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FROM THE BLOG

ADHD in the Elderly

Posted on August 05, 2017

ElderlyCouple

When I was interviewing Betty for  my article,The Many Faces of ADHD – ADHD at 85: Betty’s Profile”, I did some research on ADHD and the elderly and was shocked when I found virtually nothing on the topic; just a few short informal articles.

As our population ages, so will those currently being treated for ADHD- our children, teens, and adults. What will happen once they reach their later years? And what about the folks right now, who are in their 70s, 80s and 90s, who continue to live with undiagnosed and untreated ADHD?

Surely, there must be many hundreds of thousands of seniors who have ADHD Like Betty, one would think they lived and continue to live with symptoms that cause tremendous problems that impact their daily lives. Now, with more living and working longer than ever before, these folks must be suffering in silence, ashamed of their struggles and living, like Betty, thinking they are less than capable. We know that there is a high incidence of depression in this population; could many also be challenged with an underlying ADHD as well? Hopefully, scientists, researchers and clinicians will begin to look more closely at this population and begin to identify and treat them.

There are special considerations one must take into account when evaluating and treating older adults. As one ages, cognitive functioning often declines. Clinicians will need better assessment tools to understand which symptoms would be attributed to ADHD vs other conditions seen in the geriatric population. For example, is the patient showing signs of memory loss and/or impairment of executive functioning? What is causing these problems? How long has it been a problem? How does one differentiate between ADHD and other cognitive problems often seen in aging?

In addition, as people age, they often have one or more medical problems that need to be treated with medications. Could those meds be causing side effects that mimic ADHD? And would those conditions and treatments make an underlying ADHD worse? Untreated thyroid disease, for example, can look very much like ADHD.

If an elderly person is lucky enough to be appropriately diagnosed with ADHD, how successful will treatment be? Typically, patients with a cardiac condition are not candidates for stimulant treatment and we know from research that stimulant medications appear to be the most helpful for treating ADHD. If stimulants are not appropriate, how do we treat them, medically? Sadly, the few older individuals with ADHD whom I’ve spoken with are not at all interested in taking ADHD medication. Perhaps they are set in their ways. Or maybe they worry about adding more medication to their regime.

Further, many continue to feel the stigma of “seeing a therapist” and refuse to consider counseling.

What You Can Do

If you’re an adult with ADHD or have a child with ADHD, remember that this is a condition that is highly genetic. Look at the elders in your family and see if there is ADHD in your family tree. If they might be open to talking about the possibility of having ADHD, start off with some casual discussions on how it’s impacted your or your child’s life and see if he/she “bites.” Explain how treatment has changed lives dramatically. Go slow, though.

Consider bringing your older relative to a CHADD meeting or an ADHD conference. If they like to read, purchase a book on ADHD. Driven to Distraction, by Drs. Edward Hallowell and John Ratey is a great choice. It is also available on tape.

If you’re a senior and are wondering whether your symptoms might be attributed to possible ADHD, seek out a specialist who works with adults and consider having an evaluation. Contact your primary care physician to first have a complete medical workup to rule out any medical conditions that can mimic ADHD. If you’re cleared of any, ask for a referral to psychiatrist, neurologist or other health or mental health professional that has a lot of experience evaluating adults with ADHD. If your doctor draws a blank, call your closest teaching hospital and ask for the department of psychiatry or psychology and ask for names.

You can also contact CHADD and ask the chapter coordinator in your area for names. You can also call them at  800-233-4050 to find the chapter closest to you.

In addition, you can find online directories of ADHD specialists:

http://www.addconsults.com/

http://www.add.org/

http://www.chadd.org/

Make sure you ask many questions, including how many adults with ADHD they evaluate and if they have experience working with the older population.

It’s never too late improve your life!

Originally published On: Apr 10th 2008


The Many Faces of ADHD: Betty, a Grandmother

Posted on August 05, 2017

ElderlyWoman

She was a dancer, a dancing instructor, an art teacher and active her whole life in various community charities. Her warm smile, good sense of humor, sensitivity and a deep interest in others, made her popular amongst her peer group, from her elementary school days to the present time.

But what Betty won’t share with her friends, is the fact that she has ADHD. Betty still grapples with the devastating effects living with undiagnosed ADHD has had on her life. All 85 years. When I heard about Betty, I wanted to hear her story. There is little written about ADHD and how it affects people later in life. In fact, I was unable to find any research at all on the topic, so I wanted to learn more.

I interviewed this fascinating woman from Chicago, who shared with me some of her deepest emotions and memories of growing up with ADHD and how she still manages living with it.

