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5 days ago · Tips and Tricks for Bookworms with MCI in Living with Mild Cognitive Impairment (MCI)

Man Reading

Symptoms of Mild Cognitive Impairment (MCI) can impact many aspects of daily life, and while it can certainly be frustrating, some activities can lend themselves to compensatory techniques. One of these activities is reading for enjoyment. The memory impairments that can accompany MCI may make it difficult to retain the information you have read or challenging to keep track of plots and characters. This week, I put together a short list of some tips to help my bookworms out there who may be experiencing cognitive changes that impact their love of reading. I invite you to try some of these techniques and find what may work best for you. Feel free to comment if you have tried something that was particularly helpful!

  • Take notes while reading about events in the story that you want to keep straight. This can be particularly helpful when reading historical accounts in which many things may be happening in the same time period. You might also try making a brief summary of what you have read each time that you take a break so that you can refer to it when you return to the book later.
  • Set a timer to remind yourself to take frequent breaks to rest and contemplate what you have read so far. This would be a good opportunity to take notes as I mentioned above.
  • Consider discussing what you are reading with your partner or a friend. Sometimes the act of thoughtfully discussing the topic can help you retain the information better. Additionally, the act of thinking critically about what you have read can be a good cognitive activity.
  • Try making a cheat sheet of characters as they are introduced. You can add information as you go along and refer to it as you are reading if you forget some details.

If you find that reading long novels becomes too difficult even after trying several techniques, consider switching to reading things like short stories, magazine articles, novellas, pamphlets like CliffsNotes that provide a summary and analysis of a book.

Sep 18, 2018 · Meet the HABIT Team: Dr. Alissa Butts in Living with Mild Cognitive Impairment (MCI)

Dr. Alissa ButtsAlissa Butts is a neuropsychologist at the Mayo Clinic in Rochester, Minnesota.  She recently helped get the  HABIT Program going again in Minnesota as one of the therapists and trainers.  I had the pleasure of talking to her about this experience, as well as learning a little bit more about her in general.

Miranda Morris: When you were a kid, what did you want to be when you grew up?

Alissa Butts: I have an older brother, and I used to play with him and his friends all the time. The first thing I remember wanting to be when I grew up was a NBA basketball player (this was before the WNBA). While I did play sports growing up and even a little in college, I never came close to playing in the NBA! Luckily, I also remember early on wanting to be a scientist, which is more in line with where I ended up.

MM: What is your favorite thing about the HABIT Program?

AB: The people. It is such a treat to get to work with the couples for 2 weeks straight, especially those I get to work with during the calendar training sessions. I love working with them to establish their goals for the program and share in their excitement when they start meeting those goals. It is also such an honor to witness some of the moments during the program when the couple’s reconnect with one another in the face of this challenging illness and you can see the love between them grow stronger. Their smiles and laughter together make my day!

MM: What’s your favorite tip for de-stressing?

AB: Get moving! Even if I can feel the stress building at work, as soon as I can I try to get out of my office and go for a walk around the halls of the hospital or outside if the sun is shining. Stepping away and going for a brisk walk helps clear my mind and lower my stress. When I have a little more time, after worker on the weekends, I try to go for walks, to the gym, ride my bike, or play team sports with friends. I also appreciate talking with my family because they can always help me see perspective on the situation, even if I’ve lost site of the big picture.

MM: How did you get into studying memory?

AB: I have always been fascinated by the different aspects of human cognition and how sometimes they work and sometimes they do not. My major in college was psychology, but I minored in biology and neuroscience. In graduate school, I worked in a research lab that investigated different types of memory in people who were at risk for Alzheimer’s disease and I have been hooked ever since. Memory is particularly interesting because there are so many different types of memory. For example, in HABIT, we capitalize on procedural memory, or habit memory, because explicit memory is not working as well. I love seeing in HABIT when the people living with MCI have successes with their memory, usually their rich long-term memories that often come out when they generously share stories about their lives.

