Sunday, November 29, 2009

VASCULAR DEMENTIA IN THE ELDERLY: COWS BEAUTIFUL COWS

Cows had been part of my mother's life since 1959.   Actually, she and my  dad owned cows even before that, but it was in 1959 that she moved right into the middle of a pasture filled with herefords.  She always said she had been a tomboy, and after that move we all believed it.  She was comfortable living in a house where cows summoned you out of bed with their bawling "give me some hay" cries.  They scratched themselves on the boards of the house, and left organic gifts in the driveway and yard. 

From the large picture window in the living room of the ranch style house, a style popular in the late 50s and early 60s, one could view the whole herd, eating hay,  playing, stomping the earth,  bumping into one another like the rudest of shoppers at a firesale,  and running with no apparent goal in sight.    Large mama cows, and in the spring, cavorting babies, running and chasing each other in the bright green grass under the oak trees near the pond, or tank, as Texans label such bodies of water.  And observing it all with a stern eye, the sultan ruling his harem, stood the bull.

When she was younger and raising a family, the cows provided extra money.  They also made for a lot of extra work.  Saturdays, after she had worked all week at her bookkeeping job for a highway construction company, were often spent eartagging, branding, and treating cattle for grubworm.  It was the only time to do it, and she actually enjoyed it.   Further proof of her "tomboyishness", or perhaps her love for her husband. 

After being widowed at age 58, we (her daughters) thought she would likely give up the cattle.  Our brother and she agreed on a business arrangement, and she kept them.

When she retired at age 62, we (again, her daughters) thought she would give up the cows.  She did not.  She started talking at age 65 about giving them up at age 70; at age 70, she talked about giving them up at 75.  After 75, she stopped talking about giving them up.  Our brother still did the heavy work, and they still had a business arrangement, but she never gave them up.  One day in 2006, when she could no longer live alone, she simply had to leave them. 

DEMENTIA HINT:  Be sure that your parent has a durable power of attorney in place many years before it is needed.  It may be necessary to take over aspects of their financial dealings, and having the legal authority given before your parent shows any signs of dementia makes things much easier.

Tuesday, November 24, 2009

VASCULAR DEMENTIA IN THE ELDERLY: Insidious Onset

Guide to Dementia published by Johns Hopkins Health Alerts comnpares factors of normal age-related forgetfulness and dementia.  In the former, a person "may forget an event from the distant past" while with dementia, the person "has serious impairment of short-term memory," and "has difficulty learning and remembering new information."

My mother was 31 when I was born in 1950, the fifth of six children.  Each year, once we had moved away from home, she faithfully called each adult child, and later, her grandchildren, on their birthdays.  In her best singing voice, she gave a splendid rendition of "Happy Birthday To You" via the phone.  If no one was home when she called, undeterred, she sang to the ubiquitous answering machines.
In June 2000, we had just moved to another city, where I was busy unpacking and getting settled.  My birthday came around, and even though it should have been one of the seminal birthdays, the 50th, I had little time to think about it.  It was several days afterward that I realized with a jolt that I had not heard from my mother. 
She had not called, nor had she left a message in song on the answering machine.  When I called to tease her, she didn't immediately realize what I was talking about.  Then she apologized profusely for forgetting my birthday. 
Unfortunately, others in the family would mention when we got together later in the year that she had also forgotten their birthdays.  It was one of the first symptoms of the dementia that would take more and more from her and from our family. 
She never remembered another birthday by calling and singing, though she did get a calendar and began to use it to record birthdays and other important dates, so she would sometimes remember to send a card. 
Dementia onset is usually between ages 60-75 ,  but our mother was 81 before her symptoms appeared.

DEMENTIA HINT:  If you note significant changes in functioning, even if they seem small, get a calendar and keep track so that you can note the frequency and severity of symptoms.


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VASCULAR DEMENTIA IN THE ELDERLY: You're Saying I'm Losing It.

According to a report by Johns Hopkins Health Alerts called Guide To Understanding Dementia, one of the differences between normal age-related forgetfulness and dementia in regard to memory loss is that the person with age-related forgetfulness "jokes about memory loss" while the person with dementia "may have little or no awareness of cognitive problems."

Late in the summer of 2000, Mother came to visit.  She was frugal to a fault, and there were certain things she just would not spend money on.  One of these was long distance services.  In the years that I was in college, one of the things that I sometimes verballly chastised my parents for was the fact that they never called me.  My whining  changed nothing.  They still did not call me. 
Long distance was for emergencies only, at least that continued to be my mother's view.  Costs had gone down considerably since my college days in the late 60s, but that didn't seem to factor in to her thinking.
Today, she held in her hand a telephone bill.  She wanted me to look at it because there was a charge of $15 for a long distance call, and she believed one of my daughters had made the call when she was visiting her the month prior.  After looking at the bill, I remembered that I had called Mother on that exact date, left a message, and been very surprised when she called me back and talked for a long while.  Usually, I called her on either the landline or my cellphone, but since I had moved that summer and  now lived 8 hours away,  I had the sense that day she had made an exception because she would be seeing me less than in the past and wanted to talk.
Although I thoroughly explained this to her, reminded her of the call, etc. she was unconvinced and continued to complain about the bill.  I finally told her I would give her $15, but that I just wanted to know if she understood what I was saying (i.e. that my daughter had not made an unauthorized call on her phone.  She had her own cellphone for long distance).  Mother answered a little bitterly, uncharacteristic for her, "Yes.  I know what you're saying.  You're saying I'm losing it."
She was still living alone, driving, teaching a class at her church, going to various activities and functioning well as far as we could all tell, but her words were prophetic.

DEMENTIA HINT:  Pay careful attention when your loved one says something uncharacteristic about themselves even if it doesn't appear to be true at that time.  There may be an embedded message for you there.