This post is about my Dad.
This background helps explain my later posts about our caregiver experience and our mistakes. The next post will give more links to caregiver resources.
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Dad is an electrical engineer who sold nuclear power plants for Westinghouse in the 1960s-70s. He was widowed in 1987 (at age 53) and retired later that year. In 1988 he took over the affairs of his father, who spent the next 14 years in a care facility before dying of influenza. (That's a whole 'nother story for a different post.) Over the years my Dad became progressively more withdrawn from his friends & neighbors, favoring long walks or camping trips on his own. Today Dad's nearing the end of mid-stage Alzheimer's.
In 2008 (age 74) he felt his cognition declining. (Three years later, I figured this out from his medical records.) His doctor discussed the possible causes, tweaked Dad's blood pressure medication, and advised him to see a specialist if he didn't feel better in six months. Tragically, Dad mis-filed the doctor's written summary and never found it again.
In late 2009 Dad told my brother and me that his "slipping memory" made it hard for him to use his computer. That earned him our first family visit in over a decade. His dementia symptoms were blatantly obvious but he was coping and he refused all offers of help. He didn't even want to prepare a power of attorney and leave it in his home safe.
My brother and I consulted geriatric care managers and were told "Don't argue or nag, keep the lines of communication open, and wait until he asks for help." We did the best we could while Dad resumed his hermit habits. We hired a GCM in his town and waited for the next opportunity.
In January 2011 (as I reconstructed from Dad's financial records) his cognition abruptly declined. (This is common with Alzheimer's.) By March 2011 his malnutrition aggravated a perforated ulcer and he ended up in the hospital emergency room for "slash & mop" surgery. While Dad recovered in the ICU my brother, I, three GCMs, and the hospital coordinator scrambled for three days. We located a skilled nursing facility near my brother's home for Dad's surgery rehab. The surgeon "ordered" Dad to go there, and the doc also wrote up an Alzheimer's diagnosis for us to use with a care facility.
As Dad's rehab finished, the SNF offered him a semi-private room at their care facility. We gratefully accepted.
For the first few years at the care facility, each morning he'd wake up disoriented about where he was and what he should do. We and the staff reassured him and he would relax. He was prescribed Aricept and Namenda and he was able to carry on a conversation for 10-20 minutes before repeating himself. He went through physical, occupational, and speech therapy to recover his strength and to slow his cognitive decline. He was very social with the other residents, to the point where some visitors thought he was a volunteer.
Dad decided that he was an engineering consultant in a hotel (his care facility) helping them sort out their electrical needs. He was relieved that they let him stay there on weekends because his "slipping memory" made it hard for him to remember how to drive back to his apartment. Whenever he'd get upset by noise or other residents, he'd take his briefcase or suitcase to the care facility's front desk and ask to "check out of this hotel". He'd also try every exit door in the facility as he searched for the conference room where his "business meeting" was being held. He was usually willing to go out for Sunday lunch with my brother and maybe the zoo or a museum, but as the months went on (and the symptoms progressed) he tired quickly. He was usually happily relieved to return to the care facility.
Today, eight years after first sensing the onset of dementia, he's once again withdrawn from society. He's deep into the middle phase, or halfway through stage 6. He's lost all of his short-term memory, his problem-solving skills, and his abilities to read or to follow a conversation. As his symptoms have progressed, he's tried low doses of an antidepressant (Lexapro) and that's been changed to a low dose of an anti-anxiety medication (Risperidone). He's still mobile (and still in control of his bladder/bowels) but he spends most of his time in his room working on jigsaw puzzles. They're considered good for Alzheimer's cognition, and he no longer wants to be around people.
By the way, I'm a nuclear engineer too and I'm almost 56 years old. One of my motives for writing about Alzheimer's is to learn all I can about taking care of my family (and our finances) in case they someday have to take care of me. My spouse is of Ashkenazim ancestry and she expects to live at least a century. Our daughter is also in the Navy, she has a civil engineering degree, and she's currently at Nuclear Power School learning to be a third-generation nuke.
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