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Executive Function and Abstract Thinking

When caring for a loved one living with dementia, it’s important to understand the loss of executive function and abstract thinking. Offering simple exercises, using effective communication and solutions, and practicing compassion can help both you and your loved one cope.

Dementia relates to a person’s ability to function compared to how they once did. Think of dementia as gradual and progressive brain damage due to disease. This brain damage steals one’s power to think and interact with the world.

Usually during the middle stage of dementia, patients begin suffering from loss of abstract thinking and executive function, or the mental capacity to connect past experiences and knowledge to current situations. The effects can range from confusion and difficulties problem solving to the inability to multi-task or react as one may have prior to dementia.

To preserve function, engage your loved one in activities such as word puzzles and practicing simple mathematics and ‘transactions’ with play money. For example, give your loved one three $5 bills for a purchase of $13, and have them give you the correct change back.

To help your loved one communicate effectively, speak slowly, clearly and simply, but never use “baby talk.” Use concrete terms without sounding “bossy,” and give one clear, simple, concise instruction at a time: “Breakfast is ready — let’s go eat.” Where appropriate, add gestures to match your words. “Mirroring techniques” help a person understand more quickly. When you want your loved one to brush her teeth, make the motion of brushing as you say, “Brush your teeth, Mom.”

When your loved one is confused, has difficulties creating a solution to a problem, or makes a “mistake,” respond with an “out” to save face. You may want to take the blame by apologizing for not explaining correctly, or agreeing that, “This is tricky, isn’t it?”

Remember, the human brain’s emotional memories are more resistant to dementia than are its factual memories, so always treat the individual with respect and love, regardless of the struggles they’re currently enduring.