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…
The residence my
dad lives at does annual care reviews. This past month, because of changes in
his behavior and abilities, my dad was advanced from Level 1 (for which he
receives minimal care beyond what is normally provided to all of the community
(someone is always there to help him, room & board, medication delivery,
recreation and facility use, programming, nurse assessment, care conferences,
etc.) to Level 3. He’ll now receives help taking a shower, shaving, some help
dressing (mostly dressing appropriately), behavioral intervention (he has done “exit-seeking”
practically since he moved into the facility, often complaining that he feels
like a prisoner)but which as recently escalated to following a woman he thinks
is my mother and holding her hand (while the woman’s HUSBAND was sitting
there), his incontinence has increased, and he has a prescription for olanzapine:
“used to treat nervous, emotional, and mental conditions…may also be used alone
or with other medicines (lithium or valproate) to treat bipolar disorder
(manic-depressive illness) or mania that is part of bipolar disorder”, which
they use as needed when he gets agitated and really tries to “escape” the
place.
What does this
mean? Well, by now you know I prefer the 7 Stages of Alzheimer’s over the
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].
For me the Three
Stages of Alzheimer’s (Early, Middle, Late) seem…more open to a “shoulder shrug”
interpretation, like “Well, he has trouble coming up with the right word or
name, remembering names when introduced to new people, challenges performing
tasks in social or work settings, forgetting material that one has just read, losing
or misplacing valuables, increasing trouble with planning or organizing, so OMG!!!!
He MUST HAVE ALZHEIMER’S!!! Quick let’s get him institutionalized....” for
Early Stage Alzheimer’s.
As far as I recall,
Dad was in this stage well before we forced him and Mom to move.
With the Middle
Stage, comes forgetfulness of events or about one's own personal history, moody
or withdrawn, especially in socially or mentally challenging situations, unable
to recall their own address or telephone number or the high school or college
from which they graduated, confusion about where they are or what day it is, need
help choosing proper clothing for the season or the occasion, trouble controlling
bladder and bowels in some individuals, changes in sleep patterns, such as
sleeping during the day and becoming restless at night, an increased risk of
wandering and becoming lost, personality and behavioral changes, including
suspiciousness and delusions or compulsive, repetitive behavior like
hand-wringing or tissue shredding…
Late: Needs
round-the-clock assistance with daily activities and personal care, lose
awareness of recent experiences as well as of their surroundings, experience
changes in physical abilities, including the ability to walk, sit and,
eventually, swallow; have increasing difficulty communicating; become
vulnerable to infections, especially pneumonia.
Now, not to be
cynical or anything, but with the weed-like propagation of Memory Care facilities
(which charge exorbitant fees and seem to be a really good financial investment),
the moment a parent forgets something, with three Stages, families might throw
their arms in the air and place their parents in a Memory Care Facility when
the vague Early Stages of Alzheimer’s show their ugly head.
Dad would have
been in Late Stage for the past year or so…but with Seven Stages, when I
started this blog, Dad was between Stage 5 and 6. Most recently – like last
week – it’s clear that he’s advanced to Stage 6 with clear signs that Stage 7
is imminent. In particular, since this summer, Dad has exhibited a marked inability
to assess his environment, to wit: he called me two nights ago 23 times starting
at 1:40 am and calling for the last time at 3:42 am. He had no recollection of
that when I went to pick him up for his doctor’s appointment. He frequently has
no awareness of time of day, and lately he’s been unable to read his old watch,
becoming entirely confused when I ask him to describe… “What’s the big hand
pointing to? What’s the little hand pointing to?” I haven’t even tried to ask
him about the minute hand…
At any rate, I’ve
been working to reconcile myself with Dad’s decreasing ability…and to be
perfectly honest with you, I’m not doing really well and I find myself pulling
away.
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