Mum has been short of breath for a couple of weeks now. A week ago, she had a battery of tests, but she passed all with flying colors. Last Friday I accompanied her and Dad to the Dr. to discuss the results of the tests and see what the next steps are.
I hadn’t seen Mum in a month, and I was disturbed by her apparent decline. She could barely make it to the Dr.’s office and then had to sit down right away. All readings are normal so the Dr. is mystified. She has enough oxygen in her blood. EKG and other scans, and tests done earlier show nothing. He observed her for a while very carefully, commenting that her breathing is Cheyne-Stokes like. He ordered an echocardiogram and talked about the possibility of some sort of brain scan for a small growth or tumor as well. Otherwise, he doesn’t know.
The Dr. also noticed a change in Mum’s attitude, calling it “Failure to Thrive.” I had heard this in relation to very ill infants but not geriatric patients, at least not those who are still up and about and able to take basic care of themselves. Touchingly, Dad emphasized to Mum in the office that she deserves to live. Mum just looked back at him with a wan smile.
Dad is doing more and more now around the house, as Mum has no ambition and doesn’t have strength to do much anyway. This is taking a toll on him too.
Tuesday, September 7, 2010
Friday, August 20, 2010
Alzheimer's and Anorexia
Mum seemed to have been on a plateau for some months until about a month ago. Looking back though, I can see that she has been declining very gradually. Her decline took a more precipitous turn when she stopped eating. At the same time, she was vomiting and saying she had no appetite. She became disturbingly weak.
Her physician weighed her in at just under 80 lbs. and diagnosed anorexia. According to Dad, the doctor outlined her options in no uncertain terms: Eat, be hospitalized and force fed, or die. To push her in the proper direction, he prescribed an appetite stimulant (megestrol).
I’m very happy to report that she responded to medication, although it did take a few days. She’s now eating more at each meal than she has in months. Even my father is amazed.
What surprises me is that it took so long for the doctor to reach the diagnosis of anorexia. Mum has been underweight for several years. She actually has hypothyroidism (not hyper) and is on medication to control that. Perhaps that is a complication. However, she has had food and body image issues throughout her life, even as an elderly person. Despite having little energy, losing weight, and not being able to find clothes that aren’t baggy, she would still be concerned about her diet. For example, when the rest of us (most of whom could afford to lose a few pounds) indulged in ice cream, she would eat fruit.
I know two other elderly women who followed similar patterns. Neither one had Alzheimer’s or any kind of dementia, so I did not associate the two. I simply thought, and still do think, that anorexia in elderly women is overlooked. When I searched the Web for Alzheimer’s and anorexia, I did find that the two can be associated. Whether Mum had anorexia before she came down with Alzheimer’s or vice versa is anyone’s guess. I’m just glad that she’s eating more again, and I look forward to seeing her with a few more pounds of flesh on her bones.
Her physician weighed her in at just under 80 lbs. and diagnosed anorexia. According to Dad, the doctor outlined her options in no uncertain terms: Eat, be hospitalized and force fed, or die. To push her in the proper direction, he prescribed an appetite stimulant (megestrol).
I’m very happy to report that she responded to medication, although it did take a few days. She’s now eating more at each meal than she has in months. Even my father is amazed.
What surprises me is that it took so long for the doctor to reach the diagnosis of anorexia. Mum has been underweight for several years. She actually has hypothyroidism (not hyper) and is on medication to control that. Perhaps that is a complication. However, she has had food and body image issues throughout her life, even as an elderly person. Despite having little energy, losing weight, and not being able to find clothes that aren’t baggy, she would still be concerned about her diet. For example, when the rest of us (most of whom could afford to lose a few pounds) indulged in ice cream, she would eat fruit.
I know two other elderly women who followed similar patterns. Neither one had Alzheimer’s or any kind of dementia, so I did not associate the two. I simply thought, and still do think, that anorexia in elderly women is overlooked. When I searched the Web for Alzheimer’s and anorexia, I did find that the two can be associated. Whether Mum had anorexia before she came down with Alzheimer’s or vice versa is anyone’s guess. I’m just glad that she’s eating more again, and I look forward to seeing her with a few more pounds of flesh on her bones.
