Lapses and Synapses

Dad died on a late Thursday afternoon a little more than 16 years ago, just shy of his 80th birthday. Hewas unconscious, laid up in an assisted living facility south of Baltimore. His breathing had slowed and grown erratic in the days prior. He was no longer able to feed himself and labored to swallow when others tried to feed him. He couldn’t speak, and his eyes registered only flickers of recognition now and again. 

That afternoon, shortly before dinner time, his body simply quit. Truth be told, he had pretty much checked out months earlier. That’s the way Alzheimer’s works. 

Everyone knows about the cognitive decline and memory loss associated with the disease, but it also affects higher neurological functions such as heart rate, breathing, digestion and sleep patterns. Victims have trouble with nutrition and proper hydration. Those afflicted eventually lose balance and coordination, so are often confined to beds. They cannot communicate, nor control their bladder and bowels. Pneumonia and bacterial infections are leading causes of death among advanced Alzheimer’s patients, often because they are too weak or immunocompromised to respond to treatment that would cure an otherwise healthy person. 

I write this not to bring down the room, but as a reminder and a gentle nudge. Dad’s birthdate and anniversary of his death were recent, so I’ve been thinking about him. Also, June is Alzheimer’s and Brain Awareness Month. As all of you are younger than me, many of your parents are still alive and kicking. I recommend that you spend time with and appreciate your parents while you can, challenging or maddening as they might be. 

I don’t know if any of you have been touched by Alzheimer’s or dementia, but it’s a damnable disease I wouldn’t wish on Vladimir Putin. Anything that robs you of you is beyond pernicious and heartbreaking to those around you. 

Dad was in decline for several years, and Mom had to move him to multiple facilities for more comprehensive care as his condition worsened. She could only bring herself to visit him every few days, especially in the later stages, because she could hardly bear to see her husband and partner, her light and her rock, of 50-plus years erode into a shell of himself. 

I didn’t blame her one bit. When I visited, sometimes he recognized me and sometimes he didn’t. Sometimes I was just a friendly face who came to say hello and sit with him for a while. 

It was back in my sportswriting days, so whether he was asleep or awake, whether he recognized me or not, I told him what I’d been up to the previous couple weeks and what was ahead – events I covered, people I interviewed, who was playing well and who wasn’t. Dad’s condition also prompted my mom to tell my sister and me, regularly and insistently: Don’t wait. If there’s something you want to do, some place you want to go, don’t wait; do it, ASAP, because there are no guarantees. 

Mom and Dad did some traveling after he retired. They hoped to do more, intended to do more, but other concerns or situations arose that shelved plans. No problem, they thought, we’ll get around to it. Once Dad started to decline, hopes and intentions evaporated. 

Chances are, Alzheimer’s and dementia will affect all of us, directly or indirectly. The Alzheimer’s Association estimates that 6.5 million Americans have the disease. As the population ages, that number is expected to rise to 13 million by 2050. Approximately one in nine people age 65 or older has Alzheimer’s. The disease is expected to cost the country $321 billion, including more than $200 billion in Medicare and Medicaid payments. Unless treatment to slow or prevent the disease is developed, the cost is expected to hit $1 trillion by 2050. 

The country is woefully thin on geriatric care specialists. Half of primary care physicians reported that they don’t feel adequately prepared to care for patients with Alzheimer’s or other forms of dementia. Only 12 percent of nurse practitioners have expertise in gerontological care, and less than one percent of registered nurses, physicians’ assistants and pharmacists identify themselves as specializing in geriatrics. 

All of this is to say, be aware of your parents and oldsters in your orbit. Recognize that forgetfulness and confusion may be signs of regular aging, or may signal something more significant. Listen. Talk to experts. Get them tested. It may require some difficult decisions. Give them a hug. Give them some help, whether they think they need it or not.