Executive Function and Dementia

Executive function is the high level thinking skills that control the low level cognitive functions. It is the ability to plan, organize and implement a set of tasks in an efficient manner. It includes the ability to self-monitor and control behaviors and other cognitive functions.

Impairments with executive function is often part of dementia disease. It can be associated with daily activities such as getting dressed, bathing and feeding oneself.

For my loved one with dementia we have observed a decline in the ability to dress herself appropriately.

It is heartbreaking for me to watch the woman who once dressed well, had her hair styled and manicured nails. The facility she lives at reached out to me to discuss her clothing and what they described as a “loss of dignity”. They are concerned that she has gained too much weight for her clothes and needs larger sizes.

I already purchased the clothes but she does not wear them. She reaches out to what she recognizes and wore for many years. The new clothes are never considered.

I made attempts to remove the older clothes. Apparently she has more.

Covid19 protocols have prevented me from visiting her.

Covid19 has canceled her adult day health program. She was usually dressed appropriately for the day program and if not, the staff would work with her and engage me when needed.

Covid19 has limited my loved ones activities and as a result dementia is progressing faster than predicted, specifically the executive function.

I have been given permission to visit her this week and bring clothes. I am going to try a technique where we pick out outfits and label them for each day of the week. Simple selections.

Thankfully she is oblivious to the comments related to her appearance. The sister I once knew would have been deeply hurt. I feel them for her. As a caregiver we can’t help but feel what our loved one would be feeling if the disease let them.

Somedays are harder than others. This is one of them.

HartFelt wishes that caregivers realize this is part of the disease and not a flection on your care.