Mom gets a haircut

We went up to see Dad and Mom on Sunday.

I made burgers and helped Dad finish setting up his Dish-Network and
3ABN satellites. Two set-top boxes, two dishes on the rear of the
house, I think it is all working fine now. Mark and I even went
through his remote settings and made a short list of channels for him
that did not include any of the HBO or sport or adult channels that
he is not using. But now that he knows they are there....

Linda gave Mom a hair cut after lunch and then Linda encouraged Mom
to take a shower and wash her hair to get those final scraps of hair
cuttings rinsed away. Mom could not figure out how to use the
shower, never did figure it out, so Linda went in to help her. Mom
explained to Linda that she is uncomfortable bathing in her bathroom
since several men live in the walk in closet off the master bathroom.
(Perfectly understandable, I would not want to shower in my shower if
there were men living in my master closet either. ) So mom hopped in
the tub and proceeded to shampoo and rinse her hair under that faucet.

Linda came away from the episode quite concerned and spoke with Dad
about it briefly, asking how often Mom bathes or showers. He said he
did not really know since she goes in the bathroom and closes the
door and he is never sure if any bathing takes place. After mom got
dressed she showed Linda the guest bath down the hall and explained
how she preferred that bath, it seems it has not closet, and thus no
extra prying eyes.

Throughout the three or four hours we were there mom would disappear
into her bedroom from time to time and come out wearing a different
skirt or top or sweater or whatever. Mark commented that she kept
changing her clothes and Linda pointed out, NO, she was just adding
layers. By the time it was bath time she had on three skirts and
several tops and she usually has on two to three layers of mismatched
socks.

So we go home.

I called Dad tonight to discuss some of this with him and we had a
pretty good talk. Right now I say that Dad is in denial about just
how things stand with Mom. I suggested that it was time for him to
start investigating some type of "home health" service to get a women
aid to come in at least once a week to help Mom with a bath and her
hair and nails as needed. Dad, apparently, is withdrawing from these
things in some ways and I think he needs some help. He conceded that
this might be a good idea and YES, he does know who to call in the
community for a referral for help.

I feel like 2007 is going to be a momentous year somehow. This thing
is starting to pick up pace and exceed my understanding of what
happens next and what should be the appropriate responses to what
happens next and when should further action be taken and what is that
action and and and and and....

I know less and less about more and more.

Just a medical update

Dad has just completed a complete medical work-up on Mom performed by her new doctor in Lake County. Mom's new lady doctor has rather impressed Dad with her thoroughness and her compassion for what Mom is facing and what Dad has to deal with in the coming months. 

So, this is all second hand from Dad but the medical work-up on Mom included full physical, breast x-ray, chest x-ray, head scan (MRI or CT scan I do not know). And the results are in. With the exception of her brain, Mother is in reasonably good health. I am beginning to think that maybe a life of "eat, drink and be merry" might be the better way to live. You might not live as long, but you might have more fun and you will not need to linger so long with a healthy body but no mind to appreciate it at the end. But I digress...

In the final report to Dad the doctor referred to a couple items that are naturally distressing. 

The chest x-ray and brain scan both showed signs of TIA's or "mini strokes". A TIA or transient ischemic attack is a brief (seconds or minutes) blocking of blood flow to an area of the body, often the brain. This blockage then "breaks up or moves on" usually without medical intervention and the sequence can happen repeatedly. This process is damaging the brain by blocking blood flow. 

Next item, the doctor reported that the brain scan showed classic evidence of Alzheimer's. Or, to quote webmd.com:

CT scans can show certain changes that are characteristic of Alzheimer's disease in its later stages. 

These changes include a reduction in the size of the brain, referred to as atrophy.

Since the physical and testing was completed, last week, Mom has apparently been very agitated, displaying anger and confusion why the doctor was poking an prodding her since there is nothing wrong with her. 

Linda and Mark and I will be going up to visit on Sunday, take a casserole for lunch and give Dad a break for a while. Take Mom for a walk, help Dad get his new satellite system set up and generally be there for awhile. 

I figure the whole situation is in God's hands now.

Time slips away

Mom and Dad came over today. 

