A Passion for Pathways 

[Janna Starts off with playing Flute] 

Janna: This is Janna, an Alzheimer's driver, along with my husband Larry. 

Hi everyone. 

Janna: I have discovered that I have a passion for pathways, neural pathways that is. 

Today you'll be hearing from the horse's mouth. 

[More Flute] 

Larry: Well, here we are again sitting in the office looking out our window and it is drizzling out here in sunny San Diego. 

Janna: Yeah, but I really wanted to play. 

Larry: Tennis. Yeah. Oh gosh. So, we get to the courts. 

Janna:  Let me see. Would that be a good choice? Hmm. 

Larry: They're all slippery with puddles everywhere. 

Janna: I've slipped. I've had a Bead injury, Head Injury. 

Larry: Yeah. 

Janna: Bread injury too maybe. 

Larry: A long time ago. You didn't just have it today. 

Janna: No, not today. But maybe it's best that we do something different. 

Larry: Yeah, I mean what you said was let's go do a podcast and so here we are looking out the window and thinking, wow, we didn't expect to be doing this today. 

Janna: Well, I have a passion for pathways, neural pathways in particular. 

Larry: Okay. Let's talk about it. 

Janna: Maybe we could go with that. 

Larry: Okay. Okay. Let's do it. 

Janna: As I've walked through my life, I haven't taken much thought of neural pathways at all. Why should I? Everything's going, clicking along here. And now I come into this thing where my brain is not working very well at all. 

And it occurs to me that there are neural pathways to the brain and some of them are working and some seem not to. They seem to have a big roadblock. So, what to do about it? Can we do anything to help or alleviate that situation? 

I have a friend who is amazing. She is unable to walk in certain ways because she got smashed in an accident and lost the ability to walk real easy, but she is no victim by any stretch of the way. So, I thought, well, why don't I talk to her, and she'll give me maybe an idea of how she is so, hmm, adaptable. I'd like to imagine that I have a quiver of options, choices, as I walk through this pathway of realizing I have limitations, but I have options for how I will react to them. 

And in that, I think back to little children who are learning to do something. A little one-year-old is trying to take a step, but kind of flailing a little bit. And you say, at a girl, at a girl, at a boy. You can do it. And you clap for them and as soon as they can have any success, we award that. We celebrate it, let's say. 

Now, in this situation, when there's times I can hardly even talk, I don't pull that to the front of my psyche. I think, oh, I'm messing up. Oh, I'm blowing it again. Oh, I can't do things well. So, I have to remember that for those of us who have Alzheimer's, sometimes it is very difficult to pull up the thought. But be patient with yourself and train, be aggressive enough to train your partners, your support partners, to cheer you on, at a girl, at a girl, at a boy, for the easiest little things. 

Larry: Well, I'm constantly amazed at how many, you know, little items, tricks that you've come up with and options that you've taken advantage of. And one of the things that we found out was that ...all right, we want to create new neural pathways, so you have to learn new things. And we were doing a crossword for, I don't know, we've been doing it now for two years, but not just the normal way to do crosswords. And I think the way that you've decided to do it and how we've had to do it does create neural pathways, even though the experts say that, you know, it's already information you know. In the Alzheimer's patient, you guys lose what you already know. So, you're having to relearn many things and your brain's having to kick in in that way. So I don't know, maybe we can describe kind of that particular technique as one of the adaptations that you've made and one of the options that you've taken to create neural pathways. And it's really, really working well. 

Janna: I'd suggest that we should start with realizing that, what was that thing called that we do? Crosswords are one thing to his mind and a different thing to my mind. I don't even know the names of the words and I can't think very well about it a lot of times. I can't, I am not, I don't want to say can't. I don't read. I remember pretty well, at least for one second or two. 

Larry: Well, so that's kind of the way that it's different than a person that sits down with a crossword and comes up with things they already know. In many cases, you're learning the word for the first time. 

