dementia.

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They may have other, uh, medical
conditions that contribute to that.

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But in general, what what
you're saying is correct.

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Yes.

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Okay.

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Okay.

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Let's say a quick word about
depression, um, because again,

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I want to make the distinction.

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Remember, um, when I talk about dimension,
talk about how we think, um, uh, and

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when I talk about depression, I'm
talking about how we feel, how we feel,

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um, one, one, uh, medical definition
of depression is hopeless, helpless,

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worthless, hopeless, helpless, worthless.

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Something happens.

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Whatever it is.

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And, um, there is no hope that
that will ever get better.

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Hope is lost.

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Now remember, this, this is,
this is what one may think.

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It may not be true, but I'm
talking about what you think, okay?

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Something, something bad happens,
um, no one can help you in your,

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in your opinion to make it better.

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Hopeless, helpless.

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Okay.

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Something bad happens and
you think you deserve it.

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Hopeless, helpless, worthless.

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And this many times is, is the
pattern we see with depression.

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Um, so sometimes what I
try to, let me back up.

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My, my profession was general surgeon.

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I basically cut people
for a living, right?

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So, and that was not brain surgery.

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Alright.

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So, but my, but my, my, my point is that
as a physician, I would have patients

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who would come to me for everything
just because they know me, you know, and

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their whole thing was, well, if, if you,
if you don't know what to do, you know

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where to send me, which makes sense.

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I know.

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Okay.

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I get it.

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I get it.

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I get it.

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But my point is, um, I would say to those
patients who I felt were getting into

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that area of depression is that, uh, none
of us deserve bad stuff to happen to us.

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Because a lot of times that stems
from people who believe that they're

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not, they're not Um, Christian enough,
they, they, you know, they, they,

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they've done bad things in their life
and they're now, they're now getting

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a payback for those bad things.

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I don't particularly believe that.

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That's just me.

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Um, so my point is that what I
tell those patients before sending

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them to the psychiatrist is
that, that there's always hope.

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That's my belief.

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There's always hope.

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I don't care how, how
dark the day may look.

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There's always hope.

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And so the point I want to
make with this slide is.

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That frequently, depression can go along
with, um, um, dementia and Alzheimer's.

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Because this is a
profound change for folks.

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Men and women, doesn't matter, and
you're accustomed to something most

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of your life and now you change.

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I'll, I'll use the
example of being a father.

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You know, you're a father, you're the man,
you're the, you know, blah, blah, blah.

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Uh, and everybody sort of looked up
to you and all that sort of thing.

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But now, uh, you, you,
you don't remember stuff.

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You know, and, and, and it makes you
feel bad because you're accustomed

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to always being in charge and
always being blah, blah, blah.

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Um, and so my, my point is that
sometimes that can lead to a type of

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depression or sadness, if you will.

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Um, uh, but, and, and we'll
go into that a little more.

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The important thing to remember,
depression is always treatable.

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In general, you can treat it.

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There's medication that can treat it.

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Many times just meeting with psychiatrists
can do it, other types of things.

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But just, just to keep that in mind, not
going to spend a lot of time with this.

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I mentioned that Alzheimer's
was a type of dementia.

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These are some of the other types.

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Um, you don't have to
know them or whatever.

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Um, but just remember that
Alzheimer's is a type of dementia.

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Dementia is the overall umbrella.

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Alzheimer's is a part of that,
but it's the most serious part.

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It's the most serious part.

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And we're going to talk about why that is.

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So let's look briefly at Alzheimer's.

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And again, remember on the upper left
part of the brain, the Alzheimer's brain

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is different from the healthy brain.

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Because the Alzheimer's
brain is degenerating.

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It is, it is, it is sort of falling apart.

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It is not doing what it's
supposed to do, type thing.

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So it ends up not being as
effective as it, as it normally is.

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Um, people with Alzheimer's, uh, as, uh, a
good way to think about it is Alzheimer's

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is an extreme type of dementia.

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It's, it's, uh, uh, an
accelerated type of dementia.

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Confusion with time and place.

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We talked about that, uh, in terms
of where you are, where you're

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going, and where you want to go.

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Uh, trouble following conversations.

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Uh, and so what happens is a lot of
times, particularly people who talk a

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lot and talk real fast, the person with
dementia just doesn't say anything.

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They just sort of sit there and listen.

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At least you think they're
listening, but, but they don't have

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a clue what you're talking about.

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And what's my point?

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My point is, if you have a parent
or a family member or a friend, uh,

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and you're one of the people, slow
down, slow down, ask questions.

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So, so does that make
sense what I'm saying?

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Or what, however you wanna do it.

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But, but don't, don't just be
business as usual because a lot of

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times you aren't helping them and
you may even be making 'em feel bad.

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Right?

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Because they aren't going to say it.

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They aren't going to say, I'm
sorry, I didn't understand anything

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you said the last five minutes.

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They aren't going to tell you that.

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So, you're going to have to be super,
super sensitive to them to be able

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to help them, uh, and make sure that
they're part of the conversation.

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Um, memory loss we talked about and
we'll talk about that some more.

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Um, I, I, I use the term and I, I, I use
this term when I gave a discussion about

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a year ago about Alzheimer's and dementia.

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Uh, we all forget things.

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Keys.

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Everybody in this room, I bet, has
forgotten their keys at one time.

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I know I have.

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I have.

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And what I say, it is normal for
us to forget our keys, you know.

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I'll have my keys, I'll bring them in,
then I have no idea where I left them.

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Because I have to go and drive somewhere.

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And what I do is I just go to my
wife and she always finds them.

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She's smarter than I am, but, but
my point is, if I forget my keys and

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where I find them or where we find
them is on the counter, uh, on the

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bed or in the bathroom, no problem.

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That's probably just
normal, normal dementia.

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Uh, if I forget my keys.

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And we find them in the
refrigerator, then that's an issue.

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Get my point?

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Because your keys should
not be in the refrigerator.

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Think about it.

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Think about it.

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Okay?

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So, so, so, Graphically, that, that sort
of distinguishes between maybe a little

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dementia and a lot of dementia, right?

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Or a little dementia and maybe
early Alzheimer's, right?

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Uh, so, because we, we, we know
what the normal process is, you

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know, because we do it every day.

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Uh, but when that process is really, off.

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Then we know there's something going
on, or at least we can then more

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notice that there's something going on.

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And I'm just going to hit three
stages of dementia from beginning to

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end because again this is the most
serious Um, be worse, um, and I'm

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sorry, not dementia, Alzheimer's and
Alzheimer's can ultimately lead to death.

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Um, first stage of mild Alzheimer's
is, you know, mood swings,

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slow to, um, hear and react.

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Um, you prefer the similar, uh, when,
when the patient becomes aware of loss

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of control, um, they become irritable,
fearful, uh, restless, or depressed.

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Normal.

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Those are normal reactions with any of us
if we no longer can do what we used to do.

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And we don't know why.

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You know, we don't even say,
well, yesterday, I, I, I

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knew where my things were.

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Why is it I don't know
where they are today?

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Thank you for listening to the Healthy,
wealthy and Wise Podcast with Dr.

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William t Choctaw, MDJD.

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You can listen again to this in
any of the previous episodes.

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00:15:53,735 --> 00:15:57,576
That's www.th wwp dot.

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00:15:57,576 --> 00:15:59,105
Com and you've got it.

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00:15:59,705 --> 00:16:02,915
It's also available wherever
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00:16:03,575 --> 00:16:07,475
Be sure to follow, like, share, and
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00:16:07,685 --> 00:16:12,245
Then tune in for the next episode of the
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00:16:12,245 --> 00:16:18,500
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