As a community we can lessen the demand on everyday remembering by making alterations to our environment. We can work on turning some of those technological advances that at times bewilder us into advances that benefit us. Most of us cannot keep all the information that we need in our lives ‘in our heads’. What we need are better ways to access information when it is required. We need a ‘memory-wise society’. We need changes in our homes, workplaces and community as a whole that will reduce the amount of information we need to keep ‘in our heads’.
There are already many ‘memory-wise’ examples around us, but we can always do better! We can make better use of signs. Where? Almost everywhere! Inside buildings: shopping centres, large department stores, hospitals, large office blocks. Outside buildings: at schools, universities, accommodation facilities, holiday units, public transport centres, car parks. On nature walks and tourist routes: consistent use of symbols and signage for names of streets, speed limits, children’s crossings; signs to tell you where the toilets and drinking water taps are, and to warn drivers of various features on the road (speed humps, winding road, etc.).
Signs can take many forms. They can be pictorial, or written. Pictorial or symbolic signs are very powerful and are usually culturally universal. Digital signage can be updated easily, letting drivers know about changed road conditions, or commuters know which train station will be next. Location maps, with ‘You are here’ clearly marked on them, are useful, and of course our technical devices can always assist us with locating where we are, and how to get to where we want to go next. Some shopping centres have their own apps to use for location maps. For people with visual impairment, there are apps that provide verbal directions, and many signs now include spoken versions.
We can design places to make them memory-wise. It is easy to get lost in new environments. If we use special design features, we can make this less likely. Making each part of a large place unique in some way will help you to remember your way around it. If it all looks the same, it’s easy to get lost. Coloured lines on the floor can be used to direct you around places, such as hospitals. Way-finding in hospitals is crucial, as we are usually not familiar with the layout of hospitals, and arrive feeling stressed as we rush to visit our sick relative or friend or try to locate the department we need to go to. Car parks can include colour coding to tell you what level you’re on, and perhaps pictures, as well as numbers. Remembering that you are on the level with kangaroos painted all over it may come to you more easily than remembering you are on the third level. Residential care facilities that often cater to people with significant memory difficulties related to dementia can also be made more memory-wise by the use of familiar furniture, colour cues, appropriate signage and lighting.
Design of household or work-related appliances can be altered to place less demand on memory. Instruction booklets are a must with any new devices. They should set out the steps clearly, and be able to be displayed where the user can refer to them again and again. Written and pictorial instructions can be combined to reinforce memory. Instructions that are permanently displayed on objects are invaluable.
Medication can be packaged in ways that reduce the load on memory. Some packets are arranged like a calendar, to help keep track of your daily intake, and you can ask your pharmacist to make up a personalised dispenser packet. New car designs are including more and more memory-wise features. There are lights and special alarms that come on to remind you that you need more air in a tyre, directions on the digital dashboard for how to get to where you are driving to, and sensors to remind you not to drive into the car behind you as you park!
For many of us, our smartphones are our most important memory aids, providing portable access to an infinite amount of information, literally at our fingertips; some describe their phones as an extension of their brain! We no longer need to remember phone numbers, as they are conveniently stored in our contacts list, along with other information if we choose, such as people’s home addresses, and the names of their family members. We can take photos with our phone to help us remember things, like where our car is parked or the name of the wine we had at dinner last night. Our phone can help us find the word we are looking for, or remind us that we have a doctor’s appointment tomorrow at three o’clock!
Create time for creating
Reducing the load on memory doesn’t mean that everyone should sit back and stop using their memories. In fact, the result should be quite the opposite. If we can rely on memory back-up systems in our environment to take the load off recall of more mundane aspects of our lives, then we will be able to use our memory for other more creative or interesting pursuits.
If, for example, it takes less mental effort to find your car in a car park because you remember easily where it is with the help of the kangaroos, then it will be easier to use your memory for other things, like remembering as you drive out of the car park what the guest speaker talked about at the function you just attended!
A memory-wise community
We live together as a community, and we all experience difficulty with our memory at some point in our lives. When we are young, we might find it hard to learn information for an exam at school; in middle age, we might forget where we put something because we didn’t pay attention while we were doing it. As we get older, it can take longer to put new information into memory, and retrieve it when we want it; and because of our increasing age, there is greater risk of our developing memory illnesses, such as dementia.
As a community we need to accept that our combined memory abilities are not fail-safe, especially given the busy, multi-tasking lives we lead, while dealing with continual change. We need to talk to each other about our memory problems, so we know that others experience similar situations and we can share information about what helps. We need to be kind to ourselves when our memory lets us down, and be kind to others in the way we react to their memory difficulties. As a community, we need to be more present-minded in order to maximise our memory, and work on ways to decrease the continual distraction that results from the way we conduct our lives. We need to design everyday objects and our built environment so that they reduce the load on our already overloaded memory processes, to enhance our confidence and promote continued connectedness and independence as we age. We need to acknowledge the wisdom of our elders and be grateful for all that we learn from their combined life experience.