No surprise there, it is a privilege to have them living just an hour away. Dad and I were scheduled to do some light carpentry. 

Mom was scheduled to spend the day going for a walk and sitting and talking with us and generally having a nice day. But nice days are tougher for her then they used to be. She and Dad went last week for her first medical visit and physical with her new doctor in Lake County. She is still upset about the doctor speaking to her as if she has any problems, she is fine and does not want to see that doctor ever again. Along with general health issues the medical check-up was for a mental health review and Dad privately asked the doctor after the visit about Mom's status and prognosis. The doctor used the clear medical term, "well, she is pretty far along...." . Humm... what ever that means. 

So today, Dad and I worked, Linda and Mom went for a short walk and after Linda left for work Mom was on her own to wander the house and our very small yard. She would sit for a while in the shade, wonder over to see what we were doing, comment on the neighbor's cat wandering by, generally quiet, normal, wonderful, Mom things. Then she would start following Dad around. He has commented about her following him like a "puppy dog." I had not seen this before and she can be insistent, incessant and insolent in her following behavior. Where ever he moves, there she is four feet behind him. He stops, she stops, he moves six feet, she moves right along, back and forth... gets on your nerves after awhile. Funny when you think about it, but then, not ha ha funny at all. 

The phone rang off the hook today, each call was some recorded message telling me how to vote next Tuesday. I AM SORRY, but I will be voting on my own thank you very much, you keep bugging me, I might just vote against you, who ever you are. Another call, it was someone from Dad and Mom's church asking me if I knew their new address and could I tell them where Alan and Marjorie had moved to... I gave the phone to Dad and talked for awhile and Mom got very upset. By the time he was off the phone she was off in the shade, sitting and crying quietly to herself.  (Earlier she had been speaking with Pat Trumble, she said, except Pat is a neighbor of mine who died about a month ago whom she knew when she was in college... so at first I did not realize she was crying this time...) Dad noticed and I asked him what we should do. "There is nothing to do..." he said. "She does this every day and when I talk with her she knows she is upset but can not put the words together to say about what. So I went and sat with her, asked what the problem was. 

She said that she was upset because Dad had been on the phone and the people in the Fort Bragg church did not know where they were and she was upset because she was certain something had happened to HER mother and Dad would not tell her what that was and she wanted to go home and no one would tell her if her parents are dead or alive and why was Dad keeping information from her and he never told her anything and she wanted to go traveling but he would not take her and she did I know what happened to her parents since Dad would not tell her and this was all very upsetting to her and did I have any idea what had happened to her mother. No, it didn't feel funny to me at the time either. 

So I talked with her and held her hand and shared stories with her about her move away from Fort Bragg over 15 years ago and about her mother's funeral and her mother's grave in Cleone and how Linda and I had attended the funeral with her and how it really did all happen and even though she could not remember all these things now she had lived these things and it was OK if she did not remember. I talked to her about our neighbor Pat and told of her funeral and she said that was fine, "but I was just talking to her."  And she said that she was fine, but Dad should still tell her  things and he is keeping important information from her. She went on to say that she does not know where she is much of the time and this is upsetting to her. I asked her if she felt "scared or afraid" and she said, no, it was not like that, she just needed to be told more things about what is going on and if Dad would just tell her......

So now I was upset. 

Later Dad and I talked about it, he could tell it had been upsetting to me and I told him I guess I just needed to see for myself how she was thinking even though it will never do any good and nothing can be done to reverse this moving into darkness that she is experiencing. Yet, in between the bouts of tears she is cheerful and happy to talk to her family pictures and talk to the cats in the yard and talk to her invisible friends and where is the harm in all that. She is not in any physical pain. She is in very limited emotional pain, she has very limited emotional range. And gradually the darkness will close in completely and she will be completely gone. 

Stages of Death: 

So here we are, below are Stages 6 and 7, the final two stages in the Alzheimer's disease. 

For more information see http://www.alz.org/AboutAD/Stages.asp

Mom is deep into Stage 6, with every symptom shown below in Stage 6 except for significant incontinence and toilet issues. 

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.

May God help the living