confusion

7 Stages of Alzheimer’s

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In a recent Facebook post, I mentioned that my mother is slipping into Stage 5 of Alzheimer’s. Some of my followers  asked me, “What are the stages and how do they manifest in our loved ones?”

7 Stages of AlzSo I’ve decided to answer that question with a series of blog posts about the 7 Stages. Each week, we’ll look at the next consecutive stage – but not totally from a scientific point of view.

My journey into the world of Alzheimer’s has included my mother’s disease but also the viewpoint of a special lady – Reverend G.

These posts will include Reverend G’s personal experiences and her thoughts through each consecutive stage.

Also, each post will end with a Bible verse that Reverend G hangs on to during that stage. She is, after all, an ordained minister and her faith is important to her – no matter what is happening to her brain.

As we move closer to the book launch for the third book in the series, “Final Grace for Reverend G,” I’ll also include some videos to help my followers understand each stage of the journey.

So to introduce the series, here are the 7 Stages of Alzheimer’s – as Reverend G experiences them – with a bit of scientific information from my research. I hope you’ll join me on this series of posts and share them with your friends.

Stage 1: Preparation. No cognitive decline is present, but a sense that Reverend G doesn’t feel exactly well and wonders what is going to happen. She believes God is preparing her for something in the near future. Isaiah 43: 2-3.

Stage 2: Questions. A small amount of forgetfulness is present, but nothing that impairs life. One example is when Reverend G forgets a line from “The Lord’s Prayer.” This is the stage where “The Unraveling of Reverend G” begins. Isaiah 48:2.

Stage 3: Fear. Something is definitely wrong and life is beginning to seem more difficult. Early confusion sets in. Reverend G loses an entire carton of Chunky Monkey ice cream. Fear is a constant companion. Psalm 34:4.

Stage 4: Diagnosis. Reality confirms the diagnosis as more and more confusion affects Reverend G. Handling finances becomes more difficult and while short-term memory begins to fog, long-term memory is still coherent.

This is the stage where most families begin to consider assisted living arrangements. Reverend G begins to accept what is happening to her. Psalm 43:5.

Stage 5: Early Dementia. Reverend G no longer cares about time or the days of the week. She has difficulty counting backwards although she still knows the names of her loved ones. She still enjoys eating cheesecake with blueberries but she may have some trouble tying her shoelaces or making decisions about what to wear.

She may have dreams that seem real, although they just confuse her further. Her comment appears often, “Oh God, oh God – I can’t stand it.” Reverend G lives through Stages 4 and 5 in “Intermission for Reverend G.” Hebrews 13:5b.

Stage 6: Back to Childhood. Severe cognitive decline as Reverend G is now entirely dependent for her survival. She experiences expressive aphasia as speech become more difficult.

Her beloved Chris is with her and her family remains a source of comfort, but she has forgotten major events and the seasons of the year mean nothing to her. Time has virtually disappeared.

She does know her own name, but others will have to help her with daily living. At this point, she is relying on God to keep her faith strong, because she has no cognitive ability to comprehend what the Bible says, even though she may be able to recite some passages or find comfort in music.

“Final Grace for Reverend G” begins at the end of Stage 5 and continues through Stage 7. Psalm 56:3-4.

Stage 7: The Race is Won. In this final stage, Alzheimer’s patients are virtually infants. All speech is gone. Feeding and toileting need assistance. They lose the ability to walk and are bedridden.

Reverend G is visited by family and friends, but it is God’s faithfulness that continues to sustain her.

As the author, I wrote Reverend G with some ability to comprehend thoughts although she can no longer voice them. The deep viewpoint was the tool I used because I wanted to show what we cannot know – how the Alzheimer’s patient can still feel love and experience faith.

This is where final grace becomes most important. John 14:3.

So these are the stages of Alzheimer’s, told from the viewpoint of our beloved Reverend G.

In the end, with final grace, even a fictional character can help us understand that once we belong to God – he will never, ever let us go.

