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  • Ruth Mayer Silverstein, M.S.

I Forgot

If you're of a certain age you've probably experienced those "senior moments." You know what I'm talking about -- you can't remember where you left your keys AGAIN, you're at the grocery store and can't remember what you went there to buy, you repeat yourself and don't even realize it, driving your family crazy. You might joke about it but the fear is real -- what if I (or my grandparent, parent, spouse or friend) have Alzheimer's Disease?

Let me tell you a little about my experience with this ugly monster. My mother has it, yet everyone around her is a victim of it. For her, it rears its ugly head in a mean and angry way, with undertones of profound sadness and a wish to end it all. I actually don't blame her; I wouldn't want to live with this disease either. It started out quietly, as if tiptoeing into her brain. Our daily phone calls starting getting short; she seemed to always be angry about something and then would hang up on me. I just chalked that up to a depression that I suspected had been brewing for many years. My sisters and her sisters experienced the same thing and it became difficult to have a "normal" conversation. Yet there were times when she seemed perfectly fine.

Then there was the night that she didn't show up to a family dinner but didn't answer her phone at home. We got worried and sent someone out to trace her path to make sure she wasn't in an accident or something, but no sign of her. Eventually she called to say that she was too tired to come but we suspect she started out and lost her way. For those who know her, the word stubborn might sound appropriate, as it was for two winters in a row when blizzards took the power out at her house and yet she refused to relocate to a home or hotel with heat. The next time it happened she was in assisted living.

As often happens with the elderly, a scheduled, fairly minor surgery became the catalyst to her decline. The effects of anesthesia and even a few days' stay in a hospital can be enough to tilt the scale from independence to a ripple effect of degrading and depressing outcomes. For those who go to rehab in nursing homes, the result can be permanent placement there. We were adamant that we did not want her in nursing home care if it was avoidable, a decision fully supported by her doctor. The alternative, however, was a parade of home health aides and in-home physical therapy, a solution we much preferred but she wholly resented.

Within a few short months the aides and the therapy were no longer needed and she was back to her independent self....sort of. We noticed that she didn't go out much and we worried about what she was eating, even though she assured us she was fine. Becoming more and more recluse, smoking cigarettes all day, and then the call that changed everything...she had gone to the dentist (where she had been a patient for 20 years) and drove around for three hours, never getting to her appointment and finally finding her way home. That's when we couldn't ignore the reality any longer and began the moving process. This was clearly early-stage Alzheimer's, which was confirmed by a neurological evaluation.

Fast forward three years and mom is unhappily in assisted living, just as she was unhappily independently living for many years before. She's resentful that she doesn't have her house or her car, and does not remember the many conversations we had over these and other difficult decisions. There are activities she could do and trips she could take but she does not want any part of them, which is not that different from the way she led her pre-Alzheimer's life. She barely remembers that her older sister recently passed away. This is all consistent with middle-stage, or moderate Alzheimer's Disease. And here's what we can look forward to in severe or late-stage:

- Losing awareness of recent experiences as well as of her surroundings

- High levels of assistance required for daily activities and personal care

- Decline in physical abilities, including the ability to walk, sit and, eventually, swallow

- Increasing difficulty with communication

- Becoming vulnerable to infections, especially pneumonia

I write this post today, and share this personal story for three reasons:

1. As a health coach, I believe that everything is related and if we have any control at all in this world, it's in the way we nourish our bodies and minds;

2. As a daughter, mother and sister, I want to care for my family in the best and most positive way possible, to diminish the possibilities of this and the myriad of other health crises they could face; and

3. As a citizen, I support the research and education efforts of national organizations such as U.S. Against Alzheimer's and the Alzheimer's Association, and invite you to join or donate to our team, Laura's Girls' and Friends, in the annual Walk to End Alzheimer's, this Saturday, October 8th.

I never want to forget.

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