Sunday, May 15, 2016

Voice from the Past -- Still Present

My mother's dear friend Janet Krause sent me a letter.  It's such a joy to hear from her!

She will turn 98 in September.  That reminds me that my mother might still be with us, were it not for the Alzheimer's.  Janet's friends and family will gather to celebrate.  

She writes, "I have trouble remembering names--faces I know."

As I wrote to her:

"You represent my mother Evelyn and so many others.  Because of you they are still with us in some sense.  The times you all lived through together--the Depression and World War II and the 1950s--are more vivid in our memory because they are still in your memory."

Janet and Evelyn were nursing students together at Children's Hospital in Denver in the late 1930s. After the bombing of Pearl Harbor, Evelyn became a Navy nurse and Janet became an Army nurse.

Janet had surgery for breast cancer two years ago--and beat it!  Yay!

She spent a few months with her daughter in Colorado over the winter holidays but then returned to her apartment in an independent living facility in Mitchell, South Dakota.

"I have a collection of 82 hats hanging in my bedroom--all of which I have worn over the years," she writes.  She and her husband LeRoy both liked antiques.

Janet served as an Army nurse during World War II.  

See an article about her amazing experiences in The Daily Republic of Mitchell, SD, August 29, 2006.  Bombs fell around her as she and others waded ashore in France to provide medical care during the Battle of the Bulge.

My mother would have turned 97 on March 12. Her cousin Walter's wife Aline Pera turned 100 last August. My mother-in-law will turn 94 in September.

May we treasure these living memorials of a time fast fading.  

See also:

Saturday, April 30, 2016

Danger Zone

My mother-in-law, age 93, is happy to be back in her own home after a hospitalization of a couple of weeks followed by nearly six weeks in a rehab place.

But the transition from hospital to rehab or skilled nursing is a danger-filled time, and the transfer to home care is likewise worrisome.  See this article in the Washington Post by Jordan Rau:

Medication errors can occur.  There's no longer a heart monitor or nurses nearby in case of emergency.

Usually the care-giving is transferred from a team to one person doing round-the-clock care and trying to sleep when the patient sleeps.  A tremendous responsibility rests on that one person's shoulders.

It's better if home care can be provided by several aides, each working an 8- or 10-hour shift, with days off each week.  But these things are expensive.  If the person has long-term care health insurance, it can take weeks to activate that policy to fund or partially fund the care.

"Old age is no place for sissies," said Bette Davis (1908-1989).

But my friend Brenda Holguin doesn't like to hear people complain about getting old.  

"Not everyone has that privilege," she notes.

Saturday, April 02, 2016

Gracious Aging

Living into the 90s and experiencing ups and downs as health declines and fails is quite a trial.

I'd like to report, however, that I have one friend who is negotiating these ups and downs with relative good cheer.  

She's 99% ready to leave this earth but also very patient with the day-to-day indignities.  I'm amazed that she is not angry or sad.

Most younger people look at the problems of extreme old age and hope their lives will end earlier.

Perhaps because I spent four years accompanying my mother on this journey, I myself view being in an assisted living residence with equanimity.  It's a peaceful life surrounded by others without the kinds of worries and pressures that plague earlier years.  (A skilled nursing facility, on the other hand, is not good news.  It's more of a warehouse where people are pieces of meat, showered roughly, wheeled in and out of meals whether or not their false teeth may be in their mouths.)

What seems unendurable today--such as wearing Depends--can become just another event later if one lives in a cheerful place with kind caregivers.

When I was in my twenties, in the 1970s, I was close to my grandmother and observed her dealing with cataract surgery.  It seemed awful to me to have a surgeon cutting into one's eyes.

Today my perspective has changed.  I'm 67 and starting to feel the effects of growing old.

I didn't feel old when I got my Medicare card, or when I started collecting Social Security or began noticing increasing wrinkles and gray hair.   

