Defy Dementia #18 — Stop Multitasking

(…and the guardrailed coach pathway that makes change stick)

1) The Story — why this matters

On Monday, Mei double-dosed her dad’s blood-pressure pill. On Tuesday, she missed her own clinic review. By Wednesday she was “multitasking”—Zoom on mute, WhatsApp pinging, eyes on a BP log—when her father asked the same question for the third time. It wasn’t a time problem. It was a switching problem. Rapid-switching taxes working memory, spikes errors, and leaves caregivers and leaders running on fumes. The fix isn’t more hustle; it’s monotasking plus a structured brain-health coaching pathway with clear guardrails.

2) The Science — what credible sources say

Short answer: non-clinicians can coach dementia risk, with guardrails. A well-designed brain-health coach programme can help people act on the Lancet Commission’s 14 modifiable factors—physical inactivity, smoking, excessive alcohol, air pollution, head injury, low education, social isolation, obesity, hypertension, diabetes, depression, hearing loss, plus 2024 additions: high LDL cholesterol and untreated vision loss.

Addressing these could delay or prevent ~45% of cases (Lancet Commission 2024). For a clear visual of the 14 factors, see ADI’s infographic (Alzheimer’s Disease International).

Singapore note: These risks intersect with primary care, Health Promotion Board programmes and Active Ageing Centres (AACs)—ideal touchpoints for coaching and referral. (See also Chong, 2025, for a supervision-led community model.)

3) The Strategy — how to apply this

A) What a dementia-risk coach can (and shouldn’t) do

Can do

Educate on the 14 factors and translate them into daily habits (move more, manage BP/LDL/glucose, hearing/vision care, reduce isolation, etc.).
Use behaviour-change methods (motivational interviewing, habit design, action planning), track simple metrics, and coordinate with family/caregivers.
Signpost to community services (e.g., AACs, HPB programmes) and primary care.

Must not do

Diagnose cognitive disorders, treat depression/anxiety, interpret clinical tests, adjust medications, or manage crises—those are clinical acts.

B) Minimal training blueprint — safe & effective

Core knowledge: life-course brain health & the 14 risk factors; cardio-metabolic, sensory, psychosocial interplay.
Behaviour change skills: motivational interviewing, goal-setting, relapse planning, social support.
Screen–triage–refer: red flags (rapid decline, major depression, suicidality, delirium, uncontrolled HTN/DM, suspected TBI) and when to escalate.
Ageing-savvy communication: hearing/vision-friendly techniques; working with care dyads.
Data & ethics: informed consent, privacy, boundaries, documentation, fidelity checklists.
Supervision: regular case reviews with a clinical psychologist/geropsychologist; clear SOPs.

C) What clinicians uniquely add

Clinical Health Psychologist

Adds: assessment & formulation; CBT/ACT/BA; adherence support; measurement-based care; risk/crisis protocols; team integration.
Essential for: mood/anxiety/substance use; chronic insomnia; grief/adjustment; poor adherence; suicide risk; caregiver burnout.

PhD Geropsychologist

Adds: ageing & neurocognitive expertise; capacity/functional assessment; dyad interventions; environment/service design; programme design & evaluation; research; manuals; coach training/supervision; policy links.
Essential for: programme build & guardrails; supervision; tailoring for sensory loss/frailty/multimorbidity; outcomes selection; pilots & publications; system engagement.

D) A simple service model you can deploy

Tier 0–1 (Coaches): education + habit change + tracking + navigation.
Tier 2 (Allied health/GP): medical optimisation (BP, LDL, DM, hearing aids, cataract, sleep).
Tier 3 (Clinical psychologists/geropsychologists): complex behaviour change, mood disorders, dyadic strategies, cognition-informed support.
Tier 4 (Specialist memory/neurology): diagnostic work-up, atypical presentations.

E) 7-day focus reset (for overloaded caregivers & teams)

Monotask one high-impact task daily (30–45 min; devices on Do-Not-Disturb).
Batch communications to 2–3 windows/day.
Protect sleep (no caffeine after 2pm; target 7–8 hours).
Sensory tune-up: book hearing and vision checks if deferred.
Health basics: log BP twice this week; if SBP averages ≥135 or DBP ≥85, book a GP review.
Connection: plan one social activity (walk with a friend, AAC group).

F) How we describe our service

“Our Brain-Health Coaches support evidence-based habit change across the 14 Lancet risk factors. We don’t diagnose or treat medical or psychiatric conditions. Red-flags are escalated via our clinical pathway to partner physicians and psychologists.”

G) Next step

DM or post a comment to get the 2-page Syllabus Preview—themes for all 12 weeks, a sample Week-1 agenda, 3 MI prompts, and a light-touch KPI frame.

It’s the what & why your leaders need to decide.

Truly,

Wayne