Before my dad got Alzheimer’s I knew others whose parent had it. I’d ask out of concern and compassion, “Does she still know who you are?” That was about the extent of my knowledge of Alzheimer’s—people forgot who their loved ones were.
What I didn’t realize is that Alzheimer’s is about so much more than that. The loss of recognition may be one of the last pieces. Before that, systematically, step by step, a person with Alzheimer’s loses the pieces of their lives.
Mom can’t find her car in the parking garage. Mom can’t find her way to where she wants to go. Mom can’t drive anymore.
Dad puts his head in the armhole of his shirt. He’s dressed for church and it is Wednesday. Dad tries to put his shirt on upside down. Dad can’t dress himself anymore.
Grandpa sanded the finish off the edge of the kitchen table. He carved into the wood with a knife. He took a pair of scissors and cut the emblem off of the middle of the shorts he was wearing. Grandpa can’t have sharp objects anymore.
Mom turns on the stove, turns off the answering machine, turns on the bathroom heater with towels draped over it. Mom can’t be alone in a room anymore.
Grandma has both types of incontinence. Grandma has accidents at inconvenient places. Grandma can’t go to unessential places anymore.
Mom drops her pills on the floor. She hides them in her uneaten sandwich. She can’t swallow them whole. Mom can’t take pills anymore.
Grandpa has trouble chewing and swallowing some foods. Grandpa can’t eat steak anymore.
Grandma “pockets” the semi-chewed foods she eats in the side of her mouth. Specialists consider this a choking hazard. Grandma can’t eat non-pureed food anymore.
We made another decision yesterday and took another step with Dad. Mom is investigating visiting physicians who can come to the house to care for Dad. Yesterday we met with a nurse practitioner from the VA, and a visiting physician from a private practice.
The VA has a program for vets called In Home Prime Care. A nurse practitioner came to my parents’ house to explain the program. They have a team of specialists that includes a nurse, nurse practitioner, social worker, dietician and psychologist. They visit patients in their homes and try to take care of their medical needs including prescription refills. They are not able to come for sick visits, however. The patient needs to visit the VA hospital for most procedures. The patient receives a visit from the nurse once a month and from the nurse practitioner once every three months. The social worker makes an initial visit and assessment, as does the psychologist. The dietician can be consulted as needed.
The visiting physician came with two medical assistants. They did an initial assessment of Dad: took his history, his vital signs, and recorded his medications. Because they travel a scheduled route, if you are sick, they will try to help you over the phone and are often able and willing to order prescriptions this way. They can send out a nurse or diagnostic equipment like an x-ray machine. Otherwise you have to visit an urgent care or hospital. The physician likes to visit once a month at first, but later can be seen at least once every three months.
I don’t know what my mom is going to decide to do, but she seemed to like the doctor who visited.
The only place Dad has gone this past year has been to doctors’ appointments. So if he stops going to those, he will stop going out. Anywhere.
Dad can’t go anywhere anymore.