by Jerry Blackerby
“Your mother is in the advanced stages of Alzheimer’s disease.” This statement by the doctor was not unexpected, but still a shock. We are never fully prepared to hear those words about a loved one. In some ways it is worse than being told someone has Cancer, which is treatable and possibly curable. At this time, Alzheimer’s disease cannot be cured. It can be helped a little in the early stages but not reversed or cured.
At one time I thought Alzheimer’s disease was just a name given to old people suffering from dementia. As a young person, I heard about many older relatives with “hardening of the arteries,” “senility,” or “old age” because they were losing their memory. These maladies were widespread in our family.
I saw Mom’s parents lose their memory and forget where they were. Granny was worse than Granddad. Looking back, Granny had all of the classic signs of Alzheimer’s disease, although never diagnosed by a doctor. She died before we began to think about Alzheimer’s disease. Granddad’s dementia was probably not Alzheimer’s.
One of Granny’s nieces was diagnosed with Alzheimer’s disease and spent over ten years in a care facility before she died. She didn’t know her own husband. A few years later, her daughter was diagnosed with Alzheimer’s disease. I visited with my cousin a couple of times after she was diagnosed and began thinking that Granny probably had Alzheimer’s disease because I could see the same signs.
One of Mom’s brothers was in a VA facility when he was diagnosed with Alzheimer’s disease. He had several traumatic injuries, such as breaking a hip, which seemed to speed the process through the stages of Alzheimer’s disease. Mom’s sister suffered severe injuries in a car wreck. Her Alzheimer’s disease showed up quite rapidly following the injury.
We began seeing memory loss in Mom before Dad died, but did not think about Alzheimer’s disease. After Dad died, we saw more change in Mom. She began to eat less and would forget to take her medications or would take them more than once. My sisters lived near her and began delivering her medications daily to control the dosage. When we would visit, Mom would be telling us something, drift off into some reverie, and then pick up her story right where she left off. She became good at hiding her memory lapses and disorientation. I began to suspect Alzheimer’s disease and began to read all I could about the disease.
Mom became paranoid that someone was trying to break in to her house. Once while visiting, she walked into our bedroom during the night and thought we were strangers in her house. She began to sleep in her chair during the day and not sleep at night. She would call my sister during the middle of A the night and ask why they had not been over with her medications. Several times my sister told her it was night, to look at her clock and Mom replied, “My clocks are always wrong anymore. I don’t know what’s wrong with them.”
My sister suggested she look outside and Mom replied, “It is really overcast this morning, I have been up for a long time, had my breakfast and it’s time for my medication!” It was actually 3 a.m.
One morning, my sister walked in at Mom’s with her medications. Mom was sitting at the table with a blank stare on her face. She had poured a bowl of dry cereal and was holding a spoon of sugar in her hand. The milk carton was on the table in front of her. The chill was gone from the milk carton, indicating it had been out of the refrigerator for several hours. My sister spoke to Mom and she came back to reality. She said she had just gotten up and poured her cereal. She did not realize that she had been sitting like that for hours.
The doctor said that we should have put Mom into a nursing home a year or so before and now said that we had to put her into a home where she would have 24-hour care. Mom had gone through the same thing when she had to put her parents into a nursing home, but rebelled against the idea of a care facility and became very angry when reminded about putting her own mother into a nursing home. She told us her mother was senile but she was not. It hurt to see Mom in this condition.
The first time we visited Mom at the care facility, she told me that her parents put her in the place because they were afraid that some man might break in to her home and do her harm. Mom’s parents had been dead for 25 years. Mom began living in the past most of the time. She thought Dad was away on a job and would be returning soon. She reverted to 1949/50 when Dad had gone overseas on a job and was gone for 14 months, leaving her with five children to care for alone. This was a traumatic experience for Mom because our youngest sister was only a baby and I was a wild teenager.
Sometimes she would know who we were when we visited; other times she would not know us. Mom became a different person. She had been a pastor’s wife for 40 years and church meant everything to her. Once while attending a church service at the care facility, she stood up after the singing as the minister began to speak and in a loud voice said, “WELL! Can we leave now?”
One time, Mom shuffled down the hall to the dining room with her Bible in her hands thinking it was Sunday and time for church. Workers had the dining room roped off because they were mopping the floor.
Mom argued that she needed to get in for church. A nurse came out and explained that it was not Sunday and turned her around to go back to her room. Mom stomped the floor, looked at the nurse and said, “Just what are you going to do when you get to Heaven and Jesus is mopping the floor and won’t let you in?” She then shuffled back to her room.
We learned to laugh so we wouldn’t cry all the time. It is hard to see someone you love go through these things. Once she introduced me to one of the nurses as her brother. When the nurse told her that I was her son, Mom looked shocked and said, “He is?” The next day we walked in and Mom saw my wife and me coming down the hall and called us by name.
One trip she knew me, but thought my wife was my brother’s wife and had met me at the nursing home. Mom asked her how she knew I was going to be there and looked totally shocked when my wife replied that we had lived together a long time. That was when we realized she thought my wife was someone else.
Sometimes when visiting Mom, she could call us by name. She would ask how my family was, without using any names. This is a typical method that Alzheimer’s patients use to hide their loss of memory. When I visited Mom’s sister a few months before she died, she never called me by name. She asked me how my family was, without using any names.
One thing we noticed early with Mom’s Alzheimer’s was that she could not remember Dad’s name. She talked about Dad a lot, but never used his name. We saw the same thing with Mom’s brothers and sister. Sometimes when the family visited her brother, he would not know his own son and called his wife, “my beautiful wife.”
Mom’s sister never used her husband’s name during her last year, but would say things like, “that’s my husband.”
