An exhausted older man sits at a table staring blankly. Around him is a man reading him a menu, a woman picking out an outfit for him, and a woman reading through his mail.

Choices, Choices, Choices: Facing Decision Fatigue with Alzheimer's

I saw a story, once, about President Obama, that he had two different colored suits, blue and grey, to choose from. He had his mother-in-law or the White House chef choose his menu for meals. He had others make as many of the small decisions in his life to allow him to maintain his capacity for decisions for the big things required of the presidency of the United States. People have a limited capacity for decision making. For the person with Alzheimer’s and their caregiver, that capacity is much less.

What is decision fatigue?

They call it decision fatigue. The more decisions we have to make, large or small, the more we are drained. It is exhausting. Depleting. We may not even realize it, but our mental energy is being sapped. That is why we are so tired at the end of the day and want to mindlessly watch TV. That is why we may cave to cravings of junk food or junk cat videos. We start looking for an easy way out of our mental or emotional morass. One path of least resistance is to do nothing, but that psychological ice cream is a rocky road, indeed. (Did you see what I did there?)

When you do nothing, nothing stays the same. It generally gets worse. Some things do resolve on their own, but Alzheimer’s disease isn’t one of them. The answer isn’t to do more either. That is an overwhelming thought. The answers (there isn’t just one) are to divide and conquer. Get help. Work smarter, not harder. Eliminate the niggling choices. Make the bigger, weightier ones when you are at your best. These are more than rah-rah cliches.

As much as I wanted to live in denial and believe that there must be some mistake, I also knew I couldn’t ignore what I was being told, what I was seeing. I needed to clear out some of the noise. Simplify. I needed to cut down some of the choices that were no longer liberating, but were instead frustrating.

Changes I made to combat decision fatigue

Ordering from a menu was a process I had to take over. I had left that decision to my dad, but he wasn’t able to make it without great difficulty. It was making everyone wait and get frustrated when we were all hungry. It took away from our restaurant experience. My mom and I tried reading various selections to see which appealed to him. That was not much of an improvement. I started asking if he wanted fish, pasta, chicken, or beef. He would pick one like he was picking a card, any card, for a magic trick. I would then choose an entree that I thought he would like, and that was that. It saved us all a lot of trouble, and Dad was happy. He could be content with hearing one description rather than all of them.

Mail was another task that needed to be simplified. I really want to see an expose on 60 Minutes or by some consumer watchdog about all of the mail that comes in targeting senior citizens. My parents get an obscene amount of requests for money from political parties and charities. They all look very similar, as if each were using the same marketing group that bought my parents’ personal details on the open market. At the risk of committing mail fraud, most of those envelopes get filed in the recycle bin before they end up cluttering my parents’ rooms! I'm saving trees, my parents’ lives from slipping and falling on all that detritus, my sanity, because I’ll be sorting and pitching it later, and any inheritance possible for the grandkids.

I know the causes my folks care about. I can weed out the noise. I set up autopay online, so they aren’t writing a million checks to keep track of and spending days balancing a checkbook, which used to take minutes. I balanced the checkbook this month when it was no longer a good mental exercise but rather an exercise in frustration. My mom was relieved.

So, let’s do ourselves and our loved ones a favor. Simplify. Let’s save our energy for more presidential choices and enjoy our dinner. After all, we can’t find the launch codes if they’re stuck under a stack of mail.

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