Transcript
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First time I went to a psychologist it was because I couldn't get out of the bed.
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In law school I literally did not care about bathing or eating or paying my bills, answering the phone, taking out the trash.
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My maternal grandmother was deceased and I didn't understand why the world was still turning, why the television was still going on with programming while the mail was still being delivered.
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And I didn't care, because the biggest thing to me was OMG, other people that I love can and will die, so what is the point in continuing?
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I wasn't suicidal, but I also had zero desire of making further connections with life form.
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Yep, it was that deep.
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And I was an adult.
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I wasn't eight or 12.
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I had two degrees, I'd worked in corporate America, lived in three other nations on two continents and I was in law school and all the way falling apart.
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It's my first time working with a psychologist.
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My first time working with a neuropsychologist was when my mother was standing in the kitchen making a sandwich and urine was running down her leg and she didn't know it.
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She kept making the sandwich, did not know that there was pee puddling in her sneaker.
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What the hell?
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That's when I found out that neuropsychologists are the ones who really figure out what in the world is going on with the brain and can tell other doctors hey, go in this direction.
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They are the doctors that tell the surgeons and the neurologists which direction to investigate if a person's brain isn't working well.
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How cool is that?
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I mean, it's cool to know about it.
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You just don't want to need one of them.
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Yeah, think about if you're the expert where that has been your life's work and then, 15 and 20 years into being that expert, you're the expert where knowing how people's brain work is what you do and people are coming to you from all over the country.
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And then it's your mom, but she won't listen Because to her you're just that five-year-old little boy playing with trucks.
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Yeah, come on.
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Come on, come on in and listen and watch.
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Listen on Apple and watch on YouTube.
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Come on, patreon, let's do it.
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Woo Woo.
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Parenting up Caregiving Adventures with Comedienne Day Smiles is the intense journey of unexpectedly being fully responsible for my mama.
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For over a decade, I've been chipping away at the unknown, advocating for her and pushing Alzheimer's awareness on anyone and anything with a heartbeat.
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Spoiler alert.
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I started comedy because this shit is so heavy, so be ready for the jokes Caregiver newbies, ogs and village members just willing to prop up a caregiver.
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You are in the right place.
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Hi, this is Zeddy.
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I hope you enjoy my daughter's podcast.
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Is that okay?
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You can prevent dementia.
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A conversation with Dr Mitch.
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This episode's supporter shout out is Chloe's Glammy from Instagramout.
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Is Chloe's Glammy from Instagram.
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Hey, chloe's Glammy.
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And I quote I love Zeddy like.
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I know her Exclamation point.
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That warms my heart.
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I lost my mom, had to move back to Georgia in the home I meant to gift to her.
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I started watching you with Zetty in the midst of my grief.
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You brought me unexplainable joy the smiley face emoji and the praying hands emoji ty meaning thank you.
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And also little known fact is growing up betty's closest, closest, closest friends called her ty for theelma Yvette.
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So that is super extra wide.
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You were selected Chloe's Glammy as today's supporter shout-out yes, absolutely, and everyone else remember give a review on Apple Podcasts podcast.
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Youtube comment if you want.
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Ig comment if you want, and you too can be today's supporter.
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Shout out one of them days.
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You know what I mean.
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Our parenting up community is growing so fast I can't put out an episode as fast as we're growing.
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So text PODCAST to 404-737-1449 for updates, exclusives and suggestions on topics.
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While you're at it, share an episode with a caregiver you love.
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Review on Apple Podcasts and follow us on social media.
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Subscribe to our YouTube page.
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It really helps parenting of family.
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Listen, I know you probably like, yeah, yeah, yeah, jay, here you go again saying that you went and found somebody special.
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Well, it's true, Okay, that's why I don't give you a podcast every single day, cause it takes my team time to find special people.
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And we did it yet again.
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This time this is a guest who actually is a specialist in figuring out whose brain might not be working that well, and he's a caregiver.
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Yep, yep, go ahead and be excited.
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I'm going to call him Dr Mitch.
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I don't know what he's going to make the rest of y'all call him, but welcome, dr Mitch.
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How you doing, jay?
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I'm happy to be here.
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I'm doing great.
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It's so good to see you.
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Thank you, thank you so much.
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So your fancy schooling, as my grandfather would have said, is in neuropsychology.
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You have a PhD in that, correct?
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PhD in clinical psychology and then advanced training in neuropsychology.
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So it's a little different twist on it, because in clinical psychology we mostly deal with emotions and thoughts, basically how a lot of people get along with each other.
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So when I was just doing a lot of clinical psychology, I'd go to parties and I'd tell them I'm a clinical psychologist and I get two reactions Either they'd want to tell me all their problems or they'd run for the hills because they were sure I was reading their mind.