Betty’s childhood was difficult. The youngest of six, her parents, immigrants from Austria, struggled to make ends meet. Sleeping two and sometimes three to a bed, Betty was lucky if there was a slice of bread in the kitchen to get her though a meal, let alone an entire day. A child of the Depression, life was hard for most in her neighborhood. Just getting through the day was a feat. But Betty had more challenges. She struggled in school. In fact, her earliest memory takes place in her Kindergarten room; a memory so etched in her mind, that she recalled it with ease. She remembered being stunned and excited at seeing an entire room full of toys and feeling nearly overwhelmed by it; for as a youngster, she had virtually no toys at home.

“I saw some delicious toys in the corner of the room, grabbed a handful and put them in the middle of the floor, then went back for more. It was like being in a candy store With my arms filled with more toys, I looked for my original pile, but couldn’t find where I’d put them just moments before.” This was Betty’s first experience of feeling different from the other children. “How could I misplace a pile of toys in the Kindergarten room? I was so lost…”

When Betty started first grade, her classmates began to learn to read. While the others were picking up sight words and sounding them out, Betty stared at the letters, not understanding how to string them together to form words. Her older siblings patiently worked with her until she had that “aha!” moment, when it came together for her. But by then, her feeling of being different from the other children began to gel and define what kind of student she would become.

Once she learned to read, she still struggled in school because, as Betty continued to explain, she lived in a deep, magical imaginary world that occupied and stimulated her creative brain. Says Betty: “my greatest pleasure was looking out the school window and picturing myself like the Lone Ranger, high on that beautiful white horse. In my mind, the children would be in awe, seeing me ride up to the school as they peered out of the second floor window.” Betty spent countless hours daydreaming, while the other students were attending to the teacher’s lessons. Of course, she got further and further behind in school because she simply could not pay attention. Her inner life was much more interesting.

As she progressed through elementary school, her grades continued to be average at best. No one understood in those days how to help a struggling student. They were seen as lazy or simply not very bright. And sadly, Betty internalized those perceptions and grew to believe them- that there was something wrong with her; that she was slow to learn.

At the age of 11, her older sister saw that Betty had a gift for dance, and found enough money to enroll her in a dance class. Their mother would save pennies in a jar so that she could continue her lessons, for, in a very short time, Betty excelled in dance and became a favorite in her teacher’s eyes.

By the time she was in high school, Betty began teaching at one of the most prestigious dance schools in the city of Chicago. Still, her grades plummeted in high school, for now, her fantasy of riding a grand white horse evolved into dreams of becoming a professional dancer. While others were learning algebra and literature, Betty daydreamed about dancing on stage while memorizing the dance routine steps in her head. The dance teachers were amazed that Betty could fly through her new routines so quickly, so easily. While the others had to practice and practice, Betty had already nailed the dances by picturing each move in her head.

By the skin of her teeth, Betty graduated high school. Though she left her classmates and teachers behind, what she took with her was the belief that she was not smart and not capable. Of course, in those days, ADHD wasn’t understood. But it found an early victim and it took hold of her for the next 75 years.

Betty continued to live with a secret that would affect her entire life. Her friends and family never knew that this vivacious, creative and bright woman was struggling with the deepest of self-doubt and lack of confidence.

After high school, Betty continued to follow her dreams and became a professional dancer. While at the local dance studio, she was the star student and later the esteemed teacher. But she wanted more; she wanted to break into show business. Just as she was about to leave for California to make that dream a reality, she met the man who would become her husband and thus, she chose instead to stay in Chicago, marry and eventually have two children.

In the 1950s and 60s, few women worked, but Betty needed a creative outlet for her artistic passions and continued to dance at charity fundraisers and later, returned to teach, eventually opening her own dance studio. As she got older, other interests drew her away from dancing and she became fascinated with the visual arts. Self taught for the most part, with a short stint at The Art Institute of Chicago, Betty began giving drawing lessons out of her home and became well known in the community, with many students signing up for her popular classes.

Yet even with all of these successes, Betty continued to doubt herself. She struggled with staying organized. Papers would get lost or misplaced. She’d be late for appointments and social events, which caused her terrible embarrassment. Worse, she would struggle to remember people’s names, even those she’d known for years. ADHD had full control over Betty, but she had no clue what it was. In her mind, it was a shameful deficiency; a flaw she needed to hide.

