Both my parents lived long lives. My dad died at age 97, and my mom lived past 100. And both had well-functioning minds when they died. But my wife’s parents were not quite so lucky. While her dad died from an accident at 85, most of his siblings lived well into their 90s with minds fully intact. On my wife’s mother’s side, though, most died in their 70s with a mental or nervous disorder. All this has led my wife and me to joke that we will both live to be 100, but my wife will be crazy by age 70.

But dementia and Alzheimer’s disease are no laughing matters.

I recently watched the Oscar-nominated film, The Father,[i] for which Anthony Hopkins deservedly won the Best Actor award. This scene from the movie illustrates the confusion experienced by someone who is losing their short-term memory. But it also shows the difficulty family members have in dealing with a loved one who has Alzheimer’s. Do you put your loved one in a home? Do you hire in-home help? And what kind of strain does being their caregiver place on your other significant relationships?

Because of the brutal realities of dealing with mental illnesses associated with aging, my wife and I have made a pact with each other. If either of us come to the point where we are not physically able to wipe our own butts, or worse, don’t know that we are supposed to, the other will send the crazy one to a nursing home immediately, no questions asked, or better yet, help them peacefully move on to the next life. And so, we look for signs that we might be losing it, similar to this scene from Still Alice:[ii]

While I still remember where our bathrooms are, I often forget the names of people I have known for years or can’t find a particular word I want to use in a discussion. For example, not too long ago, I attended the funeral of a co-worker who died much too soon. At that funeral, I saw a person I had worked closely with for years, but I couldn’t remember his name, no matter how hard I tried. Even so, I carried on a conversation with him for at least ten minutes. It was not until I was driving home that I finally remembered his name.

My wife has had a few similar experiences lately, and it worried her to the point that we went to see our family physician about it. He administered a cognitive test designed to reveal indications of the onset of dementia or Alzheimer’s. I am happy to report that she had a perfect score on the test. Judi Dench, playing Iris in the film, Iris,[iii] had a somewhat similar experience:

There is a difference between losing some age-related mental abilities and dementia or Alzheimer’s. One example of that I have often heard is, if you can’t remember where you put your car keys, it might be due to age-related loss of cognitive ability. But if you can’t remember what the keys are used for, you might have dementia or Alzheimer’s.

But dementia or Alzheimer’s disease is usually harder on the loved ones than on the sufferer. I enjoy watching romantic comedies like Groundhog Day and 50 First Dates, where every new day brings a loss of memory, and the significant other must come up with ways to help the person fall in love with them again every day. And somehow, those films always end happily. Unfortunately, we cannot say the same about those with dementia or Alzheimer’s. Each new day brings the challenge of helping the sufferer remember who you are and why you are there. Check out this depressing scene from Away from Her:[iv]

More than 50 million people have dementia or Alzheimer’s disease. And that number will most likely increase to 150 million by 2050. So, in short, either you have it, will get it, or have a family member who does.

If you have a loved one with dementia or Alzheimer’s disease, you face some tough questions regarding their care. Remember, no two situations are alike, and what is best for one might not be best for another. But I believe there comes the point when it is best for all concerned to place the person with the disease in a memory care facility simply for safety reasons. For example, those with Alzheimer’s are known to wander outside when no one is watching them and end up who knows where. And since they don’t remember who you are anyway, is it wrong to put them in the care of professionals?

If you are like me and worry about maintaining your cognitive abilities for as long as possible, there are some things you can do.

1. Get plenty of sleep. A good night’s rest flushes our brains of the plaque that builds up on our neurons, a significant correlation with Alzheimer’s disease.

• Reduce stress. Many studies on dementia and Alzheimer’s disease have reached the same conclusion: stress significantly contributes to both conditions. But knowing what stress can do to us and doing something about it are two separate things, as most of us are unwilling to change our lifestyles in any meaningful way. But if you want to reduce your chances of developing dementia, find a way to simplify your life.  

• Make more neurons. Our brains continue to make neurons even in our 90s. The more neurons your brain produces, the more resistant you will be to dementia and Alzheimer’s. We cannot simply command our brains to manufacture neurons. But there are activities we can do that help do just that:

1. Maintain a healthy diet, including drinking lots of water.
2. Exercise regularly,  even if it’s just walking around the block.
3. Take time to play—dance, build something with your hands (perhaps a fort or castle with blocks with your grandkids), or engage in playful conversations with friends.
4. Perform complex skills such as learning a new language or playing a musical instrument. While doing crossword or jigsaw puzzles uses your mind and so is helpful, studies show the real benefit to your brain comes only through complex learning.

After I retired, I decided to learn how to play the piano. I have been at it now for more than two years, and I am the first to admit that I am not particularly good at it. But every time I play a wrong note or cannot master the timing of a piece, I tell myself it doesn’t matter; I’m making neurons.

But I still haven’t garnered up enough courage to try Spanish. Maybe I’ll try that in my next decade of life.

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[i] The Father:

• Production Companies: Les Films du Cru, Film4, and Orange Studio
• Director: Florian Zeller
• Screenwriters: Christopher Hampton and Florian Zeller
• Starring: Anthony Hopkins, Olivia Coleman, and Mark Gatiss
• Release date: February 26, 2021

[ii] Still Alice:

• Production Companies: Lutzus-Brown, Killer Films, and BSM Studios
• Directors: Richard Glatzer and Wash Westmoreland
• Screenwriters: Richard Glatzer and Wash Westmoreland (based on the book by Lisa Genova)
• Starring: Julianne Moore, Alec Baldwin, and Kristen Stewart
• Release date: February 20, 2015

[iii] Iris:

• Production Companies: British Broadcasting Company (BBC), Fox Iris Productions, and Intermedia Films
• Director: Richard Eyre
• Screenwriters: Richard Eyre and Charles Wood (based on the books by John Bayley)
• Starring: Judi Dench, Jim Broadbent, and Kate Winslet
• Release date: March 29, 2002

[iv] Away from Her:

• Production Companies: Foundry Films, Capri Releases, and HanWay Films
• Director: Sarah Polley
• Screenwriter: Sarah Polley (based on the short story by Alice Munro)
• Starring: Julie Christie, Michael Murphy, and Gorden Pinsent
• Release date: May 25, 2007