MM: Tell me a little bit about how you got involved with the HABIT Program.

AB: I first started with the HABIT program working with Dr. Glenn Smith when I was a postdoctoral fellow at Mayo Rochester. I helped during a few HABIT sessions and loved it even more than I anticipated! I was then away from the program for a few years during my first few years of being on staff at Mayo Rochester and involved in other activities. I was lucky enough to be welcomed back by the HABIT team when Dr. Shandera took over as director this year. It has been a very enjoyable experience working with Drs. Shandera and Chandler as I can tell they are so invested in the program, and I appreciate being able to learn from them. One of the great things about HABIT is that it has such a strong foundation and structure, and an eye for always trying to make the program as good as it can be. So, even though I trained with Dr. Smith, the same principles, goals, and strategies apply even now when working with HABIT team members from the other Mayo sites; it is very much one program.

MM: Some of the healthy habits that we talk about in the program include eating well, emotional self-care and getting quality sleep. With such a busy work life, how do you make sure to practice the habits of wellness?

AB: Honestly, this can be pretty challenging at times, which I think can be the case for most of us. During those times when it is particularly challenging, I try to double up wellness goals. For example, I schedule a time for exercise with a friend so that I can also catch up with that friend during our warm up or cool down (and usually also during the work out too!). Or, I’ll meet a friend at the farmer’s market where we pick out fresh fruits and vegetables for the week while catching up with each other. This helps me meet my goals of exercise, social engagement, stress relief, mental sharpness, and nutrition. I also have two sisters who enjoy cooking, so we enjoy talking about and sharing new recipes with one another, and I try to keep an eye out for ones that follow the Mediterranean and MIND diets. I can definitely tell that I do not feel as cognitively sharp when I am not sleeping well. So I try to maintain a pretty consistent sleep schedule, going to bed at the same time and getting up in the morning at the same time aiming for about 9 hours.

MM: What is your favorite thing about living in in Minnesota? Where else have you lived?

AB: I really enjoy the intensity of the 4 seasons. Although I often wish winter was shorter and fall was longer, I try to embrace the winter by doing something new each year. Last winter I went snow shoeing and cross-country skiing for the first time and only fell a couple of times!). This winter, I hope to try downhill skiing for the first time. I grew up in Central Illinois, went to a college in Indiana, Milwaukee Wisconsin for graduate school, and lived in West Virginia for one year before coming to Rochester Minnesota. So as you can see, I am a Midwest girl!

Alissa Travelling

 

Jul 24, 2018 · Our HABIT Staff: Meet Andrea Cuc, LCSW in Living with Mild Cognitive Impairment (MCI)

Cuc_Andrea_V_10O

Andrea Cuc is a master’s level licensed clinical social worker (LCSW) who works as a psychotherapist at Mayo Clinic-Arizona and is a vital part of the HABIT Team. If you have had the good fortune of meeting her, you know that she truly loves helping people and that she loves being part of HABIT. Somehow, I got lucky enough to catch her on a day when she had some free time and I got to know her a little better.

Miranda Morris: How did you get involved with HABIT in Arizona?

Andrea Cuc: I used to work with patients who had Alzheimer’s dementia at a previous hospital prior to coming to Mayo Clinic, and this population always held a special place in my heart.  So when Dr. Locke asked me if I was interested in joining HABIT I was very excited about the opportunity to work with patients who have MCI and share some of my knowledge of memory impairment, but also to continue to learn from them.

MM: When you were a kid, what did you want to be when you grew up?

AC: A dentist.  Teeth fascinate me.  My 9th grade science project was testing the abrasiveness of various types of toothpaste.

MM: What is your favorite thing about the HABIT Program?

AC: Getting to hear the HABIT participant and partner’s past and present stories.  People have incredible stories of resiliency.

MM: Tell me a little bit about your family!