Years later, an amazing thing happened. At the age of 75, a friend’s daughter, whose own two children have ADHD, began talking about their struggles. Betty’s spine chilled as she listened to what sounded like her own life story unfold. Then it slowly dawned on her- could she, too have this thing called ADHD? Could her life long problem of “tuning out”, not getting projects done, constantly being late, her poor sense of direction be attributed to ADHD?

She discussed the possibility with a mental health professional who did diagnose her with ADHD. Betty was relieved. But not before disbelieving the possibility. For 75 years, she believed she was simply not bright. How would she switch that perception into believing that what she’d been struggling with her whole life was actually a neurobiological condition she had at birth and most likely, inherited from her parents?

I asked Betty what happened to her when she learned of her ADHD. She said, “I was embarrassed. But I was also relieved.” Few close to her know her secret, as she still cannot shake the stigma of having ADHD, thinking no one would believe, anyway, that this striking, capable and talented woman could possibly have struggled so hard all her life. She spent a lifetime hiding it and it was nearly impossible to accept it fully; she was still haunted with the comments people made when she was growing up: “Betty can’t do it; she’s too spacey”., etc.

Betty chose not to pursue medical treatment for her ADHD. Feeling that she has been able to compensate well enough all these years, taking meds didn’t feel “right” for her. But armed with the knowledge of what ADHD is and how it affected and continues to affect her, she has let go of a lot of that negative self image and continues to work on shifting her self-concept to a more positive one.

An important lesson can be learned from reading about Betty’s story. First, knowing the devastation and damage that undiagnosed, untreated ADHD can have on an individual, regardless of their age, might help motivate them to look into an evaluation. Study after study shows that getting the appropriate treatment early in life will improve the quality of one’s life. A lifetime of self-doubt, low self-esteem and worse, can easily be avoided if appropriate treatment is given. Had Betty received this (though at the time, it obviously wasn’t even available), her life might have been much different.

We’re fortunate that ADHD is better understood now than ever before. Perhaps Betty’s story will implore others to seek an evaluation and get treatment, avoiding a lifetime of shame, secrecy and self doubt.

* I have changed the name of the person interviewed to protect her privacy. Image credit: Chicago Tribune

 


ADDdinners: Shortcuts in the Kitchen for Women with ADHD

Posted on July 21, 2017

familydinner

 

This is an article I wrote back when my kids were teens but it has some great tips for moms still cooking for children at home (and for themselves as well!). 

When you wake up in the morning, what is the first thing that pops into your head?

1. “Am I late for work”?

2. “Are the kids going to make it to the bus on time”?

3. “Where am I”?

If you answered 1, 2 or 3, then you are not a kitchen phobic.

I am one of many ADD women whose nightmares begin upon awakening, rather than during the wee hours of the night. For the first thought that comes into MY mind when my eyes open at 6:45 am is….

WHAT SHOULD I MAKE FOR DINNER TONIGHT?

The thought alone is enough to make me want to reach for a Xanax. But no, I decide to fight the urge and face the fear.

The first 20 years of my marriage produced meals that were at least consistent- daily potluck surprise, I called them. Throw something in a pot, and be surprised if it came out tasty enough to pass the lips of a living soul. Dogs and cats were excluded, of course.

I don’t know why people bothered to give me those beautiful Corningware casserole dishes for my wedding shower way back then, when an ashtray would have been more appropriate.

In my 21st year of marriage, I decided it was time to conquer my kitchen phobia head on.  Collecting cookbooks became my newest addiction, and they soon piled up on my kitchen counter. They made my kitchen look homey. They also remained unopened, unstained.  And they didn’t solve the age old question that haunted me for so many years:

“WHAT SHOULD I MAKE FOR DINNER TONIGHT?”

Let’s face it. For an ADD woman, procrastination and distractibility are often issues that are faced on a daily basis. We hate to be bored and dislike chores that are repetitive. If meatloaf is the only dish that comes out of the oven looking like it’s supposed to, no cook is going to want to repeat that meal day after day. Throw in a couple of ADD kids who are fussy eaters, and you’ve really got a problem on your hands.

So in my 21st year of marriage, I came up with some solutions. My favorite was to stop cooking. That may or may not work for you, depending on whether your budget will allow you to eat or carry out every night. That resulted in daughter number one  learning how to fend for herself…until even she got sick of frozen pot pies and Scooby Do Dinners.

Since neither of those were long term options in my case, I came up with some solutions to help beat my kitchen phobia.

Plan ahead

Ugh, the ugly “P” word. It goes against every grain of my ADD body. But believe it or not, it really does work once you get into the swing of it.

