Saturday, August 5, 2017

GUY’S GOTTA TALK ABOUT…Alzheimer’s #9: Tired of the Struggle

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

I woke up this morning with a "missed call" notification from my dad. He called at 11:22 and didn’t leave a message. It’s early morning right now and I can’t call him just yet. If he was up late, then he’ll still be sound asleep. Waking him now would just confuse him more.

He’s been calling more lately, continuing his…delusion seems harsh, hallucination sounds like an LSD trip…illusion. I like the sound of that better. When I think of the word illusion, I think of “magicians” and “magic tricks”; sleight of hand in other words – making me think something happened but it didn’t in the way I ASSUME it did.

An Alzheimer’s group in Canada has this to say in defining this experience:

“Delusions are false beliefs. Even if you give evidence about something to the person with dementia, she will not change her belief. For example, a person with dementia may have a delusion in which she believes someone else is living in her house when she actually lives alone…”

“Hallucinations are incorrect perceptions of objects or events involving the senses. They seem real to the person experiencing them but cannot be verified by anyone else. Hallucinations are a false perception that can result in either positive or negative experiences.”

Lately, Dad has been having an increasing number of both. Things like the door closing to his apartment and him believing that Mom just left for work. He has these often and so far, they have always been about Mom. He even called one day from the “floor phone” to tell me that I wouldn’t believe it, but he had just been talking to Mom in his room and he wanted me to come over right away to see that he wasn’t crazy! That would be hallucination, something he sees, hears, tastes, touches, or smells.

He’s also convinced that he’s moving “back home” (he’s recently started asking the staff where he lives if he can have a box. I already confiscated one because I’m afraid he’ll trip over it. He got himself another one.) and that a bunch of guys stop by to pick him up regularly to go to work – at a place that does charitable stuff. Also there are times that he thinks Mom left him because she wanted a divorce. These are delusions – something he believes.

But I’m going to start lumping them together into an illusion.

But I was specifically wondering WHAT was going on in Dad’s brain. While there doesn’t seem to be any recent discoveries, I found this from 2014 (http://www.sciencedirect.com/science/article/pii/S1064748113002832):

“Delusional thoughts are common among patients with Alzheimer disease (AD) and may be…linked to [the fact that they] cannot recall accurate information, which leads to inaccurate beliefs and [that they can’t] appreciate the illogic of beliefs…Delusions in AD are associated with dysfunction in specific frontal and temporal cortical regions. Delusions are…linked to memory deficits but not to insight.”

Of course, this doesn’t change anything. Dad’s illusions will continue to increase until his brain reaches a point where it can no longer function – Stage 7. Here’s a quick review the stages:

Stage 1: No memory problems are evident.

Stage 2: Minor memory problems but not distinguishable from normal age related memory loss.

Stage 3: Friends and family members begin to notice memory and cognitive problems like not being able to find the right word during conversations, forgetting new acquaintances, an frequently losing valuables.

Stage 4: Clear cut, classic symptoms of Alzheimer’s disease are apparent.

Stage 5: Need help with many day to day activities. Significant confusion, forgetting person information like phone number but still able to bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.

[Dad is probably here-ish.]

Stage 6: Confusion or unawareness of environment and surroundings, behavior problems, assistance with activities of daily living, recognizes only friends and relatives, loss of history, incontinence, wandering.

Stages 7: Lose ability to respond to their environment or communicate, assistance with all activities of daily living is necessary, and many lose the ability to swallow [Dad has trouble with this already].

So, there you go. Living in his illusory world is hard for him – but it’s got to be one of the hardest things I’ve ever had to deal with.

Later…


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