Early signs of Alzheimer's (Dementia)

I ran across this description of the "early signs of Alzheimer's" on the Milton S. Hershey Medical Center (Penn State) some time ago. I felt it might be helpful and decided to post it.


Source Milton S. Hershey Medical Center

Alzheimer’s Disease

What is it?

Alzheimer's disease is the most common cause of a condition called dementia. Dementia is a general decline in mental ability, such as memory, language skills, judgment, and concentration. Alzheimer’s is a progressive disease, which means symptoms occur gradually and become worse over time. It is named for the German doctor who first described it, Alois Alzheimer.

Who gets it?

Alzheimer’s disease affects most commonly affects those over the age of 65, although it has been diagnosed in people in their 40s and 50s.

What causes it?

The degeneration of parts of the brain, which destroys brain cells, causes the symptoms of Alzheimer’s. However, at this time researchers are not sure what causes this degeneration. Those with a family history of Alzheimer’s are more likely to develop the disease as they age, so there is a gene abnormality that causes the disease in some people. Researchers are looking for links between Alzheimer’s disease and the environment, lifestyle, nutrition, and viruses.

What are the symptoms?

Alzheimer’s usually progresses in three stages, with each lasting anywhere from one to several years. The first symptom of Alzheimer’s disease is usually mild forgetfulness. Someone in the early stages may find him or herself unable to find the right word, recall where something was placed, or recall someone’s name. It may be difficult to concentrate. At this point, symptoms are so general that they do not signal a serious problem or have a great impact on day-to-day functioning. As the disease progresses to the second stage, the forgetfulness becomes worse, making it difficult to function at work, remember directions, or to even make it through the day without difficulty. The person may be restless and unable to sleep at night. His or her personality may change considerably, with increasing anxiety and decreasing emotions. By the late stages of Alzheimer’s, patients suffer from extreme confusion and memory loss. They are unable to recall the names of close friends and family or recent events, and cannot function socially or perform basic daily personal care. Late-stage Alzheimer’s patients may have hallucinations and delusions.

How is it diagnosed?

Alzheimer’s disease is diagnosed by taking a complete medical history and performing a thorough physical examination. Alzheimer’s is generally suspected when there is a gradual deterioration in mental ability. The doctor will perform tests, such as blood tests and brain scans, to rule out other possible causes of the symptoms. The doctor will also ask the patient a series of questions to test his or her mental status. One type of test of mental status is called neuropsychological testing, which is a standardized test of memory, concentration, and visual-spatial skills. Because a definite diagnosis can only be made by performing an autopsy after death, patients are diagnosed with “probable” Alzheimer’s. An autopsy of brain tissue, however, will show areas of abnormal tissue, called plaques, made up of abnormal proteins; a loss of nerve cells; and areas of tangles in the nerve cells that remain in patient’s with Alzheimer’s disease.

What is the treatment?

At this time, there is no cure for Alzheimer’s disease. Treatment focuses on maintaining the best possible quality of life for the patient by providing a supportive environment. Memory aids, such as calendars and other daily reminders of time and place, can help the patient feel more secure and reduce confusion. There are some medications that, when used in the early stages of this disease, can slow memory loss in some patients for a limited amount of time. However, these drugs are used with caution because of potential side effects. Other drugs may be prescribed to treat anxiety, sleeplessness, depression, and hallucinations, as necessary. In the early stages of Alzheimer’s, it is important to help the patient maintain as much independence as possible. As the disease progresses, it may be necessary to seek the help of a home healthcare aid, an adult daycare, or nursing home. While there is currently no treatment to prevent or stop the progression of Alzheimer’s, researchers are continuing to study this disease and test new drugs. There is a possibility that certain types of nonsteroidal anti-inflammatory drugs (NSAIDs) may slow the progression of Alzheimer’s.

