Tuesday, September 11, 2012

When Your Parent Becomes Your Child - A Personal Love Story (Part 2)

I consider myself a dependable source in care giving, one who understands the decline of the body and mind from month to month. I, unfortunately, lost both of my parents to Alzheimer's disease. As the main caregiver for them, a part of my heart and soul was forever taken from me; a part I will never be able to reclaim. However, it advanced a decide in me, a spirit I never knew I had. Although it took an hour of driving round trip to be with each of my parents, the notion never crossed my mind. It felt good to make them happy; to make them feel gain that I would all the time be there to protect them. My whole house reacted the same way. Like we were taught in our youth: "Be a mensch!" (a nothing else but good person).

Financially, my parents' small fortune was wiped out (the midpoint cost in care is
0,000 per patient). But, the worst of it was my teenaged children had to watch
each grandparent whither away and forget who they were. With it (doubly) in their
genes, they worry it will happen to me - and to them.

My father died at 74 years young. Four years later, the same killer attacked my
mother. Was God punishing my family? Had we not lead a life of which He was
proud? There are no answers, and people must remember that. It is no one's fault.
However, we can stop it. But, more research is needed, and research costs money.
According to Frank LaFerla, PhD, and colleagues at the University of California,
Irvine, they demonstrated in the lab (with mice) that amyloid proteins cause plaque
in the brain. The demand remains: Is it plaque that causes Alzheimer's, or is it the
mass of tangled protein (which causes plaque) that causes Alzheimer's? In the
August 5, 2004 issue of Neuron, Dr. LaFerla and colleagues wrote: "These findings
raise the captivating possibility that a multi-antibody-based approach - one targeted
against plaque and one targeted against tangles - may provide the most needful
benefit for the rehabilitation of Alzheimer's disease." That is unless you wait too long.
Once the tangles reach a distinct point, your brain can't clear them. "It's important,"
he said, "to diagnose Alzheimer's in its earliest stage before the protein becomes a
tangled mass, and to look for ways to clear late-stage tangles."

Analyzing my parents' lifestyle, I tried to make sense of the cause of their disease.
The only thing I could think of was they were both smokers until their forties, and
we all ate lots of red meat almost every night. Red meat, if not lean, causes plaque
in the heart. This is not to say it causes the amyloid protein that causes plaque in
the brain. But, the old adage still remains: You are what you eat.

My mum was the most selfless, most self-sacrificial woman I have ever known.
Nothing was as prominent to her as her children and grandchildren. It was why she
gave up a promising vocation as an opera singer. From the time my brothers and I
entered elementary school in Brooklyn, Ny (this was back in the 1950s) my mum
worked full-time (in Manhattan) so there would be less of a burden on my father.
She loved to laugh and make others laugh. Her personality and effervescence was
infectious. She deprived herself of the many rewards she could afford, so she would
have that much more money to leave to her children. In that, she was steadfast.
Believe me, she had her complaints and demands - and many opinions - but don't
we all?

My mum started moderately with the progression of her disease. She could no longer
stay at home because there was no one to take care of her twenty-four hours a day.
I made the decision to place her into assisted living, where she could live in an
apartment with her own furniture and have her meals in a restaurant-style setting,
with her medications administered to her four times a day. Of procedure this was
expensive, but we had no other choice; she wouldn't allow strangers in her home. I
visited her almost everyday and spoke with her about all imaginable. She
seemed okay, but she wasn't. She was forgetting things at a rapid clip. It was
difficult for her to make friends, she hated the food, and she became resentful and
excitable. Still, we stuck to our plan. Every weekend my wife and I would bring our
children there for lunch, and my mother's spirit soared. We brought in pizza,
Chinese food (her favorite), deli, homemade meals that she had taught me to cook
every Sunday growing up. We spent hours with her and she laughed and laughed
(she was all the time my best audience). But when we were gone, the nurses would call
us daily and tell us how she would get undressed and stroll her room naked. From
then on, whenever I would visit her, I would go to the nurses' middle point first and ask
them to go into her room to see if she was dressed. The last thing I wanted was to
see her naked. (I didn't need that nightmare.) The staff also said she was starting
fights with the other patients and physically hurting them. It was time to move her
into a nursing home. She was progressing faster than my father had.

