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21 October 2014

We Choose to Laugh

Dr. Barry Reisberg developed a staging system framework for Alzheimer's Disease. There are seven stages, although the first three to four stages may be undetected by not only those closest to the patient, but also to the medical professionals who provide their care. Stage 1 presents as no cognitive impairment, no memory issues. I don't understand how this is stage 1; why is there even a stage 1? Stages 2 and 3 seem remarkably similar, although stage 3 is still innocuous enough that some cannot detect the early symptoms of the disease, instead choosing to write them off as part of the normal aging process (alz.org, 2014). Stage 4 is where we found ourselves in January 2013. At this point, mama was still living alone, driving herself, and taking care of every aspect of her life ... or so we thought. Seemingly out of the blue, we receive a phone call telling us that mama had gotten lost on the way to Uncle Robert's house (a fact she vehemently denied) - before sunrise. The three of us come home, trying to find out what is going on with a round of doctor's appointments and testing. A geriatric neuropsychiatrist tells us she can no longer drive, and does not need to have any appliances that do not have an automatic shutoff. The Mini Mental Status Exam (MMSE) is quite the eye-opener.

This leads to a few months of staying with both myself and Cheryl, and we soon realized that mama could no longer safely live alone. Once the decision was made, we placed her in the Memory Care Unit. At that time, she was teetering between stages 4 and 5 - still fairly lucid for long periods of time, she knew us and our children, knew her siblings and nieces and nephews. Paul, Cheryl, and I decided that we would laugh as often and as much as we could, for we knew the tears would come.

Alzheimer's, like many other diseases, seems to have a mind of its own. While it is 'staged,' some sufferers do not go through all the stages. Each person's journey down this heartbreaking path is unique. Because I am a compulsive reader, I pore over available information, hoping against hope that there will be one bright spot in the grim forecast. There isn't.

Today's visit was not a good one. Although mama eventually called me by name, I am not certain that she knew who I was. I asked her if Paul had come to see her and she immediately responded "no" even though he was just there yesterday. I asked her if Michelle had come to see her and she said "yes, the other day, and Paul came the other day." We give each other progress reports after every visit, good or bad. And we recall good memories, and we laugh.

I started taking pictures as much as I could, of mama and of us, and of us with mama. I take pictures with the grandchildren, and with the great-grandchildren. Earlier this summer, Danielle and I were taking Samantha and Jonathan to see mama. We reminded Sam (she's 7) that Honey's brain was sick, and that Honey might not remember her name. Samantha's response? "That's okay, I'll tell it to her." We laughed.

Today, I cried. She sat in the chair in the dining area, feet swollen and bare, vacant stare looking through me. I said "Hey, mama" and she responded "Hey, mama." No recognition crossed her face. I sat beside her and took her hand. She told me she was okay. She took my hand in both of hers, turned it palm up, and traced every finger on my left hand with her forefinger. Did she do this when I was a baby? I did with my own children - and my grandchildren. And I cried. Not the big ugly nose running red faced cry (that came later), just silent, painful tears.

I'm sorry, mama. I don't think you noticed, and I hope you didn't. When I left you, you were dozing off in your chair, insisting that you were not ready to go to bed. I gave you a hug and told you I loved you, but you were drifting in and out at that point. The tears are not over, but I remember mama calmly walking in the house where an iron skillet was on fire, throwing baking soda on the pan, grabbing a pot holder and walking back out the door with the skillet. When the fire department got there, we were all sitting outside in the yard.

I remember driving down I-95 on the way home from North Carolina when we approach a state trooper. Mama always did have a lead foot, and she slowed down, sure she was about to get a ticket. When the trooper paid her no mind, she sped up and kept on heading home. And I laugh at the memory.

Find the memories that make you laugh, for tears come in abundance. Look for the laughter. Jesus, I ask that your strength enfold us in the days to come. Help us to find the joy and peace that comes with knowing You are in control.

Sing, O heavens! Be joyful, O earth! And break out in singing, O mountains! For the LORD has comforted His people, And will have mercy on His afflicted.~Isaiah 49:13 NKJV

alz.org. (2014) "Seven Stages of Alzheimer's." Retrieved from http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp?type=eNews_thankyou_page