Based on the comments and question I received from “BeWell” on my blog posting entitled “It’s All Brain Work, Baby!” I thought it would be a good idea to expand a bit on the practice of “cluing and coaxing.”

As a caregiver helping a person with dementia play a brain fitness program like Dakim BrainFitness, “cluing and coaxing” is pretty straightforward. As I said in my comment to “BeWell,” I like to think of it as “me taking little steps toward the person with dementia until they have enough clues to help them take just one step toward the answer to whatever question is floating in the air at the time.” And that is true.

But brain exercises are pursued in a bell jar of sorts, where the goal is to build cognitive skills that can be transferred over to tasks of daily living. That is, although Dakim BrainFitness exercises are created to reflect daily living, during a brain training session, the real world is put on hold so that attention, focus, and concentration can be practiced to their fullest with a minimum of distractions.

So, what about the real world? Where the decks are not clear, the lighting isn’t perfect, time is not on our side, alarm clocks and doorbells are ringing, we have not had enough sleep, pots are boiling over, meals have been skipped, the engine on the car smells funny, and there’s way more than just one baby bird chirping for quality one-on-one time. These are the very natural and human factors that often contribute to the moment at hand, and they are not optimal for the same kind of “cluing and coaxing” that you do during a brain fitness session.

If your loved one has come to live with you and your family, or you’re just trying to include them in special family events, you  have got to learn what you’re up against (both from your and their perspectives) and plan for how you are going to achieve it.

As I’ve mentioned previously, playing along with the player can teach you a lot about your loved one’s “cognitive coping skills,” which is important in understanding how much they can absorb and process and how quickly they can respond in the real world. As you play together, however, you will also learn a lot about your own coping skills as you react to their abilities (or lack thereof) while trying to keep all balls in the air AND the world spinning on its axis at the same time. Perhaps the harshest news is that the latter is as critical as the former in how you are going to go forward together living with dementia in your lives because, yes, while the dementia marches on in your loved one, it is you, your family, and your friends who will need to adjust the most—particularly in understanding your own fallibilities and intolerances. Hence my title, “Caretaker, heal thyself!”

Now, you wouldn’t be reading my words here in the first place if you weren’t committed to trying to do just that—and although changing yourself may seem (and be) very difficult, and painful, and maybe even impossible at times, you also know it will be well worth the effort because celebrations and daily life are just not the same without our senior family members.

An invaluable place to begin is by using brain training sessions as not only your loved one’s cognitive workout for the day but also as a platform on which to train yourself for including and communicating with your loved one in the real world.

For now, we’re just going to start by observing your loved one during a brain fitness session:

• What’s the best time of day for them to do their brain fitness session?
• What are the activities they do successfully on their own?
• What are the exercises that take them a lot of time to accomplish?
• What activities require a LOT of “cluing and coaxing”?
• On which activities do they seem completely lost—perhaps not even able to get beyond the instructions for a given game?
• Which of their cognitive abilities seem to come and go from day to day?
• Which of their cognitive abilities appear to have completely disappeared?
• How do they respond to your method of “cluing and coaxing”?
• What seems to make them nervous?
• What embarrasses them or creates the most frustration for them when they can’t do it?
• When do you most often see frustration degenerate into impulsiveness, impatience, or anger?
• How do they react to missing a question?

Now look at your own feelings and behavior during the session:

• What’s the best time of day for you to help your loved one play their brain fitness session?
• Are you trying to squeeze this session in between other demands on your time?
• What frustrates you about their way of doing things?
• What saddens or even scares you about what they can’t do?
• What kinds of exercises do you seem to have tons of ideas on how to “clue and coax”?
• What kinds of activities do you seem to have no idea at all how to “clue and coax”?
• How do you react when your loved one misses a question, despite all the help you’ve given them?
• How do you react to their emotional state at a given moment?
• At what point(s) do you feel yourself “digging in” and perhaps becoming overly driven to compel them into delivering the correct answer (or any answer at all)?
• Does your method of “cluing and coaxing” somewhere along the way degrade into something more like “demanding and interrogation”?

Naturally, all of this can be better or worse from day to day and depending on outside influences, but in general, if all of these areas are in the negative, this is a pretty good recipe for turning a relatively simple “crockpot” brain fitness session into a real pressure cooker!

My next blog will talk about using WHAT you’ve learned from observing your loved one and yourself during brain fitness sessions to modify HOW you do things in the real world.