In my book, Journey through the Infinite Mind, I wrote about when the person with dementia loses memory, they can’t plan future. Future planning can be as simple as trying to make a ham sandwich. Let’s look at what it entails to make that sandwich.
To begin with, I need to recall what is a sandwich, what goes in it in and where those ingredients are in order to follow the steps to making one. I have to remember what I need is in the kitchen and so I have to know what is a kitchen and where it’s located. When I get there, I need to recall that the ham and mayonnaise are in the fridge, the bread is in the bread box, the plates in the cupboard and knives in the drawer and be able to locate those. In the refrigerator alone there are dozens of items camouflaging the ham and mayo. Where is the bread box? What is a bread box or how do I open the refrigerator door?
Finally, you have found what you need, now what? You don’t remember the mechanics of putting a sandwich together. How do you get this stuff out of the packages, open this jar of mayonnaise or use this knife?
For us, the future planning of making a sandwich is effortless and without thinking can just make the sandwich. This is not the case for those with dementia. When even the simplest of tasks requires memory.
I’m fascinated by neuroscience and while writing my book I did a great of deal research on memory. I found Professor Donna Rose Addis’ research at the University of Auckland in Zealand, on how we use memory to stimulate future events and generate creative ideas. According to the results of her investigation of the brains of subjects while in an MRI, there is a striking overlap of neuronal associations to when we remember and when we imagine something. To create future, it takes both imagination and memory working together.
In order to create a ham sandwich, you first have to imagine it and that requires using material from our past memory. This is eventually lost with the progression of dementia. If we lose memory we lose our ability to imagine and we can’t plan future.