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Alzheimer's One Day at a Time
Posted by: Margaret Kreiner
May 10, 2012

New challenges now have to do with food and body weight. My husband's dexterity is decreasing, not only in walking, but in his hands. He cannot tie his shoe laces anymore, so we have graduated to loafers. He cannot hold a sandwich together while he is attempting to eat it. He cannot cut up his meat with a sharp knife. His chewing seems to be labored, although his teeth are good. I have had him to a dentist often now because he forgets to brush his teeth most every day. He is not eating lunch when I am not at home, and sometimes even if I am home. He claims he can't find any food in the refrigerator, when it is on an eye level shelf when you open its door. His weight has dropped to 130 from 160. Her is bent over from his scoliosis. He is 76 but looks 96. He gets cranky if you try to help him, because it shows him how much assistance he needs and how much he is deteriorating.

My husband is wonderful in that he always thanks me for doing things for him. He appologizes for his needs. He never cries "poor me" or "why me." I couldn't ask for a more loving man. I look around and see other caregivers who have my concerns but have to deal with combative or annoying behaviors in their loved ones. So I turn to my God and thank him for the man that I married and that I am here for him. 

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Day by Day, One Day at a Time
Posted by: Margaret Kreiner
April 17, 2012

My husband who has four college degrees has no concept of numbers. He cannot tell time or understand what measurements of time mean. Yet he can read his science journals and the newspaper every day cover to cover, and comprehend the material discussed.

Dementia is a horrible disease. It steals the mind of your loved one. Alzheimer's dementia is only one of 51 kinds of dementia that exist today with our present knowledge of medicine. We have defned the Alzheimer's type of dementia into stages to show the decline of the mind and body. Some people wioth dementia getvilolent. Some become perverts. And some become very laid back. There is no link to how you act with Alzheimer's dementia to how you have lived. Peaceful quiet church going ladies can become violent and swear like drunken sailors. There are two deaths connected with dementia. The first is when he no longer recognizes you. The second is when the soul leaves the body in death.

As I watch my husband of 26 years deteriorate, it makes me sad. He can only do a few things a day. He never complains though. He thanks me profusely for taking care of him. I cannot tell what stage he is in because he has multiple dementias. He does have Alzheimer's dementia, but he also has other forms. Not only is his mind failing him, but his body as well. He suffers from scoliosis which has tuned his spine into a pretzel. Wearing clothes is difficult, but finding clothes to fit is also difficult. His heart problems make him very tired. He is losing his dexterity of his hands due to his Parkinson's disease. He may not be able to form sentences at times, but for the most part he knows what is going on.

People ask what they can do to help. My husband is very dependent on me. He follows me around like a puppy. He says he is bored. I work three days in my Cuyahoga Falls office and two days at my home office. My husband wants me to take him wherever he has to go, usually the doctors. No one can do these things but me. But what is needed is visits. He may fall asleep on the couch or slip away for a nap, but it breaks up his day. He will complain about the company sometimes disrupting his daily routine, but the visits also help me. I need someone to talk to outside of the office. My husband can still talk most of the time and make sense, but other times not.

My time has to stretch to meet the needs of my husband as well as my law practice. This advice is directly opposite of what I counsel caregivers in my office. I do have someone with my husband the days I work outside the home. I am fortunate to have such good help that I can trust. Alma who was with my husband on  a Thursday in December was there to call 911 when he had his stroke. Jack is there to see that he is OK and also helps me with maintenance of my house and yard.

Prayer is a good outlet to express one's feelings. It gives me strength. We have many blessings to count as well. God never gives you more than you can handle.

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One Day at a Time
Posted by: Margaret Kreiner
December 12, 2011

Patience is a key factor in keeping your sanity. Another detrimental key factor is fear. second guessing yourself brings on a lot of fear and anxiety. Am I doing everything right? Am I imagining these problems of forgetfullness on his part? Is it me that is not normal?

 I recommned a geriatric assessment so that one, you can establish your own credibility; two, you can set a base line to the dementia so you can follow the progression of the disease; and three, you can get an expert's opinion of what you are doing is right. In taking my spouse to Dr. Mary Jo Cleveland at Summa Geriatric Department, she confirmed the fact that he had Alzheimer's dementia, but also other kinds as well. In fact I learned that there are 51 kinds of demenitia. She explained it doesn''t matter what kind of dementia he has, because he has it and there is nothing one can do about it. She did have a face to face confrontation with him about giving up driving. He agreed reluctantly, and to my surprise he has not driven since that visit.

