All Jumbled Up

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."