Alzheimer's Disease

Alzheimer's Disease affects 5 million American people. The underlying cause of the disease is still unknown and a cure is not available at this time. Some of the medications available on the market can help to slow down the progression of the disease, and help the patients to remain functional till older age. The article presents some of the signs and symptoms of AD, starting with the slow onset, which makes it hard to distinguish the symptom and to establish a diagnosis, especially since one of the disease traits is the ability of the patient to hide the facts from friends and family. Nurses Rock Article

Alzheimer's Disease

According to the National Institute of Aging, the Alzheimer's Disease is " an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually even the ability to carry out the simplest tasks of daily living. In most people with Alzheimer's, symptoms first appear after age 60. Alzheimer's disease is the most common cause of dementia among older people." (National Institute on Aging)

How many Americans have Alzheimer's disease?

"Estimates vary, but experts suggest that as many as 5 million Americans age 65 and older have Alzheimer's disease. Unless the disease can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. That's because the risk of Alzheimer's increases with age, and the U.S. population is aging. The number of people with Alzheimer's doubles for every 5-year interval beyond age 65." (nia.nih.gov)

During nursing school and later during my nursing career, I had learned about AD, aging process, brain function deterioration and signs and symptoms of the disease. Occasionally, I was assigned to take care of patients affected by AD. But in the last ten years, as a pediatric nurse, I did not have many chances to be exposed to such patients. So, in my practice, over the years, my knowledge about AD faded, especially due to lack of exposure and lack of continued education classes in the geriatric field.

Taking care of pediatric patients, my awareness about AD remained dormant. The only older people I was very close to, were my parents, getting older, but still independent in most aspects of their lives. Our close daily relationship, either over the phone or visits, stopped me from noticing the slow, but progressing change in personality and in ability to perform daily activities.

Once in a while, my mother complained about not remembering things, having difficulties performing house work. I attributed all of them to normal aging process, and I did not take it seriously. I did not see the early stage of AD. "Memory problems, are typically one of the first signs of Alzheimer's disease." I reassured her that we all forget sometimes and that is OK.

My father brought to my attention that mom became lately very slow , and spent more and more time getting dressed, or getting ready for an appointment, at the point of being late all the time. He expressed his frustrations, but day by day he started to take away some of her house chores and tried to balance their lives at his best abilities.

One of the changes that startled me, was the changes in my mom's vocabulary. She started to use in a regular daily conversation words from her native language, archaic words that she never used before. When I asked her what does that word mean, she looked at me very surprised. Sometimes during our conversation she did not remember facts and tried to change the subject, tried to make up an answer, or to admit very embarrassed that she did not remember. At that time, caught in a busy life, between work and school, I did not see the gravity of her condition. Every day she lost some of her abilities to take care of others and herself.

One day she flooded the bathroom because she forgot the water was running, or forgot to turn off the stove and burned the food. Than I stepped in and I started to realize that she needs more help, and I was happy to spend more time with her and do laundry, cook or take her shopping. And I did still considered that her age was number one in her decline. These were already signs of mild Alzheimer,s disease as per National Institute on Aging

One winter, at Christmas time, my son came home and spent time with his grandparents. He noticed that something was wrong with grandmother, and asked me about it. He had not seen her in a few months, and was scared to see how much she changed. Mother was always a very nice, calm person with a lot of patience. Now, she started to have episodes when she became very agitated and aggressive. I was very surprised and my son suggested to take her to a neurologist.

At her first visit she was able to answered all the questions , but still, after examining her the doctor diagnosed her with initial symptoms of AD. He prescribed medications to keep her calm and also to increase her cognitive functions. Every three months we followed up and I was able to see the changes compared to the last visit. I became more and more aware about the worsening of her symptoms. On a daily basis I did not see a lot of changes. Mom, like other patients with AD, was trying to hide her symptoms and inability to function from friends and family. She was able to keep the appearances and hide her forgetfulness, memory loss, inability to perform her daily routine.

After reading books, articles and other specialty literature, I was able to see clearly more and more signs and symptoms of AD, the pattern of the disease and the decline of her health. As the symptoms worsened, mom stopped recognizing one by one the family members, her home, her husband. She had days when she packed her clothes and some food to go "home to her kids". Her ability to perform the daily tasks was less and less and she needed more help every day. I was happy to help, but, at the same time, very sad about her deterioration.

Today my mother continues to live a life, what I call "happy and comfortable". She does not recognize any of her children, but she knows we are the people taking care of her. It keeps me happy to see her smiling when I come home from work, to see her pleased after a watching cartoons, or resting. It is very hard for me to accept her condition and her limitations. I do not know how much she remembers, or her thoughts, since sometimes she cannot express herself, or find the right words. But it is very rewarding when she gives me a kiss or a hug, or thanks me for caring for her. "People with severe Alzheimer's Disease cannot communicate and are completely dependent on others for their care."

The AD had built a wall between her and the reality; she is trapped in her own limited world, but sometimes a window opens and she reconnects with me. There are days when I stand in front of that window ready to interact with her, when she can, with a bath, a massage, a good meal that she still enjoys. She spends her days playing with toys. The day is a very happy for both of us, when she calls my name.

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lprutean

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Specializes in NICU, PICU, Transport, L&D, Hospice.

Recently an elderly man carring for his wife with Alzheimers dementia called for EMS support for her. Police arrived first and the guy was thrown to the ground and arrested. He required sutures to his head.

