I just spoke with Father

Dad has been very busy this week with continuing to finalize papers
on the home equity credit line he will be using for the purchase of
the new house. Faxing papers to the credit union and answering
questions has taken several days. He is also working on final details
of the new house yet to be ordered, colors, windows, final details
take an amazing amount of time when ordering a modular home.

During this time, Mother continues to be changing, it seems, on a
daily basis. Oh, news flash, Mom and Dad found the missing purse and
ID and credit cards and everything. It was all hung up on a hanger in
the back of the closet next to the old winter clothes that even Mom
will not wear.

I just got off the phone with Mom tonight. I try to call on Friday
nights since things are quieter and calmer here at my house. Tonight
I tried to just sit on the couch and connect with the ebb and flow of
Mom's thoughts and feelings. She was eating her usual supper of
healthy toast with healthy peanut butter and healthy bananas and
plain yogurt. When I asked what she was eating she could describe all
the items except for the yogurt. She turned to Dad and said, "I have
not talked about my supper with someone before, what is the white
stuff called...?" So he reminded her it was yogurt.

Mom has been on heavy medication for her vasculitis, http://
www.niaid.nih.gov/factsheets/wegeners.htm, for many years. Just last
week Dad saw a commentator on the Olympics comment that one of the
athletes has a vasculitis similar to mother's; he pointed this out to
Mom and she told him she did not know what he was talking about. So
tonight, while on the phone, I asked her about the vasculitis. She
wondered why I was asking, commented that Dad had commented recently
about it and then declared that it was a problem that "some doctor"
had checked her out for "years back" but it had not been a problem
for a long time.

This would be merely interesting except for the fact that she is
starting to strongly resist taking the medication each day she needs
to stay alive.

Well enough complaining about the reality of the changes.

On a different subject. This weekend is the wedding event of Timothy
and his wife to be. I wish I could be there both to see him and his
wife and catch up with every one else. But it is not to be.

Just spoke with Dad

I may bore you guys with little notes from time to time. Tough luck.

Dad said that the bank and title company that is doing the loan on
the Cirby Creek property will need each of our signatures to complete
the papers for the trust. I suppose it will all get mailed around.

So, I spoke with Mom on the phone and told her I was looking forward
to seeing more of her as she and Dad drove back and forth preparing
to build their new home in Clearlake Oaks. She just giggles and says,
"oh, are we doing that? I did not know that had been decided yet. I
thought it was just an idea."

OK then.... tough to explain all the stuff at home boxed up in the
garage.....

Well, a cheery hello and update on Mom

As is my tradition to myself, this will be posted to my blog at http://okbacktothestory.blogspot.com.

Welcome Cowboy, Brian gave me your address, I hope I have it correct. If the two of you are interested I can include you on emails I send to the blog. I don't want to be boring so do let me know. 

Tonight I am going to focus on what happened when Mom and Dad came by my office today. I will recount one item and then I am going to post a rather lengthy item from another website. 

Dad used his utility trailer that normally has his trash in it at the Cirby Creek house to haul his first load of stuff over to his new lot in Clearlake Oaks. I do not have the address yet but when I get it I will post it. Just to give you and idea of where thew will be, do a mapquest on this address. Hickory Ln, Clearlake Oaks, CA. That should get you close for now. Hickory land is a loop in this development. There are probably three lots on the straight edge of the loop and three more lots around the nose of he loop. The small space "inside" the loop is just landscaping. The whole place is carved out of an old walnut orchard and well over 80% of the lots have modulars already installed. Some units are probably over ten years old, maybe older. So anyway... Dad dropped off the first load of his stuff including scaffolding and other outdoor stuff that can lay in the rain at the rear of his lot, out of the way of the foundation that is soon to be built. 

Dad has taken out a home mortgage line of credit against the Cirby Creek property through the Silverado Credit Union. He and Mom came over today to drop off papers at the Angwin branch to complete the financing. On the way over they stopped at the restaurant where Mom thinks she lost her purse two weeks ago. This is very confusing to her. She did not lose her purse there. She had her purse later in the day in question. But she has lost her wallet and ID and a credit card and thinks it happened at this Mexican restaurant.  

So, they drop by my office and Dad tells me they stopped at the eatery to inquire one more time (for Mom's benefit) regarding the lost item. She listens to him tell of the restaurant visit and then proceeds to tell me that they will be stopping there on the way home to check and see if anyone has reported a missing purse. Confusing. Bless Mom's heart, I was flirting with the waitress when we ate there two weeks ago and now she is certain I know all the staff in the place and could I please get the purse back that she lost there that the staff and not giving back. OK, moving on. 

So a wonderful coworker of mine, Monty, stops by my office space and I introduce him to Mom and Dad, he recognizes Dad from the several summers that Dad has worked on plastering in and on the campus buildings. He also begins to say nice things about me (some of which are true) and Mom jumps in with stories about her three boys.  

AND THIS IS THE PART THAT GOT TO ME. 

She could not remember which of us was born first. She could not place what city or geographic region each of you were born in. She sorted out birth order eventually but it left her confused and she drifted into giggling and saying, "well, I sure have not thought about that in a long time." This was the first time that I had seen her this confused regarding family history. It left me feeling emptier inside then I have felt for some time regarding this topic. And I find myself thinking thoughts that you are not supposed to put into words. Thoughts like, "I sort of hope this whole process of losing our mother does not take too long....."

OK, now to the information from the website; www.alz.org/AboutAD/Stages.asp  regarding the stages of Alzheimer's disease. I have edited each stage for briefness.  In my opinion I am seeing a move from late stage 4 into early stage 5. It seems each stage is only visible after you are well into that stage. 

