Trained to learn? Fascinating example of new skill acquired by a person with dementia.
Gentleman in his eighties, undergoing six weeks' reablement support after hospital stay with some rehab post-stroke. Right side weakness, some sensory and cognitive impairments, ?vascular dementia.
On his return home a few weeks ago (less than six), the gentleman's family had a stairlift installed. On my first visit to him, he did not know how to use it; and unfortunately design is rarely good enough for these machines to be intuitive or self-explanatory. Foot plate down. Seat down. Arms down. Pivot chair through 90º clockwise using armrest control. Seat oneself. Pivot through 90º counterclockwise using armrest control. Continue to press same control while stairlift descends.
So: there are quite a few steps to get in order, all told, and it isn't obvious.
This week, last three evenings, while keeping up his running commentary on random subjects (not always very lucid), this gentleman walked with his rollator to the stairlift and operated it without pause, hitch or error. Rather more smoothly, in fact, than many support workers might have done for him hem-hem.
Among the things he has mentioned in his evening talks that are confirmed by his wife is that he was a crane driver. In his decades in industry, he was required to get into the cab of any given multi-million dollar piece of kit and make it work - in mines, on construction sites, on dams, in cities...
Lowering teams of men into 200 foot shafts he remembers as quite stressful, for example.
So on one level you can see that a little old stairlift is not going to *worry* him.
But that doesn't explain how he has been able, in days, to *learn* a new process. He's not supposed to be able to.
So does he have a dedicated process-learning centre in his brain which is different from most people's, and remains intact?
I'm wondering also if the post stroke rehab was involved? One of my cousin's daughters used to work at a TBI rehab center; I was surprised to learn of some of the things patients could relearn to do. It's been several years since we discussed this, so my more specific memories have already filtered out of my memory banks.
Was any of his rehab through a Veteran's medical center? You raise an interesting point in using different terminology for different people. For Veterans, especially career military, certain terms are ingrained, as you noted.
Still, this is very, very positive, and perhaps could inspire research into how to use ingrained patterns in different ways.
Thanks for sharing!
I do have OT colleagues. I might see if any of them wants to do a bit of work on linking past occupation to present problem-solving in patient-centred therapy.
There must be something in there about how to tailor tasks within the therapeutic program to a person's most deeply ingrained, practised skills. E.g. if you want a veteran to take four or five little sideways steps to get in the right position to sit down, the correct command is "dress right" - if his drill sergeant was worth his salt sixty years ago, the old soldier should still shuffle along without even thinking about it.
We see lots of little old ladies and gentlemen, but what we're actually seeing is veterans, teachers, bus drivers, dancers, craftswomen, gardeners...
Maybe your OT daughter and you could write a paper?