What My Husband's Dementia Means, Part Two

With his recent trips to the hospital for UTI and another for a fall, I get asked if my husband has gone into a further stage of Alzheimer’s. This post is an attempt to answer that question. He did not receive an anesthesia in the hospital—a sure road to a future stage.  I do not think he is in a further stage.  I have seen three different lists of stages.

• Alzheimer’s Reading Room HERE.

• Alzheimer’s Association HERE.  He is in stage four of seven stages.

• Mayo Clinic HERE.  He is in stage three of five stages.

On July 8, 2012 I posted Part One HERE. As in Part One, the red below is from the Family Doctor Organization, but the link in Part One seems to be broken. Nonetheless I want to credit these red descriptions.

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.  My husband is very conscious of his short-term memory and we use techniques to compensate.  I have been working out in the yard and he has wondered where I am, upsetting to both of us because of course I had told him I had gone out. Now I have a sign that says Carol is outside.

• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it. When I have left the house to substitute teach early in the morning, hubby would often forget to take his morning pills. I have been dealing with this aspect for quite some time now. For example, he kept the sprinkler on overnight some time ago. Fortunately Kenny comes in and the two gentlemen take their own pills together, with Kenny pointing out that he takes more pills than my husband does.  No more forgetting lunch. Kenny comes over and fixes it for hubby and sees that he eats.

• Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want. He does forget nouns, but really no worse than in July of last year.  I have read about “word salad” and have been watching for that, but it hasn’t happened.

• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home. No further deterioration. Very alert any time I am driving us somewhere.

• Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather. Hubby's judgment is still fairly good. I am not sure if this is because I give him coconut oil, turmeric, and Ribonucleic Acid, but he has good judgment and often if something is arbitrary, or not to my liking, I bend to his suggestion. I do not need to get my way, unless something has to do with logic and safety. For example, I can talk him into a shower and shave with reason. You need showers so you do not end up back in the hospital with another Urinary Tract Infection, or You have to shave with your razor every other day or I have to use the trimmer on you.

• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them. Has little to do with finances now, or will ask how we are doing financially. I tell him the IRS owes us our tax refund which should come by the end of the June according to our accountant,  so we can make it through the summer when I work less.  Hubby likes to take notes now on what is happening for the day. DH wants me to say only one idea at a time—to not switch subjects. I still have to work on telling hubby one idea at a time. Hubby is training me by how he reacts when I say too much.

• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later. Sally has trouble with Jake misplacing things. Jake put his electric shaver in their RV for example. I thought "Alzheimer's" and suggested she look there and sure enough Jake was planning a camping trip in his mind and put his shaver there. "Thinking Alzheimer's", as Bob DeMarco on the Alzheimer's Reading Room suggests, helps you to help your loved one. So far he is not losing cell phones as he once did.

• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes. DH can swear at other drivers when I am driving, as if that will help. As I noted in the last post, swearing is common in Alzheimer's patients.

• Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful. Have yet to see much personality change. Love his sense of humor. Hubby is happy. Kenny often texts me while I am working that hubby is in a good mood. Linda Born calls it "pleasant dementia" HERE. I am accepting that loss of initiative and grateful for every little thing hubby willingly does. For example, to get our gas guzzler in the garage is a challenge now with bags of mulch to be spread in the yard. I have him direct me so I do not get too close to the bags of mulch. I thank him for his help.

• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people. Monday night hubby wanted to go to Toastmasters with me. On the way home from Toastmasters he said he doesn't want to attend this two hour meeting again, but worries about me being out in the evening. I said to him that we will work this out and that the LORD is our protector. He agreed. So glad for my husband's faith, and mine. Knowing that he has loss of initiative makes me not nag him to do something he used to do enthusiastically. Sometimes I just say to him that he and Jake are lucky they married younger women and pass inactivity off as part of the aging process.

I am  so glad that I blog. The July 8, 2012 entry helps me see that my husband is really not going downhill quickly. Caregiver Kenny thinks that he will remain like this for several years.

What My Husband's Dementia Means, Part One

My hubby has mixed dementia, meaning the neurologist diagnosed him with about 50 % Vascular Dementia and 50% Alzheimer's. The Family Doctor Organization helps explain what the broad category of dementia is.

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question. Perhaps this is the most annoying aspect until you get used to it. DH's grandson talked to him on the phone before church today and I heard my husband ask repeatedly "What have you been up to?" Special events in the past month and even year he does remember, but day-to-day conversation with him can be taxing if you aren't used to it.

• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it. Hubby has always had me cook or plan the meals. He can warm up things in the microwave that I have clearly labeled for him. He can leave the lawn mower outside and forget to put it away. Or, it could be his lack of initiative for finishing a task. Jake, on the other hand, loves to feel useful and will even pack up their RV to go camping even when they aren't going camping! AS THEY SAY, WHEN YOU HAVE SEEN ONE CASE OF ALZHEIMER'S YOU HAVE SEEN ONE CASE OF ALZHEIMER'S--EVERY PATIENT IS DIFFERENT.

• Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want. They say that with dementia the nouns are the first to go. I have seen this once recently, and LOL I can't remember what it was that he was trying to describe to me. He did describe a function of an object without that word.

• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home. Today my husband wanted to clarify where he lives and I told him Plant City, Florida. This surprised me, but it shouldn't.

• Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather. DH still has good judgment, but I notice that our friend Jake needs to be watched. Sally caught him spray painting something that didn't need it. Jake has lots of initiative to do things, in fact he helped my husband mow on Saturday.

• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them. I do the finances now. He turned them over to me when I retired from full-time work several years ago. I really appreciate the systems he set up--on-line banking and an Excel spreadsheet to help maintain the budget. Hubby loves movies, but the older ones without subtleties are best for him.

• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later. So true and I have blogged here about loss of keys and cell phones.

• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.  Life can be confusing for him and the result can be swearing and anger. Later he will forget the incident.

• Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful. Knowing this I try to keep his life as calm as possible.

• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people. My husband is an extravert and so he does enjoy people still. He also wants to go places. However, he does show loss of initiative; often he wants to do the masculine jobs still, like mow the lawn, take out the garbage and carry heavy things, but I walk a fine line between encouraging him to mow the lawn and nagging. This will be worse this summer because of all the rain here.

The link above also deals with hallucinations, agitation and wandering, problems that are not huge so far.

One strange thing I have noticed is that when I am driving hubby will say things like:

• "That's [whatever] been on the road a long time." Don't think so, but they say never argue with someone with Alzheimer's.
• "They have been fixing this road for years." Not so.
• "That car needs to get out of the way." His agitation can be peppered with swearing, but I roll with the punches and at times change the subject. Sometimes he says he is glad that he doesn't drive anymore and of course I am also.

Sally has a backseat driver on her hands when she drives; Jake is constantly telling her how to drive.

Both of our husbands are very protective of us. When Sally was going to go get groceries on Saturday, Jake suggested I go with her while he helped my hubby in our yard. Jake felt better if someone was with Sally. While my hubby likes to go on errands with me, he can tolerate my going out to teach or to Weight Watchers, activities that he can't really attend.

Both Sally and I are in our marriages "for better--for worse" and count our days as lovegivers precious in this stage, knowing that the worse will come.