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So then I started doing a lot more work with how people thought, how they paid attention, how they remembered, how they were able to solve problems, which is how the brain works.
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It's called clinical neuropsychology.
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So then when I go to parties they'd say what do you do?
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I'd say I'm a neuropsychologist.
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They'd look at me and say, hmm, and that was fine.
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So it's a lot better being a neuropsychologist for at least that reason, if nothing else.
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Yeah, at parties.
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People say, huh, that sounds really important.
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It's a whole lot more fun doing what I do because it gives me the chance to really understand how people's brains work.
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I tell you what I know people like you help save my mom's life.
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Now, for better or for worse, that was fun.
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I hate that I needed a person like you, but it's fun that she's still alive.
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I'll tell you that, Dr Mitch.
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I'll tell you that.
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So you wrote a book and what I think is cool about the book okay, dementia prevention that sounds pretty standard and classic, but what I love is your tagline using your head to save your brain.
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Now we're going to get deeper into it later on in our conversation, Letting us know kind of what's going to be in here, Like if you do your homework and you think smart, you might be able to prevent some of this stuff, which is that this is just a nice idea to even think we might have some control, because right now, most people going around in the world believe that dementia and Alzheimer's is just a big old boogie monster and we can't do anything about it.
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So just the tagline saying, hey, use your head, save your brain.
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I'm like you know what, Sign me up for this book, because the fact that I might have a freaking chance in the world to do something is exciting.
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What I want to talk about before we even get into that, because we are a community of family caregivers is who were your caregiver for, or who have you cared for, and what was their ailment?
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So the irony is that the ailment was dementia and the person who came down with it was my mom, when she began to show signs of confusion and forgetfulness, and there were significant changes in her behavior that were entirely unlike the woman who raised me and my brother along with my dad, but she was.
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You know, moms do most of the heavy lifting in raising children in my experience, and there was a very important relationship that both of us had with my mom.
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And so here I was in midlife dealing with all these other people who were having problems with their thinking, testing them, advising them and their families, talking about how we could help them.
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And here my own mother came down with this, and so I spent my 50th birthday in a basically a psychiatric unit where my mom had been taken because she had lost really all touch with reality at that moment and thought that there were people in the trees, thought that somebody was going to come up and whisk her off and become her 12th husband Now her only husband, my dad had died about six years before that, so there's no way in the world this could possibly have been her 12th husband, but that was what was going on in her brain at that time.
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Hold on, Doc.
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You're saying your 50th birthday.
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Yep time.
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Hold on, doc.
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You're saying your 50th birthday, yep, now wait.
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Okay.
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So you know I'm a comedian and we're having people around here pissed off because during COVID they didn't get a chance to go have a seafood dinner on their 50th birthday and they just had to stay home and maybe order hamburgers from Uber Eats or something.
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But here you are experiencing your 50th birthday with your mom in a psych ward or some mental health facility and you don't even know what in the world is happening.
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At that point you didn't know what it was.
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Huh, I did.
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I did.
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You know, as with most people, you at first attribute the changes that are sort of episodic they happen and they go back to normal as being due to stress, and in fact they usually start under stress.
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So you see people who are perfectly okay, it seems, in the routine environment, but things change.
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They go on vacation, they can't figure things out as well, or there's a big change due to health and they don't adapt.
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One of the real unveiling circumstances for many of the people I see is the death of a spouse.
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Because even if they were the one who was the caregiver for that spouse, having to care for that spouse gave them the structure, gave them the routine that oftentimes allowed them to keep it together.
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So when their spouse dies, everyone says, well, he or she's different than they were, but you know they're grieving and so oftentimes I see people for the first time about six months after widowhood and at that point people are saying you know, this isn't the way it should be.
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She hasn't or he hasn't bounced back to normal.
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And that's where we see that that's been holding them together in the past.
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So you knew your mom, you knew it was a form of dementia and not some other type of psychosis or something.
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Very much so, yeah, and it was pretty clear to me.
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I could not convince her, however, to get the kind of help that I thought she needed at that point.
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Now, the saying is that a prophet there's no prophet in his own land that you have to be from some distant place and help, you know, preferentially, carry a briefcase with you in order to be viewed as an expert.
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So parents, my family, I have to remind them.
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I say you know, people actually pay me to come and get my advice.
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Why aren't you taking it for free?
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But they don't, because I was the kid that they remember for being five Right.
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So my mom wasn't about to listen to that, she just poo-pooed it.
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It wasn't until things really went off the rails that we realized we needed to do something quickly in order to make, to keep her safe and to provide her with the care that she needed her safe and to provide her with the care that she needed.
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What do you what prior to her having to be admitted?
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What did you see that let you know?
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Hey, this looks like dementia or Alzheimer's or anything that lets you know.
