Research strives to understand, intervene

A black canvas notebook and a timer are the low-tech tools Eleanor Catlin is using to keep her independence.

For the past year, she has been keeping track of her life hour by hour throughout the day. On the right page is her plan, where she writes down any appointments or errands she needs to do, and the left page of her notebook is what she actually does.

Thursday, Feb. 23: 11 a.m., lunch; 1:30 p.m., appointment at WSU.

Over the past year Catlin and her husband, Jay Scheldorf, have had many appointments at the WSU Psychology Department, both as study participants and as clients at the Psychology Clinic. They have been working closely with Maureen Schmitter-Edgecombe, a WSU associate professor of psychology who not only is studying the effects of memory loss on everyday activities, but is developing interventions to help people cope with memory loss.

For Catlin, a kindergarten and elementary school teacher for 27 years, having that simple canvas notebook is the difference between being in control of her life and giving up control to someone else.

“I can go back and see when something happened,” she said recently, flipping through her notebook at the sun-splashed dining table in her northeast Moscow home. But more than that, it helps her focus. When writing in her notebook, she said, “I just feel centered and alive.”

Catlin, 71, still enjoys visiting with friends and family, watching television programs with her husband, going for walks around town, spending time with her grandchildren. But about four years ago, she was diagnosed with slow, progressive dementia.

While it is a difficult diagnosis to hear, Catlin said in some sense it was a relief to finally know what was wrong. “I felt understood,” she said. “I don’t feel judged negatively for it.”

Notebook fills in gaps

The notebook, she said, has made a huge difference in her life because it helps compensate for her diminished ability to learn and store new memories.

“The explanation we were given is that this would be part of her brain,” said her husband of seven years, Jay Scheldorf, 74. Pointing at the notebook, he said, “It replaces the part of her brain that is going bad.”

Part of Catlin’s brain is going bad, but other parts of her brain, including other parts of her memory, are functioning well. Dementia — what works, what doesn’t work and how memory loss progresses — is a focus of research by Schmitter-Edgecombe.

According to Schmitter-Edgecombe, people can develop subtle cognitive difficulties, meaning problems with memory, language and reasoning, as many as 10 to 15 years before they are diagnosed with dementia.

“With a better understanding of the impact that these cognitive difficulties can have on activities of everyday life, it may well be possible to develop and teach intervention techniques in the early stages of dementia to help those suffering from the disease better maintain their independence,” she said.

Study assesses skills
That’s why Schmitter-Edgecombe is looking for about 120 people over age 50 to participate in a study on mild cognitive impairment. For the research, Schmitter-Edgecombe is looking for people who report no cognitive impairment as well as people who report slight impairment and those who report more significant impairment.

While the tests Schmitter-Edgecombe and her graduate students perform do not — and are not intended to — diagnose disease, they do provide study participants with a comprehensive written assessment of their memory, language and problem-solving skills relative to other people of the same age, which participants can share with their physicians.

This study is directly related to the work she and her colleagues are doing to develop early intervention techniques such as the memory notebook.

“The underlying research is going to better inform the types of clinical interventions we use,” she said.

Before diagnosis
Scheldorf and Catlin first participated in one of Schmitter-Edgecombe’s studies in 2001 when they responded to an ad in the Daily News. That was before Catlin had been diagnosed with dementia. But after the diagnosis, her neurologist suggested she return to WSU to participate in Schmitter-Edgecombe’s research on mild cognitive impairment. Because Catlin’s cognitive difficulties were mostly limited to memory, she was deemed a perfect candidate for memory notebook training in the Psychology Clinic. She began working with Michelle Kayne-Langill, a graduate student in clinical neuropsychology.

Catlin and Scheldorf also were able to turn to the WSU Psychology Clinic for help in negotiating their changing relationship.

“Rusty had always been very independent,” Scheldorf said of Catlin, but when she started forgetting things, he felt he needed to step in more, and she resented it.

With the help of the clinic, he said, their ability to communicate what they needed and wanted from each other improved dramatically.

“In our case, it made an incredible difference,” he said.

According to Schmitter-Edgecombe, coping with memory loss imposes a tremendous strain on any relationship, and any counseling intervention must be adapted to work within the framework of someone dealing with memory loss.

“This is beneficial for everyone,” said Scheldorf, a retired professor of chemical engineering at the University of Idaho. “Not only are we benefiting from this, but we are helping train the next generation of clinical psychologists.”