Being a caregiver for a confused patient who may not recognize that you ARE NOT the intruder or scary person can be dangerous when police hurt first and ask questions later.

Recently an elderly man carring for his wife with Alzheimers dementia called for EMS support for her. Police arrived first and the guy was thrown to the ground and arrested. He required sutures to his head.

Being a caregiver for a confused patient who may not recognize that you ARE NOT the intruder or scary person can be dangerous when police hurt first and ask questions later.

How awful. It really pains me to read about situations like this.

This was beautifully written. As someone who works with AD patients on the regular (I work for an assisted living facility for people with memory loss) I can relate to the joy of just getting them to the "happy and comfortable" place. A lot of the family members don't quite understand how AD works or just choose not to acknowledge that their loved one is living with it, so they get upset when they see their mom or grandma playing with toys or reading children's books. They would prefer them playing chess or reading the latest edition of Reader's Digest. However with someone living with that condition, in their mind, reading The Three Bears is just as entertaining to them (if not more so) as reading something more "suitable". I know this cause I have been caught in many a snooze fest while attempting to read Edger Allen Poe to them. My pt have late stage AD and at this point my goal is to preserve what they do have (without forcing them) and to help them (safely) do what makes THEM happy. Your mom is lucky to have such an understanding daughter and I'm sure if she could communicate with you she would tell you say and thank you a thousand times. So as a person who works with people living with AD, I would like to thank you.

That was a beautiful article! Thank you! Your experience reminds me of my time with my mother who had dementia. My mom has passed away and I miss her so much. She, too, did not recognize her children during the last years of her life but she did know that we were special people....different from other people that came to see her. She was sweet to everyone and always had a smile but the smile and the twinkle in her eye was bigger for her kids. I'll never forget arriving for her birthday one year toward the end of her life. She burst into a huge smile when I came through the door. She laughed and said, "you're here!!!" She couldn't tell me my name or say who I was but her reaction said it all. And it warmed me to the core! My mom still knew me!

I enjoyed so much just sitting on the couch snuggling with her and watching Animal Planet. She'd point at the cute animals and ooh and ahh at them. She'd try to find the words to say they were cute and always failed but I knew what she was trying to say. We'd go for slow walks, holding hands and she'd point out all the pretty flowers. She couldn't find the words to express how much she liked them but that was o.k. I could fill in the blanks because she was still my mom and I knew how much she loved gardens. I could carry the conversation even if it had to be one way. I'd joke around with her and she'd ALWAYS laugh. She was a great audience :-) We had fun together even though it was a very different kind of relationship than we had pre-A.D.

When a loved one has Alzheimer's disease it's like they die a thousand little deaths. Each time they lose an ability, a little piece of them dies. By the time my mother was nearing the end, I thought it would be a relief. A relief for us and especially for her. She never wanted to be like that (who would?). She had been a nurse in a VA nursing home and used to say to us "if I ever have dementia, just take me out back and shoot me." I never expected I would miss her so much! I thought I'd already been coming to terms with losing her since she had slowly become a shell of her former self. Once she was gone, I missed her physical being so much! I missed the time we spent together even though most might say it wasn't of much quality. I wouldn't wish her back on earth because I know she wouldn't want to be back in her Alzheimer's ravaged body, but what I wouldn't give for an occasional quick visit!

Very good article Iprutean, your mum was indeed a lucky woman. She is among the few lucky ones to remain in the environment she was used to. I worked in nursing homes aswell, i love working with older people. But my heart bleed when they do not get the care they deserve either from family or staff that only think of the financial benefits of working in such an environment. And i can only do so little to make them comfortable. Most owners of nursing home really do not bother to listen to the residents.

Specializes in None yet..
This was beautifully written. As someone who works with AD patients on the regular (I work for an assisted living facility for people with memory loss) I can relate to the joy of just getting them to the "happy and comfortable" place. A lot of the family members don't quite understand how AD works or just choose not to acknowledge that their loved one is living with it, so they get upset when they see their mom or grandma playing with toys or reading children's books. They would prefer them playing chess or reading the latest edition of Reader's Digest. However with someone living with that condition, in their mind, reading The Three Bears is just as entertaining to them (if not more so) as reading something more "suitable". I know this cause I have been caught in many a snooze fest while attempting to read Edger Allen Poe to them. My pt have late stage AD and at this point my goal is to preserve what they do have (without forcing them) and to help them (safely) do what makes THEM happy. Your mom is lucky to have such an understanding daughter and I'm sure if she could communicate with you she would tell you say and thank you a thousand times. So as a person who works with people living with AD, I would like to thank you.

Oh, yes! Family members who insist on telling the person with AD that they are wrong, that they live here now and can't go home or maybe worst of all, that their spouse has been dead for years so that they either escalate into anger or relieve the freshness of the grief that comes from a new loss. Gratitude for you, OhWow, and people like you.

Specializes in None yet..

Iprutean, thank you for your heartful, well-written article. I had to take some time before responding because it brought up so many emotions. Still don't feel able to name everything I feel but I don't want to wait any longer to say thank you.

Specializes in as above.

we termed ALZ as the world longest funeral. ALZ patients return to child/baby hood, mentally and eventually, physical. Yes, you need to keep yourself in good shape, because they can strike out at you, but dont take it personally. Their minds eye sees you as someone else. just be aware. Its hard for the family to accept their mom or dad at that stage. They need to be educated to what WILL happen to mom and dad.

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