Our brains change as we age: our memory gets foggier, our joints start to creak. Researchers at Jefferson who conducted cognitive studies with black participants suggest that being active socially, physically, and mentally (or cognitively) may actually prevent memory loss in those who start showing signs of forgetfulness. While this might sound familiar, the science suggests that the trick is to set achievable, or small goals, and to do them consistently, integrating them into everyday life.
“Many people feel, ‘I’ve worked my whole life, retirement is my time to rest,’” said Joann Akpan, Clinical Research Coordinator at Jefferson, who helped participants set and keep goals for more active living as part of the study. “People don’t realize that our bodies and minds stop working as well when we don’t use them.”
Keeping brains, bodies, and social lives active – all three, if possible – may significantly help reduce memory loss. In fact, study participants who set and met activity goals saw an 88 percent reduction in risk of memory loss compared to those who didn’t. But finding ways to set and keep realistic goals isn’t easy. Only about 9 percent of people who set New Year’s resolutions ever complete them. We spoke with Akpan and study authors, Barry Rovner, MD, Professor of Neurology, Psychiatry, and Ophthalmology at Jefferson (Philadelphia University + Thomas Jefferson University) and geriatric psychologist, Robin Casten, PhD, for seven tips on finding and setting effective activity goals that all older adults can stick to.
1. Start with a script
If you’re helping a family member with memory loss, create a script you can follow to start the discussion and avoid landmines. (Use the tips and activity suggestions below to guide your scripting.)
“It can be difficult to talk to loved ones about their memory loss – it can be scary, they may get defensive, and not want to engage,” said Akpan. “A script offers a roadmap if you hit an obstacle and keeps you focused. Most importantly, allow time to listen after initiating a discussion.”
2. Find motivators
Ask questions that allow the person to reflect on his or her observations about their memory – acknowledging that your memory isn’t as strong as it used to be. That can be a strong motivator and a point of commonality.
“I would tell stories about me or others forgetting their keys, or appointments, and say, ‘do you ever notice things like that? How does that make you feel and what do you do about it?’” said Akpan.
“Realizing there’s a problem can be very motivating, especially if there are things that can help improve that memory.”
3. Help family members come up with goals
Explore their interests, from their past or current life, and develop goals around those interests. Don’t force activities that someone does not really want to pursue. No one is motivated by someone else’s goal.
“A key element of our study was that all of the goals were realistic goals that the participants wanted to achieve,” said Akpan. “They may seem small, or simple, but the key here is interest, which leads to commitment.”
4. Start with goals attuned to the individual’s abilities; modify if needed
If the person is not moving around the house much, start with activities they can do in their chair such as phone calls to a friend or family member every week, and reading. If they are active but don’t like exercise, incorporate extra movement into tasks they already do, such as taking a few extra laps around the grocery store with the cart or adding steps to their laundry routine.
“If a person is bored with a goal that may be too easy or too hard, modify it,” said Akpan. “Increase or decrease the number of times it’s completed per week, add a new goal, or switch to a more complex or simple goal, depending on need, for example, switch to doing Sudoku puzzles instead of word-finds.”
5. Bake routine into each goal
None of the goals should be one-offs. Instead of “do a jigsaw puzzle,” it should be “do one jigsaw puzzle every Tuesday.” Or “go to the senior center once a week.” Build the activities into regular daily or weekly routines. Consistency is key.
6. Break the goals into steps; create a checklist
For people with more advanced memory problems, checklists can be essential, although they can be useful motivation tools for anyone. Start your checklist with the goal at the top and below that, the six or seven simple steps that might go into achieving that goal. The participant would then check off the steps he or she has completed and feel accomplishment in the progress towards that goal.
For a social/physical goal like “take a walk with a friend,” the steps might include: 1) mark your calendar to call your friend 2) call and find a date and time that works 3) decide on a meeting location 4) mark your calendar with the date and time for the walk 4) call the night before to confirm 5) put on comfortable shoes, etc.
“Keep in mind that memory is an issue, so memory aids like calendars, refrigerator whiteboards, or leaving a jigsaw puzzle in plain view become much more important in helping a person achieve their goal,” said Akpan.
7. Compassionately manage setbacks
A loved one may have a medical setback or admit that they have not met their goals. This is normal. Managing through these setbacks – with compassion and understanding – will go a long way. What caused the setback and were the goals too daunting? Is there an opportunity to create smaller, more actionable steps that do not overwhelm?
Akpan had some participants give her empty stares, while others broke down in tears over the fear of losing their memory. “Both are normal and natural responses and participants were usually very honest when they didn’t complete their goals,” she recalls “The key is to make each step do-able not to over-challenge. Sometimes a participant would have a medical setback, which would throw the routine and we’d often have to start the process from the beginning, which is ok.”
Bring a menu of options or suggestions to the table. Try to have one goal in each area and complete each at least once per week.
Mental Health (Brain): Activities that make you focus, think, or reflect
* Playing cards
* Sudoku puzzles, jigsaw puzzles, word-find games
* Memory matching games
Physical Health (Body): Simple activities that get the blood flowing
Loved ones don’t have to become Olympic athletes, in fact, you might want to check with their doctor first to ensure any physical goals are not too strenuous.
* Start at the person’s baseline and if mobility is an issue, start small. Maybe stretching every morning, or walking around the apartment five times or down the stairs and then taking the elevator up is a good start.
* Add legs to the usual routine. For example, take a few extra trips up and down the stairs to get the laundry.
* Line dancing classes (very popular among study participants) at the local senior center can accomplish both physical and social goals.
Social Health: Simple positive human interaction is key to improving mood, reducing stress and creating positive feelings
* Visit a senior center or church group
* Text or call a niece or nephew once a week