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Sun, Nov 23 2008 

Published: August 19, 2008 05:53 pm    print this story   email this story   comment on this story  

McDONALD: The long and winding road

By TIM MCDONALD
Local Columnist

There are no guarantees in life. There are no guarantees that we will go through life not contracting a fatal disease or become involved in a fatal accident. Life comes at you and you have to play that hand that you are dealt.

The ability to play that hand comes from both experience and blind faith that ultimately things will work out for the better and that there is a larger purpose. One must have the faith that your experience has prepared you for decisions that have to be made that are emotional and may cloud the facts of a situation.

Over the weekend my sister, brother, step-father and I placed my mother in a nursing home. This was not an easy decision to make and it has been coming for quite some time. For more than a year and a half we siblings have been attempting to convince Dad that Mom could no longer remain at home. She needed skilled care.

A little more than five years ago we began to notice that Mom was not only losing her memory but also her personality was changing as well. Gradually she was becoming childlike and immature in her attitudes and conversations. We took her to a gerontologist where the diagnosis of Alzheimer’s disease was made.

The long and winding road since that diagnosis has been both challenging and emotionally painful as we watched the person who cared for and nurtured us as children descend into a nether world of confusion and mental torture.

Those first couple of years were painful to witness as Mom knew the diagnosis and what was slowly happening to her. She had witnessed it in her own mother, sister and brother. She knew what was coming and it terrified her. She would not even use the word Alzheimer’s; she would simply say it was her memory problem.

She has seen her mother and siblings eventually placed in nursing homes and the thought of that as her future frightened her even more. She wanted my sister and brother and me to promise we would not place her in a nursing home. We sadly could not make that promise.

The long and winding road led Saturday to her arrival at the nursing home. My sister and I had taken a few family pictures, her music CDs and CD player along with some clothes to her room on Friday.

On Saturday, my wife and I in one car and my sister with her husband and daughter in another took Mom for a ride to her new home. Fortunately for us, when we arrived at the nursing home, Mom did not have the cognitive ability to realize it was a nursing home, it was simply a different place and a bit of an adventure. As we took her to her room she met other people on the Alzheimer’s unit and began having conversations.

There are questions that have to be addressed at the time of admission that one may not be prepared to answer. As for me, my wife is a nurse and I have heard these types of questions before and so I had an idea of what was coming. My sister did not and I regret that I did not prepare her.

The question that takes you back is: In the likelihood of a life threatening event or illness how do you want to code your mother? Simply stated, do you want her revived or resuscitated or would you like her to slip away? I could see the tears begin in my sister’s eyes and I said to her, you know that Mom would not want to continue this way.

The insidious disease of Alzheimer’s is much larger than the effect on my family. There are many in my age bracket (52) that will be facing this same dilemma with their parents. The next generation, our children, will most certainly face a much larger number of these decisions as the baby boomers reach their elderly years.

As many as 5.2 million people in the United States are living with Alzheimer’s.

• 10 million baby boomers will develop Alzheimer’s in their lifetime.

• Every 71 seconds, someone develops Alzheimer’s.

• Alzheimer’s is the sixth-leading cause of death.

• The direct and indirect costs of Alzheimer’s and other dementias to Medicare, Medicaid and businesses amount to more than $148 billion each year.

My neighbor asked me how it went with my mother on Saturday and I told him it was actually better than I had expected. The hard part was leaving the nursing home and my mother in her new environment. It was decidedly more difficult for us than it was for her. He told me that he had a conversation with his elderly parents about the potential of placing them in a nursing home. His mother said “you do what you feel you need to do in that eventuality with no guilt from us whatsoever.”

This is a conversation for families to have in advance of the decision so that all parties know going in what to do. Given the statistics I listed from the Alzheimer’s Association, this has larger implications for national health policy and our economy. God bless all of you who read this column and are dealing with your own decisions.

My Mother is free to live safe and healthy in her confused world and that is a relief for her husband, sister and children.



Tim McDonald lives and teaches in Clark County and can be reached at timothy.mcdonald@agsfaculty.indwes.edu

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Tim McDonald, local columnist / (Click for larger image)

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