AC: I was born in Romania and I am married with two kids (both in high school). We have traveled the world together and my youngest son was actually born while we were on vacation in Mexico. My husband and sons are my initial “test subjects” for all of my new therapy techniques.  They are all incredibly resilient men now!

MM: Do you have a favorite memorable experience from your time in HABIT?

AC:  A HABIT participant couldn’t remember my name, but I’m equally bad with remembering people’s names which is why we all wear name tags, and he called me the “Good Wife” because he thought I looked like the actress Julianna Margulies on the television show.  The name stuck because by the end of HABIT all of my support group participants were calling me the “Good Wife.”

MM: What is one of your goals for 2019?

AC: To travel more!  Our world is a wondrous place rich with beautiful people, cultures, and stories that need to be explored, heard, and shared.

MM: What do you do when you aren’t in a HABIT session? Meaning, what is the rest of your work-life like?

AC: I’m a master’s level licensed clinical social worker and I work with the Mayo Clinic department of psychiatry and psychology and provide counseling services to our patient population.  I teach people mind/body/emotional wellness skills

MM: Do you have a hidden talent?

AC: I’m still very flexible and I can jump (in high school they called me “twinkle toes”)!  I was a cheerleader from middle school through high school, and I don’t think that S-P-I-R-I-T ever left me! In all my travel photos there is at least one picture of me doing some sort of cheer jump (toe touch, herkie etc.), leap, heel stretch, splits, or stunt.  It’s important for me to maintain a sense of humor and bring joy along on my journeys.  Happiness is an inside out job, not an outside in.

MM: What advice do you have for someone who is just finishing the HABIT Program and may be finding it hard to stick with the program?

AC: It takes time for a new habit to become an old familiar (automatic) habit, so be gentle and kind with yourself.  The beauty of living in moments is if we stop doing something in one moment, we have the next moment to try again.  If participants stop using their MSS book and want to resume using it, then I would encourage them to get help from their partner and/or come in for a HABIT booster session so we can work through any obstacles and get the MSS habit reinforced again.  Other components such as physical and cognitive exercises may need to be changed and modified so it remains interesting and challenging.

MM: What is a life lesson that you learned recently?

AC: I’d like to think I’m a patient person, but it’s one of those values that continues to get reinforced by life so I get ongoing practice with it.

During impatient times I like to remind myself that, “patience is the calm acceptance that things can happen in a different order than the one you have in mind.”

Jun 14, 2018 · What's a Driving Evaluation and Why Should I Take One? in Living with Mild Cognitive Impairment (MCI)

Driving Evaluation

This week, I checked in with Peggy Gannon at Brooks Rehabilitation in Jacksonville, FL to ask about Driving Evaluations. This is a topic that comes up often in HABIT Healthy Action to Benefit Independence & Thinking® sessions for individuals with Mild Cognitive Impairment, so we know how important it is for many people.

Miranda Morris: If someone asked you “why should I get a driving evaluation?” what would you say?

Peggy Gannon, CTRS, CDRS: The driving evaluation gives a snapshot view of your skills at the present time.  Even with memory problems people can drive safely.  The goal of the evaluation is to provide information on someone’s knowledge of rules, their response times, and physical and cognitive skills both in and outside the vehicle.  It can provide verification that your skills in the car are still safe despite changes in thinking.  On the flip side, however, if it appears that the memory and cognitive changes are affecting safety, it is important to know that so driving can either be adjusted, or unfortunately, ceased for your safety and the safety of others.

MM: What is involved in the exam? Is there both a written and a driving portion?

PG: The clinic portion is about 2 hours, and the driving portion is about 1 hour.  How long we spend behind the wheel depends on how they are doing.  We use a Brooks car for the driving, not the client’s car.  The clinic portion is: a video on driving situations with multiple choice questions; a road sign matching test; and examination of useful field of view (e.g., peripheral vision), brake reaction, vision screen, and gross physical check of arms, legs, neck and trunk. In total, people should expect it to take about 3 hours.