Self-care tips

A diagnosis of probable Alzheimer’s is devastating for someone who has been accustomed to living an independent life. It is important to provide the patient with emotional and physical support as he or she adjusts to living with this disease. Keeping the daily routine consistent and as stress free as possible is helpful. Because depression is so common in the early stages of Alzheimer’s, you should be aware of the signs of depression and seek help for the patient as soon as possible. Caring for someone with Alzheimer’s can be demanding and discouraging, especially when the loved one does not remember who you are. Your doctor or local social services agency can direct you to support services to help make this time a little easier. Also seek legal advice so it is clear who has the power to make medical and financial decisions once your loved one is no longer able to do this for him or herself. If you have a family history of Alzheimer’s disease, see your doctor for regular checkups. An early diagnosis is important, especially as the medical community learns more about this disease and its treatment. While there is no way to prevent this disease, you can lower your risk and protect yourself from many illnesses by following a healthy diet that is high in fiber and antioxidants and low in saturated fat, and participating in regular physical exercise. Performing activities that stimulate your brain on a regular basis, such as crossword puzzles, word searches, or memory games, may also help maintain mental ability longer.


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This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.

What If It's Not Alzheimer's: A Caregiver's Guide to Dementia

Kids bring joy to Alzheimer's Sufferers

The following article shows that our children can really play an important community service role in our society. The kinds of interactions with Alzheimer’s patients that are described not only benefit the patients they give the children important lessons in life. I found this article uplifting.

On a personal note, I can tell you my mother is reacts very positively to children. A child always brings a smile to my mothers face. If you look closely you can see she is experiencing real feelings of joy and happiness. On those days where my mother has interactions with children or young adults she usually has a better, brighter day.

Source Sioux City Journal

The generations appear to mesh seamlessly when kids from Building Futures Child Care, a public program of the Boys & Girls Home, make their weekly visit to the Alzheimer's Association's Adult Day Services room.

Without being told, the youngsters eagerly fill in the couple of empty chairs at each table. The clients who came Thursday have been chatting, listening to music or just sitting. Soon, the children's teacher, Julie Bell, and aide Cindy Levering, are passing out clear plastic suncatchers and squeezing splats of bright-colored paints into trays for each person.

The children, ages 4 to 10, have come for an hour or two every Thursday this summer. They play board games, read a library book or do a craft and then share a snack with the clients. Both generations benefit from their time together, even if not everyone remembers it well.

'I love it'

"My middle name is Mess-up," client Marian Persinger laughed as she fixed a drip on her suncatcher. She said she enjoys the children's visits. "The camaraderie. Whatever (craft) they bring, we do. We frosted cookies with them last week," she remembered.

"I know. We made caterpillars," Dylan Thompson, 5, offered. It's not clear whether he meant last week or another time. It doesn't matter.

"Oh, I love it," client Kay Erskine said. "Seeing these kids and watching them, it's really neat."

The children provide a flashback to a happy time for Linda Young, as well. She has attended the center nearly every day for the past three years, since suffering a brain injury in a fall at work.

"It's my first time. I'll watch," said one man who actually comes to the center five days a week. Matt Elgert, 6, unperturbed by the disconnect, painted his suncatcher and talked about playing Candy Land on an earlier visit.

Client Mike Biderman, a retired Navy man who comes to the center often, said he thinks the interaction is good for the children, too. "They should have some exposure to adult life as early as possible," he said.



'Bring somebody joy'

Mary Jo Sikkema, director of the Alzheimer's Association, said the children's visits are important. They keep clients busy, stimulate their brains and give them an opportunity to socialize with other people. She said it's rare that a client doesn't want to participate, or gets agitated.

Stephanie Altamimi, director of Day Services, said she think the clients especially like doing crafts with the children because they feel they are helping the kids. And, she said, the adults feel a connection to all children who visit the center, whether it's the day care children or a family member's child.

Levering said she was surprised at first at how well the children handle their visits. "They're so patient with the clients," she said.

Bell added, "I explained to them they're volunteering their time to bring somebody joy. They really got the concept."

Altamimi said other young people also visit the Day Center. She said sometimes a church or high school group will come and stay most of the day. Some have played band instruments, or drummed up a game of chair volleyball with clients. "We don't ever turn anybody away," she said.

Bell said her group plans to keep its visits going, even after summer ends. They'll come to the center on all the "early out" Mondays of the school year. Days when classes end at 1 p.m., the kids in her program will assemble at the Alzheimer's Day Services Center for crafts, snacks -- and bringing joy.