Sunday, June 21, 2009
A Sad Milestone
Recently my parents drove 45 minutes to my father's eye doctor appointment, as he was due to get a shot for his macular degeneration. Since his eyes have to be dilated for this procedure, my mother drove home. Almost home, they stopped at the main building of their senior citizen facility to pick up their mail. Dad popped out to pick it up. Once back in the car, Mum put her foot on the brake after the car rolled a bit. She took her foot off and the car rolled again. She then put her foot on the brake and said "The car isn't going anywhere." In that moment, Dad realized that she thought she had been putting her foot on the gas and he resolved to keep her from driving ever again.
I give Dad much credit, not only for immediately realizing the gravity of the situation, but for knowing what had to be done. And none too soon.
I give Dad much credit, not only for immediately realizing the gravity of the situation, but for knowing what had to be done. And none too soon.
Monday, May 18, 2009
Unkind Remarks and Good Memories
In denial about her Alzheimer’s, my mother does not understand why she needs to see the geriatric psychiatrist, Dr. S., every couple of months. This comes up fairly often when I’m with her, because during the last visit with him, he asked her to scrapbook an album page and bring it in. I happened to be at that visit and brought up the scrapbooking when he asked my mother how she spends her time. Otherwise I’m not sure she would have mentioned it. He greatly encouraged her to do as much scrapbooking as she likes. It’s good for her in so many ways, using creativity, organizing materials and concepts, rekindling old memories. For a few weeks after that Dr. visit, she kept saying that she didn’t understand why she had to bring in a new page, and even proposed bring in an album she’d done a few years ago. I would patiently explain that he wanted to see work she’s done between visits. At some point, she stopped talking about it and just scrapbooked. She now has several pages done. I’m not even sure if she remembers she’s supposed to bring something to show Dr. S. now.
Dr. S. prescribes Aricept for my mother and monitors the progression of the disease. Clearly my mother doesn’t understand that, but at one time she did understand that she has “early dementia” although I don’t know where she got that phrase. On some level I believes she still knows this. Sometimes when she forgets things she becomes very discouraged and says that she doesn’t know how my father puts up with her. This happens more and more often.
Her incomplete comprehension of Dr. S.’s purpose in her life took an odd turn, I think, during one dinner in her senior citizen community dining room. As I understand it, my parents were dining with another resident who they referred to as a Know-It-All. Ms. Know-It-All, as I’ll call her, apparently learned that my mother sees Dr. S., and said something to the effect that Dr. S. treats people with Alzheimer’s, crazy people. I don’t know what else was said at that time, but the remark clearly upset my mother. Telling me the story, my mother ended it with the total denial that she has Alzheimer’s or anything like it.
At the very least Ms. Know-It-All’s remark was insensitive, at worst, mean and cruel. It’s hard to fathom what she was trying to accomplish. Always prone to denial anyway, it served to tip my mother into Denial River head first. While that in itself is not such an awful or unusual thing, as most Alzheimer’s patients are unaware of their condition during all or most of their illness, such talk doesn’t help her in relating to Dr. S. and certainly isn’t good for her self-image. I’d like to find Ms. Know-It-All and give her a good shake.
But I want to end this post on a more positive note. During my visits, while my mother scrapbooks, I’ve been going through their box of old photographs. At this point I’m just trying to get them out of the old box and into safe storage while roughly sorting them. When I see photos that are very old and have people in them that I’m sure my sister and I don’t know, I ask my mother to identify them then and there instead of waiting. Last time, I found a photo of my grandparents with six other people. The photo looked to be from the 1940’s. When I asked my mother who they all were, she was able to identify all of them. They turned out to be her aunts and uncles, people who are long gone, and who I’d never met. I don’t even think she had met them many times because they lived in Canada and didn’t visit much. I was gratified to see how quickly she rattled off their names. That, I think, was one of the best things that happened during that visit.
Dr. S. prescribes Aricept for my mother and monitors the progression of the disease. Clearly my mother doesn’t understand that, but at one time she did understand that she has “early dementia” although I don’t know where she got that phrase. On some level I believes she still knows this. Sometimes when she forgets things she becomes very discouraged and says that she doesn’t know how my father puts up with her. This happens more and more often.