MM: Does taking a driving evaluation provide any legal protection in the event there is an accident if the driver of the vehicle at fault has a memory disorder?

PG: Good question.  It provides a snapshot of the person’s ability and highlights how they drove on that particular day.  I imagine a good lawyer could make it work either way.  It does hopefully show whether a person in several domains, makes safe or not safe choices, which would then go in their favor in a legal case.

MM:  Is there any time for family to give you their opinion/observations about the patient’s driving ability as they see it in day-to-day life?

PG: We like to have information from family on how they perceive the client getting the driving evaluation. I usually get input from family, but I won’t say it is 100% of the time.  Sometimes the client comes alone or the family leaves quickly and provides very limited, if any, information.

MM: Do you send any documentation to either (a) the Department of Motor Vehicles (DMV) or (b) the referring physician about the results of the exam?

PG: Keep in mind first of all that I am working in Florida, and reporting to the DMV may vary from state to state.  In Florida, I send the physician and the medical review board of the DMV my report if (a) their license is under medical review or (b) if it is felt they should not be driving.  Many times I send a copy to the client also.

MM: What is the cost of the exam at Brooks Rehab in Jacksonville? Does insurance cover the cost?

PG: It is $420, and insurance does not cover this cost.

MM: How long does it take to get feedback about how someone did on the exam?

PG: Feedback is usually given on the same day at the end of the test.

MM:  What if a person does not think they need a driving evaluation, or they cannot get one for financial or other reasons, and the family is concerned about their driving?

PG:  Speaking again for those living in Florida, if family has concerns, they are always able to call the medical review board of the DMV.  It is confidential and the client will not know who reported them. Check with the DMV in your state to see how this may differ where you live.

 

Mar 20, 2018 · Our HABIT Team: Meet Dr. Melanie Chandler in Living with Mild Cognitive Impairment (MCI)

Dr. Melanie Chandler

This week, I got the chance to interview my mentor and the reason that I am a part of HABIT. Dr. Chandler is the HABIT Florida Director and one of the creators of HABIT. I can tell you that besides being an inspiring mentor, she is also a fantastic mom to three of the cutest kids that I have ever seen. Enjoy!

 

Miranda Morris: When you were a kid, what did you want to be when you grew up?

Dr. Melanie Chandler: A veterinarian until my dad started telling me stories of all the gross stuff I’d have to do.

 

MM: What is your favorite thing about the HABIT Program?

MC: The people, their stories, and their resilience. If I wasn’t a neuropsychologist, I could probably go around interviewing people for StoryCorps or something like that. I just love to learn about people.

 

MM: What’s your favorite way to de-stress?

MC: Riding my bike. There is always a moment on the ride when a big sigh literally just hits me, and I can appreciate being in the moment and being outside in nature.

 

MM: How did you get into studying memory?

MC: My interest began watching old Nova and similar PBS shows with my dad at night as a teenager. We bonded watching these shows.

 

MM: Some of the healthy habits that we talk about in the program include eating well, emotional self-care and getting quality sleep. With such a busy work life and a family, how do you make sure to practice the habits of wellness?

MC: I do not do well without sleep, so it is always a priority.  Having kids, and wanting to be a positive role model helps me eat well and exercise.  Plus, everyone around me knows to have me eat regularly, or else I get very hangry! A veggie (or fruit if it’s breakfast) at every meal!

 

MM: What do you usually use the “Notes” section of your calendar for?

MC: To jot notes while I’m in meetings or phone conferences at work. I find I usually refer back to these things in that same week when I use them, so this works much better than a notepad where everything gets jumbled.

 

MM: How long have you been a part of HABIT?

MC: Since the beginning when it was just an idea in 2004.  I wrote the first grant with the aid of my mentor, Dr. Glenn Smith, for the start-up funding to launch in 2005

Dr. Smith and I on MPR in 2006 with HABIT Begginings

HABIT beginnings: Dr. Smith and Dr. Chandler in 2006 for Minnesota Public Radio Interview

 

MM: How many times a day do you refer to your calendar?