The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Alzheimer's, Validation Therapy and the CareGiver

I ran across this article while "fishing" on the Internet. This tried-and-true technique can be used when you are at "wits" end when dealing with difficult behavior. The article contains examples that should help you develop your own frame of reference, techniques when dealing with difficutl situations on a daily basis.

The article should be particularly useful in helping you understand that the often bizarre behaviors evidenced by your Alzheimer's loved one are not uncommon and can be dealt with effectively. This article is worthwhile reading and is worth "salting away" for future reference.

Nursing Homes, June, 2000 by Mark Warner

DESIGNS for Validation Therapy

Mark Warner

This tried-and-true technique can be supported in the Alzheimer's environment

As each member of the group sat in the circle hoping the balloon would gently drift their way, Roxanne burst from her chair in a fit of rage, shouting "There'll be no ball-playing in my house!" Furious at the insolence of the players who ignored her commands, Roxanne forcefully attacked a staff member, who tried to comfort her by explaining that she was not in her house, but merely with her friends playing a game. Roxanne didn't buy that and swung wildly, hitting the staff member squarely in the chest.

Fearing that I, too, might fall victim to the same fate, I cautiously approached Roxanne.

I put my arm around her shoulder and supported her in her cause that there should be no ball-playing in her house. "This is terrible," I said. "You're right, they should not be throwing that ball in your house, should they?"

"No, they shouldn't," bellowed Roxanne, showing only the slightest relief that someone saw her point of view.

"But you know, Roxanne, the only way they will stop throwing that ball is if we write down the rules for them. I think it's the only way they'll listen." Roxanne was buying this approach, so I suggested, "Let's go into that room over there and write down all the rules for them, okay?" Much to my relief, Roxanne agreed, and hand-in-hand we went into the room to write down the "rules."

"Okay," I began, "Rule Number One is 'No ball-playing in the house,' right?"

"That's right," agreed Roxanne.

"So what will Rule Number Two be," I asked, and then offered, "How about, 'No running in the house'?"

"That's right," said Roxanne, "my grandchildren are not allowed to run in my house."

"Roxanne, you've got grandchildren," I said, raising the tone of my voice with delight.

"Oh, yes, my little gran'boy is six years old, and he is as smart as they come." Roxanne was on a roll now, and the upset caused earlier by the balloon toss in the next room might as well have been miles away. Fifteen minutes later, when the game was over, Roxanne and I emerged from the room, both of us just as happy as we could be, the "rules" left on the table and the incident long forgotten.

The technique used here is called Validation Therapy. It assumes that no matter what illusion the person with Alzheimer's disease (AD) is living, she is right, and nothing you can say or do will convince her otherwise. Naomi Feil is the acknowledged expert on validation therapy and wrote the book The Validation Breakthrough. The basic concept is that you have to buy into the resident's illusion and convincingly play along with it, there by validating it. Eventually you'll see opportunities to mold the tale--and the resident's behavior--into something that is acceptable and no longer upsetting.

"What has this got to do with design," you ask? Everything, in fact. Understanding Alzheimer's disease and the many creative ways to deal with it are as much a challenge of designing an environment as of caregiving within it.

Angie is always complaining about the stranger in the bathroom. She won't use the toilet while "the other lady" is in there. She says that the bathroom is occupied, not realizing it is her own reflection that she sees. Do you explain that she is seeing herself in a mirror?

No. You go along with her. How about, "I'm sorry, Angie, let me see what's taking that lady so long." You go into the bathroom and somehow cover the mirror. One family confronted by this situation told their mother that the mirror was dirty and needed to be cleaned. They sprayed it with a powdered deodorant, creating a haze that obscured any reflection. "Mom, she's out of there now," her daughter said. "I wonder what took her so long. Let me know if you need anything. I'll be right here waiting for you."

Caregiver 1: "Deborah won't eat anything. She just sits at the table and stares at the food. She loves gardening, though; we spend hours every day weeding and pruning the vegetables in our garden."

A golden opportunity awaits us here. Figure it out. Deborah loves gardening, but won't eat.

