I haven’t talked much in this blog about cognitive problems related to Parkinson’s. Partly this is because until a couple of years ago the motor symptoms were dominant and demanded more of my attention. Cognitive symptoms tend to develop more slowly, and it’s easy to be in denial about them.
Cognitive problems are also difficult to talk about. I should also add that my cognitive problems are nothing compared to people with Alzheimers or Huntingtons Disease, and to some extent this also makes it easier to be in denial.
Nevertheless, here is a description of my current cognitive problems:
The first cognitive symptom to appear was a growing inability to do more than one thing at a time. This limits my ability to do things like write a blog post while there is music playing, or to have a conversation while looking for my keys. My neurologists explain that Parkinson’s patients are, in effect, multi-tasking all the time, as we gradually lose the ability to carry out physical or mental tasks on “automatic”. Consequently, we have fewer resources available for multi-tasking in daily life.
The next symptom to appear was difficulty finding the right words for a thought I’m trying to explain. Unlike with a disorder like Alzheimers there is no real memory loss and the words are still there, but it can take what seems like a long time to retrieve them.
Most recently, and probably the hardest in terms of my social relations, is a growing difficulty with staying focused. For example, when I’m sitting in a restaurant I can find that my attention has been drawn away from the person I’m with and towards other things I can see. This can be annoying to the person I’m with, especially if they are trying to communicate something important and I drift off. I am generally unaware that I’m doing this until after the fact.
My neurologists concur that these are all typical symptoms of Parkinson's. They have all gradually gotten worse over time.
People who meet me for the first time often try to tease out how much of this cognitive change is Parkinson’s and how much is my basic personality. I think that when people wonder in this way, what they are really asking is whether I can give them a way to explain my lapses in concentration or my difficulty focusing, or my inability to multi-task as symptoms of a disease, and thus give them a way to forgive me for them. The alternative seems to be some kind of judgment that I am being deliberately insensitive or unkind.
The approach I would prefer, of course, would be to ask “what can I do that would help?” For instance, when my attention wanders, it would be more helpful to say “hey, stay with me” rather than “why are you ignoring me?” I’m not saying that anyone is obligated to treat me with kindness in this way, and I realize that these symptoms are not easy to be around. But I do think it would be more accurate to assume that I'm doing the best that I can and that I'm not choosing to have this difficulty.
I’m about to start doing some therapy which is aimed specifically at these cognitive issues. Over the next few months I hope to be able to report some improvement. But if I cannot, then the question is, will people still be able to - or want to - deal with me, or not.