I've been off the board for a while. Some of it's been catching up on projects, some of it's been holiday family fun. But a big part of it has been coming to grips with helping my father.
My Dad's been widowed for over 20 years and lives in the rural Rockies. He's an electrical & nuclear engineer and he's been ER'd for over 20 years. (Yeah, I know, apple: tree.) He's happy in a small apartment, he drives the national parks, and he hikes the mountains. He doesn't like to socialize but he chats with clerks & cashiers. He doesn't like to travel, especially to Hawaii. He's pretty much made himself a hermit by choice, and we hear from him on birthdays & anniversaries. It's been this way for decades.
About 18 months ago he e-mailed that his doctor said his blood pressure wasn't responding to exercise & diet, so after trying a couple medications they eventually settled on Fosinopril and hydrochlorothiazide. Otherwise, today at age 76 he's healthy and in good physical condition from hiking at altitude in all sorts of weather.
A year ago he mentioned that he'd had his first "slipping memory" incident. He set out in the car for somewhere, forgot where he was going, gave up but got lost, and had to read a map to figure out how to get back home. His doctor recommended a "specialist" (Dad's word) who immediately alienated him with homeopathic diet/exercise lifestyle advice. Now Dad feels that doctors are wasting his time and he doesn't want to be endlessly tested/medicated, although he claims he's still taking the BP meds. He says he's done speaking to doctors because he doesn't think that anything can be done about his memory problem. As far as he's concerned, it's caused by getting old and he doesn't think anything will help. I offered to talk with his doctor about it but he said he doesn't want to give the doctor any chances to prescribe more tests.
A few months ago he stopped responding to e-mail, and last month he announced (by letter) that his memory made him unable to use his computer. This set off all sorts of personal alarms so I made my first trip to his home in almost 25 years.
I hope I'm wrong, but from what I've seen and researched he seems to show classic symptoms of vascular dementia. He doesn't hold up his half of a discussion. He responds to conversations with a remark or he answers questions but he doesn't carry on with a story or a question of his own. There is no more witty repartee. He repeats himself. Almost every time we left the apartment he showed me where he hides a spare key. He checks his mailbox several times a day (including Sunday). He can't remember what we have planned for the day or when. He prepares his meals well, but he ends up opening every kitchen cabinet door every five minutes to look for everything. When we agreed one evening that we needed to leave for the airport at 5:45 AM next morning, at least twice more that evening he asked me to tell him again-- and next morning he said that he'd forgotten what time we were leaving.
His old long-term memories seem affected too. When I was a kid we watched Julie Andrews musicals incessantly and played their soundtracks on our stereo. On this visit we happened to catch "The Sound of Music" on TV. He recognized Julie Andrews but couldn't remember why she was famous. He had no idea that she would be in the next movie on TV: "Mary Poppins". We stopped watching TSOM just before its dramatic final 30 minutes because he felt that the plot wasn't going anywhere. The VCR remote control that he's been using for over a decade now gives him a lot of trouble, although he's figured out how to work around it.
Like any good [-]nuke[/-] ER, he keeps a one-page calendar on his refrigerator and each morning he marks off yesterday. Every 10th day is circled to remind him to do his grocery shopping. It saddens me to see the little arrows he's drawn between the months to remind him which month comes next.
Despite all the memory problems, he frequently remembers that he agreed to something and he just needs a refresher what the agreement was. Still other memories seem to be no problem at all. I don't know if this is all part of dementia or a combination of problems.
Otherwise he seems to be taking care of himself. He's remarkably cheerful. He seems to be fine with hygiene and healthy meals/snacks. (He doesn't like to eat out much.) He watches the news and reads the daily paper. Driving is no problem. He says that when he hikes, he chooses trails going uphill so that he can easily return to the car when he's tired. He's embarrassed that he doesn't dust the apartment enough but it's amazingly clean. He keeps his address, my name, and my phone number in his wallet. He says that if he "gets lost" again then he'll ask a police officer to get him home and to give me a call.