"So we tried something a little different. Though the tomatoes were days from ripening, I went to the grocery store and picked out some beautiful red ones. Instead of putting them on the table in front of her, I pretended to come in from the garden, tomatoes in hand. As Deborah Looked at the tomatoes, I told her, 'They came from our garden and don't they Look delicious?"'

Granted, such ploys are not always so successful, but many are. Sharing the bounty of the garden, enjoying the fruits of your labor that you grew together, can somehow trigger pleasant, guiding thoughts and behaviors when all else fails. Perhaps it stirs up memories from long ago, or maybe it's just the thrill of eating your own garden vegetables. Regardless, it adds a new dimension to life that might very well conquer the ravages of the disease and perhaps bring new purpose to those waist-high gardens many facilities are installing these days.

Taking validation to the next step often involves anticipating the problem and creating the illusion. Validation, also referred to as deceptive therapy, white lies and fiblets, means creating a story--in the best interest of the person who is "confused."

"Dad, who's president? Do you remember his name?"

"Of course l do, it's Roosevelt!"

If your family member believes it is the 1930s, so be it. As he regresses in time, so do his memories of values, experiences and people. What was important then becomes important now!

Given residents' belief that they are living when Roosevelt was president, what would the world have been like back then? What would the good experiences and environmental features have been? How can we recreate the familiar feelings of that period in a convincing and subtle way?

For example, those were the days when they hung the clothes on a line in the back yard. Isn't that the kind of good and secure feeling we would want to recreate--possibly by merely providing a clothesline? Others might be enjoying the time when they were raising their families. What better way to indulge them than by allowing them to once again care for their spouse or children by hanging "their" clothes out to dry?

Or, perhaps they have less comforting memories.

Caregiver 2: "Mom collects everything--rubber bands, paper clips paper...everything! And she stores them everywhere. You can hardly walk in her room, there is so much stuff in there!"

Perhaps Mom is reliving times when the country was at war, when every little scrap was valuable in the war effort, or the Great Depression, when times were so tough that you had to keep everything, when nothing that might be useful was thrown out. Environmental validation then might mean providing easy-to-see drawers, trunks or cabinets to store these important items.

How were evenings spent in the good ol' days (before TV, let's say)? Many families spent hours sitting on the porch, watching people go by, talking to neighbors, etc. Why not create a porch, complete with rockers and swing gliders? Locate it carefully and safely, but within view of interesting activities (maybe a playground where children play). Make sure it is secure for those who might try to leave or climb over the railing; it should also be far enough from strangers outside who might be perceived as intruding into their space. Perhaps a screened porch would do the trick.

One should also beware of environmental miscues.

"Bruce, why aren't you eating?"

"I didn't bring my wallet and can't pay for the meal."

Although Bruce is living in an assisted living facility and doesn't have to pay for his meal, he doesn't realize that. As far as he is concerned, this large, beautiful dining room is a restaurant, and the more he eats, the bigger the bill. Perhaps if we had divided the room into smaller, more homelike dining rooms and spared the expense of the huge chandelier, Bruce would feel more comfortable with his home-cooked meal.

Don't forget that little environmental touches can mean a lot.

Caregiver 3: "My mother refused to take a bath. For years, soaking in a warm tub of water had been the highlight of her day. But now, for some reason, she feared the tub and everything it represented. Eventually she confided in me, relating a childhood story about a little girl who got sucked down the bathtub drain. She recalled that tale and, like that little girl, she was afraid that she too might fall victim to that terrible fate. The solution: We put a mat over the drain. Her fear suddenly disappeared."

In a daycare center, angry and impatient residents wait for their rides to take them home. Each time the door opens, one, two or even three of them race to it and powerfully attempt to get into the van, which has actually arrived to transport someone else. Staff members intervene, often unsuccessfully, overcome by the strength and determination of people with a very important cause (the van is there for them). If we, as facility planners and designers, can anticipate this kind of behavior, we can plan door placement to eliminate visibility of the van outside, thus avoiding this upsetting and potentially volatile situation. There are design solutions for problems like these, if problems are simply acknowledged and thought about ahead of time.

