The Masterclass on Memory: How to Protect Your Mind as You Age

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Coming up on this episode of the
Healthy, Wealthy, and Wise podcast.

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One of the things that always comes
up with, well, how can you sort of

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prevent stuff that it always has to
do with healthy eating and exercise,

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avoiding alcohol, um, um, doing things,
coming to masterclasses, learning new

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stuff, reading new stuff, listening
to podcasts, whatever works for you.

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That's all good.

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Going back to, what are the part about
the The, the patients to come in and

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bring it in and mom and dad, at some
point, one of the issues that comes up.

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Welcome to the healthy, wealthy,
and wise podcast with Dr.

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William T.

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Choctaw, MD, JD.

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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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With executive experience being a former
mayor of Walnut, California, as well as

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the current chairman of the nonprofit
Servants Arms and as president of

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Choctaw Medical Group, Incorporated.

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This is the Leadership Masterclass
Edition, already in progress.

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And remember, Alzheimer's is

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a degenerative disease.

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disease of the brain.

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Like it's, it's gradually getting worse.

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Now that could be a huge time.

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And again, it takes us back to the
fact that, uh, we're all different.

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That the time it takes for me to
get to a certain stage, uh, may

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be different from the time that it
might take you to get to that stage.

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And that's why it's difficult to say,
well, I, I saw one person with blah,

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blah, blah, so now I know how everybody is
going to be, how everybody is going to do.

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Uh, and that just does not work.

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The middle stage of Alzheimer's is
stage two, uh, disability occurs.

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Uh, distant pasts may be
recalled, but recent events

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become difficult to remember.

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Um, uh, folks may start inventing
words because they can't

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remember the right words to use.

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Um, you may not recognize people
that you know or used to know, um,

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which then really becomes disturbing.

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Um, and it certainly becomes
disturbing for your family or your

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caregivers and that sort of thing.

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And you say, but, but, but dad,
this, this is your, this is your

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daughter, your second daughter.

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This is Mary.

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You don't know Mary?

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You know, that, that sort of thing,
and, and so that's obvious, right?

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I mean, you, you can
tell when that happens.

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And then the third and the final
stage, which is even more obvious,

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um, uh, where, uh, people, patients
just become less responsive.

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They don't want to get out of bed.

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They don't get out of bed.

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Um, unable to recognize anyone, unable
to recognize anyone, uh, wife, husband,

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family member, whatever, whatever.

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Um, um, loss of, of, of, uh, Uh, bladder
control, loss of normal activity, uh, type

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thing, uh, and then can ultimately die.

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Uh, people go through that, uh, people
do it, um, um, and this reminds me to

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bring up a quick category, caregiver.

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If you are a caregiver, or if you've
ever been a caregiver, and I'm talking

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about caregivers can be for your
kids, all the way to your parents.

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You know how difficult this is because
one of the challenges with caregivers have

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to face is that when you're dealing with
that adult, uh, person with dementia or

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Alzheimer's, um, they are difficult to
take care of because they keep changing.

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They keep, they keep changing that,
that loving wife or that loving

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husband or that loving mother or
that loving father is changing.

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It's changing and it's frustrating.

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I would have patients come into, when
I was in practice, uh, to my office

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and bring in their, uh, I'll say their
mom or their dad, and they would be

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very frustrated and they would say
something like, I don't know what to

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do, I don't know what to do, um, um,
uh, she yells at me, I try to, um, um,

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help her to do this and she does that.

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blah, blah, blah.

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Um, and what happens with
caregivers is they're human, right?

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They get hurt like
everybody else gets hurt.

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Um, and sometimes they yell back and
when they yell back, they feel horrible.

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They said, Oh my God, I'm yelling at my
mother or my father or my husband or my

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wife or whatever, whatever, whatever.

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So what's my point?

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My point is You caregivers
got to take care of yourself.

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You got to get out, go take a walk in
the park, go, I don't know, go to church

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twice a day instead of once a day.

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You got to get out, right?

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Because you're human.

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And, and, and we humans have our limits.

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We do.

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We may tell ourselves we're
Superman and Superwoman, right?

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You know, I, I know I've been superman.

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I tell myself a long time,
but we're human, right?

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Right?

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And so my point is Um, you,
you, you, you've got to take

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care of yourself frequently.

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The scenario I would see patient
comes into my office, um, and bring

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in their parent, blah, blah, blah.

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And usually the other siblings in
the family, but there's usually

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only one sibling that does the work.

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The other brothers and sisters,
and they're the ones on the phone.

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Well, how is so and so did you do this?

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Did you take her to this?

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You miss that appointment?

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How could you do that?

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Blah, blah, blah, blah, blah,
blah, you know, because they

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don't have a clue to what you do
because you've got your own kids.