Her incomplete comprehension of Dr. S.’s purpose in her life took an odd turn, I think, during one dinner in her senior citizen community dining room. As I understand it, my parents were dining with another resident who they referred to as a Know-It-All. Ms. Know-It-All, as I’ll call her, apparently learned that my mother sees Dr. S., and said something to the effect that Dr. S. treats people with Alzheimer’s, crazy people. I don’t know what else was said at that time, but the remark clearly upset my mother. Telling me the story, my mother ended it with the total denial that she has Alzheimer’s or anything like it.
At the very least Ms. Know-It-All’s remark was insensitive, at worst, mean and cruel. It’s hard to fathom what she was trying to accomplish. Always prone to denial anyway, it served to tip my mother into Denial River head first. While that in itself is not such an awful or unusual thing, as most Alzheimer’s patients are unaware of their condition during all or most of their illness, such talk doesn’t help her in relating to Dr. S. and certainly isn’t good for her self-image. I’d like to find Ms. Know-It-All and give her a good shake.
But I want to end this post on a more positive note. During my visits, while my mother scrapbooks, I’ve been going through their box of old photographs. At this point I’m just trying to get them out of the old box and into safe storage while roughly sorting them. When I see photos that are very old and have people in them that I’m sure my sister and I don’t know, I ask my mother to identify them then and there instead of waiting. Last time, I found a photo of my grandparents with six other people. The photo looked to be from the 1940’s. When I asked my mother who they all were, she was able to identify all of them. They turned out to be her aunts and uncles, people who are long gone, and who I’d never met. I don’t even think she had met them many times because they lived in Canada and didn’t visit much. I was gratified to see how quickly she rattled off their names. That, I think, was one of the best things that happened during that visit.
Sunday, February 1, 2009
Organizing Breakdown
Yesterday I spent a few hours with my parents at their place, helping my mother to organize photos. We visited a bit beforehand, and except that she just can’t remember the date, she seemed fairly with it and normal.
Until I saw her scrapbooking table. My mother, who has always been an organized person, was at a loss. Her table was covered with photos that she couldn’t seem to categorize. Photos were mixed in memorabilia (ticket stubs, programs and such) and embellishments (decorative items to dress up photo album pages). Clearly she was trying to do too much at once, and didn’t have a plan in mind.
I helped her separate everything and organize it. Although she seemed grateful, she also seemed perplexed, as if she wasn’t sure of the need for organization. I’m unsure as to the cause of that. I suggested she work on one group of photos at a time but I honestly don’t know if that registered.
I am forming a plan for my mother and the organization of all her photos. Yesterday’s visit was mostly to evaluate the situation. The most important things I gleaned were 1) the plan must be flexible 2) there must always be some interesting and realistically accomplishable task to keep my mother engaged. She doesn’t need to be overwhelmed.
It was an exhausting day, but I’m looking forward to next time.
Until I saw her scrapbooking table. My mother, who has always been an organized person, was at a loss. Her table was covered with photos that she couldn’t seem to categorize. Photos were mixed in memorabilia (ticket stubs, programs and such) and embellishments (decorative items to dress up photo album pages). Clearly she was trying to do too much at once, and didn’t have a plan in mind.
I helped her separate everything and organize it. Although she seemed grateful, she also seemed perplexed, as if she wasn’t sure of the need for organization. I’m unsure as to the cause of that. I suggested she work on one group of photos at a time but I honestly don’t know if that registered.
I am forming a plan for my mother and the organization of all her photos. Yesterday’s visit was mostly to evaluate the situation. The most important things I gleaned were 1) the plan must be flexible 2) there must always be some interesting and realistically accomplishable task to keep my mother engaged. She doesn’t need to be overwhelmed.
It was an exhausting day, but I’m looking forward to next time.
Sunday, January 18, 2009
Bright Spots
Yesterday my sister and brother-in-law spent the day with my parents. The main purpose of the visit was to computerize the checkbook tasks. For all of their married life - nearly 58 years - my mother has been in charge of the family finances. She did a great job all of that time, managing the budget and paying all of the bills.
For the past several months, she has been having difficulty balancing the checkbook. This has been causing her much angst. My father has made noises about taking it over, but really, at 88, it seems to be beyond him, in his view. That appears to be his message although he doesn't come out and say it. So my bil, who possesses strong practical financial skills and knowledge, has generously offered to take it over (he handles the finances in that marriage). It's a steep set up curve, but he managed to get through 2 months of checks yesterday. Apparently my folks write many checks.