Diagnosis may not be so difficult, but as far as he's concerned treatment isn't even an option. He knows that someday he'll be unable to care for the apartment and will have to move into a facility, but he's not interested in researching it yet. He doesn't see himself as "old". We drove by a place labeled "Retirement Apartments" and I asked him what they were. His answer was "Oh, that's a care home for old people." When the day comes that he has to go to a facility, I'm afraid it's going to be a short-term crisis-- if indeed there's anything available. He prefers to stay in his rural town. However by the time he needs a care facility he might not be able to tell his town from the city, or he may decide to have more choices by moving into a city care facility. I believe him when he says that he couldn't stand Hawaii's heat/humidity, so neither one of us is interested in moving him here.
Ironically my Dad is no stranger to this situation. In the late 1980s, his dad was diagnosed with severe dementia and spent nearly 14 years in a full-care facility before dying at age 97. At least my Dad made some preparations in the 1990s-- he has long-term care insurance and his will & medical directive are still effective. But he's not interested in powers of attorney or having me help with his finances. Being the person he is, he says he doesn't want to give up his independence or leave his home or get anyone's help. He's effectively chosen to do nothing else... until he runs out of choices.
I've talked with a geriatric care manager who says this is typical of the situation. An elder will stubbornly hunker down in their home until the hassle becomes too much and they reluctantly accept help (technology, delivery services, and visitors). Eventually managing all the help becomes enough of a hassle/expense that they're grudgingly willing to move to an "independent living" apartment which offers a transition to a full-care facility. Or they break a hip and it's a crisis.
I'd like to smooth the way even more by checking out help, technology, and facilities... and maybe even getting on waiting lists. I've tracked down a few names/places in his area but I don't see how I can talk to them or visit them without bringing up his name. I'm concerned that they'd contact him by "mistake" or even spam him, and I can only imagine his reaction if he found out what I was doing without his knowledge.
I'm just very thankful that I have the time, finances, and ability to help. It seems that all I can do is keep the lines of communication open, be ready to offer geriatric-care managers and full-care facilities, and wait for "the call".
My Dad's been widowed for over 20 years and lives in the rural Rockies. He's an electrical & nuclear engineer and he's been ER'd for over 20 years. (Yeah, I know, apple: tree.) He's happy in a small apartment, he drives the national parks, and he hikes the mountains. He doesn't like to socialize but he chats with clerks & cashiers. He doesn't like to travel, especially to Hawaii. He's pretty much made himself a hermit by choice, and we hear from him on birthdays & anniversaries. It's been this way for decades.
About 18 months ago he e-mailed that his doctor said his blood pressure wasn't responding to exercise & diet, so after trying a couple medications they eventually settled on Fosinopril and hydrochlorothiazide. Otherwise, today at age 76 he's healthy and in good physical condition from hiking at altitude in all sorts of weather.
A year ago he mentioned that he'd had his first "slipping memory" incident. He set out in the car for somewhere, forgot where he was going, gave up but got lost, and had to read a map to figure out how to get back home. His doctor recommended a "specialist" (Dad's word) who immediately alienated him with homeopathic diet/exercise lifestyle advice. Now Dad feels that doctors are wasting his time and he doesn't want to be endlessly tested/medicated, although he claims he's still taking the BP meds. He says he's done speaking to doctors because he doesn't think that anything can be done about his memory problem. As far as he's concerned, it's caused by getting old and he doesn't think anything will help. I offered to talk with his doctor about it but he said he doesn't want to give the doctor any chances to prescribe more tests.
A few months ago he stopped responding to e-mail, and last month he announced (by letter) that his memory made him unable to use his computer. This set off all sorts of personal alarms so I made my first trip to his home in almost 25 years.