When we moved her into the home, I went straight through her belongings in her condo and
found old pictures of family, dating back to when she was a exiguous girl. I hung them
all over her new room. The long-term memories are a relax to the patient, and
with her violent outbursts, she needed a relax zone to recollect herself. I even
found her high school year book. We went straight through it and she remembered so many
old friends. I took her to restaurants (her popular pastime), as did my brothers. My
wife and I took her to religious services (as she was a devout woman). Her dignity,
and anyone moments of happiness she could experience, was the best emotional
medicine for her.

Every day I was at the home I noticed something that bothered me. Very few people
came to visit their relatives. Even on weekends. These poor souls cried all day,
screaming out their children's names while trying to convince themselves and
everyone nearby them that their son or daughter was advent that day.

But, they never did.

Many house members think that because their loved one is forgetting their name
they no longer remember them and don't have to visit anymore. But many
Alzheimer's patients remember it as they sit alone and reflect, and because time
moves so moderately for them it seems like an eternity since anyone has come to see
them. It is sad and pathetic. My parents were there when I was a child; I had to be
there when they became one.

My mum got worse very swiftly (as had my father) and became even more
combative. Then, she couldn't, or wouldn't, do anyone herself. She had diabetes
and emphysema (which convinced me to finally quit smoking). But I had a family,
and more and more I had to be home for teenagers who needed rides and the such.
Everyday visits turned to three times a week and weekends. In a short time her
beautiful hair turned fully gray and scraggly, her teeth began to fall out, her
memory got worse, and she was relegated to wearing adult diapers. However, it was
two months until my daughter's Bat Mitzvah (when a girl turns thirteen and is
allowed to read from the Torah) and I was busy planning the ceremony and
reception. To my amazement, my mum kept talking about how she couldn't wait
to go. She was subconsciously willing herself to live; she wanted to see her
grandchild come to be a woman in the eyes of her faith. It was the one thing she
refused to forget.

We hired a nurse for the day of the celebration, had a hair appointment set up, and
clothes picked out for my mother. We notion she might last straight through a half hour of
the two-hour service, but she sat there in the front row with the rest of the house
and lasted the whole time. I suggested to my brother that we allow her to go to the
reception for the cocktail hour. She made it straight through the hour as if she were the
honoree. people came up to her, and I never saw her smile so much. It was as if the
disease had disappeared. After the cocktail hour, the candle lighting ceremony
began. My mum was called up to light the second candle, after my daughter lit the
first one in memory of my father. My brother wheeled my mum up to the cake in
the middle of the dance floor (to a standing ovation) and led her to her
granddaughter. My mum took the long candle and blew it out. Everyone laughed
and so did she. Re-lit, she was directed to light a candle on the cake. She then
leaned in toward my daughter to give her a kiss, got back in her wheelchair, and
waved to everyone, most with tears in their eyes. (My mum was such a diva.) We
were about to have the nurse take her back, but dear ol' mom was having a grand
time. She ate more than usual, with her six grandchildren nearby her, then left the
reception after dessert. It was a miracle. Somewhat like the miracle of my father
squeezing my hand right before he died.

It was one of the happiest days of my life.

For two distinct reasons.

Shortly afterward, my mum no longer remembered her grandchildren, then her
children and my father (an Alzheimer's victim forgets the most recent memories
first and the oldest ones last). By then, she was fully bedridden. She forgot
how to eat and swallow and the doctor said it was a matter of weeks. We decided
against any life support, because it was in her living will, and she swiftly shriveled
up into a shell of herself. It was horrible to witness. Some people say they can't
handle that and they leave their parents to die alone, but my mum would never
have left my side, no matter how painful it was for her to see me in that state. I
wasn't going to leave her.

For three weeks, my mum lay in a coma. And for three weeks we were there by her
bedside. It was our duty, what we thinkable, of ourselves, the right thing to do, as I
explained to my two teenagers. By the third week of her coma, her weight had
dropped to less than 70 pounds and she advanced pneumonia. Her breathing
became labored. Her emphysema became worse and her throat kept filling with
phlegm. One lesson was so frightening that she started to turn blue from
asphyxiation. I put a surgical glove on my right hand, put my left arm behind her
back, and bent her forward, hoping she would cough it up. When she didn't, I stuck
my fingers down her throat and pulled out a large mass. She began breathing
normally again. Yes, at this point I wanted my mum to die, but I wanted her to die
peacefully.