Although the stories I've recounted are all too familiar to healthcare professionals, they are often "Greek" to design professionals. Nevertheless, it is a design credo: To design for any client, you have to understand the client. Why should those who have Alzheimer's disease be treated any differently?

We are only in the earliest days of learning how to design for dementia. Hopefully, there will soon be a cure for these devastating diseases, making an article such as this a moot exercise. But until then, we must continue to delve into our creative minds, take chances and discover what works and what doesn't for this population. Nursing home/assisted living managers should help designers understand how people with dementia perceive and interpret their worlds. Only when equipped with this knowledge can we designers begin to address these problems with the tools that we have available to us.

Mark Warner, AIA, is the author of The Complete Guide to Alzheimer's Proofing Your Home, the first book in the Homes That Care series on age related conditions and creating homes for those suffering from them. His firm, Ageless Design, Inc., offers consultation and assistance in the design of environments for seniors. For more information, call (561) 745-0210, visit the Web site at www.agelessdesign.com or e-mail ewarner@agelessdesign.com.




The Emotional Survival Guide for Caregivers: Looking After Yourself and Your Family While Helping an Aging Parent


alzheimer's, assisted living, behavior, caregiver, loved one, nursing home, validation, Validation Therapy

Mental Activity Helps to Lower Risk of Alzheimer’s Disease

Taken directly from the Rush Memory and Aging Project news release.

How often older adults read a newspaper, play chess, or engage in other mentally stimulating activities is related to the risk of developing Alzheimer’s disease, according to a study by researchers at Rush University Medical Center.

Taken directly from the Rush Memory and Aging Project news release.


Frequent Brain Stimulation in Old Age Reduces Risk of Alzheimer’s Disease


(CHICAGO) – How often older adults read a newspaper, play chess, or engage in other mentally stimulating activities is related to the risk of developing Alzheimer’s disease, according to a study by researchers at Rush University Medical Center published June 27 in the online edition of Neurology®, the medical journal of the American Academy of Neurology.

For the study, more than 700 people in Chicago with an average age of 80 underwent yearly cognitive testing for up to five years. Participants were part of the Rush Memory and Aging Project, a longitudinal study of more than 1,200 older people. Of the participants, 90 developed Alzheimer’s disease. Researchers also performed a brain autopsy on the 102 participants who died.

The study found that a cognitively active person in old age was 2.6 times less likely to develop dementia and Alzheimer’s disease than a cognitively inactive person in old age. This association remained after controlling for past cognitive activity, lifetime socioeconomic status, and current social and physical activity.

Researchers say the findings may be used to help prevent Alzheimer’s disease.

“Alzheimer’s disease is among the most feared consequences of old age,” said study author Robert S. Wilson, PhD, a neuropsychologist at the Rush Alzheimer’s Disease Center. “The enormous public health problems posed by the disease are expected to increase during the coming decades as the proportion of old people in the United States increases. This underscores the urgent need for strategies to prevent the disease or delay its onset.”

Wilson says the study also found frequent cognitive activity during old age such as visiting a library or attending a play, was associated with reduced risk of mild cognitive impairment, a transitional stage between normal aging and dementia, and less rapid decline in cognitive function.

The study was supported by grants from the National Institute on Aging and the Illinois Department of Public Health.

The Rush Alzheimer's Disease Center is one of 29 NIA-supported Alzheimer's Disease Centers across the U.S. which conduct basic science, clinical, and social and behavioral research on dementia and AD. General information on aging and aging research can be viewed at the NIA's home website, www.nia.nih.gov. For more information on the Rush Alzheimer’s Disease Center, visit www.rush.edu.





"ACTIONALZ.ORG", alzheimer's disease, blog, brain, stimulation, caregiver, care giving, chess, mental-health, National Institute on Aging, neurology, prevent, Rush University Medical Center

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life

This best-selling book is the "bible" for families caring for people with Alzheimer disease...



Read the full text review at The Alzheimer's Reading Room

Americans Fear Alzheimer’s More Than Heart Disease, Diabetes or Stroke

A recent study by the MetLife Foundation found that Americans fear getting Alzheimer's disease more than heart disease, stroke, or diabetes. Alzheimer's ranks second in the minds of American's only to cancer.

