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Practical information for aging health & family caregivers
A few years ago, while I was at a family celebration, several people mentioned memory concerns to me.
Some were older adults concerned about the memory of their spouses. Some were adult children concerned about the memory of their parents. And a few were older adults who have noticed some slowing down of their own memory.
“But you know, nothing much that can be done at my age,” remarked one man in his eighties.
Wrong. In fact, there is a lot that can and should be done, if you notice memory or thinking changes in yourself or in another older adult. And you should do it because it ends up making a difference for brain health and quality of life.
First among them: identify medications that make brain function worse.
This is not just my personal opinion. Identifying and reducing such medications is a mainstay of geriatrics practice.
And the expert authors of the National Academy of Medicine report on Cognitive Aging agree: in their Action Guide for Individuals and Families, they list “Manage your medications” among their “Top 3 actions you can take to help protect your cognitive health as you age.”
Unfortunately, many older adults are unaware of this recommendation. And I can’t tell you how often I find that seniors are taking over-the-counter or prescription medications that dampen their brain function. Sometimes it’s truly necessary but often it’s not.
What especially troubles me is that most of these older adults — and their families — have no idea that many have been linked to developing dementia, or to worsening of dementia symptoms. So it’s worth spotting them whether you are concerned about mild cognitive impairment or caring for someone with full-blown Alzheimers.
Every older adult and family should know how to optimize brain function. Avoiding problem medications — or at least using them judiciously and in the lowest doses necessary — is key to this.
And don’t give anyone a pass when they say “Oh, I’ve always taken this drug.” Younger and healthier brains experience less dysfunction from these drugs. That’s because a younger brain has more processing power and is more resilient. So drugs that aren’t such problems earlier in life often have more impact later in life. Just because you took a drug in your youth or middle years doesn’t mean it’s harmless to continue once you are older.
You should also know that most of these drugs affect balance, and may increase fall risk. So there’s a double benefit in identifying them, and minimizing them.
Below, I share the most commonly used drugs that you should look out for if you are worried about memory problems.
1. Benzodiazepines. This class of medication is often prescribed to help people sleep, or to help with anxiety. They do work well for this purpose, but they are habit-forming and have been associated with developing dementia.
Supreme Court Justice Clarence Thomas Slams Feds’ Marijuana Stance As ‘Contradictory’ And ‘Unstable’
The way the United States Senate is supposed to work, the “world’s most deliberative body” would now be debating and negotiating the most far-reaching voting rights bill in half a century. Sadly that version of the Senate, the one of civics textbooks and Schoolhouse Rock, is firmly in our political rearview mirror. Instead, we have an institution in which dysfunction and cynicism reign. This has allowed Republican senators to block a bill meant to confront an urgent need, a need being created by their fellow party members in state governments who are assaulting the democratic electoral process. Thus an initiative that has the support of the majority of our upper legislative chamber is rendered dead on arrival. The stakes for our democracy are dire and to call the omens concerning would be an understatement.
Trying to make sense of the multitudinous dichotomies, inconsistencies, and outrages left in the wake of these developments can be a head spinning enterprise. We are facing an existential threat to our nation, as powerful anti-democratic forces sweep aside the will of the majority of the American public. Orchestrating this harvest of obstruction and sabotage is Mitch McConnell, who is playing the role of the Grim Reaper in the Senate, wielding his scythe of bad faith rhetoric and false equivalence to proclaim even the compromises offered up by Joe Manchin to be grave injustices to our national purpose (always projecting, that one).
A democracy is rooted in free and fair elections dependent on the vote. Over the course of our history we have been strengthened by the expansion of the franchise to those previously barred from the full rights of citizenship on the basis of their race, class, and gender. The compact under which we are supposed to live is that if a majority of our fellow citizens do not approve of our political leadership we can remove them, peacefully and legally. In our system, there are many protections for the will of the minority. Our federal system has local and state oversight. We have a Bill of Rights and other legal remedies. However, our history also provides many lessons of caution. We have seen that the rights supposedly available to political minorities have been withheld, often through force or the threat thereof, from racial minorities, particularly Black Americans. And now that past is a prelude for the unfolding drama.