Together, as a community, we can nurture and support our collective memory abilities. Let’s make being memory-wise part of our individual and community thinking and, in so doing, seek to enhance the dignity and self-respect of every citizen, young and old.
Acknowledgements
One way to be memory-wise is to learn from the experience of others. Over the years, I have been fortunate to be surrounded by supportive mentors who have provided continued opportunities for learning. Memory-wise enables me to share this collective learning. I am indebted to Annette Barlow at Allen & Unwin for publishing this book, and to Angela Handley and the editorial team for their assistance and attention to detail.
Delys Sargeant recognised the need for people to know more about memory, and encouraged me to share my knowledge with the community. While writing Memory-wise, I’ve had flashbacks to working with Delys many years ago in her office at VicHealth, hearing the passion in her voice, and seeing her beautiful flowing handwriting on her note pad. This book contains many of Delys’s anecdotes and words, thus preserving her essence and wisdom, so she can provide a lasting legacy to us all.
Back in 1989, David Ames employed me as a graduate neuropsychologist in the first public hospital memory clinic in Victoria. Five years later, he suggested that Delys consult me about her memory, which led to the creation of the previous version of this book, Remembering Well. David is an international expert in the field of dementia, and I am very thankful for his ongoing encouragement and guidance. He has generously given his time and expertise to reviewing the information about dementia in Memory-wise.
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Thank you to the colleagues I have worked with in my clinical practice. I have learned so much from working with you all in the Cognitive Dementia and Assessment Service at the Royal Melbourne Hospital, the geriatric psychiatry units at the Peter James Centre and the Albert Road Clinic, and my private practice. Thank you to all the people I have consulted with in my clinical work. The time I have spent with you and your family members has enriched my understanding of memory. Thank you for sharing your stories and the many creative ideas you have developed for supporting memory in everyday life.
Knowledge is passed on both ways when you teach, and I have learned a great deal through teaching. Thank you to the many students I have worked with in their clinical training. Thank you to the organisations that have invited me to provide regular education sessions to the community, including Council on the Ageing, and Dementia Australia, and thanks also to the people who have attended these sessions.
Christina Bryant gave me the opportunity to conduct research into memory during menopause, and I am deeply grateful to her and to Glynda Kinsella, Fiona Judd, Ben Ong, Bei Bei, Martha Hickey, Kerryn Pike, Liz Rand and Liz Mullaly for their mentorship and guidance. Thank you to the women who volunteered their time for the research and shared their experience of memory at midlife.
I am grateful for my supportive friends who motivate me by valuing my work. Thank you to the Symons family, and to Fel, David, Catherine, Dasha, Mum, Dad, Maddie, Will and Elsa. Finally, thank you to Mick for being there every step of the way.
Resources
Details for these organisations and apps were correct at the time of publication, but it may be best to check these details before contacting them.
Helpful organisations
Australia
Dementia Australia
Provides support, information and services for people with dementia, their family and friends, and health professionals
Phone 1800 100 500
www.dementia.org.au
Council on the Ageing
Advances the rights, interests and futures of older Australians
Phone 02 6154 9740
www.cota.org.au
Carers Australia
Provides information and support for carers
Phone 1800 242 636
www.carersaustralia.com.au
My Aged Care
Provides access to Australian Government-funded services
Phone 1800 200 422
www.myagedcare.gov.au
Australian Psychological Society
Provides information about common mental health issues and access to contact details of psychologists by location and area of expertise
Phone 1800 333 497
www.psychology.org.au
APS Find a Psychologist service:
www.findapsychologist.org.au
Beyond Blue
Provides support and information about mental health issues, such as anxiety and depression
Phone 1300 224 636
www.beyondblue.org.au
Lifeline
Provides 24-hour counselling for crisis support and suicide prevention
Phone 13 11 14
www.lifeline.org.au
Australasian Menopause Society
Provides information about menopause and access to contact details of doctors who specialise in women’s health at midlife
Phone 03 9428 8738
www.menopause.org.au
Jean Hailes for Women’s Health
Provides information and access to clinicians and research in women’s health
Phone 1800 532 642
www.jeanhailes.org.au
New Zealand
Alzheimers New Zealand
Provides support, information and services for people with dementia, their family and friends, and health professionals
Phone 0800 004 001
www.alzheimers.org.nz
Age Concern New Zealand
Provides information and access to services to promote the rights and wellbeing of older people
Phone 04 801 9338
www.ageconcern.org.nz
Mental Health Foundation of New Zealand
Provides information and support for people who experience mental illness and their family and friends
Phone 09 623 4812
www.mentalhealth.org.nz
Australasian Menopause Society
Provides information about menopause and access to contact details of doctors who specialise in women’s health at midlife
Phone 03 9428 8738
www.menopause.org.au
United Kingdom
Age UK
Provides information and support for older adults
Phone 0800 678 1602
www.ageuk.org.uk
Alzheimer’s Society
Provides information about dementia and links to local support and research projects
Phone 0300 222 1122
www.alzheimers.org.uk
Women’s Health Concern
Provides advice and information to women of all ages about their gynaecological and sexual health, wellbeing and lifestyle concerns
Phone 01628 890199
www.womens-health-concern.org
North America
Alzheimer’s Association
Provides information about dementia and links to local support and research projects
Phone 1 800 272 3900
www.alz.org
National Institute on Aging
Supports and conducts research on ageing, and provides information for the health and wellbeing of older people
Phone 1 800 222 2225
www.nia.nih.gov
Mental Health America
Promotes mental health and provides information and support for people who experience mental illness
Phone 1 800 969 6642
www.mentalhealthamerica.net
Alzheimer Society Canada
Provides support, information and services for people with dementia, their family and friends, and health professionals
Phone 1 800 616 8816
www.alzheimer.ca
The North American Menopause Society
Promoting women’s health at midlife and beyond
Phone 440/442-7550
www.menopause.org
Canadian Menopause Society
Advancing the health of women at and beyond the menopause transition through education
Phone (604) 736-7267
www.sigmamenopause.com
Memory apps
The following links provide information about specific apps for supporting memory.
