Alzheimer's symptoms begin so mildly and progress so slowly that it's easy for friends and loved ones to deny them until one day there may be a 'defining incident'; an incident so strange, so bizarre that not even the spouse, child or other loved one can ignore it or explain it away.
Various 'defining incidents' have been recounted. Some people get lost driving home and end up bewildered and many miles away. Some leave the house in their pajamas and some fail to recognize a close friend or family member. These are just a few of hundreds of examples.
Yet the disease starts with things of little or no significance. Not being able to come up with a common word. Mixing up someone's name. Forgetting to turn off the stove. Things we all do from time to time. But for the person just entering the fringes of Alzheimer's, they may begin to happen more and more often.
Years may pass between the earliest occasional confusion and the possible 'defining incident.' And during those years, the person may annoy or even anger friends and family members by being late, forgetting important appointments, being short-tempered, being unable to perform their routine chores and exhibiting a whole variety of other troublesome behaviors.
As the person's brain slowly deteriorates, he or she struggles to adjust and continue functioning. This alone takes extreme mental effort, often leading to anger and agitation. During this time, the person is also usually in denial, realizing something is wrong and trying to understand it in any way possible that doesn't involve the words 'Alzheimer's' or 'dementia.'
It was obvious to me that my life partner, Ed, was worried about possibly having Alzheimer's. He used two coping mechanism to deal with those fears: alcohol and humor. He started drinking prodigious amounts of vodka, beginning before noon and continuing until after midnight, and he ended every doctor's visit by pronouncing loudly, "At least it isn't Alzheimer's!" Then he laughed heartily.
My denial of Ed's symptoms was particularly strong. I worked hard to come up with explanations for each of his symptoms. When he repeatedly confused the name of his bank with the name of the grocery store, I thought it was just a normal sign of aging. When he couldn't pay his bills properly, I thought he'd just had too much to drink that evening.
Then when his symptoms became more severe, I still made excuses for him. When he got lost driving to the corner gas station, I thought he was just temporarily confused. Even when he was found driving on the wrong side of the road one night I decided it only happened because he was driving at night -- something his doctor said he shouldn't do because of his failing eyesight.
But a defining incident' finally occurred. I was talking to him on the phone one evening and he told me he couldn't find his scissors. I told him to go look in the kitchen, which was where he kept them. I was shocked and frightened at his response.
"Kitchen?" he asked. "What's a kitchen? I don't have a kitchen."
My heart started beating faster and my hands were shaking as I kept trying to jog his memory, but nothing worked.
After a long silence, he said, "Oh, how silly of me. I do have a kitchen, but it only has clothes and shoes in it."
Considering this and all the other signs of dementia he'd been exhibiting, I finally had to face the cold, hard truth: Ed was probably developing Alzheimer's. And my heart broke as I realized it. There are few, if any, things in life more painful and chilling than believing a loved one may have Alzheimer's.
But people noticing consistent signs of confusion and forgetfulness in a loved one should not wait for a possible 'defining incident.' One early action to take is to review the Alzheimer's Association 10 signs of dementia (posted on its website, Alz.org) and ask yourself whether the person is exhibiting any of them.
1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, at work and at leisure
4. Confusion with time or place
5. Difficulty understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Losing things and inability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality
It's easy to ignore these signs or fail to connect the dots, but when a loved one is showing them it's essential to dig down deep into your soul and find the strength to get a medical evaluation as soon as possible. Early detection gives you and the affected person time to prepare for the future and allows for appropriate medication to be prescribed at an early stage.
No one wants to be evaluated, or have a loved one evaluated, for possible Alzheimer's disease, but sometimes it has to be done -- and the sooner the better.
Marie Marley is the award-winning author of the uplifting book, 'Come Back Early Today: A Memoir of Love, Alzheimer's and Joy.' Her website (ComeBackEarlyToday.com) contains a wealth of information for Alzheimer's caregivers.
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