Inside the Dementia Epidemic: A Daughter's Memoir Read Online Free Page B

properly and may, without supervision, make mistakes such as putting pajamas over daytime clothes or shoes on the wrong feet
         Experience major changes in sleep patterns—sleeping during the day and becoming restless at night
         Need help handling details of toileting (for example, flushing the toilet, wiping or disposing of tissue properly)
         Have increasingly frequent trouble controlling their bladder or bowels
         Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an impostor) or compulsive, repetitive behavior like hand-wringing or tissue shredding
         Tend to wander or become lost
    Stage 7: Very severe cognitive decline. Severe or late-stage Alzheimer’s disease. This stage may last from several weeks to several years. The person may:
         Lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases.
         Need help with much of their daily personal care, including eating or using the toilet.
         Need assistance walking, then cannot walk at all.
         Lose the ability to smile, to sit without support and to hold their heads up. Reflexes become abnormal. Muscles grow rigid. Swallowing becomes impaired.
         Death often occurs from pneumonia from aspirated food.
    In May of 2011 an international workgroup of more than forty top Alzheimer’s researchers will recommend that Alzheimer’s disease be broken down into three wider stages:
    The preclinical stage
    “Mild cognitive impairment (MCI) due to Alzheimer’s disease,” and
    “Dementia due to Alzheimer’s disease.”
    With mild cognitive impairment, problems with memory and cognitive ability are noticeable, but don’t affect the person’s ability to take care of themselves from day to day. Not everyone who has mild cognitive impairment will develop Alzheimer’s disease. In the third stage, “dementia due to Alzheimer’s disease,” independence in day-to-day function becomes difficult, then impossible.
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    A fter the visit with Dr. Gavin, I experience the mood and decision reversals that further reveal my mother’s instability. Mom calls me to tell me that she cried and cried all morning.
    “Why are you making me move in with you?” she asks. She says she called her neighbor Susan who told her, “You shouldn’t need help if you can still write your own checks.”
    I feel myself beginning to shake. This neighbor has managed to undermine all my tentative progress with Mom. Yes, she can write checks, but she forgets why she’s writing them, how much they’re for, and how to enter them in her check register. Mom cannot remember why she was excited to move in with us, and I have toexplain it all for the twentieth time. I remind her of the fall, the disorientation on the dark road, the weight loss.
    Mom laughs—a nervous laugh—on the other end of the phone. “I thought I had to move because I have a few cobwebs in the house.”
    “No, it’s much worse than that, Mom. You seem”—I search for the right word; I want her to know how serious this is—“disconnected...from all of the trash around you.”
    M onths earlier, I had been shocked by my discoveries as I tried to clean the cottage. My mother watched as I scrubbed a coating of black filth out of the refrigerator and shower, and cleared piles of little plastic bags of rotten trash off the kitchen counter. An old mattress, ancient clothing, bundles of newspapers, and boxes of paperwork crowded the living room. Between this garbage, Mom had left a narrow path, like a trench.
    In her downstairs bedroom, the extra twin bed sat covered with a pile two feet high of empty cookie packages and rinsed-out ice cream cartons, each item bagged individually in a clear, plastic gallon-sized bag and sealed with a twist tie. Now, I suspect that for some time she’s been