For the Caregiver: Brain Nourishment

Older patients need to try to maintain their mental sharpness during cancer treatment, even though fatigue, depression, and frustration may sap their energy. This means caregivers need to help patients keep their minds and bodies active.

Research suggests that exercising regularly and maintaining social connections may be just as important to the brain as to the body. Whenever possible, caregivers should make time to go for walks with their loved ones, or encourage the weekly bridge club or other social activities. Maintaining activities that stimulate mental engagement and intellectual functioning are important for emotional and cognitive health.

If you notice the patient’s memory slipping after chemotherapy begins, be sure to seek the advice of a doctor who can rule out other causes and help assess whether the symptoms are because of cancer treatment or just part of the normal course of aging. To that end, try to have a good sense of where a patient’s capabilities are before treatment. Also be aware that older patients, especially those with advanced cancer, may also be more susceptible to delirium, including hallucinations, which may be terrifying but should not be ignored. Delirium often has a concrete cause, such as infection or medication reaction, and therefore might be more immediately relieved.

“Be upfront if you do have issues,” says Andrea Bial, MD, a Chicago geriatrician who has studied cognition in cancer patients. Often, she says, denial—or a fear of bothering doctors—keeps patients and families from complete honesty with themselves or others. Yet a physician may be able to offer help, such as cognitive rehabilitation, a switch in medication, or drugs that might protect memory. Physicians and other mental health specialists can also perform tests that might provide an assessment of a patient’s mental functioning.

Caregivers can also help patients get more organized so that a lapse in memory doesn’t cause unnecessary stress, says Tim Ahles, PhD, of Memorial Sloan-Kettering Cancer Center. Caregivers can schedule tasks and establish routines. For example, he says, “the car keys live in only one place, and that’s it.”

Figure out the biggest problems in a patient’s daily life, and help come up with a practical solution. Try to help a patient get good rest, as sleep is also an important component of memory and concentration.

“We try to help train people,” Ahles says. “You need to be able to just keep yourself on track.”