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This is not a normal gradual aging process.
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Mom needs significant help.
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She used to be very organized and be able to manage bunches of things at once, and now she couldn't do that anymore.
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I remember one Thanksgiving dinner where we were all set to sit down and she said well, I think it's time to start the turkey.
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We said, you know, I hadn't smelled it.
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I thought the other smells maybe were covering it.
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But we haven't started the turkey.
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Well, no, no, it won't take long.
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We said mom, you've made turkey, you know, hundreds of times because we had it several times a year.
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She always knew how to time those kinds of things and to organize them.
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She once came up to visit me from Pennsylvania.
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I live in Massachusetts and I had taken the entire day off of work.
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I was set to meet her at this particular place for breakfast and she never showed up and I tried to get a hold of her.
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This was before the days of cell phones, so getting a hold of her was a bit more of a problem.
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I think we may have had flip phones back then, but all I can tell you is she ended up deciding, on the way up from Pennsylvania, to stop at Mohegan Sun and spend the day playing slots.
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It just didn't connect with her that I'd gone to this extent to be with her that day and she thought nothing about it.
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It wasn't like it was malevolent, it was that it just didn't connect.
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Okay, the turkey would have sent chills up my spine.
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That takes the longest.
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That takes the longest to cook of the whole thing and the basic.
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First of all, no one in my family has ever let me be in charge of the whole thing and the base thing, okay.
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So, first of all, no one in my family has ever let me be in charge of the turkey.
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I am the turkey.
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They're like Jay, you are the turkey, you just come in and you laugh and create the jokes.
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They let me put ice in the cups.
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That's about all I get to do, but that had to be startling.
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And then, yeah, the Mohegan Sun.
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I've lived in Massachusetts before and you have to decide to get off at that exit because it's pretty windy.
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And then you know you got to park and you got to make it.
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This.
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It is a concerted effort to stay in there too.
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You know it's it's not easy to get up in that place.
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So you're right.
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Were there other family members who believed you too?
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Or did everybody think that you were a little bit, a little dramatic?
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No, my brother understood One of the best things, and I hope for your caregivers in your audience that they and their siblings, if they're in that position, see things eye to eye, because it's really so much easier when you both agree, or the five of you agree, and you recognize what the problem is.
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I've seen so many families where that's not the case, and usually the people who are farthest away have the least appreciation for what's going on.
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They're also oftentimes held in the highest regard by the person who's experiencing the dementia.
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So there's this horrible kind of irony where the people doing the most get the least credit and the people doing the least are thought to be just wonderful.
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You know you should talk by my, your brother in Los Angeles.
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He doesn't think there's a problem.
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You know you haven't talked with him except briefly for the last three months.
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Of course he doesn't think there's a problem.
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Tell you what I'm going to send you out there to spend a week with him.
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We'll talk then, yeah with them, we'll talk then.
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Yeah, I hear of that all too often and it causes a rift between the siblings, like if the rift already existed.
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Then it just continues to create a larger wedge between.
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Because it's like, hey, how dare you like call or come back home trying to tell me what to do when you haven't been here, but the one who's living further away is emboldened by this empowerment that the parent is giving you know.
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But hey, but mom or dad called and asked me to get involved with the finances or ordering X, y and Z supplies.
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You know, so it does.
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It can get tricky.
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It can get tricky really, really fast.
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So what caused you to write?
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Go ahead.
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One of the things that's really good about what I do professionally, though, is that when you test somebody in a standardized environment, you bring them into a neuropsychological office.
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You administer very standard tests, things like I'm going to read you these 12 grocery items, write them down, and then, when you take the paper away, you see what they can remember from the list, and maybe you have them repeat the list a couple of times and see 10 minutes later how much they can hold on to, or you tell them some standardized stories and see what they can remember standardized stories and see what they can remember.
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When you give them those kinds of objective tests, that really, in many cases, reveals the problems that they're having, and it's an opportunity for a number of the family members to look at the problem together.
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You don't always get the person who's been tested to agree that that's what's going on, because sometimes they have a lot of excuses.
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You know well, I wasn't thinking it was a bad day for me.
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The sun was in my eyes that kind of, you know, excuses the dog ate my homework, right but it does give everybody else at least a chance to say wow, I see what you're talking about now.
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When would you suggest a person request a neuropsychological exam?
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Ideally, we would have family doctors doing brief cognitive examinations every year every six months, depending on what the person's like, beginning at about age 65.
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Okay, and they would be able to get a track record.
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The other thing that would be great, and something that my wife and partner, emily, and I, are working on, is taking a five-minute dementia test that we developed and has been used by hundreds of doctors, and developing a form of it that could be used by family members to test mom or dad or their partner's cognition at home, using something that we know reflects what we see in a testing laboratory, because that's where we developed it.