Yesterday, however, when I sat in my ophthalmologist's office and scheduled a cataract surgery, it happened.  I'm where my grandmother was, and now I know I am old.

End-of-Life Choices

Should someone who has Alzheimer's--especially the early-onset kind--have the right to end his or her life before it gets to the point of being placed in a Memory Care floor with assistance for daily life tasks such as bathing and dressing or even eating?

The prospect of wearing Depends and needing personal assistance is humiliating.

How can we respond when a friend or loved one expresses a wish to die before this point?  

No one wants a long period of wasting away.  On the other hand, no one wants to die in a car accident or plane crash.  Ordinarily we don't get a lot of choice in how or when our life ends.

Nevertheless, I want to affirm someone who expresses the wish to avoid long-term care, possibly when unable to recognize friends and family.  It's important to share our feelings with friends and family and to cry out to God.

In a post on December 6, 2014, I rather flippantly said "Why bother to make such wishes?  The bottom line is that we don't get to choose when to clock out... unless we oppose both law and custom."

I'd like to say now that I respect the decision to end life through physician-assisted suicide in a case of terminal illness, even Alzheimer's.

There needs to be a way to express this wish on paper, legally, before one gets to the point where one's decisions are impaired by dementia and one is seen as not competent to make this choice.

On the other hand, treatments to halt and even reverse impairment with Alzheimer's are already being tested.  See the February 11, 2016, issue of Time Magazine with this cover story by Alice Park:

I have a friend who has said he would shoot himself first if he were on the verge of being put on an Alzheimer's care.  Is it a blessing that he has since had two strokes and one ablation surgery for atrial fibrillation?  Despite having one parent who died of Alzheimer's, it looks as if he is not headed for a Memory Care floor--unless by stroke.  

Hi Anne.

Your Dec 6, 2014 post ends by saying:

As for Ekekiel Emanuel's essay about preferring to die at 75 yrs. rather than waste away later, why bother to make such wishes?   
The bottom line is that we don't get to choose when to clock out... unless we oppose both law and custom. 
As a Biblical Feminists do we not both oppose law (in the past) and custom (always)???

So why do you say "why bother" re:  Ekekiel's preference to die at 75 and let custom and law prevail in his case?

This is too personal for me.  It is entirely possible that I will not know you at 75. Or maybe I will have the good fortune re: my cognitive impairment and it will level off at some point before it gets too bad.

Monday, February 22, 2016

New Treatments for Alzheimer's

Researchers are testing treatments for Alzheimer's Disease that may be able to reverse the symptoms, not only arrest them.

Thank you to Alice Park and Time Magazine for this cover-story article on the progress being made.  With four related articles, the entire February 22, 2016, edition of Time is titled "The Longevity Issue."

It's "sticky, insidious plaques of amyloid" that are the main feature in the brain identifying Alzheimer's Disease (AD).  

Not everyone who has these plaques develops the disease.  

A new drug, LM11A-31, helps to keep the brain cells of mice stronger and counteract AD.  This drug is in Phase II of testing for use with humans and being approved by the Food and Drug Administration.

The article's accompanying charts and boxed sidebars are great too, so go to a library and look through an actual paper copy of the magazine.

The related articles are:
  • "The new age of aging" by Laura L. Carstensen.
  • "Lessons from long-lived animals" by Alexandra Sifferlin
  • "Eat better, move more, stay positive" by Alexandra Sifferlin
  • "How to afford an extended old age" by Dan Kadlec
Money spent on research is valuable not only to individual persons but to society as a whole: By 2019 the global cost of Alzheimer's care could reach $1 trillion.

Saturday, January 30, 2016

Young Blood

It turns out that blood from young people can bring new function to brains beset by Alzheimer's.

After the factors in blood that rejuvenate are isolated, these products can be used instead of blood itself.

Eventually, the needed proteins can be manufactured.

Thank you to my friend Diane for bringing this to my attention.