From the website:

 

Experts have documented common patterns of symptom progression that occur in many individuals with Alzheimer’s disease and developed several methods of “staging” based on these patterns. Progression of symptoms corresponds in a general way to the underlying nerve cell degeneration that takes place in Alzheimer’s disease. Nerve cell damage typically begins with cells involved in learning and memory and gradually spreads to cells that control every aspect of thinking, judgment, and behavior. The damage eventually affects cells that control and coordinate movement.

Staging systems provide useful frames of reference for understanding how the disease may unfold and for making future plans. But it is important to note that all stages are artificial benchmarks in a continuous process that can vary greatly from one person to another. Not everyone will experience every symptom and symptoms may occur at different times in different individuals. People with Alzheimer’s live an average of 8 years after diagnosis, but may survive anywhere from 3 to 20 years.

Within this framework, we have noted which stages correspond to the widely used concepts of mild, moderate, moderately severe, and severe Alzheimer’s disease. We have also noted which stages fall within the more general divisions of early-stage, mid-stage, and late-stage categories.

 

Stage 1:	No impairment (normal function)
	Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.
Stage 2:	Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease)
	Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to 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 deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:      . Word- or name-finding problems noticeable to family or close associates      . Decreased ability to remember names when introduced to new people      . Performance issues in social or work settings noticeable to family, friends or co-workers      . Reading a passage and retaining little material      . Losing or misplacing a valuable object      . Decline in ability to plan or organize
Stage 4:	Moderate cognitive decline (Mild or early-stage Alzheimer's disease)
	At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:      . Decreased knowledge of recent occasions or current events      . Impaired ability to perform challenging mental arithmetic-for example, to count backward from 100 by 7s      . Decreased capacity to perform complex tasks, such as marketing, planning dinner for guests or paying bills and managing finances      . Reduced memory of personal history      . The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations
Stage 5:	Moderately severe cognitive decline (Moderate or mid-stage Alzheimer's disease)
	Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:      . Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated      . Become confused about where they are or about the date, day of the week, or season      . Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s      . Need help choosing proper clothing for the season or the occasion      . Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children      . Usually require no assistance with eating or using the toilet
Stage 6:	Severe cognitive decline (Moderately severe or mid-stage Alzheimer's disease)
	Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:      . Lose most awareness of recent experiences and events as well as of their surroundings      . Recollect their personal history imperfectly, although they generally recall their own name      . Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces      . Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet      . Experience disruption of their normal sleep/waking cycle      . Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)      . Have increasing episodes of urinary or fecal incontinence      . Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding      . Tend to wander and become lost
Stage 7:	Very severe cognitive decline (Severe or late-stage Alzheimer's disease)
	This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.      . Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered      . Individuals need help with eating and toileting and there is general incontinence of urine      . Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.

 

Gonna Be a Bumpy Ride

It has been a good long while since I posted anything to my blog.

The reason for the delay is simple and confusing. The blog started
out focused on Mark and Linda and I but it has evolved into a focus
on the changes that are taking place with Mom.

I went over to Cirby Creek several weeks ago for a weekend of
visiting and working on my old Pathfinder with Dad. I knew that I
would see changes in Mom but ultimately I found it hard to see and
absorb the changes I did see. I intended to write out my feelings and
observations after that weekend, but writing things down still is too
hard most of the time since it seems to make 'things' too real
sometimes.

Last week Mom and Dad came over to Lake Co to close escrow on the lot
they purchased in Clearlake Oaks. The lot is on a nice cul-de-sac and
has rather new existing modular homes on each side. The small
property is already fenced and it has two walnut trees (used to be an
orchard) and it has a row of ornamental cedar trees that one neighbor
planted well across the lot line. So Dad just bought part of the
neighbors landscaping.

So I met them at the civil engineers place, a new neighbor, and then
we visited the property before lunch. Mom was generally confused
about what was going on although she did know that they are buying
this lot and intending to place a house there. Over the course of the
next three hours she lost.... her umbrella, her tote bag and her
purse and wallet with all her ID and at least one credit card. Before
most of that happened she and I had a talk. I drove her to the
restaurant while Dad followed and in the course of conversation she
said. "Your father has told people that I have Alzheimer's disease."
I responded that "yes" the doctor had confirmed that was the case....
So she says, "well what kind of witch doctor did you and your father
find who would say a thing like that". Well, chatty, chatty, that
started a conversation that lasted for ten miles. I spoke to her of
the changes in her life and how she was no longer involved with the
check book, the insurance, the bills, lost her right to drive....
covered a lot of ground. For about 4 minutes in the middle of the
conversation she conceded that "things were different" in her head,
but Dad did all those things now and she did not need to worry about
such stuff. There was also a fantastic story about the "evil women"
at the DMV who would not help her get her license renewed. I used
that comment to point out that the way she sees incidents and events
was no longer the way others saw what happened and she needed to
trust Dad to care for her needs and not ragg on him all the time.

Like I said, she was connected to the conversation for about 4
minutes, but it left her agitated for the rest of the week. After a
nice lunch where I got her to smile and laugh even though she could
not follow the story of office politics, she and Dad went over to the
title office to close escrow and I went home. At the title office she
needed to sign a notarized document (possible the last she will ever
need) and she could not find her ID in her tote bag. Gone, full
search of cars and trucks and offices and restaurant and it is long
gone. Might have been gone for weeks before now, we don't know. We
did find her umbrella, but by the next day, she had lost the tote bag
of the day before. Never been seen since.

Dad and I have spoken almost every day, sometimes several times a
day. She has continued agitated all week and has continued to loose
things around the house that are minor but annoying. What does it all
mean. Part of me says I have no idea, part of me says I know exactly
what is going on.... gonna get ugly.

Dad and I have spoken of the eventual need for "day care" at a senior
center or some other resource. He says, not yet, but I want to keep
him as healthy as possible also. So there you go.