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We have a database of thousands and thousands of people and we have their scores on this test called the MOST, the Memory Orientation Screening Test, and five minutes, and we actually had it in an app that was used by doctors where they could give the test.
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It would spit out a whole treatment plan based on the score, the test, redistributing it and coming up with a version of it that hopefully people will decide is worthwhile getting and giving to mom or dad so that they can go to the doctor and say look, I'm concerned.
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Could you please get the background tests, the MRI scan the blood tests, the things that we need to look at, and then maybe we send them to neuropsychologists.
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Problem with us is there's not enough of us and therefore the waiting lists tend to be too long.
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Oftentimes I hear horror stories about people waiting six to ten months to get somebody in to be tested.
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Now, in my practice, we figured that out.
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We get people in within three weeks because we became efficient years and years and years ago and figured out how to do this in a much different way.
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Everyone else is like little cobblers working on shoes in their workshop.
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We have a mass supply kind of thing where we move people through, get really great results, but we figured out how to do it much more economically.
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Get really great results.
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But we figured out how to do it much more economically Because I see about 700 to 1,000 dementia patients every year.
00:24:53.248 --> 00:24:57.199
What yes, yeah, that's unheard of.
00:24:57.560 --> 00:24:58.143
It is unheard of.
00:24:58.434 --> 00:24:59.497
It did take.
00:24:59.497 --> 00:25:11.523
I think it took about eight weeks for my mom to get her neuropsychological test and that was the first step.
00:25:11.523 --> 00:25:23.402
She was about 62 years old and that was the first step in her journey to the diagnosis of Alzheimer's, and it took forever.
00:25:23.402 --> 00:25:24.795
I thought I was going to implode and it took forever.
00:25:24.795 --> 00:25:26.056
I thought I was going to implode.
00:25:27.316 --> 00:25:36.839
It feels like forever, but in actuality, based on what I know about the country, that today is pretty much average, maybe even a little faster.
00:25:36.839 --> 00:25:52.026
So it's a problem, and because of that, oftentimes we don't get the good starting data that allows us to then decide how do we begin to treat this now, and that's really important.
00:25:52.026 --> 00:25:53.046
How do you start early?
00:25:53.046 --> 00:25:55.987
How do you get the person diagnosed?
00:25:55.987 --> 00:25:59.888
How do you rule out the things that are the great imitators?
00:25:59.888 --> 00:26:01.548
Because you have those.
00:26:01.929 --> 00:26:06.590
Somebody looks like they have dementia, but they're really depressed that's a big one.
00:26:06.590 --> 00:26:10.432
Someone looks like they have dementia, but they're really depressed that's a big one.
00:26:10.432 --> 00:26:16.595
Someone looks like they have dementia, but it's because their vitamin B12 levels are next to zero.
00:26:16.595 --> 00:26:28.095
They have dementia, but really what's going on is that they are experiencing an infection or they're having some other medical problem, or they're having some other medical problem.
00:26:28.095 --> 00:26:45.887
There's a variety of things that we go through that we then advise doctors to order to try to make sure we have the right diagnosis and then starting the patient on treatment and lifestyle changes, because there's a lot of lifestyle and general health problems that are very important.
00:26:45.887 --> 00:26:57.048
Even if you have already a diagnosis of dementia, you can do a great job of slowing it down or stopping it in its tracks if you deal with it early on.
00:26:57.048 --> 00:27:06.190
So I have a lot of patients who are the same five years later as when they walked in my doors because of treatment and because of lifestyle change.
00:27:06.190 --> 00:27:06.411
I love it.
00:27:06.612 --> 00:27:07.314
Let's get into of lifestyle change.
00:27:07.314 --> 00:27:07.634
I love it.
00:27:07.634 --> 00:27:09.520
Let's get into that right now.
00:27:09.520 --> 00:27:10.765
I love that segue.
00:27:10.765 --> 00:27:17.365
So the book Dementia Prevention Using your Head to Save your Brain.
00:27:17.365 --> 00:27:22.045
You co-authored it with your wife, who's a medical doctor.
00:27:22.045 --> 00:27:25.285
What is her area of expertise?
00:27:30.442 --> 00:27:39.842
Taking care of me is number one Believe me, that's a full-time job?
00:27:39.862 --> 00:27:42.513
If that's the case, she has an MD, a PhD, an MRSD.
00:27:42.513 --> 00:27:47.919
See, because I suffer from AWD acquired wife deafness.
00:27:47.919 --> 00:27:48.921
So it's hard for her.
00:27:48.921 --> 00:27:49.741
I feel for her.
00:27:49.741 --> 00:27:59.176
As they say in the South bless her heart, bless her heart.