MC: At least once a day on the weekend, but probably 10+ times a day during the week.

 

MM: What is a typical day like for you as the HABIT Director in Florida?

MC: Emails, phone calls, telling people (nicely) to do stuff – not as glamorous or fun as doing the sessions themselves. Then I go home and heard cats (and dogs) aka my children.

Raining Cats and Dogs Halloween Photo

 

 

 

Feb 27, 2018 · Our HABIT Staff: Meet Dr. Dona Locke in Living with Mild Cognitive Impairment (MCI)

This week, I sat down with Dr. Dona Locke to get to know more about her. Dr. Locke is the HABIT Director at Mayo Arizona and is a delightful person. I hope you enjoy reading this interview as much as I enjoyed conducting it!

Dr. Dona Locke

 

Miranda Morris: How did you get into studying memory?

Dr. Locke: I worked as a psychometrist for a neuropsychologist. A psychometrist is trained to administer and score cognitive tests, but not to interpret them. I found the interpretation part fascinating and decided to go to graduate school to become a neuropsychologist after that.

 

MM: What is your favorite thing about the HABIT Program?

DL: When my patients and partners come around to loving the MSS as much as I do!

 

MM: Tell me a little bit about your family!

DL: I’m married with two kids—ages 6 and 3. They came along as surprises a little later in life after years of trying. I also have two adults stepdaughters, ages 19 and 20. I have two younger sisters—One here in town and another in New Mexico. My parents are also here in town. Most of my extended family is spread out, but I’m originally from Louisiana and have some family still there. There is nothing like Cajun food anywhere. I’m a Cajun food snob for sure.

Locke Family

MM: What’s your favorite tip for de-stressing?

DL: For me, it is nice to be able to have a moment where I can do NOTHING. No work, no housework, just rest and relax. Read a book, enjoy some sunshine. I’m working to add exercise into my de-stressing routine on a more regular basis.

 

MM: Some of the healthy habits that we talk about in the program include eating well, emotional self-care and getting quality sleep. With such a busy work life and a family, how do you make sure to practice the habits of wellness?

DL: I have to be honest that it always feels like a work in progress to me. I’m rarely doing all the wellness habits as well as I should, but I am always working on it. The one habit I do well regularly is quality sleep. I’ve long had a bedtime routine that helps me wind down at bed time and I’m quite reliable in that routine. I sleep well most of the time. This one has been easy for me since I had my children and realized how much less resilient I was during those normal baby sleep deprivation times. I also fairly routinely look for moments to express gratitude. Sometimes that is something I actually write in the Notes section of my MSS, sometimes it is just a mental reflection when I notice I’m feeling stressed or anxious. Reminding myself of something I’m grateful for helps in those moments.

 

MM: How long have you been a part of HABIT?

DL: We ran our first full clinical HABIT session here at Mayo AZ in July of 2013. However, I was involved in some earlier research projects that led up to HABIT for a few years before that.

 

MM: How many times a day do you refer to your calendar?

DL: A million!

 

MM: Do you have a hidden talent?

DL: I won a barrel racing rodeo when I was 6. My horse’s name was Cornflakes. I’m also a pretty good long distance swimmer. My secret dream would be to do one of those long swim challenges like swimming the English Channel or from CLocke Swimuba to Florida.

 

MM: What was a lesson that you learned in 2017?

DL: I don’t know if this is really a lesson, but I’ve really appreciated getting to run HABIT with two amazing women. Dr. Chandler is not only my colleague, but probably my best friend even though she lives 1000s of miles from me. Realizing that our relationship is not just professional but also personal was like taking a deep breath in allowing me to be all versions of me—mother, wife, neuropsychologist—with more welcome fluidity. And getting to know Dr. Shandera-Ochsner better has been fantastic!  She’s so smart and enthusiastic and joyful. I appreciate her spirit and new ideas. Fun fact—Dr. Schandera-Ochsner and I graduated from the same graduate program—University of Kentucky, GO CATS! (although we did not go there at the same time).

