The Twilight Years Are Here

The Twilight Years Are Here

Sunday, May 27, 2012

Seven Stages of Alzheimer's (A Loose Guide)

Seven Stages of Alzheimer's Alzheimer's symptoms vary. The stages below provide a general idea of how abilities change during the course of the disease. Not everyone will experience the same symptoms or progress at the same rate. This seven-stage framework is based on a system developed by Barry Reisberg, M.D., clinical director of the New York University School of Medicine's Silberstein Aging and Dementia Research Center.

Stage 1: No impairment (normal function) The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptoms of dementia.

Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease) The person may feel as if he or she is having memory lapses — forgetting familiar words or the location of everyday objects. But no symptoms of dementia can be detected during a medical examination or by friends, family or co-workers.

Stage 3: Mild cognitive decline (early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms) Friends, family or co-workers begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. Common stage 3 difficulties include: Noticeable problems coming up with the right word or name Trouble remembering names when introduced to new people Having noticeably greater difficulty performing tasks in social or work settings Forgetting material that one has just read Losing or misplacing a valuable object Increasing trouble with planning or organizing

Stage 4: Moderate cognitive decline (Mild or early-stage Alzheimer's disease) At this point, a careful medical interview should be able to detect clear-cut symptoms in several areas: Forgetfulness of recent events Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7s Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances Forgetfulness about one's own personal history Becoming moody or withdrawn, especially in socially or mentally challenging situations.

Stage 5: Moderately severe cognitive decline (Moderate or mid-stage Alzheimer's disease) Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer's may: Be unable to recall their own address or telephone number or the high school or college from which they graduated Become confused about where they are or what day it is Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s Need help choosing proper clothing for the season or the occasion Still remember significant details about themselves and their family Still require no assistance with eating or using the toilet

Stage 6: Severe cognitive decline (Moderately severe or mid-stage Alzheimer's disease) Memory continues to worsen, personality changes may take place and individuals need extensive help with daily activities. At this stage, individuals may: Lose awareness of recent experiences as well as of their surroundings Remember their own name but have difficulty with their personal history Remember: It is difficult to place a person with Alzheimer's in a specific stage as stages may overlap. Distinguish familiar and unfamiliar faces but have trouble remembering the name of a spouse or caregiver Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet Experience major changes in sleep patterns — sleeping during the day and becoming restless at night Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly) Have increasingly frequent trouble controlling their bladder or bowels Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor)or compulsive, repetitive behavior like hand-wringing or tissue shredding Tend to wander or become lost

Stage 7: Very severe cognitive decline (Severe or late-stage Alzheimer's disease) In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases. At this stage, individuals need help with much of their daily personal care, including eating or using the toilet. They may also lose the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing impaired. According to Alzheimer’s Association at the following link…

Sprinkling Profanities

May 16, 2012

It is getting so much more difficult to deal with Dad lately. He obviously recognizes the people around him less and less. Rarely does a day go by that he doesn’t ask who someone is or ask repeatedly where we are. He says horrible, hateful things to anyone anytime. When he is confronted about it, he gets offended and accuses everyone of picking on him or he simply outright denies it. He is paranoid, convinced that everyone is out to get him or wants something from him.

For the last few weeks, he tells anyone who will listen (including the children), “This is my God*#mn house! If you don’t like it here you can just get the f*ck out!” I know this is part of the disease but you have to understand, this is a man who rarely swore and never in front of ladies. Now, he can’t get through much of a day without using his two new favorite words. The children are here less often now and I am thankful for their sakes.

One of the things he does that irks me to no end is the version he tells of why we live here. According to him, we were homeless, living on the street with no jobs or vehicles. He took us in to help us. While people who know us, know differently, it is hard to hear him tell it to complete strangers in waiting rooms or even the occasional telephone solicitor who happens to get him on the phone. He simply cannot fathom that we gave up our jobs, home, belongings, lives, etc. to come here to take care of them. It is even harder for him to acknowledge that he was the one who needed help. Somehow, it makes him feel better to think that he was helping us out.

By the end of every day, I am grateful when he goes to bed just so I can have a break from the chronic torture of this disease. I feel like such a bitch for saying that but, it’s the truth. So often lately, I feel emotionally battered and bruised, exhausted beyond anything I could have ever imagined. I feel guilty, very, very guilty for feeling like I can’t handle it sometimes. I feel like I am letting him down somehow. In fact, I frequently feel like I am letting someone (sometimes a lot of someone’s, if not everyone) in my life down. I feel as if my grip on every situation is tenacious at best. I don't like feeling this way.

April 23, 2012

About 6:30 this morning, Cameryn (our grandson) found Dad lying on the kitchen floor. Quite literally, he had fallen and couldn’t get up. He got Richard who made a startling discovery when he attempted to lift him and couldn’t. Richard helped (Dad weighs app. 190 lbs) get him rolled over and up on his hands and knees before slowly helping him to rise. He checked Dad for injuries and then assisted him to his chair in the living room. We aren't at all certain how long he was on the floor and he can't tell us.

This is the first time something like this has happened (with me home and sleeping through it). Richard did a good job of handling the situation and I felt a huge weight fall from my shoulders as the events were repeated to me. As a primary caregiver, one of the most difficult things to grasp is that we can NOT be there all the time. Rather than lamenting the fact that I only knew about it afterwards, I was delighted to know that Richard handled the crisis well. However, a decision was rapidly made. We will be adding a second monitor, stationed in the kitchen that will be able to pick up sounds in the kitchen and dining room clearly. It is just too far away from the one in his bedroom which only picks up into part of the living room. Between the two of them, we will be able to clearly hear him anywhere upstairs. An added bonus will be hearing when the boys sneak into the kitchen at night.

Dad has been consistently more confused lately. Every evening, as the sun begins to set, he gets steadily more confused and disoriented and more depressed. The phenomenon, which affects up to 20% of the more than 5 million Americans with Alzheimer’s, is called, appropriately, “Sundowner's Syndrome.” In the past, he only experienced it when he was in a hospital or rehab. Now, he suffers it daily anywhere. And tomorrow is the second anniversary of Mom's death.