After three weeks in a coma, we were all sitting in my mother's hospital room: Me,
my wife and kids, and my brother, his wife and son. It was the High Holy Day of
Rosh Hashanah (the Jewish New Year, the ten-day period where you atone for your
sins), and we had just returned from services. Suddenly, we heard, "What are you
doing here?" It was my mother's weak voice. Now, all my life my mum told us that
God makes sure the Jewish New Year is filled with sunshine (and most of the time
she was right). Upon hearing her, I noticed the sun shining straight through her window (she
was right again). We turned toward her in shock.

My brother went up to her bedside. "Mom, do you know who I am?"

She said, "Of course, you're Barry."

He asked her, "Are you hungry?"

In her typically old Jewish way, she answered, "I could eat."

"What's your popular food?"

"You know, vanilla ice cream." (It was.)

He went and got her a Dixie cup of vanilla ice cream and began feeding it to her in
little increments. She kept saying, "Mmmm." When she terminated the whole cup, she
said, "I'm tired now." Every one of us leaned down to kiss her and she kissed each of
us. She terminated her eyes and fell back into her coma. We all looked at each other,
asking, "What was that?"

It was my mum saying goodbye to us, as my father had done when he squeezed
my hand. It was my mum telling us all would be alright. It was my mum
telling us to go on with our lives, that she would all the time love us.

It was my mum being a mum one last time.

Three days later, at eighty years of age, a extraordinary lady passed on. She passed on
to a best place, filled with many memories of reciprocal love and devotion.

How do we stop this? If we had the answer, tens of millions of people would not be
going straight through this agony, and tens of millions more caregivers, like myself, would
not be faced with emotional and financial suffering for years on end. Presently, there
are almost 5 million Alzheimer's victims in the United States, and 18 million
worldwide. The Alzheimer's association projects those numbers will quadruple in
the next twenty to thirty years (that's 72 million people!), causing immeasurable
hardship for everyone, as well as for governmental health coverage.

The governments of the world, and the people of the world, need to take
responsibility and start fighting this terrorist now. We must all be our brother's (and
sister's) keeper. Otherwise, Alzheimer's disease will be the Baby Boomers'
swansong.

Should our children be forced to worry even more in their lives? Should they be
forced to watch their loved ones live such a brutal end? There is a vicious killer
attacking without regard to race, religion, or nationality, and if we let it continue to
fester and spread, we will soon have an epidemic of unimaginable proportions
worldwide.

Something must be done!

We are a world made up of good people, loving people, as proven by the relief
visited upon the tsunami victims. Billions of dollars of aid came pouring in from all
over the world, from people and governments. Can't we do the same for killer
diseases? More people die each year from cancer, heart disease, and Alzheimer's
disease than from tsunamis, hurricanes, tornadoes, and earthquakes combined.
If we all take an active part in making our lives safer, even in the smallest of ways,
collectively we will make a huge difference. As I experienced with my parents'
disease, exiguous miracles happen when your spirit leads your way. It's time we all come
together and generate a big miracle.

Alzheimer'S Disease (according to the American Alzheimer's Association)

Statistics:

Increasing age is the many risk of getting Alzheimer's disease.1 in 10 individuals over the age of 65, and 50% over the age of 85 suffer from it. Some forms of Alzheimer's can attack individuals in their 30s and 40s. Life expectancy averages from 8-20 years after diagnosis. 7 out of 10 people with Alzheimer's live at home - with 24/7 care required.

Alzheimer'S Patients Experience:

3.4 times more hospital stays than patients without the disease. 3.2 times higher costs for hospital care (,074 vs. ,204/person). 3.8 times higher medicare home health care costs (8 vs. 0/person). 1.3 times more physicians visits (14.4 vs. 1.3 visits/person)

Alzheimer'S Cost To Government, Long-Term Care, & Business:

Alzheimer's is the 3rd most costly disease after heart and cancer and unlike these others there is no cure. By 2010, Medicare costs are thinkable, to growth 54% from .9 billion dollars to $ 49.3 billion. By 2010, residential dementia care will growth 80% from .2 billion to billion. Cost to American businesses is billion yearly: .6 billion for Alzheimer's healthcare and .5 billion to cover caregivers' costs for lost productivity, absenteeism, and laborer replacement. Half of all nursing home residents have Alzheimer's or linked dementia with an midpoint cost of ,000-0,000 every year in many locations.

Alzheimer'S Is On The Rise As A Major Killer:

Heart disease is down 3%. Cancer is down 1%. Cardiovascular disease is down 2.8%. Alzheimer's disease is up 5.8% - with deaths up over 20% since 1999.

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