This is a picture showing my Dad on the day that we moved him into the nursing home. He is smiling because I am taking his picture with his oldest granddaughter Briana, and her two boys, Tavian and Breckin. It was September 11 of this year....but let me go back to what led up to that decision, as well as give you a few tips and some background information on Dementia.
There were many decisions that needed to be made after Dad spent a week in the hospital in May after falling several times. One decision occurred before he left the hospital. My parents had two vehicles, a full-sized GMC truck and a compact-sized car. The truck caused problems for Dad due to his failing vision. Several times he ran into the side of the garage when he would be pulling it inside (and he used duct tape to hold the trim in place). My Mom felt that the truck was too large, and that the car was too low to the ground. What she had really been wanting was a smaller-sized truck. We took her to the local car dealership (the same one that they had been dealing with for decades) to see what kind of a vehicle they could find her. Lo and behold...they had a shiny red truck on the lot that fit her description! This was the first new vehicle that she had ever purchased because Dad always insisted that they buy a good USED vehicle. It took some prodding and encouragement from a few family members...but she finally agreed to it. I remember when we brought it home...Mom was excited, but also nervous about what Dad's reaction would be. She made me drive it to their house. Dad came out and said, "That isn't new, is it?" I told him that it was, and he told me that it had better be used (it did have about 13 miles on it....so technically....it was!). It was hard for Dad to adjust....especially to the idea that he was NOT going to get to drive it...which was a HUGE battle! He kept insisting that until the doctor told him that he wasn't to drive, he was fine to drive around town. It was a source of concern for our family. He was scary to ride with, and we tried to keep him from driving as much as we could, until the doctor did finally tell him in August that he was no longer allowed to drive.
This is him holding their dog, Punky, during his first ride in the new truck. Don't be deceived by the smile...as soon as I took the picture he began grumbling about the new vehicle and not getting to drive it....just once! He also kept insisting that they needed a second vehicle....what would happen if she had trouble with the truck and he needed to come and get her?? No matter how hard we tried to explain what OnStar was in a vehicle...his mind just couldn't wrap around that one (not surprised given that he didn't understand how automatic headlights worked either!). He kept telling my Mom (and anyone who would listen) that he was going to call the car dealership and have them start looking for a used car for him. [Tip #1: make phone calls to places that your loved one called frequently and explain to them what the situation is. I had to call the car dealership and the implement dealer that Dad had purchased his mower from.] This gave us some peace of mind to know that at least even if he DID call them....they knew to agree with him or distract him. Living in a small town helped out in this area, but if he had lived in a larger city, the same tip would apply. [Tip #2: visit with your neighbors and explain the situation as well. They can keep an eye out in case the loved one takes a fall outside, or they see them doing something unusual.]
After Dad came home from the hospital in May, he continued to stay at home for about three-and-a-half months. Mom would take care of him to the best of her ability, while continuing her daily activities. [Tip #3: when the primary caregiver has to start giving up their daily activities, it may be time to find another option. The primary caregiver can become exhausted and wear themselves out, causing health problems of their own.] My Mom was diagnosed with Type 2 Diabetes during the time that she was taking care of Dad. Stress had taken a toll on her. I have also heard of the caregiver spouse having heart problems or other health issues made worse because of taking care of the loved one with Dementia.
