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COLUMN: Alzheimer’s – when loved ones are present, yet absent

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By John Lapp

You may not have yet experienced alzheimer’s in your family, but it is the sixth leading cause of death in the United States. The number of people with Alzheimer’s disease (AD) or some other form of dementia is projected to reach 14 million in a number of years.
It is stated regularly that families caring for someone with dementia or AD are barely able to stay afloat. Observing a person sort of “disappear” while you’re actually watching it happen can be very depressing and disheartening, to say the least.
This person may be a grandparent, a parent, a spouse, or some other type of relative. It may also be a close friend you’ve known many, many years and whose friendship will now take a serious turn from where it has always been.
I present a real example from my own family. My father, in his 70s, while standing near the top of a ladder, had suffered a serious fall while reaching for an orange he had attempted to pluck from one of the trees in my brother’s back yard, reportedly causing a stroke, along with rapidly promoting the onset of dementia and/or Alzheimer’s disease. He already had symptoms of Parkinson’s disease.
Some time later, Dad and Mom, now both retired, had sold their house, and temporarily resided with us in Jacksonville, Fla. One day, having just arrived home, I was walking up the back steps into our house and noticed my Dad sitting in a chair on our back deck.
He greeted me with, “Hey Alex (the name of my mother’s youngest brother), when did you get here?”
I gave him an answer like, “Well, not very long ago.” We chatted for a few moments, and he then proceeded to ask “Why did you answer me when I referred to you as Alex?”
I sort of gave him a nonsense answer, and he then asked: “don’t you know your own name, John?”
I kind of changed the subject so as not to aggravate him, which can be one of the symptoms of Alzheimer’s disease and the conversation continued and he didn’t seem to know that the previous dialogue had taken place.
On another occasion, our son, daughter-in-law and granddaughter, Ashley, then about 18 months old, were visiting, Dad suddenly looked at Ashley, who was toddling around in the living room, and asked “When did the plumber get here?” referring to Ashley, and when that brought a few chuckles from some of us, Dad broke into a wide grin, seeming to enjoy the humor of what he had just asked.
Whether or not he knew, when he posed this unusual question, that it did not make any sense was never addressed by any of us who were present with him, and did not necessarily need to be addressed.
That example, with the AD person present is not an unusual event with respect to the family members of an AD patient. Alzheimer’s and the factors that affect the family and friends of the patient are important to address.
Often many family members can be in denial as it is too frightening and painful to witness and acknowledge the change that AD has now presented. Many also feel inadequate or unsure of being a caregiver which was the case for the next several months for both my wife and me.
We had discussions with Mom as to where they would finally live, also not knowing if Dad would eventually require nursing home care. My wife carried a “lion’s share” of much of the care during that time because I was still in practice with a heavy counseling load which often kept me at the office into the evening hours.
Mom had recently suffered a fall and had fractured one of her wrists, and was elderly also, and had recently needed a pacemaker for her heart. Dad was a fairly big man, weighing about 180-200 pounds, therefore Mom could no longer help him get ready for bed and help him in the shower. They eventually moved back to New York state and Dad’s health had deteriorated to the point where he entered a nursing home. My youngest brother had sufficient room for Mom to live and the nursing home was only a few miles away, so she could visit.
Another factor that affects the family is that they may not know how to assess how competent or incompetent the family member is, as this often requires either referring the family to a geriatric physician or other medical person to obtain more clarity relative to the future of the disease.
Some may even resent, for a variety of reasons, having to step in or take over, having no warning or advance preparation for this sudden change and responsibility.
A real case example: a single parent in her early 50s had made an appointment to have therapy for increasing anxiety and depression. She was an only child with a mother, now 82 years old, who had been diagnosed with AD four years earlier. The client’s father was 86 years old, a prosperous doctor, very strong-willed, liked by others, but feared by the family including both her and her mother.
She had described him as difficult all her life, describing him as being abusive to both her and her mother. At the time of the appointment, he had been unwilling to let anybody else help, which was continuously a battle over the care of her mother. There was also some suspicion that her father might have some dementia. Eventually the client received the necessary help to settle both of her parents into an assisted living facility.
This case was presented to let you get a picture of two different situations that are very different in scope and care. It is important for all of us to prepare for what may seem inevitable, that all of us may at some time be called on to be of support for members of our families. We may, at least, need to lend an arm of emotional support to those who are potentially struggling with caring for, while hopefully continuing to love and be a part of the life of, the one with AD. This person can present, often without being aware, how this has become an added burden to many members of the family.
Probably most of you who are near the age of 40 to 50 years old, have elderly relatives you know and love, who may be at or near the mild to moderate stages of AD. The very least that you could do is lend an arm of support to those who care for the AD person.
Hey, I am 77 years old and although neither I, nor members of my family, are aware that I have any of the known symptoms of AD, I may someday be the one in need of special love and care.
I’m praying, however, that I will, as did both my mother-in-law, and a brother-in-law, live to be 99 years old. Both experienced some of the obvious signs of aging, but neither displayed any known symptoms of AD.
I hope that this topic, while not presented in its fullest, has helped some to better understand the needs of
the family with an AD member.
To better have a complete understanding of AD, I’m recommending a wonderful book I have somewhere in my library, titled “The 36 Hour Day.” You could possibly find
this in your local library, or you may be able to buy it online. Again, may God bless you as you bless others who carry this load.
For more information, contact me at 502-477-2818.