Enjoy some of these previous posts by Dr. Locke:

Patient Spotlight-Reducing Dependence and More Dancing

Having a Conversation about Driving

Common Questions After Being Diagnosed with MCI

 

Feb 9, 2018 · Our HABIT Staff: Meet Dr. Shandera-Ochsner in Living with Mild Cognitive Impairment (MCI)

Dr. Anni Shandera-Ochsner

Some of you may have had the great opportunity to meet and work with Dr. Anne Shandera-Ochsner when she was with our Florida team in 2013 and 2014. After she finished her Fellowship in Jacksonville, she and her husband moved away from Florida to begin the next chapter in their lives. Last year, the position of Director for the Rochester HABIT Team became available and to our great delight, she accepted the position! Dr. Shandera-Ochsner will have two HABIT sessions in Rochester this year.

We thought it might be great to start introducing the team to all of our readers so that you can get familiar with the entire HABIT Family. Last month, I chatted with Dr. Shandera-Oschner and asked to learn a little more about her.

Miranda: Thanks for chatting with me, Dr. Shandera-Oschner! First, I’d like to start at the beginning. When you were a kid, what did you want to be when you grew up?

Dr. Shandera-Oschner: Since high school, I have loved working with the older adult population and wanted to be a psychologist. In college, I became more interested in the biological side of psychology, and considered switching to medicine. Then a neuropsychologist came and spoke to my “Geriatric Issues in Healthcare” class, and I knew it was the perfect mix for me.

 

Miranda: What is your favorite thing about the HABIT Program?

Dr. Shandera-Oschner: I spend most of my professional time evaluating and diagnosing various brain problems. I love getting to actually help treat problems in HABIT and to see the progress patients make over the 2 week program.

 

Miranda: What’s your favorite tip for managing stress?

Dr. Shandera-Oschner: I love to attend group fitness classes at the YMCA – I feel energized by the group and exercise and find that it’s hard to think about anything but what I’m doing in the moment, which is great.

 

Miranda: Some of the healthy habits that we talk about in the program include eating well, emotional self-care and getting quality sleep. With such a busy work life and a family, how do you make sure to practice the habits of wellness?

Dr. Shandera-Oschner : We participate in a local farm share CSA (Community Supported Agriculture) which provides us with a large box of local, organic vegetables and fruit from May to December. This forces us to make most meals with the produce we receive and helps us stay on track with our eating habits.  We also get to try vegetables we’ve never heard of through this program. Since the birth of our first child, we have made a regular bedtime a major priority for the whole family. We realized that nothing feels better than being well rested, and with a toddler, sleeping in is not an option. My husband and I are pretty strict in making sure the television is off and we are headed to get ready for bed by 9PM every night.

 

Miranda: How long have you been a part of HABIT?

Dr. Shandera-Oschner : I got my first taste of the Memory Support System part of HABIT as an intern at Emory Medical Center in Atlanta while learning from Dr. Melanie Chandler. Soon after my rotation with her, Dr. Chandler left Emory to direct the HABIT program at Mayo Clinic in Jacksonville, FL. I felt so passionate about what I learned that I applied for my post-doctoral fellowship training at Mayo Clinic and was very fortunate to match there and continue to work with Dr. Chandler in HABIT throughout my 2-year training period. Afterward, I took my current position as a staff neuropsychologist in the Mayo Clinic Health System in La Crosse, Wisconsin. When the opportunity arose for me to take over directing the Rochester HABIT program, I jumped at the chance and have not looked back.

Ochsner Family

Welcome Back to the HABIT Team, Dr. Shandera-Ochsner!!!

 

Enjoy some of Dr. Shandera-Ochsner’s prior posts:

How Big was That Fish? When Memory Loss Changes the Story

Coping with Memory Loss in Social Situations