The Diagnosis

I’d seen reports on the news about people who got lost while driving and ended up hundreds of miles from home.  I’d read stories about people who went for a walk and were found days later wandering in the woods.  Worst of all, I’d heard about the people who no longer recognized their loved ones.  So when my father was diagnosed with Alzheimer’s disease, I girded my loins in anticipation of the devastating day when he would look at me with a blank stare and not know who I was.  That day has come and gone, and believe it or not, it turned out to be a minor event in the big scheme of things.  To be honest, I find it more devastating that he cannot remember how to flip on a light switch.

Dad was diagnosed with mild cognitive impairment (MCI) in 2002, however he’d been exhibiting signs for several years prior to his diagnosis.  One of his business partners vividly recalled Dad’s inability to calculate a 20% tip at a luncheon in 1997.  That would be a stunning revelation for anyone, but for a CPA, it was extraordinary. 

While MCI doesn’t always develop into Alzheimer’s disease, in Dad’s case it did.  We took him to a neurologist and he was put on medication.  According to the National Institute of Health:

http://www.nia.nih.gov/Alzheimers/Publications/medicationsfs.htm

Several  prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease (AD). Treating the symptoms of AD can provide patients with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well.

It is important to understand that none of these medications stops the disease itself.

Every 6 months we returned to the neurologist for a checkup.  ‘Checkup’ is a bit of a misnomer – it proved to be nothing more than a method of documenting Dad’s decline.  The doctor conducted the Mini-Mental State Examination:

    “I’m going to tell you three words.  I will ask you to remember them later: tree,     blue, pencil.”

    “Who is the president of the United States?”

    “What is today’s date?”

    “What day of the week is it?”

    “What month is it?”

    “What state are we in?”

    “What county are we in?”

    “What were the three words I asked you to remember?”

    “What year is it?”

    “What season is it?”

    “What floor are we on?”

    “Draw a picture of a clock with the hands indicating 10:30.”

    “Spell the word ‘WORLD’ backwards.”

    “Count down from 100 by 7s.”

    “What is this object I’m holding in my hand?”

    “Copy this shape onto that blank piece of paper.”

    “What are the three words I asked you to remember?”   

    “Repeat the following phrase: No ifs, ands, or buts.”

    “Read the sentence written on this piece of paper and do what it says: Close your eyes.”

    “Take this piece of paper in your right hand, fold it in half and lay it on the floor.”
    “Write a complete sentence.”

    “What are the three words I asked you to remember?”

At first Dad could do most of it.  Within five years he couldn’t do any of it and the neurologist advised us there was no point in coming back - that was in 2007.

No point in coming back.     

Nothing more can be done.  We helplessly watch Dad continue to lose ability and function.  We witness his frustration, his struggle and his anxiety – and we are powerless to help him.   It’s an odd sensation; a sickening sensation – like watching someone being tortured to death in a horror movie.

If he becomes too distraught, we could try medication to ease his mind.  (Ease his mind?  Now there’s a politically correct euphemism….)  Let me put that another way: If he becomes too distraught, we could try medication to dope him up so he isn’t aware of his fate.  Unfortunately, medication would increase his risk of falling and it would be awful if he was injured in a fall – though physical pain pales in comparison to the mental anguish he suffers.

So now we wait.  That's it.  That's all there is.  We watch him continue to disappear and we wait for him to die.  Just like Mom.