Stages of Alzheimers

The Alzheimers Association lists 7 stages of the disease.

Stage 1: No impairment
Stage 2: Very mild decline
Stage 3: Mild decline
Stage 4: Moderate decline
Stage 5: Moderately severe decline
Stage 6: Severe decline
Stage 7: Very severe decline

Mom seems to be mostly in Stage 4:

Stage 4:
Moderate cognitive decline
(Mild or early-stage Alzheimer's disease)
At this point, a careful medical interview should be able to detect clear-cut symptoms in several areas:

• Forgetfulness of recent events
• Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7s
• Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances
• Forgetfulness about one's own personal history
• Becoming moody or withdrawn, especially in socially or mentally challenging situations 

but perhaps moving into the beginnings of Stage 5:


  Stage 5: Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)
Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer's may:

• Be unable to recall their own address or telephone number or the high school or college from which they graduated
• Become confused about where they are or what day it is
• Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s
• Need help choosing proper clothing for the season or the occasion
• Still remember significant details about themselves and their family
• Still require no assistance with eating or using the toilet 

Most of the time, it's not a big deal.  She goes to the Dunedin Day Center three times a week, which she just loves.  Edna, her home health aide, comes on Thursdays for her shower.  We go to Felix's Hair We Are every 6-7 weeks for our haircuts, grocery shopping every other week, to the drugstore monthly.  She's always cheerful and pleasant and easy-going.

But every once in awhile, something comes up that reinforces for me that even though the decline is very gradual, it is still there.

We went to a local restaurant for Thanksgiving dinner and had to park one small parking lot over  due to the crowd.  When we left, the walk from inside the restaurant, around the line of people still waiting outside, and maybe 40 yards on to our car had Mother so winded that she had to lean heavy on my arm the last few feet, and she huffed and wheezed half the way home.  It has nothing to do with her lung function, and everything to do with the fact that she not only watches TV every waking moment she's not at the senior center, but that she lies down on the couch to do it.  She is so very sedentary that any amount of walking seriously tires her.

After going out to dinner for her birthday, we stopped at the drugstore to pick up one of her medications that was waiting.  Since the pharmacy is in the rear of the store, she has to walk more than she would like and more than she is used to.  After picking up her meds and returning to the front of the store, we had to wait a moment for Steve to check out at the front register.  Since Mom was tired, she wanted to sit down, but there was no chair or bench.  So, she sat down on a stack of cases of plastic water bottles in a display at the front of the store, with no idea that this was not good plan or a safety issue.  I told her she couldn't sit there, and she couldn't understand why not, and I had to insist that she stand while she was insisting that she was tired and needed to sit.  And, since Mom is very hard of hearing, this conversation was carried out at a volume to allow everyone in the store to listen in.


When we got home, I talked to her about it again, and explained that the water bottles could have fallen, then she would have fallen, then they would have fallen on top of her, and she needed to agree that in the future she would only sit on things that were chairs or benches.  She agreed, but she seemed amused by it and I don't think she really understood my concern or why I was making such a big deal about it.

Conversation

Mom: You said yesterday that today is your twentieth wedding anniversary?

Me: No, Mom.  Steve and I got married a year ago.  We've only been married for one year.  Remember we had the wedding last year?

Mom:  So, it's not your anniversary?

Me: Yes, today is our anniversary, but our one-year anniversary.

Mom:  Oh, okay.  Happy anniversary!

Tripping Over Dr. Laura

I try to be positive.  I try to look at the good happening in my life and in the world.  If there are things that aren't going well, I try to figure out how to fix them.  If someone is unhappy (including me), I try to find solutions to whatever difficulties are in the mix.  I don't watch the network news.  I listen to NPR, which keeps me informed without feeding me flaming rhetoric.  I do my best to avoid negative people, negative situations and drama.  And for the most part, I succeed.

Last night, however, a link to Dr. Laura's blog showed up on my Facebook feed, with the poster's comment that she is "right on the money" concerning relationships between men and women.  Even though I know better, even though I know she is amazingly negative, I clicked through.  And tripped over and fell into a blog entry so full of vitriol, I am still upset and shaken this morning.  Hyperbole, you're thinking.  Please remember that I've been fairly successful at insulating myself from negative people and situations.  So successful, in fact, that it seems I have little immunity to general hatefulness and deliberate offense.

In her response to an op-ed piece in Slate on-line, entitled "Sex is Cheap: Why Young Men Have the Upper Hand in Bed, Even When They're Failing in Life," she posits that the failure of men in our society is directly attributable to female promiscuity.  Since every woman is ready to "put out", men have nothing to strive for in order to obtain ready sex with socially desirable partners.

When I started writing this, I thought about using quotes from her blog post and rebutting, but as I look through it, it's all offensive, I don't want to post any of it here, and I would have to try to find reasonable responses to words that were mostly chosen to inflame and offend.  I just can't bring myself to do it.  So, if you really want to read it, here it is. 

What I initially found most offensive about this piece is that it reduces the relationship between a man and a woman to that of a sexual war.  A woman must hold the front lines against a man's unrelenting assault at all costs, until a favorable treaty (i.e. marriage) can be negotiated.  This also means that a woman's sexuality is the only asset she has to bring to the negotiation.  If she decides that she does not want her sexuality to be held in reserve and used only as trump card in the treaty process, then she is an "unpaid whore" who isn't even getting good recompense for the only thing of value she holds. Oh, and she is also contributing to the downfall of civilization.