Having dementia is a serious problem, but sometimes you just have to laugh. He told me as we were leaving Dr. Cleveland's office that it was my fault he lost his driving privileges. He said that I should have told him about the testing so he could have studied up before the visit to her. Of course the testing, as some of you know, is drawing a clock and putting in the hands for what time she gives you. My spouse can read scinece journals and undersatnd them, but he cannot comprehend numbers at all. He can't add, or tell time. He doesn't understand any concept of numbers, such as I'll be back in 45 minutes.

Trying to obtain peace of mind for the healthy spouse is a goal in dealing with this dreadful disease that your love one suffers from. So patience and relief of anxiety are two very serious issues for the healthy spouse to set as a goal. This can only be accomplished by seeking a geriatric doctor to oversee your life and an attorney to protect your assets. I will talk about that in my next blog addition.

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First Day at a Time
Posted by: Margaret Kreiner
September 21, 2011

This Alzheimer's blog is depicted as one day at a time, because that is the survival mechanism for the caregiver of a loved one afflicted with Alzheimer's disease. As in a twelve step program or a weight watcher's plan, it is proven that small steps keep you targeted and positioned for success. If you saw the whole process laid out before you to achieve your goal, most people would give up before they started. So this one day at a time mentality is a sanity lifeline.

Alzheimer's comes like a thief in the night, pinching off minute pieces of our mind which in the beginning makes us feel foolish when we falter especially in front of family or friends. These "magic moments" are overlooked and explained away as silliness, or inebriation, or sleep deprivation, or personality quirks. But in time, people start to notice the odd behavior for what it is. The pathetic irony is that the afflicted also begin  to recognize what it is. If Oscars were given to any class of people, they should be awarded to those afflicted with this disease. For they become very good at hiding their shortcomings, even to the point of making you doubt that you are seeing what you are seeing. Your own sanity comes into question.

I was told that that there are 51 types of dementia. We called anyone in the past who was losing their marbles senile. But today as people live longer, we are finding that senility is just another word for dementia. Dementia is a disease that can be caused by head injuries, frontal lobe problems, arterialscolosis and Alzheimer's disease which involves the synaptic links in the brain, to name a few. But it really isn't as important for the caregiver to know what caused the dementia as it is to know that your loved one has it. The first item on the agenda is to have a geriatric assessment performed by a trained physician. This allows the caregiver to stop questioning and doubting the idea of whether the person has the disease or not. It allows the caregiver to take the next step to start a plan to deal with the disease and its future ramifications. This sounds like an easy step, but it is not. No one wants to go willingly to have a test to see if they are crazy. No one  wants to deal with that reality. If you aren't labeled yet, you aren't crazy yet. So by trickery or persuasion, the care giver must somehow make the assessment appointment and get the loved one to participate.

I often joked with my husband about both of us going for a crazy test. But eventually he did go. I had tried to take the car keys from him a year earlier, but to no avail. After four accidents, the rule was that he could drive his own car, but if we were both going out, I was to drive. He hadn't been with the doctor for more than half an hour when she came to see me to ask me if I wanted to tell him he could no longer drive, or should she tell him. That answer was clear to me. When she told him, he wanted to know why. The accidents he had were snow related in his mind, and not his fault. He claimed I was yelling at him which caused him to drive through a neighbor's garage door. I was yelling, I admit. But yelling stop didn't abort the accident. He also told me later that it was my fault he couldn't drive anymore. It was unfair of me to take him to see this doctor without my giving him the test questions so he could study them first. The test that he failed was to draw lines from scattered numbers on a page starting from one to two and so forth to twenty. He couldn't get past four after three minutes.

This also brings to mind two situtations in my past about testing for dementia. My 89 year old grandmother was asked who the president of the United States was. She proudly in her Slovak broken English replied President General Motors. Our president at the time was President Ford.  Confused but not demented. The second was a client whose family had called me to see their grandmother at a nursing home.The staff told the family that she needed a guardianship because she was incompetent. Arriving there first, I started to converse with her about generalities like the weather etc. I told her that it was a really fine sunny summer day outside. She replied that she liked the facility. I asked her how her health was, and she stated that she missed her late husband. The answers were getting more bizarre as we chatted. Finally I wrote a question on a piece of paper and she answered it perfectly. I asked her how long had it been since she wore her hearing aids. She had not seen them since the second day she moved into the facility.

Life is not easy for any caregiver, but especially not for someone taking care of a dementia victim. There are two victims here, not one. 

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