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You've got your own job.

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You've got your own health issues
on and on and on and on and on.

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Nobody knows your world.

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They do not.

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They do not understand.

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And even if you tell them they
don't, they wouldn't believe you.

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They say, Oh, come on, come on, come on.

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It can't be that man.

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It is a lot of times.

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It is.

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I've seen it.

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I know it exists.

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So what's my point?

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My point is, um, number one, caregivers,
you got to take care of yourself.

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Whatever that means for you.

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And it means different
things for different people.

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That's okay.

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But because if you can't take
care of you, how are you going

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to take care of him or her?

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Right?

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Because you're it.

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That, that, that's why you're there.

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Those, those other siblings,
those brothers and sisters of

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yours, they are going to suddenly
come in and say, you know what?

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Chill.

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I got this.

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I got this.

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You, you go and take a trip
to Hawaii or the Bahamas.

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I'll take care of mom for
the next three months.

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They're not going to do that.

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They're not.

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If so, they would have done it already.

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And they're not going to do that.

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So my point is that these are realities.

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Uh, that we didn't create, but we have to
adapt to, we have to adjust to, and, and

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it is possible to adjust to these things.

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One of the things that always comes up
with, with how can you sort of prevent

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stuff, it always has to do with healthy
eating and exercise, avoiding alcohol.

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Um, um, uh, doing things, coming to
masterclasses, learning new stuff,

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reading new stuff, listening to
podcasts, whatever works for you.

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That's all good.

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Going back to, what, what are the part
about the, the patients to come in

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and bring it in, mom or dad, at some
point, one of the issues that comes up.

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That's always very difficult.

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Um, usually with parents, um, is do I
need to put mom or dad in a facility?

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to take care of them?

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Uh, am I, am I able to adequately
take care of them by myself or myself?

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Most of the times, what, what makes
that decision tends to be safety.

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Safety.

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Example.

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Let's say mom has Alzheimer's, and you're
doing your best, you're taking care

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of her, and that's working out okay,
but mom tends to, um, go sleepwalking.

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So while you're asleep, mom gets up,
unlocks the door, and leaves the house.

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Or mom, mom can drive a car.

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Uh, and she tends to get in
the car and just goes out and

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you don't know where she is.

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Most of the times, and, and most
people hate even considering that,

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but usually it ends up being safety.

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Um, mom or dad tries to cook, but
they don't remember how, how to

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turn the flame this way or what
to do with the match or whatever.

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And so then you're concerned about,
um, um, you know, them harming

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themselves, burning down the house.

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You have other children.

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In the house, little kids, you know,
so my point is that if you move or

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movement in that direction, most of the
times it has to do with safety, safety

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of the person of the patient, mom, dad,
whoever it is safety of everybody else.

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Okay, so just, just sort
of keep that in mind.

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Again, cognition as we
talk about is thinking.

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Function is what you can do.

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Now with dementia, you probably won't
see as much problem with function,

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um, like going out and not taking
a bath and whatever, whatever, but

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you will see it with Alzheimer's.

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Because remember, Alzheimer's a more
advanced, uh, part of this problem.

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Um, what are the, one of the types
of abnormalities that can come up

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with dementia and or Alzheimer's
is what we call hallucination.

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Well, what is a hallucination?

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A hallucination is something somebody
experiences that is not true.

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Now it's true to them.

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I see little green men
walking in the room.

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That, that's my visual hallucination.

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Now, there are no little green
men in the room, but I see

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them and they're real to me.

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So my point is, well, what do you do
when that person with dementia and

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or Alzheimer's has hallucinations?

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It's it's it makes it
even more challenging.

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It is best to try to work
with them as much as you can.

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And what do I mean by that?

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You don't want to, you don't want to say
there are no low grade men in the room.

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Your mom stopped saying that.

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They, there's nothing there.

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And she said, but I see them over there,
and there are two of them, and they're

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walking around, and you say, mom, they,
you know, don't do, don't get into that.

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Don't do that.

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Don't do that.

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You are going to change her mind.

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She sees them because she has dementia
and, or, and, or maybe Alzheimer's.

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So you're not going to change her mind.

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by yelling at her or getting upset.

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So my point is, you need
to calm down, right?

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Uh, and I'll tell you, as a surgeon,
and I learned this, I've been in

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situations where people yell and
scream and throw stuff and call people

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names and all that sort of stuff.

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Um, um, and this is particular at Yale
and this is in the 70s and 80s, uh, and

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what I learned, what I, as a physician,
what I learned is things really don't go

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well when you do that, not, not really.

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And when I said things go well, the
patient does not necessarily benefit.