Janna: So, you have to remake, you kind of are remaking the whole game. Yeah. So, I read the clue and it, what happens is, is that you come up with a word that we don't really know very well and/or know at all. And I work around it and for example, here's one, a noisy racket, a noisy racket. So I just say a noisy racket and then you, and I say it's three letters and what would it be? And we have no letters to start with, haven't worked around yet. And this is a, a word and you would say, what? No idea, right? 

It didn't jump out of my head right away. 

Yeah. I, in my head, I'm thinking it could be a big ado, you know, ADO, but no. So then I have to work around it. 

And as I do the downs and the crosses and whatnot, and I get maybe the first letter and the first letter is D. And so I say, okay, first letter D. So that, that wasn't there until I, as her helper worked, worked it around to, to find out that that was the end of another word. 

Janna: You gave me that. 

Larry: Yeah. So, I give you that cue. 

Janna: Boost, right? That boost. Yeah. 

Larry: And then, so that, that really doesn't, does that ring a bell? Noisy racket with a D, three letters. 

Janna: I want to say dong, but I know that's not it. Ding dong. 

Larry: So without much pause in between, you know, a person doesn't want to feel like what? You don't want to feel like, oh, I don't know anything, you know? So, I just try to keep it upbeat and try to keep it positive. And I say, okay, well, the second letter is i. So, it's D-i blank. And so, there's a, the blank is a word. 

Janna: Din? 

Larry: Din! Yes. Din. Good. Okay. 

Janna: So, we got to feel free to take chances and it's, it's just fine to fail. It's fine to fail. 

Larry: And you know, we're, we're using the Dell Puzzle Lover's Easy Crosswords. Get that at the grocery store in the checkout stand. And they have it like every month or two, I think it's every month. So, it's a Puzzle Lover's Easy Crosswords. And the reason we're using Easy Crosswords, they do have words we don't know, but you need to have success. 

Janna: Yes. You need to experience success. 

Larry: Yeah. And so, when we're, we're working it through, I'm, because I'm able to, with the Easy Crosswords, I'm able to pretty much know the answer..I could go to the back of the book and sometimes I have to, but you know, I pretty much know the words so I can give clues. And then if, if, if the clues aren't working and not getting the word, then I can change it up. Like we're playing some other type of game. I can say, you know, it's a much to do about nothing or a much to do about nothing. Or I could say it rhymes with tin, you know? And so finally we get the word. So, you always do get the word. And I think that's, that's important. It rhymes with tin? Din. 

Larry: Din. Okay. Yeah. Okay. So, one way or another ...or I'll make some kind of an analogy. 

Janna: But you help me to be successful. It's not like when you're competing as you did with, as a child, you know, I can, I've got it. I've got it. I've got it. No, that doesn't help me at all. 

Larry: I think for some of the people that might be like, ”Oh, that's too easy.” 

You know, “I can just read it and get it,” you know? But at some point, this is a great way to regenerate, maybe create new workarounds for neural pathways. So, I find I get real self-conscious and just angst full of trying to figure out what word and all that. And then I realize, no, everybody wants me to be successful. I want to be successful. I don't need to be paranoid. I need to just take a chance. 

It occurs to me that we're referring to neural pathways and perhaps people don't realize what that means. So, let's make that clear. 

Larry: Yeah, because your whole life you're making neural pathways and the way that that happens is that you're learning new things and the more new things you learn, apparently this, you guys can do research on this, but we've done quite a bit of research on neural pathways and creating those pathways, creating new neurons requires just a learning that goes on in life and then your education. 

Janna: And repetition, repetition. 

Larry: So cognitive reserve would be the neural pathways that you still have that you've created throughout your life. And then now that you have Alzheimer's, the doctors tell us that you can create new neural pathways when you learn new things with the part of your brain that's still working. So that's what we're trying to get to. And you've done a marvelous job at figuring out ways to do that. 