www.brainline.org/article/life-changing-apps-people-brain-injury
www.my-therappy.co.uk
https://otswithapps.com/ots-with-apps-mtool-kit-6-2-2013
www.tbistafftraining.info/SmartPhones/Phone_PHP/index.php
Notes
Chapter 1: How memory works
1 Ackerman, D. (1996). A Natural History of the Senses. London: Phoenix.
2 Anderson, M. (2015). Incidental forgetting. In A. Baddeley, M. Eysenck & M. Anderson. Memory (2nd edn, pp. 231–64). London; New York: Psychology Press, Taylor & Francis Group.
Chapter 2: How memory changes as we get older
1 Prince, M. et al. (2014). Dementia UK: Update Second Edition report produced by King’s College London and the London School of Economics for the Alzheimer’s Society www.dementiastatistics.org/statistics/prevalence-by-age-in-the-uk/.
2 Toeppera, M. (2017). Dissociating normal aging from Alzheimer’s disease: A view from cognitive neuroscience. Journal of Alzheimer’s Disease, 57, 331–52.
3 Basak, C. & Zelinski, E.M. (2013). A hierarchical model of working memory and its change in healthy older adults. In T.P. Alloway & R.G. Alloway (eds), Working Memory: The connected intelligence (pp. 83–106). New York: Psychology Press.
4 Basak & Zelinski (2013). A hierarchical model of working memory and its change in healthy older adults. In Working Memory (pp. 83–106
).
5 Verhaegen, C. & Poncelet, M. (2015). The effects of aging on the components of auditory–verbal short-term memory. Psychologica Belgica, 55(4), 175–95.
6 Drag, L.L. & Beiliauskas, L.A. (2010). Contemporary review 2009: Cognitive aging. Journal of Geriatric Psychiatry & Neurology, 23(2), 75–93.
7 Luo, L. & Craik, F.I.M. (2008). Aging and memory: A cognitive approach. The Canadian Journal of Psychiatry, 53(6), 346–53.
8 Luo & Craik (2008). Aging and memory. The Canadian Journal of Psychiatry, 53(6), 346–53.
9 Rose, S. (1993). No way to treat the mind. New Scientist–UK Edition, 138(1869), 23.
10 Meredith, A., Shafto, M.A., Burke, D.M., Stamatakis, E.A., Tam, P.P., Tyler, L.K. (2007). On the tip-of-the-tongue: Neural correlates of increased word-finding failures in normal aging. Journal of Cognitive Neuroscience, 19(12), 2060–70.
11 Nilsson, L. (2003). Memory function in normal aging. Acta Neurolologica Scandinavica, 107 (Suppl. 179), 7–12; Hedden, T. & Gabrieli, J.D.E. (2004). Insights into the ageing mind: A view from cognitive neuroscience, Nature Reviews Neuroscience, 5, 87–97.
Chapter 3: What else affects memory? Health, attitude, lifestyle
1 Gulpers, B., Ramakers, I., Hamel, R., Köhler, S., Voshaar, G.O. & Verhey, F. (2016). Anxiety as a predictor for cognitive decline and dementia: A systematic review and meta-analysis. American Journal of Geriatric Psychiatry, 24(10), 823–42.
2 Bouazzaoui, B., Follenfant, A., Ric, F., Fay, S., Croizet, J-C., Atzeni, T. & Taconnat, L. (2016). Ageing-related stereotypes in memory: When the beliefs come true. Memory, 24(5), 659–68.
3 ‘A Consensus on the Brain Training Industry from the Scientific Community’, Max Planck Institute for Human Development and Stanford Center on Longevity, accessed 11 October 2018, http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community/; Lillard, A.S. & Erisir, A. (2011). Old dogs learning new tricks: Neuroplasticity beyond the juvenile period. Developmental Review, 31(2011), 207–39.
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