About Cognitive Change | Blog 6 of 15 in the Soulfull Aging series
Aging is not something to be managed.
It is something to be accompanied—with dignity, presence, and care.
Healthcare professionals and caregivers often stand at the threshold between the clinical and the personal, translating symptoms into stories, and confusion into comfort.
This chapter explores how we—professionals, loved ones, and family—can support those who are aging through emotional, physical, and spiritual shifts.
Whether in hospitals, homes, or transitional care settings, how we show up—with empathy, clarity, and consistency—makes all the difference.
Because in the end, it’s not only about what we do.
It’s about how we are with the people we serve.
High Altitude Confusion – The Stories We Miss
She was panicking.
I could hear it in her voice—tight, rising, unsure.
I was sitting in business class on a flight home to Suriname for the holidays.
Behind me, an elderly woman was trying to manage her husband, whose behavior had started to shift.
Her voice grew sharper, more urgent. She tried to reason with him, to explain things, to ask him questions he couldn’t answer.
Confusion turned to frustration.
She sounded more irritated than concerned—but beneath it, I could hear fear.
The stewardess had checked on them a few times. Nothing had changed.
I stayed quiet. Listening.
Waiting for the right moment.
As someone with years in emergency care—pulmonology, cardiology, internal medicine—I recognized the signs. Something was off.
On my way back from the bathroom, I paused near their seats.
I leaned in gently and asked,
“Are you alright?”
That opened the door.
She looked at me—tired, overwhelmed—and out came the story. Her husband had never acted like this. She didn’t know what to do. She felt helpless.
I listened. Then, softly:
“Would it be alright if I shared something with you—as a medical doctor?”
She nodded, relieved.
I explained that high altitude can affect cognition—especially in older people.
Dehydration, low oxygen, and travel stress can all trigger temporary disorientation. I suggested we get some water—for both of them. Elderly passengers often don’t drink enough when flying.
She nodded again. Her face softened.
We signaled for water. The energy shifted.
I returned to my seat. Giving her back her space.
Or maybe… giving myself space again.
Because in a setting like an airplane—a public bubble of private lives—support can be about balance: being there, without taking over. Stepping in without intruding. Stepping back without abandoning.
The Context That Matters
At the time, I’d been working in healthcare for about seven years. I was running on empty as nothing made sense to me.
My personal life was shifting, my work had no goal, and my soul was craving clarity.
Going home to Suriname felt like a return to something essential.
My mother had upgraded my ticket—a rare treat.
She and my father would be waiting for me at the airport.
They had built their life from scratch—through poverty, perseverance, and self-determination.
And here I was, their youngest daughter, suspended between two worlds.
I had learned through travel—especially with my sisters—that altitude affects everyone differently.
My second sister always got sick flying to New York. I, on the other hand, could sleep anywhere—any chair, any delay, any turbulence.
So I knew. I knew what altitude, oxygen, pressure, and stress could do—especially to someone elderly, vulnerable, or already showing signs of cognitive decline.
What She Couldn’t See
The woman behind me was trying to control the situation.
But what she didn’t know—what many people don’t know—is that her husband wasn’t choosing to be difficult.
He was confused.
Likely dehydrated. Possibly hypoxic.
Maybe already living with undiagnosed early-stage dementia—now pushed to the edge by stress and altitude.
His mind was under pressure. Quietly losing its footing.
And she couldn’t see it.
She was reacting, trying to hold on.
But what she needed was explanation, not just solutions.
Why This Story Matters
What helped in that moment wasn’t my medical title.
It was presence. It was listening. It was offering words that fit the moment.
I realized how often these moments are misread.
How many elders get labeled “difficult” when they’re really disoriented, anxious, or quietly breaking down.
And how often their spouses or children are left without guidance—unsure, unsupported, and scared.
This story isn’t about being a hero.
It’s about being aware.
Because when we pause and really see what’s happening,
what once seemed irrational becomes deeply human.
And understandable.
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