Eldercare & High-Support Caregivers - Bodily Needs Impact On Cognition

Hello, A new essay is up on the blog, and this one started somewhere more personal than usual. I've spent time with older relatives recently, and I kept noticing something I've spent twenty+ years noticing in a completely different setting. When a person's capacity drops — an afternoon that goes badly, a sudden inability to do what they could do that morning — the first explanation reached for is almost always a mental one. Confusion. Agitation. Behavior. And almost never: what has this body been asking for, and for how long? I've watched the same reflex in classrooms. A nine-year-old under a desk gets an incident report. An eighty-one-year-old at a locked door gets a chart note. Different vocabularies, seventy years apart, same reflex — and in both cases the body's contribution goes unmeasured because no discipline is responsible for it. Medicine gave the body to the organ specialties and the mind to psychiatry. The person is the seam. The essay is about what falls through that seam, and about a set of things sitting in the wrong file. Scheduled toileting. Pain checks for people who can no longer report pain. Glasses actually on the person. One instruction at a time instead of three. These are filed as comfort — worthy, low-status, unrelated to the real clinical problem. I think they belong under cognitive support, because each one removes a demand the brain would otherwise have to service out of the same finite control it uses for orientation, language, and memory. To be clear about what I'm not saying: none of this reverses dementia or rewires a developmental trajectory. The claim is narrower. A person can get more of their own brain back — not because anything was repaired, but because something competing was removed. You can read it on evostress.blog If you work in elder care or with people whose support needs are high, I'd especially like to hear from you. This one is heading somewhere, and I want it shaped by people who are in the room. — Lori