It is scary considering all of the family members with Alzheimer’s disease; my Grandmother, all four of her children, Granny’s niece and the niece’s daughter. I checked with relatives around the country and found many more cases of Alzheimer’s disease on Mom’s side of the family.
Now I really began to investigate Alzheimer’s disease. Is it hereditary? What do I have to look forward to?
What is Alzheimer’s disease?
Alzheimer’s disease is a degenerative disorder of the brain. People gradually become disoriented, have memory loss and cannot think clearly. They lose the ability to learn, reason, make judgments, communicate and do daily activities. People with Alzheimer’s disease may undergo personality and behavioral changes. A person with Alzheimer’s disease may experience delusions and hallucinations, suspiciousness or agitation and anxiety. These symptoms also may be called dementia. This definition matched most of what we saw with Mom.
How Long Does the Degenerative Process Take?
Alzheimer’s disease progresses at different rates for different people. It can vary from three to 20 years. The earliest signs in Mom were before Dad died and lasted until she died nine years after Dad died. The progression gradually kills brain cells until a person needs complete care. Alzheimer’s disease is always fatal. If a person does not have any other illnesses, the eventual loss of brain cells will stop other bodily functions, including breathing. The person actually forgets how to swallow or breathe.
Who gets Alzheimer’s disease?
Statistics on the Internet show that nearly four million Americans have Alzheimer’s disease. One in ten people over age 65 has Alzheimer’s disease. Nearly half of those over age 85 have Alzheimer’s disease. Alzheimer’s disease can also occur in people as young as their 30s. Some research shows that more women than men get the disease.
Is Alzheimer’s disease hereditary?
If someone in the family has Alzheimer’s disease, relatives are at a higher risk than the general population. People with at least one parent or sibling with Alzheimer’s disease are 3.5 times as likely to develop the disease. This risk increases for each additional relative with Alzheimer’s disease. Scientists have found several genes that are involved in early onset Alzheimer’s disease, but have not identified the gene responsible for inherited late-onset Alzheimer’s disease.
This is scary since Mom, her three siblings, their mother and many cousins all had or have Alzheimer’s disease. So far, none of Mom’s five children have shown any signs of the disease.
What are the warning signs?
Some of the signs of Alzheimer’s disease include:
• Asking the same question over and over again.
• Telling the same story, word for word, again and again.
• Misplacing things by putting them in strange locations; such as, storing the iron in the refrigerator, as we found Mom doing.
• Getting lost in familiar surroundings and misplacing things.
• Forgetting how to do common activities that were previously done with ease.
• Losing the ability to pay bills or balance a checkbook.
• Neglecting to bathe or wearing the same dirty clothes over and over again.
• Relying on someone else to make decisions or answer questions.
• Changing personality such as becoming belligerent when usually meek or becoming passive when usually assertive.
• Losing the initiative to do things, becoming very passive, sitting in front of the TV all day.
We saw almost all of these signs in Mom. Even though someone has some or all of these signs, it does not mean they have Alzheimer’s disease. It does mean that a doctor should check them.
What treatment is available?
Currently, there is not any treatment to completely prevent or stop Alzheimer’s disease. There are medications available that can help prevent some symptoms from becoming worse during the early and middle stages. There are medications that may help with behavioral control; such as sleeplessness, agitation, wandering, anxiety, and depression.
Alzheimer’s disease begins slowly. The first symptoms may only be mild forgetfulness. As the disease progresses, symptoms become more noticeable. For example, a person with Alzheimer’s disease may forget how to do simple tasks, such as brushing their teeth or combing their hair.
They cannot think clearly and begin to have problems speaking, especially on a telephone and reading or writing. People with Alzheimer’s disease can also experience drastic changes in personality, mood or behavior. They can become extremely confused, suspicious, fearful, violent or even quite passive when they were not passive before.
Mom was a mild-mannered person before Alzheimer’s disease, except when I needed disciplining as a child and then as a wild teenager. She had good days and bad days in the care facility, but most of them were bad. Some days she would get very belligerent and violent.
Once the head nurse, a family friend, walked by Mom’s room and saw that she was resting in bed. As the nurse returned from her walk down the hall, Mom stepped out of her door and swung a haymaker at the nurse’s jaw. We do not know of any reason she would it her and if the nurse had not been a family friend, they would probably have removed Mom from the nursing home.
One time Mom was sitting in the dining room drinking coffee with one of my sisters and did not know my sister’s name, but seemed to know she was a relative. My sister made a suggestion to Mom about her hair. Mom slapped her and said, “Don’t tell me what to do!” She slugged me once when I was visiting.
Mom’s doctor was a family friend. About a year before Mom died, the doctor and the head nurse stepped into Mom’s room, where Mom was standing by her bed. She had always greeted the doctor with a hand shake when he walked up. This time he stepped up and asked how she was doing. In a loud voice Mom said, “I’d be better if you’d get out of my face.” The doctor stepped back a couple of steps to not be confrontational. This put the nurse between him and Mom. Mom then blared out, “Just like a man, hiding behind a woman!”
Mom was never confrontational before Alzheimer’s. Her youngest brother and her sister never showed violent tendencies, although the other brother did. Mom became so different compared to the way she was before Alzheimer’s. Mom was just a little over five feet tall and weighed about 120 pounds normally. With Alzheimer’s disease and not eating very much, her weight dropped to less than 90 pounds.
Eventually, people with Alzheimer’s disease become completely incapable of caring for themselves. In the later stages they have difficulty walking, talking, swallowing or controlling bodily functions. They reach a point where they forget how to breathe. Mom reached that point in late 2002. Her pain is now gone.
Copyright © Jerry Blackerby 2005, 2006, 2007, 2009