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Now, my specialty was surgery, uh, more
specifically trauma surgery, uh, which

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means at three o'clock in the morning
when somebody's been shot ten times and

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run over by five cars, they call me in.

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All right?

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I get out of bed, drive my car into
the whatever, whatever, uh, at three in

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the morning and I say, what do we got?

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And they start talking, Dr.

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Chalk, we got a 45 year old male
who's blah blah blah blah blah, and

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I'm not talking, I'm just listening.

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And they go on and go on and go on
and go on, and then I say, okay,

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you do this, you do this, you
do this, you do that, let's go.

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And we go, we go.

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What I have learned is, you,
you, you have to understand that

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everybody's a little different.

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Now, if, if I get to the OR and I've
got a nurse or PA who's, who's freaking

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out because of the blood or whatever,
whatever, I kick them out of my room.

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I do.

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I do.

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I said, they don't have
time for you right now.

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I love you, but you gotta go.

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Because I need everybody
focused on the patient.

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We got one job is to get this guy
or this woman off the table alive.

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That's our job.

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Um, and, and so what, what I've learned
is that you have to understand that

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you have to be focused on the most
important person and that is your loved

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one who has dementia and Alzheimer's.

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They will do and say stuff
that will drive you crazy.

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They will say stuff to
you that will drive you.

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Why are you so mean to me?

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You've never been, I never liked
you and I always liked your

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sister better than I did you.

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I was like, you know, but I mean,
they'll go down those roads.

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You can't let that bother you.

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You got to say, I'm the caregiver.

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I'm the caregiver.

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God put me here for a reason.

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I'm going to do my job.

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I'm going to do my job.

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Now you can do whatever you need
to do, but I'm going to do my job.

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And I can tell you, someone who's
been through, uh, particularly in

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terms of the job thing, it works.

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It works.

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And not only does it work if you've
got other people helping you and

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you're respectful to them, you don't
yell and scream and call them names.

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I do the very opposite.

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You know, when we go into the operating
room and we put the patient on the

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bed and the blood hits the ceiling.

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You know, first we cover it up, we put
something over it, and then I said,

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okay, I want everybody to calm down.

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And then we talked two or three minutes.

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I said, I'm going to do this,
I'm going to do this, you do

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this, you do this, you do that.

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Okay, everybody ready?

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And they said, yes, sir.

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Then we do it, and we
get it taken care of.

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As compared to, give me this!

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No, I don't want that!

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Give me this!

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Oh, no!

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Throwing stuff on the floor, because
when you throw stuff on the floor,

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as a surgeon, they have to clean it!

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They can't pick it up
and give it back to you.

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So what have you done now?

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That's your favorite, I don't know, stall.

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You threw it on the floor because
you didn't like the way it felt,

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uh, and now all you've done is
delay the surgery even more.

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So, you know, my point is
very simply, stuff will happen

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that you have no control over.

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You don't.

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Uh, because this is not about
you, quite honestly, it's

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about her or it's about him.

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Your job is to be the caregiver.

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Your job is to get them
there, to get them there.

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And then if you need to go out and hug
somebody else, or hug your neighbor, or

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say a prayer, or go to church, you do
what you need to do to take care of you.

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And you must take care of you.

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Because if you don't make it,
if you're not capable, you

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can't take care of her or him.

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Right?

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Does that make sense?

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Okay.

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Oh, let me also say there is a specialty
in healthcare called gerontology.

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Gerontology, we don't talk a lot about it.

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Gerontology are doctors who
only deal with elderly patients.

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They do exist.

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That is a specialty.

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Uh, you can put into your
search engine gerontologist

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near me or something like that.

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But I would suggest first
start with your primary doctor.

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Um, and say I, I want us to
have a plan to deal with blah,

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blah, blah, blah, blah, blah.

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Start there.

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Um, and then, then, then move on.

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Now is medication available?

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I won't spend a lot of
time on it for Alzheimer's.

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And for, um, um, uh, dementia and therapy.

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Um, uh, the drugs are effective
depending on which drugs that are used.

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All of this, and this goes back to
us being independent and individual,

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everybody's a little different.

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Everybody's a little different.

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And this is where, uh, the good exam
and the tests that have been done

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can sort of help you with stuff.

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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 and
any of the previous episodes.

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00:16:06,175 --> 00:16:14,035
Leave a comment or pose questions to
the doctor by going to www.thwwp.com.

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00:16:14,365 --> 00:16:19,855
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00:16:20,395 --> 00:16:23,545
It's also available wherever
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00:16:24,225 --> 00:16:25,755
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00:16:26,165 --> 00:16:29,365
and subscribe if you haven't
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00:16:29,365 --> 00:16:32,865
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00:16:32,865 --> 00:16:33,415
William T.

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Choctaw, MD, JD, a production of
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