Nurse's Notes
2003
WHERE HAS SHE GONE?
My best friend’s Mom is 95 this year, in amazingly good health,
spry, blood pressure and heart normal, vision clear, hearing intact.
The only problem is that Gwennie has no idea who she is or where she
is, nor does she recognize any of her three children or her six
grandchildren, let alone the rest of us who have known her for more
than 40 years.
This thing we call “dementia” is a horrible affliction, robbing
folks we love of their very personalities—the “person” we knew and
loved is gone. Alzheimer’s Disease and other dementias have been
described as killing people twice—first we lose our loved one to
some other dimension, and then finally, and blessedly, we lose their
bodies. They “die” twice and we mourn them twice.
The aging of our society has brought about a surge in old age
dementias—like other forms of disease that primarily affect the
elderly, dementias were not so common when life expectancy was in
the 40’s or 50’s. Now it is the rare family that has not experienced
someone near and dear with the problem. According to those who know,
as many as 10 million Americans will experience some form of
dementia by 2050—a staggering number, given that there is no cure
and at this time, no substantial treatment. The financial and social
costs are extreme and stretch the capabilities of an already
overburdened health system.
Dementia is a general term that refers to a condition where there is
memory impairment and at least one of the following problems:
aphasia (speech impairment—sometimes just the inability to get out
the right word), apraxia (coordination problems), and agnosia (which
is a problem with sensory input or disturbances in functioning, such
as the use of judgment or problem solving). These deficits are
progressive and show a decline from a previously higher level of
functioning.
Memory impairment is one of the earliest signs of developing
dementia and is of great concern to those of us who experience
“senior moments”. Older people often worry about not remembering
names or misplacing items such as car keys. The difference between
normal age-related memory impairment and early dementia is the
degree of memory loss. Forgetting where you put your keys is not the
problem; forgetting what the keys are for is.
Alzheimer’s is the most common type of dementia and affects about 3
percent of the population older than 65. Vascular dementia (caused
by stroke) and Alzheimer’s both increase in occurrence with age, so
that about 1 in every 5 people older than 85 (20 percent) experience
some symptoms. Dementias also occur in varying percentages with
other problems, such as in some Parkinson’s patients, Korsakov’s
dementia (associated with alcohol abuse), head trauma, “mad cow”
disease, and other such diagnoses.
As with any disease process, the goal is to maintain as much quality
of life as possible and to provide as much comfort as possible.
Right now the emphasis is on early diagnosis because there are some
newer drugs that seem to slow down the progression of the more
common dementias in the early stages. They also seem to help
regulate moods and enhance attention and concentration.
Families are often in great distress when dementia strikes a loved
one. Do they take care of him at home? “We always promised Dad we’d
never put him in a nursing home!” is a phrase I hear over and over.
All family dynamics are unique, but it should be pointed out that no
one person can give 24/7 care, and reasonably none of us should
expect such sacrifice from our families.
It falls to us at St. Margaret’s to extend our love and support to
families making crucial decisions about the care of loved ones, and
also to recognize when there may be a problem developing in one of
our parishioners. Help is available in many forms, not the least of
which is prayer.
Gwennie, and her family, are in my prayers daily. And Gwennie,
although she doesn’t know it, is safely cared for in a special
Alzheimer’s facility where we can visit as often as we want, whether
she knows us or not. The Gwennie we knew is gone, but we loved her
then and we love her now. No one can ask for more.
Send comments to webmaster George Reeves, email: greeves@stmargarets.org