Welcome to the SeriesWelcome to the Me with Dementia Talking About… weekly series.
Each Wednesday, I share an excerpt from my book—Me With Dementia Talking About—where I share reflections from the perspective of someone living with dementia. These gentle reflections are designed to help caregivers, family members, friends, and healthcare professionals better understand what dementia may feel like from the inside.
Whether you’re joining us for the first time or have been following along from the beginning, I’m glad you’re here.
Executive Functioning
“You know how a good orchestra needs a conductor? Someone to keep all the instruments in time — to start, stop, and bring everyone back when things go off-key? Well, my frontal lobe used to be that conductor. It helped me plan, organize, decide, start something, finish something, and switch to the next thing.
Now… the conductor’s getting tired. Sometimes he forgets where we are in the song.
Here’s what’s supposed to happen:
The frontal lobe neurons are in charge of executive function — that’s just a fancy way of saying “the boss of the brain.”
These neurons help me set goals, prioritize tasks, and control impulses.
They work closely with dopamine neurons — those are the brain’s little motivators — giving me the drive to get up, get dressed, and move through my day.
Messages travel from the frontal lobes down to the basal ganglia and motor cortex, telling my body how to follow through on a plan.
But here’s the trouble with my dementia:
The neurons in those areas don’t talk as smoothly anymore. The signals that say “Okay, it’s time to start breakfast” might stall halfway there.
Sometimes I lose the thread halfway through a task. I might open the closet, forget why I’m there, and just stand holding a hanger.
Other times, I get stuck. That’s called perseveration — when my brain keeps looping on one thought or action, like a record with a scratch.
Decision-making becomes harder because my brain can’t weigh options the way it used to. A simple question like “tea or coffee?” might feel like a pop quiz I didn’t study for.
And my inhibitory control — the part that tells me “maybe don’t say that out loud” — sometimes fails me completely. Words come out before I even know they’re on the way.
So when I seem scattered, unmotivated, or inappropriate, it’s not that I don’t care or that I’m lazy. It’s that my brain’s conductor is waving his baton, but the musicians can’t quite hear the beat.”
What Caregivers Can Do to Help
- Simplify the choices. Instead of “What do you want for breakfast?” try “Would you like cereal or toast?” Two options feel possible — five feel like chaos.
- Break tasks into steps. “Let’s put on your shirt first.” “Now let’s sit at the table.” Each step gives my neurons a single path to follow.
- Use gentle prompts instead of questions. Instead of “Are you ready to get dressed?” say, “Let’s get dressed now.” My brain responds better to direction than to decision.
- Give me time. Starting is the hardest part. A little silence and patience can do wonders.
- Keep routines steady. Familiar patterns help my brain anticipate what comes next — less planning, more comfort.
- Avoid scolding or rushing. Pressure makes the neurons panic. Calm helps them connect.
And when I finally do manage to complete a simple task — even if it takes all morning — celebrate it with me. My neurons may be struggling, but your encouragement is like music that helps me find the rhythm again.”
Continue the Journey
Thank you for reading this week’s chapter from Me with Dementia Talking About…
This series follows the book in order, one chapter each week, making it easy to read from beginning to end.
