Tuesday, October 29, 2013

Observations of Aging

My mother had a friend who developed Alzheimer's. This friend of hers was unmarried and had lived independently and was loosely in touch with her one daughter. Somewhat strangely my mother's friend had purchased insurance through a door-to-door salesman that covered long term care facilities. It was fortuitous that she had purchased this insurance because within a few years she had developed Alzheimer's disease and needed 24 hour care. My mother drove an hour each way to take her friend to breakfast once a week. She continued this tradition long after her friend did not remember her name and did not know who she was. My mother continued this because she sensed that her friend was at peace during these visits and it provided a change in her day to day routine. She continued these until her friend was unable to leave her facility due to physical decline and then brought breakfast to her although towards the end she did not eat much. I know all of this because sometimes I went with her on these visits and my mother's friend became dear to me too.

My own family has been touched by dementia and its hand has often been heavy. My Grandmother showed early signs of dementia but was sadly killed in a car accident before her disease progressed. Her sisters also developed the disease which eventually took their lives. More recently one of my uncles has developed dementia but through testing he was found to have Frontal-temporal dementia. In his case my Aunt is his sole care-taker and this has been a difficult role to fill for her. She has an amazing number of challenges especially because my family are all very handy and have woodworking and mechanical skills and thus there are many (now) unsafe items in their house which of course my Uncle is drawn to as his tools have been an extension of himself for all his life. My aunt works endlessly to redirect him when he becomes frustrated often not sleeping well because he is active and restless during the night. He has required more and more assistance with his everyday needs.  They live in a remote area and one time she related to me that at times when it has just been the two of them for a prolonged periods of time she wonders if they are both crazy. She is a very dear person and it is difficult to witness this progression.

I am lucky enough to have also have family who have lived into their 90's and lead productive lives. My Grandfather has led by example his entire life. He was in World War II and was a pilot. He had been shot down and his plane had landed in Switzerland. He returned home and obtained an engineering degree and spent his career in architecture but was also active on the water board in his community which is something he remained active in until his last years. He was also very devout and played an instrumental role in his church. He remained very sharp his entire life but he did unfortunately suffer a fall and struggled with a weak heart and failing kidneys but remained dedicated to his family, his church and to God his entire life. My Grandmother had been his caretaker during his last several years and had needed to take over the responsibility of driving at some point. She made all his meals and managed his house for him. We all know if it had not been for her my Grandfather may not have lived as long or as well as he had.

In my own community I became friends with a remarkable gentleman. The day not so long ago I sat down next to an older gentleman who had brought his grandchildren to the park. One of his grandchildren knew my son from kindergarten and they began playing together. This led to a remark which led to a conversation and before long I knew this gentleman's life history. He has worked in "beverages" his entire adult life and he retired from Coca-cola about 10 years ago. I asked what he has been doing in his retirement and he replied that for the first 5 years he and his wife cared for his ailing mother-in-law and that she had passed away 5 years ago.  At about this time his wife had begun showing signs of dementia and was diagnosed with Alzheimer's. He cared for her at home until one year before she passed away. He had some very difficult times caring for her as her behavior became more unpredictable and she suffered falls leading to fractures and hospitalizations. He finally could not care for her at home and she was placed in a nursing facility where he visited her every day. He said it became more difficult as time passed to make these daily visits as she became more withdrawn. She did die about one year prior. He was tearful as he said this but he straightened and returned to watching his grandchildren play. He said that in the last year he has slowly began traveling which is something he and his wife had always wanted to do. He has remained active in his community and cooked up award winning chili once a year for a boy scouts fundraiser. He drove down to visit once every couple of months and stayed active in his children's and grandchildren's life. Amazingly he is very involved in my son's kindergarten class (despite the fact he lives several hours away) - and most of the kids know him.

I have been so fortunate to be able to learn from those around me about growing old gracefully or about living with disease. I am so lucky to have all these people in my life and their experiences have deeply influenced who I am today and for this I am so grateful.

Submitted by Casey Kimber, DO

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