Hiking thousands of miles over a few months involves a fair bit of potential monotony. Personally, my mind and spirit are perpetually engaged when hiking above treeline, or when following a creek, but there remains stretches of miles upon miles where being engaged presents a challenge. Mental games help to make these stretches go by.
“Back in the day” some of the mental games we played were Twenty Questions, Botticelli, Name that Tune and solving conundrums (The music stops and she dies. What happened?) For our upcoming PCT thru-hike perhaps I’ll play a few of these with Charissa, but what about Cindy? Her Alzheimer’s is at a stage where playing these old trail games is not possible … but I’ve come up with alternatives.
In every test Cindy has undergone she was given three words to remember. The doctor would then proceed to talk about other things before coming back to those three words. As I’ve been studying up on this, failing at that test alone indicates a likelihood for dementia. As an aside, Cindy failed at the “three word” test right from the start, more than three years ago, yet doctors consistently ruled out Alzheimer’s because she got other questions right, such as what year is it and who is President, and because she was “too young.” At the time I was all too happy to believe in this diagnosis, to think there was only something temporary that could be changed.
Cindy and I have started our training regimen, going for 4-6 mile hikes wearing full packs. I’ve come up with a new game for us based on the standard dementia testing. I give Cindy three words to remember, I get her to focus on something else as we continue hiking, then come back to those three words.
I already know that Cindy cannot simply feed back to me those three words, so I do a little variation of the game. I choose six words, including the chosen three and for each I ask: “Is this one of the words I asked you to remember?” The first time we played she struggled; I’ll charitably give her 3 out of 6. The second time we played her score was a rather confident 5 out of 6. Improvement!
I’m going to discuss this with Dr. Carson Smith, whose research we will be helping to fund. Perhaps there are some other appropriate trail games we can invent that will actually serve as a type of therapy.
After giving Cindy her three words distracted her by going down the names of the family using two descriptors. This also was a type of therapy for her memory. She was able to repeat “my only son Noah,” “my oldest daughter Charissa” and “my youngest daughter Serena” without any problem. However, she always struggled when asked to repeat “my fabulous husband Kirk.” In fact, she always broke down laughing. Some room for improvement there.
Hi Kirk,
These games are a good idea. I agree it’s quite a challenge. The latest version of OEC (Outdoor Emergency Care) suggests asking four questions of a patient (referred to as “AO x 4” or “alert and oriented times four”). I almost always give a patient a “magic word” (usually “MickeyMouse”), and, in addition to checking the LOR (initial level of responsiveness), I will continually ask the patient for the magic word. If the patient hesitates, I know I need to check something out.
I think engaging Cindy with the questions the way you ask them is excellent. Another thought – can she still perform any simple math in her head? Much of what we learn early in life regarding math skills tended to be rote memory in our day. Perhaps the act of doing some simple calculations may help trigger specific mental connections. Just some thoughts and observations. Looking forward to seeing you.
Thanks for the suggestions Mike. I have done some simple arithmetic with her. Since she never liked math in the first place it’s a little more of a struggle to play math games.