Dementia expert thinking: Before I embarrass myself, I want to stop working


My wife said that I love my work too much to retire. Maybe she is right. However, as a neurologist and clinical director of the Alzheimer’s Center, my experience reminded me of the wise move to continue.

In fact, I have reached 60s – thus joining the fastest growing segment of our population – and I’ve been thinking about what changes in my cognitive skills will lead me to not want to continue working.

More specifically, I have started to develop a “willingness in working life,” similar to the high medical directives, but it clearly points to professional life.

Some of the patients we recently met in the center convinced me of the value and potential urgency of this action.

When I was starting out as a young physician, I noticed there were always a few older, formerly very accomplished doctors who would consistently stand up during important meetings and make irrelevant comments that caused me and others to cringe.

If I helped to take care of their patients, I was often struck by the mediocre treatment they were providing.

At the time, my youthful colleagues and I remained oblivious to the possibility that their fate could ever become ours.

Since then, I have had the opportunity to help care for many previously high-functioning professionals with progressive dementing illnesses.

Depending on the stage of the disease and the degree of disruption of brain systems important for self-awareness, patients have widely varied insight into their predicament and appreciation of the impact of their neurological disease on their work.

A desire to keep working

This lack of self-awareness was disturbingly evident in the case of a professor in her mid-60s who continued to give lectures, supervise students and even consult, despite being diagnosed with Alzheimer’s disease of mild to moderate severity.

When strong cognitive-testing evidence of her deteriorating mental status and examples of her difficulty carrying out professional responsibilities were brought to her attention, she insisted that her problems were only minor.

Sadly, these “minor problems” included delivering the same prepared lecture to her class twice in one week and the recurring loss of bowel control, even during interactions with students.

For many of us, including this professor, work is not simply a job, but a calling. We may experience giving up work as losing our selves or at least a big chunk of who we are.

Members of my own profession are well known for their commitment to their work. Thus, it is not surprising that almost 30 percent of active U.S. physicians are over the age of 60.

Working into old age has many potential benefits. The intellectual and social stimulation derived from continuing to work as we grow old is very likely to promote brain health and counteract cognitive decline.

The accumulated knowledge and experience of seasoned workers benefit companies and organizations, and may help to offset expected personnel shortages in the future. Many of my older colleagues continue to be amazing sources of clinical wisdom and expertise.

Nonetheless, by the time we reach our 60s, most of us have developed some …read more

Source:: Week Facts – Health


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