Alzheimer's Reading Room: Americans Fear Alzheimer’s More Than Heart Disease, Diabetes or Stroke

Fruit Smoothie Could Improve Thinking, Memory In Alzheimer's Patients

This article on the smoothie really caught my attention. Why? I drink one of those almost every day. Oddly, when I try to get my mother, the Alzheimer's patient, to drink one along with me she refuses.

A simple fruit smoothie could soon help improve thinking and memory in Alzheimer's patients.



Fruit Smoothie Could Improve Thinking, Memory In Alzheimer's Patients

St. Louis University is the only U.S test center to study whether the drink actually works. The beverage isn't a new drug, but a nutritional drink with a combination of vitamins, antioxidants and lipids that are consumed once a day. The smoothie comes in peach or cappuccino flavors.

Dr. Theodore Malmstrom is one of three researchers looking into what could soon be a very important weapon in the fight against Alzheimer's.

"There is increasing evidence that concentrated components of natural foods can improve memory so those components have been put in a drink and we are hopeful it will help," said Malmstrom.

The goal now is to get actual patients to test it out.

SLU researchers need at least 10 Alzheimer's patients to take part in the study. They are looking for people recently diagnosed with Alzheimer's, but not currently taking medications.

Patients will be divided in two groups. One group will get a daily supply of drinks with nutritional supplements. The other group will get a similar drink but without the nutritional additions.

Results of the 24-week study will hopefully end with good news.

"There is always great hope whenever you can have new research emerging. One of the Alzheimer's Associations mission (is) to fund research programs so we are very excited," said Stephanie Rohlfs-Young, the outreach director for the St. Louis Chapter of the Alzheimer's Association.

The risk of side effects from the drink are very minor compared to side effects from the five FDA-approved medications that treat Alzheimer's.

For more information, contact Malmstrom at 314-577-8745.

Alzheimer's Disease Rate Rises to More Than Five Million in the United States

Someone Develops Alzheimer's Every 72 Seconds, According To New Alzheimer's Association Report.

The Alzheimer’s Association today reports that in 2007 there are now more than 5 million people in the United States living with Alzheimer’s disease. This number includes 4.9 million people over the age of 65 and between 200,000 and 500,000 people under age 65 with early onset Alzheimer’s disease and other dementias.


Read more about this topic at The Alzheimer's Reading Room

Trouble identifying odors points to Alzheimer’s

One thing I noticed a long time ago was that my mother's sense of smell was gone. I am always looking for ways to take better care of myself and of course to detect any symptoms of Alzheimer's in myself and other members of my family. By now you might guess that I will be paying close attention to my ability to detect odors.

Dr. Robert S. Wilson told Reuters Health that difficulty identifying odors seems to be related the buildup of 'tangles' in the brain that appear early in the development of Alzheimer’s disease. “We found the correlation of difficulty identifying familiar odors with Alzheimer’s disease pathology even in people without dementia,” he added.


Go read the entire article at The Alzheimer's Reading Room Weblog: Trouble identifying odors points to Alzheimer’s

Exercise slows decline in Alzheimer's patients

I can attest, exercise makes a difference. My mother now has the tendency to sit around all day. On those days when I can get her to go to Gold's Gym with me she is a completely different person. The look on her face, from dull to smiling, is more than enough to tell me that exercise works to her benefit.


"Nursing home residents with Alzheimer's disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care, researchers have shown."


Read the article in its entirety at the CareGiver: The Book Weblog

Why Didn't I Get It?

The signs were there but no one could see them--not even me.


Why Didn't I Get It?

