All Jumbled Up

By Lois Gilman

Is it possible for a 63-year-old man with a Ph.D. to have attention-deficit disorder? That was the question English professor Richard Haber asked himself six years ago as he sat in his doctor's waiting room and flipped through a book on ADD, as the ailment is known. Haber, who taught at Western New England College in Springfield, Mass., thought he might learn something about his students' problems. Instead, he says, "I recognized myself."

Haber, now retired, had always been disorganized. His life was full of clutter. He had trouble managing everyday tasks and meeting deadlines. "I would ask myself, 'Am I lazy?'" he says. Then a diagnostic workup revealed that Haber has ADD (also known as ADHD, or attention-deficit/ hyperactivity disorder). Now he's treating it. He takes the stimulant Ritalin to help him focus, and he sometimes consults with an ADD coach, who helps him keep the clutter at bay.

Not so long ago, ADD was widely regarded as a children's ailment. But experts are increasingly discovering that it afflicts all ages. Psychologist Thomas E. Brown, author of Attention Deficit Disorder: The Unfocused Mind in Children and Adults, has seen his practice, which centered on young children 20 years ago, expand to include younger adults and seniors. They come to him and say, "I've had this problem for so long. If there's a treatment, let me try it."

Dr. John Ratey, co-author of the landmark Driven to Distraction, says seniors are often referred by their children in a "stair-step" sequence--first the grandchild is found to have ADD, then the parent and finally Grandma or Grandpa. Recalls Virginia Cooper, 73, who has a grandchild with ADHD: "My daughter said, 'Mother, I think you've got it.' And I said, 'Don't be ridiculous.' But then I read about it and realized that maybe she was right. I've always been distracted. I cannot stick to one thing. It's like somebody's changing channels in my brain over and over again." Cooper too has tried Ritalin and hired a personal organizer.

Seniors may be unaware of their underlying ADD, but they sometimes seek professional help because they are having trouble managing their lives. Many retirees find it tough to adjust to the loss of structure that their jobs had provided--the scheduled tasks, the meetings and mealtimes, the office assistants who kept things organized. According to psychologist Kathleen Nadeau of the Chesapeake ADHD Center of Maryland, in Silver Spring, retirement leaves some individuals "swimming in murky water." Even downsizing from a house to an apartment, with all the attendant decisions about what to keep and what to throw out, may prompt seniors to seek therapy.

Often the non-ADD-afflicted member of a retired couple will drag the partner in for help, says Nadeau, who estimates that 20% of her patients are seniors. They come because those never-ending unfinished projects, once relegated to the garage, are spreading all over the house, and the spouse's persistent forgetfulness, unawareness of time and difficulty with decision making is driving the partner crazy. Recalls former police officer Don Sherwood, 55, about the trying months between his retirement from the Torrance, Calif., force and his condition's diagnosis: "My home life was falling apart. I thought my marriage was beyond repair."

Could these people be suffering from early-onset Alzheimer's rather than attention-deficit disorder? Definitely not, insist Ratey and others. "They had the symptoms throughout their life," says Ratey. "They had memory problems since they were adolescents." Clinicians look for behavior patterns that extend back into childhood and include a history of distractibility, disorganization, underachievement and, often, complaints of laziness from parents, teachers and peers. "You're looking for a lifelong pattern," says Nadeau, "and a familial pattern."

Once a diagnosis of ADD is made in seniors, doctors try to improve patients' concentration by prescribing the same stimulant drugs that are used for children and younger adults: Ritalin, Concerta, Focalin, Adderall or the nonstimulant Strattera. Where stimulants are used, the doctor needs to watch for drug interactions with other prescribed medications and closely monitor patients' blood pressure and cardiac status, given that the side effects of these drugs can include elevated blood pressure and pulse rate--risks that many seniors normally face with age.

In addition to medication, ADD coaches can be of help. These private practitioners, who are unlicensed, typically enter the field with backgrounds as psychologists, counselors or educators. They concentrate on life skills and strategies rather than therapy and psychological issues. Haber's ADD coach, Sandy Maynard, describes her role as enhancing her clients' success by "providing structure, accountability, support and feedback." She helped Haber set realistic goals and priorities and plan for his retirement. Maynard taught him a visualization exercise in which he "throws away" extraneous thoughts, enabling him to focus on the task at hand.

Adult ADD support groups, like the one that Patty Kropelnicki, 63, attends at the University of Washington in Seattle, can also be beneficial. Kropelnicki learned that she had ADD three years ago after she turned in desperation to the pediatrician who had treated her son for ADD years earlier. The support group and medication have "allowed me to be a complete person," she says.

For former policeman Sherwood, there is an unexpected side effect to his treatment. He has been wearing hearing aids for the past eight years. Now, with his improved concentration, he's hearing better because he is more "tuned in."