I hope I'm wrong, but from what I've seen and researched he seems to show classic symptoms of vascular dementia. He doesn't hold up his half of a discussion. He responds to conversations with a remark or he answers questions but he doesn't carry on with a story or a question of his own. There is no more witty repartee. He repeats himself. Almost every time we left the apartment he showed me where he hides a spare key. He checks his mailbox several times a day (including Sunday). He can't remember what we have planned for the day or when. He prepares his meals well, but he ends up opening every kitchen cabinet door every five minutes to look for everything. When we agreed one evening that we needed to leave for the airport at 5:45 AM next morning, at least twice more that evening he asked me to tell him again-- and next morning he said that he'd forgotten what time we were leaving.
His old long-term memories seem affected too. When I was a kid we watched Julie Andrews musicals incessantly and played their soundtracks on our stereo. On this visit we happened to catch "The Sound of Music" on TV. He recognized Julie Andrews but couldn't remember why she was famous. He had no idea that she would be in the next movie on TV: "Mary Poppins". We stopped watching TSOM just before its dramatic final 30 minutes because he felt that the plot wasn't going anywhere. The VCR remote control that he's been using for over a decade now gives him a lot of trouble, although he's figured out how to work around it.
Like any good [-]nuke[/-] ER, he keeps a one-page calendar on his refrigerator and each morning he marks off yesterday. Every 10th day is circled to remind him to do his grocery shopping. It saddens me to see the little arrows he's drawn between the months to remind him which month comes next.
Despite all the memory problems, he frequently remembers that he agreed to something and he just needs a refresher what the agreement was. Still other memories seem to be no problem at all. I don't know if this is all part of dementia or a combination of problems.
Otherwise he seems to be taking care of himself. He's remarkably cheerful. He seems to be fine with hygiene and healthy meals/snacks. (He doesn't like to eat out much.) He watches the news and reads the daily paper. Driving is no problem. He says that when he hikes, he chooses trails going uphill so that he can easily return to the car when he's tired. He's embarrassed that he doesn't dust the apartment enough but it's amazingly clean. He keeps his address, my name, and my phone number in his wallet. He says that if he "gets lost" again then he'll ask a police officer to get him home and to give me a call.
Diagnosis may not be so difficult, but as far as he's concerned treatment isn't even an option. He knows that someday he'll be unable to care for the apartment and will have to move into a facility, but he's not interested in researching it yet. He doesn't see himself as "old". We drove by a place labeled "Retirement Apartments" and I asked him what they were. His answer was "Oh, that's a care home for old people." When the day comes that he has to go to a facility, I'm afraid it's going to be a short-term crisis-- if indeed there's anything available. He prefers to stay in his rural town. However by the time he needs a care facility he might not be able to tell his town from the city, or he may decide to have more choices by moving into a city care facility. I believe him when he says that he couldn't stand Hawaii's heat/humidity, so neither one of us is interested in moving him here.
Ironically my Dad is no stranger to this situation. In the late 1980s, his dad was diagnosed with severe dementia and spent nearly 14 years in a full-care facility before dying at age 97. At least my Dad made some preparations in the 1990s-- he has long-term care insurance and his will & medical directive are still effective. But he's not interested in powers of attorney or having me help with his finances. Being the person he is, he says he doesn't want to give up his independence or leave his home or get anyone's help. He's effectively chosen to do nothing else... until he runs out of choices.
I've talked with a geriatric care manager who says this is typical of the situation. An elder will stubbornly hunker down in their home until the hassle becomes too much and they reluctantly accept help (technology, delivery services, and visitors). Eventually managing all the help becomes enough of a hassle/expense that they're grudgingly willing to move to an "independent living" apartment which offers a transition to a full-care facility. Or they break a hip and it's a crisis.
I'd like to smooth the way even more by checking out help, technology, and facilities... and maybe even getting on waiting lists. I've tracked down a few names/places in his area but I don't see how I can talk to them or visit them without bringing up his name. I'm concerned that they'd contact him by "mistake" or even spam him, and I can only imagine his reaction if he found out what I was doing without his knowledge.
I'm just very thankful that I have the time, finances, and ability to help. It seems that all I can do is keep the lines of communication open, be ready to offer geriatric-care managers and full-care facilities, and wait for "the call".