How Elderly People Deal With Forgetfulness in Everyday Life

This post is notes about a paper that I reference and find important in memory / forgetfulness information. These are just notes and quotes from the paper and links for where to find it.

Becoming Forgetful: How Elderly People Deal With Forgetfulness in Everyday Life

Abstract: Studies show that complaints about being forgetful are weakly correlated with standardized measures of memory impairment. Little attention has been paid to those complaints in a healthy elderly population. Therefore, this qualitative, grounded-theory study investigated the experiences and consequences of becoming forgetful. In-depth interviews with 32 participants were conducted and analyzed. The findings show that forgetful- ness became part of daily life through 3 strategies, conceptualized as doing forgetfulness: (1) reducing complexity; (2) creating and maintaining routines; and (3) dealing with feelings of embarrassment and shame. The well-being of people experiencing forgetfulness depended on how successfully they performed the strategies of doing forgetfulness. Gaining insight into this process allows health care professionals to assess the phenomenon early and to individualize counseling and further diagnostic procedures.

Because complaints about forgetfulness do not correlate well with objective memory test scores, a patient’s self-reported memory complaints have been treated as unreliable information for diagnostic purposes.
(8-11) Guarch J, Marcos T, Salamero M, Blesa R. Neuropsycho- logical markers of dementia in patients with memory complaints. Int J Geriatr Psychiatry. 2004;19:352-358. Jungwirth S, Fischer P, Weissgram S, Kirchmeyr W, Bauer P, Tragl KH. Subjective memory complaints and objective memory impairment in the Vienna-Transdanube aging community. J Am Geriatr Soc. 2004;52:263-268. Riedel-Heller SG, Schork A, Matschinger H, Angermeyer MC. Subjektive Gedächtnisstörungen—ein Zeichen für kognitive Beeinträchtigung im Alter? Ein Ueberblick zum Stand der Forschung [Do memory complaints indicate cognitive impairment? A review]. Zeitschrift fur Gerontologie und Geriatrie. 2000;33:9-16.

… regardless of memory decline’s predictive usefulness, forgetfulness is worrisome for elderly people as a sign of possible cognitive deterioration and impairs their quality of life. [15. Commissaris CJ, Ponds RW, Jolles J. Subjective forgetfulness in a normal Dutch population: possibilities for health education and other interventions. Patient Educ Couns. 1998;34:25-32.]

Forgetting led to failures in social interactions and influenced their proper performance of everyday tasks. As such, they reported that forgetfulness changed their lives, producing worries and feelings of shame and embarrassment, and creating the need to establish new practices in everyday life. At the same time, forgetfulness decreased their ability to establish new practices.

Reducing Complexity
High-paced, multiple tasks and the demand for new skills, such as coping with a touch screen on a vending machine, increased forgetting. Participants attributed these situations to either technological progress, which increased the pace of the world, or their reduced bodily capacities due to the aging process. To avoid failures, they created new an less-demanding structures and practices. Temporal ordering reduced complexity through planning, sequencing tasks, and decisions for behavioral changes. Spatial ordering reduced complexity by collapsing objects into simpler categories and less demanding structures.

Temporal ordering. All participants explained that they slowed down the pace and rhythms of activities, which reduced their forgetfulness. Participants gave themselves more time to perform certain activities. As Mrs. O. explained, “In stressful situations I forget things that are clear. If I allow myself to take it easy and to give myself more time to do it, everything is okay.”
Participants changed the sequence of activities to avoid multitask situations, because “being distracted” or “paying little attention” to specific tasks
increased failures.
Activities of daily life are usually performed as rou- tines. Forgetfulness interrupted this flow in routine and produced an arduous life. Participants reported that it was physically and emotionally challenging to manage failures

Writing notes became the most commonly used routine. Notes were used for all tasks at high risk of being forgotten. This risk increased if tasks stretched over a long period of time, included several places to go, and were part of a series of combined tasks. The notes reflected 3 levels of complexity in what they tried to capture. First-level notes were simple and provided a hint for future activities, whereas second- level notes included a detailed to-do list. Third-level notes were more comprehensive, taking on the characteristics of a diary with descriptions of past and future events. Participants had to stick with these notes to organize a smooth functioning of their daily life. Further classifications of taking notes are based on (1) the time frame, ranging from plans for this afternoon to those a year from now; (2) different types of activities that become part of the lists, including everyday routines and extraordinary and rarely performed activities; (3) how often notes are used; and (4) how fast after the event notes have to be written down.

Forgetfulness changed the person’s self-perception. Dealing with feelings of fear, embarrassment, and low self-esteem was part of doing forgetfulness.
These findings are consistent with Pearman and Storandt,29 who suggest that interventions need to be individualized to address feelings of anxiety and low self-esteem.
A major goal of health care providers is patients’ successful performance of everyday tasks.30 As such, supporting successful processes of doing forgetfulness may be valuable. However, because these processes require developing and maintaining new skills or rou- tines, assistance given in forgetful people’s homes may be most effective.
29. Pearman A, Storandt M. Predictors of subjective memory in older adults. J Gerontol B Psychol Sci Soc Sci. 2004;59:P4-P6.
30. Klie T. Demenz-—Ethische Aspekte [Dementia—ethical aspects]. In: Tackenberg P, Abt-Zegelin A, eds. Demenz und Pflege: Eine interdisziplinäre Betrachtung [Dementia and nursing: an interdisciplinary approach]. Frankfurt a.M: Mabuse; 2003:54-61.


Links for paper:

The online version of this article can be found at:

Lorenz Imhof, Margaret I. Wallhagen, Romy Mahrer-Imhof and Andreas U. Monsch AM J ALZHEIMERS DIS OTHER DEMEN 2006 21: 347
DOI: 10.1177/1533317506292499

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