As I was falling asleep last night, I wondered how such an intelligent, articulate woman (and she is intelligent and articulate, which makes her opinions all that much more baffling to me) could also be such an amazing misogynist. As I awoke this morning, however, the flip side of her argument dawned on me.  If women (and their controlled sexual urges) are the only guard against our society's downfall, what place does that leave men?  They must be mere homonculo-penises, capable of being motivated only by the prospect of eventually attaining exclusive sexual rights claim on the body of a respectable "nice-girl".  And if you give a donkey the carrot early, he won't have any motivation at all, right?

That's when I realized that Dr. Laura is not merely a misogynist, but a full-blown misanthrope.  How very sad for her to have to live in the hateful world she has created for herself.  I'm really glad I don't have to live there, too.

T-Shirt Contretemps

Mother has a t-shirt from her old job.  A comfy, tan, heavy cotton t-shirt with a slogan from some past customer service-oriented advertising campaign.  She likes it .  She likes to wear it.  She likes to wear it often.  She likes to wear it repeatedly.  She does not, however, like to do laundry.  So, her favorite comfy shirt gets worn several times before I realize that I've seen it many more times than I've seen her do laundry (more on that later), and I feel compelled to comment.

"Mom, you've worn that shirt four or five times already.  It needs to be washed," I point out.

"It's fine," she replies.

"Mom, you've worn it the last three times you've gone to the senior center.  They'll think you don't have any other clothes. Also, you need to wash it before you wear it again."  I stop short of ordering her to go change.  She wouldn't anyway, not without what I anticipate would be a really big battle - I'm not sure because I haven't pushed that hard yet.

"Okay," she says, in that voice and tone that I recognize immediately as meaning, 'I'm agreeing with you so you will stop talking at me about this.'  So that's where I get it.  Hmmm.

Yesterday morning was at least the third time we've had this conversation.  My husband overhears and says I should make her change, or tell her the shirt will go away, but I'm not ready to be that much of an authoritarian for anyone, especially not my mother.  I do have to agree with him on his point that it is not only a matter of esthetics, but also a health issue.  *sigh*

So, I phone the senior center and have a chat with the social worker.  She says to take the shirt and put it in the laundry, telling Mother it is no longer available as it needs washing and is in the laundry.  Great plan - except that that still makes me the de facto laundress because Mother doesn't do laundry unless/until I go into her closet and pull out all the clothing that she has already worn and rehung and announce that it is Mom's Laundry Day.  I don't want to do this.  I am still trying to figure out how to get out of doing my own laundry.  (No luck so far on that one, either.)  *sigh*

I do have a Plan B, though.  It won't get me out of my laundry duties, but it might reduce their frequency a little.  I call Mom's old job.  I speak to the manager.  I explain to him a little bit of the situation, and how I attribute her fondness for the shirt to a combination of its inherent comfiness and the fond memories Mom has of working there for twenty-plus years.  Is there any way, I ask him, I can get a couple more employee t-shirts for her.  He transfers me back to the office manager, instructing me to tell her what size and how many I want.  Hooray!  The office manager also remembers Mom, and in addition to the three new t-shirts - one yellow, one orange, and one green - she will be including notes from current employees who also remember Mom from her time there.  She starts to address the package to me, but I suggest addressing it directly to Mom so she will open it immediately and have a nice surprise.

I hope it arrives today.

Albino Tree Frog!

We came home the other night to find an albino tree frog sitting on the ledge under our porch light.  The gnats flying all around him, alighting on him off and on, didn't seem to bother him in the least.  I gently prodded him with my finger, just to confirm he was alive. He moved a little bit, but this didn't seem to bother him, either.  So, I got my camera and took a few photos.

He was completely underwhelmed by the whole encounter, but I am quite excited about having him (her?) living somewhere in my garden.

Sunflowers!

Several weeks ago, I bought sunflower seed packets from our local gardening center.  "Giant" sunflowers, which the package said will grow up to 16 feet tall, "Mammoth" - 8-12' tall, and then two varieties that should get to be about 4 feet tall, one red and the other a "Moonflower" - with petals a paler yellow than other sunflowers.  I got some edging that's been on the side of the house since we moved in, and made a flower bed especially for the sunflowers.

Then I took out my garden book and sketched out plant placement based on potential flower height and how the bed is angled toward the lanai.

I planted the seeds in little starter pots and waited for them to sprout. The "Giant" ones sprouted very quickly, the others took a few days longer.

The pictures above were taken on May 4th.  I finally got the poor, neglected, perhaps even abused, seedlings into the ground this afternoon.  I forgot to look at my notebook, with my carefully-planned planting sketch, because I just wanted to get them into the ground before they completely expired.

 

If you zoom in, you can see the twisted, stunted seedlings trying to stand up, now that they have space to stretch their roots and find some stability and balance.  I also gave them plant food and a thorough watering, in an attempt to assuage some of my guilt from having ignored them for so long.  I do feel a little better, and they look like they feel better as well.  I hope so.

Today's Happy Moments (so far)

Mother had her appointment at the USF Alzheimer's Center this morning.  Everything looks fine; pretty much the same as when we did the baseline neuro-cog eval about three years ago.  Perhaps some very minimal decline, but really everything is great.

Afterward, we went to the Village Inn restaurant for lunch, where I ordered the Grown-Up Grilled Cheese (made with tomatoes and bacon).  When it arrived, I was very pleasantly surprised to see their unique way of keeping that nasty pickle juice from getting on my sandwich and making the bread soggy.  It made me very happy.

Then, even better, when I got home, I was able to successfully transfer the photo I took from my cell phone to my computer via some clever chip adapters so I could share with y'all! 

I love living in the future!