The summer passed without too many mishaps with Dad. His short-term memory continued to be a problem throughout the summer. When school started, we took him to a couple of football games to watch his grandson play. He sat in the vehicle to watch the games. The turning point came on a Saturday night while Mom and I had gone to watch the older grandson's college football game. My husband, Terry, stayed behind to stay with Dad so that we could enjoy the game. Without Mom there, he became very disoriented and wanted to get his jacket on to go and help his parents. His parents have been gone for decades now. Dad became agitated with my husband for not letting him leave. Terry called me and had my Mom call home to explain to Dad that he was at his home and to just go to bed. When the phone rang, Dad confused the TV remote as the telephone and missed the call. Mom left a message on their answering machine, and when Dad heard her voice in the kitchen, he went out there. When my husband explained that it was the answering machine, Dad insisted that he had talked "face to face" with his wife. Mom did call back and speak to Dad and told him that he was at his own house and he needed to go to bed. He went into his bedroom, but then got confused and couldn't find the door to get back out. Then he went around the house turning on all of the water faucets so that the pipes wouldn't freeze (it was September). Finally, he then went and turned on the shower and when my husband asked him what he was doing, he responded that he was "releasing the water pressure". Dad worked at the power plant for many years,and apparently thought he was back at work. He finally did settle down, but he had worn out my husband by that time! The next decision was whether to take him to the hospital that night, or wait until the next day, which would be a Sunday. My Mom worked at the hospital for many years so she knew the routine there. She decided that we should wait until Monday and call his regular doctor's office instead of take the chance of getting the "on call" doctor. When I called on Monday, the nurse said to take my Dad to the ER. The doctor admitted him to the Observation Unit for the night. [Tip #4: always keep a CURRENT and ACCURATE list of ALL medications and/or supplements that your loved one takes.] They watched Dad all night on the medications that he normally takes. While he was there, he saw the TV cord unroll and roll back up on the wall, and many other hallucinations. The next morning, the doctor advised that he would arrange for Dad to get into the nursing home. Mom and Dad had purchased nursing home insurance several years ago, and it would prove to come in very handy. The doctor diagnosed Dad with Vascular Dementia. A question that I have been asked many times since Dad's diagnosis is: What is the difference between Alzheimer's and Dementia? Alzheimer's is actually a type of Dementia. And Vascular Dementia is caused by Strokes, or a series of mini-strokes. Rather than try to explain what this is to you, I have included this excerpt from a website:
[Vascular dementia is the second most
common form of dementia, according to the Alzheimer's Association. Like other
forms of dementia, vascular dementia affects the elderly, particularly people
between the ages of 60 and 75. The National Institute of Neurological Disorders
and Stroke (NINDS) notes that men have vascular dementia more often than women.
The patient has a decline in cognitive functions as a result of a disrupted
blood flow in the brain. Helpguide.org notes that a series of small strokes
causes the most common type of vascular dementia, multi-infarct dementia. The
inadequate blood flow damages the brain cells.
Cognitive
Symptoms
A patient with vascular dementia may have memory
problems, which affects his ability to recall stored memories, form new
memories or both. The Alzheimer's Association notes that the severity and type
of memory loss depend on the location of the damage in the brain. For example,
damage to the hippocampus, the part of the brain that converts short-term
memories into long-term memories, prevents the patient from storing new
memories. A doctor can detect the area of the brain damaged by using a brain
scan, such as an MRI or CT scan. The patient may also have concentration
problems and difficulty following directions. Confusion may also occur, which
worsens at night, according to the Alzheimer's Association. Other cognitive
problems with vascular dementia include difficulty planning and language
problems.Movement
Problems
Vascular dementia also affects the
patient's ability to move. For example, the patient may experience sudden
weakness. The weakness can occur in the patient's arm or leg. Helpguide.org
notes that when the patient moves, he may walk with rapid, shuffling steps. The
patient may also slur his speech when he talks. The Alzheimer's Association
adds that the movement problems, combined with the cognitive decline, cause the
patient to have problems taking care of herself.
Other
Symptoms
Helpguide.org states that vascular
dementia causes abnormal behavior in the patient. For example, the patient may
cry or laugh at inappropriate times. The patient may also wander or get lost
easily, even in places he knows well. Other symptoms of vascular dementia
include a loss of bowel or bladder control, dizziness and difficulty managing
money. The NINDS adds that the problems managing money affects the patient's
ability to complete monetary transactions appropriately: she might, for
instance, overpay for an item.
According to medical evidence, dementia--symptoms of cognitive and behavioral impairment--can be brought on by some medications, health conditions such as lung disease, and
diseases. (Dad has had difficulties with his lungs due to years of smoking and then working in his workshop and inhaling wood dust.) The Merck Manual notes that the most common cause is Alzheimer's disease,
which accounts for 75 percent of dementia cases. Other than Stroke (Vascular), Lewy Bodies, Huntington's Disease, Parkinson's Disease (my Dad's mother passed away from this), and Creutzfeldt-Jakob Disease can cause dementia in people. There is also Mixed Dementia, which has abnormalities from more than one type of dementia occurring, most commonly from Alzheimer's and Vascular Dementia. I believe that Dad has Mixed Dementia. Here is a link that tells you 10 signs to watch for Alzheimer's:
10 Signs to Watch to Alzheimer's
10 Signs to Watch to Alzheimer's
Dad in his lift chair on his first day in the nursing home. Physically, he was in fairly good shape, just very confused. Next time I will talk about the process of getting someone admitted into a nursing home, and tips to keep in mind. I wish everyone a very Merry Christmas!
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