In February, 2006 my sister brought to my attention that our mother and father had something wrong with them. She visited them every Sunday and said she particularly noticed strange behaviors in my mother. I lived 1300 miles away from my parents, but hopped on a plane to check things out for myself. It was during this first visit, I observed their behavior and suspected Alzheimer’s. I made them an appointment with a Neurologist who examined, tested and diagnosed my father with Stage 4 Alzheimer’s and then diagnosed my mother with Stage 6 Alzheimer’s. He then told me my mother had less than a year and a half left to live, but felt my father had many years left. The doctor was right-on with my mother, but he was dead-wrong with my father. My father died before my mother. My father passed away in October, 2007 and my mother passed 36 days later in November. They died 36 Days Apart of each other, which is why I titled my book – 36 Days Apart – in honor of my parents love for each other. Thirty-six days was the longest my parents had ever been separated from one another.

I’m grateful, to this day, that God blessed me with taking care of my mother and father. God blessed my father, because he did his best to take care of my mother until I could get there to take care of the both of them. He must have been so tired, so worn down, which makes me believe this is why he passed before her. The night I drove him to the hospital, he asked me who was going to take care of mother. I knew then, that he knew he was not coming home. My last promise to my father was that I would hold my mother’s hand until the very end. I kept that promise, and seconds before her death, as I held her hand, she told me she loved me. This was the first time in months she had spoken recognizable words.

According to the Alzheimer’s Association experts have documented common patterns of symptom progression that occur in many individuals with Alzheimer’s disease and developed several methods of “staging” based on these patterns.

Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center outlines key symptoms characterizing seven stages ranging from unimpaired function to very severe cognitive decline.

Stage 1: No impairment (normal function)Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.

Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease)
Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.

Stage 3: Mild cognitive decline
Early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms:
Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:
Word- or name-finding problems noticeable to family or close associates. Decreased ability to remember names when introduced to new people. Performance issues in social or work settings noticeable to family, friends or co-workers. Reading a passage and retaining little material. Losing or misplacing a valuable object. Decline in ability to plan or organize

Stage 4: Moderate cognitive decline (Mild or early-stage Alzheimer’s disease)
At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:
Decreased knowledge of recent occasions or current events. Impaired ability to perform challenging mental arithmetic. Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances. Reduced memory of personal history. The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations.

Stage 5: Moderately severe cognitive decline (Moderate or mid-stage Alzheimer’s disease)
Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:
Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated. Become confused about where they are or about the date, day of the week or season. Have trouble with less challenging mental arithmetic. Need help choosing proper clothing for the season or the occasion. Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children. Usually require no assistance with eating or using the toilet

Stage 6: Severe cognitive decline (Moderately severe or mid-stage Alzheimer’s disease)
Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:
Lose most awareness of recent experiences and events as well as of their surroundings. Recollect their personal history imperfectly, although they generally recall their own name. Occasionally forget the name of their spouse or primary caregiver, but generally can distinguish familiar from unfamiliar faces. Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet. Experience disruption of their normal sleep/waking cycle. Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly). Have increasing episodes of urinary or fecal incontinence. Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding. Tend to wander and become lost.

Stage 7: Very severe cognitive decline (Severe or late-stage Alzheimer’s disease)
This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement. Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered. Individuals need help with eating and toileting and there is general incontinence of urine. Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.

God bless our loved ones and God bless the earth angels (caregivers) who take care of them,
 

Deborah Tornillo
Author, “36 Days Apart”