I’ve since developed my “POS” (Plan Or Starve) Cards , as I fondly call them. For every day of the week, I have an index card with a full menu on it. By menu, that means there is one home made course- the main dish- and ready made side dishes. If you are like me, then preparing just one part of a meal is enough to feel like an accomplished cook.

My cards, then, look like this:

MONDAY: Meatloaf, frozen peas, mashed potatoes from a box, bagged salad

TUESDAY: Roast Chicken, canned string beans, bagged salad….and so on.

In addition to the M-F cards, (no cooking for me on Saturday or Sunday-those days are sacred) I also add a couple of Jokers (wild cards). These consist of two choices: take out, or a *really* quick and easy recipe, like cooked pasta with bottled spaghetti sauce. Or tuna on toast, topped with cheese. You get the picture.

Now, I am not beyond cheating. Not by any means. So, if I find that on a particular Monday, I will be arriving home late from a meeting, I ditch the Monday card for my wild card, which in that case, usually means stopping at a fast food restaurant to pick up burgers.

This “POS” card method solves one of the biggest kitchen phobia symptoms that I happen to suffer from- making decisions. Once that particular anxiety is out of my mind, all I have to do is to remember to have the ingredients on hand. Another “P” issue.

Self Acceptance

Why is it that some people are able to grocery shop one day a week and have an entire 7 day’s worth of menus all set to go? That is truly beyond me. So, I’ve learned to compensate and accept the fact that I will always be the type of person who will have to run to the store at least 4 days out of the week, in order to pick up ingredients for that day’s dinner.

Recruit!

I was blessed with a daughter who is comfortable in the kitchen. I was doubly blessed with a husband who cannot differentiate between the textures of shoe leather and pot roast.  So, when I’m in no mood to cook, I let my teenager fix her own dinner and let my husband fend for himself. Eating tuna out of a can never killed anyone, and besides, he likes to reminisce about his bachelor days at times. If I’m really lucky, there’s enough leftovers from my daughter’s culinary experiment to feed her younger sister.

The lesson here? Let go of your internalized expectations of needing to have a hot cooked meal on the table every night. Not only will you teach your children to become more resourceful, your husband will then pay you a million compliments the next time you follow a recipe from the back of a Campbell’s soup can.

Easy Cooking

You may have noticed that I only gave two examples of meals on my POS cards. That’s because I’ve kept the best secret for last. It’s a strategy that isn’t quite cooking and isn’t quite carry out, but it is one of my favorite tricks, aside from eating out. You can add these ideas to your wild cards for those days where you don’t want to or don’t have time to cook.

Easy cooking entails finding ready made foods at the market that look as if you’ve spent a couple of hours over a hot microwave…er….stove. I promise you that if you take the time one day to really study what is offered in your local supermarket, you will be shocked and pleased to see all the possibilities.

One of my favorites is the frozen bag that contains “everything” you need for a full meal: chicken, vegetables, and if you’re really lucky, a starch like rice or noodles. VOILE!. Buy two bags and dinner’s on the table. You can even get away without adding a salad.

Some other ideas-

* Check out the deli section for cooked chickens, ribs, etc. Grab a ready made container of potato salad or coleslaw, and you’re set.

* Scour the ethnic foods section- a great meal can be made from pita bread, hummus spread and canned soup.

* Buy large quantities of a frozen side dish you like, and make that the main dish. Instead of one box of mac and cheese, buy four. Add a salad or cut veggies and you’re set.

Break The Rules

Since when does making dinner mean having a meat, starch and veggie…every day?

Here are some ideas that will make your kids’ friends drool with envy:

* Serve breakfast for dinner. Scramble some eggs, toss a couple slices of American cheese on top- or sliced hot dogs- and dinner is ready in minutes.

* Have an appetizer dinner: buy cocktail hotdogs in a crust (in the freezer department), tator tots and if you’re really feeling adventurous, slice some fruit and thread them onto skewers.

* Make mish mosh: Pull out everything in your fridge that is one day away from turning green, and throw together into a surprise meal. There’s no reason why you can’t have a plate of cold cuts with left over soup and re-heated veggies from the night before. Be bold!

Nobody said that dinners have to be fancy. In my house, the sole purpose of a cooked meal is to fill hungry stomachs. Anything more is icing on the cake.

Remember, no one is going to suffer from your cooking shortcut methods. I truly believe that once we, as ADD women, give up the pressure of having to “perform” in the kitchen, we’ll end up actually enjoying our time there.

Now…pass the menu, please!

How about you? What kitchen/cooking tips work for you? Please share in the Comment section below.