We are witnessing a Republican Party, in an effort to try to lock in its privileged perch of control, exploiting every lever of power to which it has access. At the national level this means relying on the filibuster to prevent Senate action on voting. This is made possible by the nature of the Senate itself, which allocates unequal influence to small states, which in turn just happen to be dominated by Republican politicians. At the state level, however, the party has no similar concern for the will of the minority. Republican-controlled statehouses, often bolstered by extreme partisan gerrymandering, are running over any principled resistance to ram through draconian voter suppression bills and other election laws that are meant to weaken the faith in and function of our democratic system.
I have written earlier about the unique role played by Senator Manchin in this drama. With the voting bill however, at least for the moment, divisions between Democrats are no longer the story. The party voted in unison, and was met by a unified wall of obstruction in response. And let’s be clear, this was just to debate the bill not to vote for it.
What are the Republicans so afraid of? I suspect a lot, and for good reason. And it is in answering this question that I can find some faint rays of hope.
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The Republican Party’s anti-democratic crusade is a bet, a big one, and a risky one. That they are willing to blow up the norms that have governed this country for this bet is a sign of desperation and not of strength. The calculus is rather simple. Rather than winning elections by drawing more voters to their candidates, Republicans are trying to win elections by limiting the number of voters their opponents can get for theirs. This bet is predicated on gerrymandering and a Senate that requires 60 votes to get anything done. It is also dependent on locking in these gains in the short term before the demographics of the electorate further dilute the Republican base.
Republicans fear the will of the majority. And they fear the future. They see this as perhaps their last shot to use their structural advantages to secure the enduring power of their minority position. And they use the fact that they are a political minority as a rallying cry to unite their voters under specious claims of being suppressed by the majority of voters supporting Democrats — which just so happens to be a coalition of many groups who have long been marginalized. This is how white privilege is recast as oppression, raw political power as a return to American “normalcy.”
An honest surveying of this landscape is daunting and demoralizing. But for the first time since the voting rights battles of the 1960s, I see a passionate national movement for enfranchisement. I see energy and activism. I see a unity of purpose. I see a determination that Senate skullduggery be exposed, lies called out, and pressure exerted. This is indeed the biggest struggle of our time, the one upon which all other struggles are predicated. Without free and fair elections, solutions for climate change, income inequality, and all the other urgent needs will be elusive. But I suspect you know this.
And that you know this already, that you and millions of others are aware of this battle, is itself a form of progress and reason for hope. The 2022 elections will be pivotal. History suggests that the Democrats, as the party in power, will face stiff headwinds. But many political observers caution that this may not be the case this time, especially with how partisan the electorate has become and with the question of the future of democracy as a rallying cry. This is what frightens the Republican leadership, although they will never admit it. If enough people come out to overwhelm their election hurdles, this big bet of theirs can implode in spectacular fashion. This is not assured, and it may not even be the likely outcome. But a united Democratic Party around the question of democracy can be a potent force, just ask Stacey Abrams.
Everything is now in the open. The quiet part is no longer quiet. Republican professed concerns about “voter fraud” have always been meant to mask a lust for voter suppression. This is the banner under which the majority of the Republican Party is marching in lockstep. It’s led to dangerous farces like the vote “audit” in Arizona. And it’s led to Senators tying themselves in rhetorical knots trying to explain their positions. But it’s also led to a laser focus on protecting the vote among a wide coalition of interest groups rallying in opposition to this creeping authoritarianism. It’s led to Democratic senators, across the ideological spectrum, coming out in favor of a generational mandate for voting rights. It’s led to the press covering election laws with increased seriousness. It’s even led to a lawsuit from the Justice Department stating that Georgia’s new election law, enacted by Republican lawmakers, denies equal access to the ballot —particularly for Black voters.
It may be trite to say that any one issue is a battle for the soul and future of the nation. But in this case that may be an understatement. The dangers are real, but they are also provoking a backlash that might not only save the nation but strengthen it as a vibrant democracy. A nation that encourages voting — it’s a hopeful vision and one that terrifies the likes of Mitch McConnell.
—Dan and Steady Team
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