I was talking to my sister one evening and she said to me, “You better call Mom she says she hasn’t talked to you in months.” I laughed and said I talked to her two days ago and for more than an hour. Later in the evening, I decided to call my mother. After she recognized my voice she said, “Well its about time you called.” When I said I just talked to you two days ago she just shrugged it off and we began our usual conversation.
I really don’t know why I wasn’t more concerned at the time but to be honest I wasn’t. And neither was anyone else. The typical comment, “she sounds good to me.” I guess like most people I just accepted the fact that she was getting old. Nobody saw a problem not even her friends who saw her on a daily basis.
Looking back there were plenty of signs. For one thing, she was developing a very negative attitude. But, it seemed when I spent time with her, a few days, she would turn back into her normal self and start to have a more positive outlook on things. Another sign occurred when she began to scrape her feet as she walked. I suppose I should have concluded something but I didn’t. We thought she was finally slowing down. I could go on and on.
Then Christmas came and I decided to take her shopping. To my surprise she could barely walk for five minutes without stopping. In fact, she was almost slumping over. Out of the clear blue sky, or so it seemed, she just couldn’t walk any distance and it was struggle just getting her back to the car. Clearly something was a-muck.
I went to talk to her doctor. Other than her high blood pressure, her heart was fine and her overall blood work was pretty good—more than pretty good for a woman her age. Keep in mind we are talking about an 87 year old woman at the time, a woman who had never had a major illness or operation her entire life. The closest she had come to any of that was when she had an operation on a bunion on her foot.
Yet now for some reason she was no longer able to walk comfortably. I began to notice how she was somewhat unsteady, how she began to reach out and hold on to things as she walked, and how she no longer had an interest in doing anything that required her to walk. Two years earlier this woman, my mother, walked more than a mile round trip with me in New York to eat breakfast.

My Mother the Dynamo

She lived on her own, paid her own bills, and took care of herself.......



My mother at the age of 85 was a dynamo. She lived on her own, paid her own bills, and took care of herself. She had been doing this for more than ten years since the death of my father. She was on her own.

My mother was often spotted walking to the pool in her community. A tiny women the senior citizens all around her marveled. It seemed as if father time had forgotten about her. There was no limit to what she could do. Walk 20 blocks, no problem, you name it. Up at dawn and awake at midnight she was a real dynamo.

My mother was very funny, a real character. She made people laugh and smile. She read the paper and watched CNN, she had opinion on everything and wanted to know your opinion. She was a wonderful person: always welcoming people into her home. She was noted for all of my 50 years for her great Italian cooking. I remember as a kid that all of my friends really looked forward to staying over our house. Donuts, spaghetti and meatballs you name it. Ravioli anyone?

Me? I was there with my mother when my fathered "passed away'; this was when I really started about her longevity, her health. I was thinking about her for years knowing that someday she had to live with one of us (I have a brother and sister). As the years flew by I started to think about it more and more. But she just kept going ang going without a health problem of any kind. Rarely a minor illness. She was the real energizer bunny.

At times, my brother, sister and I had discussions about putting my mother into some kind of "facility". But to be honest, to be honest now, I knew I would never be able to do it. While I had only mentioned it to a few people, I had made a promise to my father not long before he died. I promised him no matter what, I would take care of his wife of 55 years, my mother, our love. Dot. It was not a promise I made haphazardly. I made up my mind about this while we were taking care of my dying father. It seemed as natural to me as breathing. I already knew in my mind and my heart, I was the one.

I knew the day would come. I just didn't know when. Or how.

All American Senior Care

Maybe I Should Have Known

I should have started this three years ago. My, how time flies. I have a lot of catching up to do for sure so just bear with me. Some days I’ll go back to the beginning and tell you our story. On other days I will tell you what is happening on the spot. I’ll vent about my mother. If she is up to it I will encourage her to tell you in her own words what is going on in her head.......


I became a CareGiver before I had any idea that the word existed. It all started back in late 2003 after a series of strange occurrences by my mother. I guess I should have known when my mother ran her car over an abutment and scraped off the entire side of her car on a tree. Me, more than 1000 miles away, I was told the car was not that bad. Two days later and on the scene, I found out the car was totaled. Fortunately, my little tiny five foot tall, 87 year old mother was just fine. At least that is what she and all the doctors told me. While I accepted it at the time I just knew something was not right. And this is where the story about me and my mother begins.
I am just beginning this Blog. If you somehow found me, welcome. Please feel free to say 'hi". If you are a care giver or if you believe you have something to add please feel free to do so. If you have comments make them.
Ok then, this is our story.
Bobby