©2015 RJ Thesman – Author of the Reverend G books http://amzn.to/1rXlCyh

3 Levels of Alzheimer’s

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Until I started researching and living Alzheimer’s with my mom – nobody told me about the three levels of this disease. But I’ve seen them again and again as I’ve talked with other caregivers and observed my mom.Alz awareness

Level One: Your loved one begins to realize something isn’t quite right. He forgets where he parked the car. She forgets how to brush her teeth. They can’t count or say the alphabet. This is the level where Reverend G forgot part of the Lord’s Prayer. http://amzn.to/11QATC1

They begin to use coping mechanisms to help themselves remember. My mother parked in the exact same parking space every time she went to the grocery store. That’s how she remembered where her car was. She pinned her house keys to the inside of her slacks so that she was never locked out of her house because she couldn’t find her keys.

In Level One, the Alzheimer’s patient is afraid and usually keeps this fear a secret. During this time, the rest of the family needs to begin making some difficult decisions.

Level Two: I call Level Two, the intermission. This is the level where the Alzheimer’s medicines begin to work, where the loved one is more content, where everything seems to be okay – for a little while. None of the levels have a time frame because every patient reacts differently. Your loved one still remembers you and may be able to take care of herself, especially within the protective confines of assisted living.

During “Intermission for Reverend G” http://amzn.to/1l4oGoo, we see a love story, the residents play Bingo and converse fairly easily with each other although confusion still reigns.

Level Three: The Alzheimer’s patient begins to move into the final stages. He will probably forget his family members; she may forget how to speak and how to eat. For the patients, this is not nearly as stressful as Level One, because they don’t care anymore and don’t even know what they’re doing.

This is the most difficult level for the caregiver. Mom or Dad have now become infants, wearing diapers, needing to be fed and dressed. We grieve every day and beg God to take them home.

No matter what level your loved one is in right now, the important point is to take care of yourself, love them however you can and know that someday – no one knows when – someday this Alzheimer’s journey will end.

©2014 RJ Thesman – “Intermission for Reverend G” – http://amzn.to/1l4oGoo

Mom Walks Tall

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As a child, I thought my mother was literally ten feet tall. At 5’8”, she towered over me both in height and in authority.

During the last few years, osteoporosis has reduced her to almost the same height as me, 5’4”. Now we look at each other on equal footing, although I still emotionally look up to her.

Lately, Mom has seemed taller again – or maybe she’s just feistier.

For several months, she seemed content with her apartment in assisted living. “You’re so lucky,” I told her. “This is such a beautiful place.” I thought about Cove Creek, the assisted living facility in my book and how much Reverend G loves it.3D Rev G cover

“I don’t have to cook or clean here,” Mom said. “The food is good.”

But during my recent visit, Mom regressed back to the anger she felt when we first moved her. “I want to go home,” she repeated. “I can’t believe I’m here.”

No amount of placating seemed to help. None of my comments about how lucky she is made a dent in her attitude. She was back to anger and frustration, both of us ignoring the fact that Alzheimer’s would keep her out of her home for the rest of her earthly life.

Yet her dogged determination still persisted and in spite of everything, she complied with what we told her to do, especially when we came to pick her up and take her to an event. “Put in your hearing aid, Mom.” “You’d better put on a sweater. It’s cold outside.” “You’ll need your scarf. It’s windy.”

But I could tell that anger waited, right below the surface, along with confusion and the strange reality that is now her life.

After a family lunch together, we drove Mom back to the facility. She stepped out of the car and let me hug her, but she wouldn’t say, “I love you,” even though I said it first. I wanted so desperately to hear her say it. “I’m going back to Kansas,” I reminded her.

Won’t you please tell me that you love me? Can’t you forget the anger for a moment?

Instead, she walked away with that perfect posture back into the building – her shadow reflected on the windows as she proceeded down the hallway – back to her apartment, back to the place she doesn’t want to be.

I don’t want you there, either, and I don’t want you to struggle with Alzheimer’s.

I want to see her standing tall again over the kitchen sink or planting flowers in the garden or hanging wash on the line. My mother shouldn’t be 85 years old with her complexion as white as her hair.

This is not fair, God. I can’t stand it, and I’m sure Mom can’t either.

I wonder…what does she do during the nighttime hours? Does she cry for the life she once had or has she forgotten it entirely? Does she remember the confusion, how she passed out and needed a pacemaker? Does she realize the doctor told us she could no longer live alone?

Does she ever think of us, her children, and how we are feeling about this difficult family dynamic?

Does she know how proud I am of her that she still walks tall?