The bright spot here regarding my mother, is that she remembered without hesitation what all the check entries are. Many of the entries are reportedly mysterious to outsiders, noted in initials or abbreviations rather than spelled out. As bil asked Mum what these things meant, she was able to rattle everything off.
Wonderful, and interesting. While her math logic has clearly been affected by aging or disease or both, her memory for these particular things in her checkbook register has not. Amazing since she often cannot remember something said to her an hour, a day, or a month ago.
For the past several months, she has been having difficulty balancing the checkbook. This has been causing her much angst. My father has made noises about taking it over, but really, at 88, it seems to be beyond him, in his view. That appears to be his message although he doesn't come out and say it. So my bil, who possesses strong practical financial skills and knowledge, has generously offered to take it over (he handles the finances in that marriage). It's a steep set up curve, but he managed to get through 2 months of checks yesterday. Apparently my folks write many checks.
The bright spot here regarding my mother, is that she remembered without hesitation what all the check entries are. Many of the entries are reportedly mysterious to outsiders, noted in initials or abbreviations rather than spelled out. As bil asked Mum what these things meant, she was able to rattle everything off.
Wonderful, and interesting. While her math logic has clearly been affected by aging or disease or both, her memory for these particular things in her checkbook register has not. Amazing since she often cannot remember something said to her an hour, a day, or a month ago.
Tuesday, January 13, 2009
Why
My mother has Alzheimer's Disease. The family learned this just two days after I arrived back here in Massachusetts, having driven across the country just ahead of a moving van full of my stuff, after living in California for 15 years. This happened in early November, 2008.
One of the reasons I returned was to be closer to family. We all knew something wasn't quite right with my mother, although no one was sure exactly what until the specialist told us. It was more shocking to me, which wouldn't seem surprising to most people as I had only been able to see my mother once a year. But what really shocked me was my own level of denial. Beginning several years ago, I began noticing curious lapses of memory and other behavioral issues. When I mentioned them to other relatives, they said "normal aging process." I didn't think so. Then, about a year and a half ago, she had surgery to remove a benign mass in her lung for which she had to undergo general anesthesia. The operation went well, but her memory and some aspects of her personality were never the same again.
That's when the family began to get concerned. And as it turns out, the specialist also said that she had had some strokes, probably as a result of the anesthesia. So I was thinking along the stroke line when the Alzheimer's diagnosis came through. I so much didn't want it to be that, I had simply put it out of my mind.
We are all at the beginning of this. My mother knows, but seems peculiarly unconcerned - especially considering that her mother had dementia for years and my mother was sure it was Alzheimer's and that she would get it. She dreaded that. Maybe her lack of concern is common in Alzheimer's patients, I don't know. I need to read up on this more. Anyway, no one knows where this disease is going in my mother, although I'm sure we're all imagining something similar.
This blog is my attempt to drag myself away from imagining the undoubtedly grim course of this disease in my mother by writing about it as it's happening. Perhaps in some small way, it will help. Please feel free to leave comments.
One of the reasons I returned was to be closer to family. We all knew something wasn't quite right with my mother, although no one was sure exactly what until the specialist told us. It was more shocking to me, which wouldn't seem surprising to most people as I had only been able to see my mother once a year. But what really shocked me was my own level of denial. Beginning several years ago, I began noticing curious lapses of memory and other behavioral issues. When I mentioned them to other relatives, they said "normal aging process." I didn't think so. Then, about a year and a half ago, she had surgery to remove a benign mass in her lung for which she had to undergo general anesthesia. The operation went well, but her memory and some aspects of her personality were never the same again.
That's when the family began to get concerned. And as it turns out, the specialist also said that she had had some strokes, probably as a result of the anesthesia. So I was thinking along the stroke line when the Alzheimer's diagnosis came through. I so much didn't want it to be that, I had simply put it out of my mind.
We are all at the beginning of this. My mother knows, but seems peculiarly unconcerned - especially considering that her mother had dementia for years and my mother was sure it was Alzheimer's and that she would get it. She dreaded that. Maybe her lack of concern is common in Alzheimer's patients, I don't know. I need to read up on this more. Anyway, no one knows where this disease is going in my mother, although I'm sure we're all imagining something similar.
This blog is my attempt to drag myself away from imagining the undoubtedly grim course of this disease in my mother by writing about it as it's happening. Perhaps in some small way, it will help. Please feel free to leave comments.
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