Janna: Hey, I have been called an Alzheimer patient. I didn't like it. I don't like it. Why don't I like it? I guess it sounds like she's a loser. She's a goner. And then they say, mmm, patient. Mmm. What else could I say? What if I turned it around, just flip it over and said Thriver. Can you choose to thrive? We can choose to smile. You can choose to look grumpy. I'm going to choose to thrive. 

Larry: It seems like we've got a new vocabulary starting here. 

Janna: Yes. Words are important. For instance, instead of I'm an Alzheimer's patient or I'm an Alzheimer's victim, I coined the phrase Alzheimer's ThriverTM. 

Larry: It's like you're a person with Alzheimer's, like when they say a Cancer thriver. 

Janna: You have red hair or green hair or whatever. 

Larry: Yeah. 

Janna: It's not a judgment. 

Larry: Yeah. It doesn't pigeonhole you, does it? 

Janna: No. 

Larry: And so, I really like that. And you've told me you feel like others should take on that attitude too and call themselves thrivers. We could have a whole community of Alzheimer's thrivers instead of Alzheimer's patients. 

Janna: Let's start a fad. 

You've also coined the phrase Care Partners. What's the difference between a care partner and a caretaker? 

Janna: I'm going to speak directly to you, another person like me who has Alzheimer's, okay? So, we are not victims. I want to be sure we understand that. We have to teach people not to treat us like victims. So, do you like this phrase caretaker? Do you want somebody to be your caretaker? I don't think so. I sure don't. So, I want to be a Care Partner. That's acceptable I'd do that. 

Larry: So, I'm your care partner because I do care about you and I do things to help. When I let you. 

Janna: When I let you. I'm in charge. I've got to remember I'm in charge. 

Larry: Well, I wear the pants in the family as long as you give me permission. 

Maybe you guys out there in podcast land can think of some other words that pigeonhole both the care partners and the Alzheimer's patients that you don't like. 

Janna: So that we can veto all of them. Big list up there and put it on a veto. Yeah. Let's make a chart. Be fun. 

Larry: This but not this. This but not this. Right? 

Yeah so, I think it's important to for your self-confidence. Right? I mean because you are a person, as I say, with a disease. 

Janna: But I'm not the disease. It's not the disease. 

Together: And it doesn't. Doesn't define you. 

Larry: That's very important. 

Well, I think you've really explained a lot today about some neural pathways and maybe some ways to do it. 

Janna: We try. 

Larry: We've given you one example of the crossword and how to do it differently. 

Janna: I'm hoping the people in our audience will be thinking, hmm, neural pathways, what is that? Maybe they'll look it up and find out more. And there's probably something that could have apply to everybody's psyche about pathways. What is that about anyway? And are they positive and negative? Is it directional? What is that about? And what can I benefit from? How can I benefit? 

Larry: Good words, Jan. 

Janna: This is Janna, an Alzheimer's ThriverTM. And you've been hearing this from the horse's mouth. Signing off until next time. 

[Janna ends with a little playing of the flute, along with her stringy friends] 

🔬 Related Research & Articles 

• Show Notes – Revised Resource Section 

🔬 Related Research & Articles 

Plasticity in Early Alzheimer's Disease: An Opportunity for Intervention — Review showing potential in adaptive neural rewiring postdiagnosis.  
🔗 Dr. Brian Ableson 
 

Physical Activity and Neuroplasticity in Neurodegenerative Disorders — How exercise and dual-task cognitive engagement strengthen neural pathways. 🔗 Frontiers 

Lifelong Cognitive Reserve Reduces Dementia Risk — Meta-analysis linkin enriched lifestyles to lower dementia incidence. 🔗 PMC  
 

Association of Lifelong Cognitive Reserve with Dementia and MCI — Cohort data showing cognitive resilience even among low-education elder populations. MCI 
 

Why Words Matter: “Care Partner” vs “Caregiver” – Alzheimer’s San Diego 
Discusses the language shift from “caregiver” to “care partner,” emphasizing empowerment and mutual respect.  
🔗   Alzheimer’s San Diego