The only constant in life is change. Dealing with health issues affecting loved ones may be the hardest "change" of all.
“Over, under, under, over…right? No – that’s not working,” Robert said to himself as he gazed into the mirror. For some reason he could not get his bow tie tied today. It just wasn’t coming out right. He was dressing for Sunday dinner at his daughter’s house and his grandkids looked forward to those colorful ties. He decided to wear a turtleneck sweater instead and forget about the tie for now. That bow tie had been his signature look for the last 35 years as the accounting manager of the local bank and he’d only retired 5 years ago. He would tell the kids it was getting colder now that it was fall and this sweater kept him warm. In the back of his mind he noticed he was making a lot of excuses like that lately. The last pair of tennis shoes he bought was the “slip-on” kind with no laces. “It was just easier,” he had rationalized, pretending his intermittent inability to tie shoes was just a momentary lapse of memory as well.
He walked into the bathroom to shave and removed the gear from the mirrored cabinet above the sink. He closed the door and saw his reflection again; he had already shaved. When did he do that? Must have been early this morning when he was still groggy. “Oh well, probably all that blood pressure medication is making me foggy,” he said to Charlie the cat.
He descended the stairs and made a pot of coffee, got the morning paper and put a few slices of bread in the toaster. While it cooked he took his pills, turned on the radio and opened a few windows. The smell of the fall air brought back memories of his wife, who had passed on 3 years ago next month. He choked back a tear, buttered the bread and sat down at the table to read the paper. Charlie sat in the window sill basking in the sunlight.
Robert began to look at the headlines, but his wife’s absence was strong in him today. The letters on the front page began to blur. He put the paper down and his head in his hands and began to weep. Where had the years gone? He began to think about all the challenges he had faced as a man, a husband, a father, a son, a brother, an employee, a manager of people, a citizen of this town and a child of God. He thought about all the days that he had endured problems and pain and all the days where his cup had runneth over in gratitude for all the love and good fortune with which he had been blessed.
The cat leaped to the table and began to rub against his shoulder, sensing that something was wrong. Robert patted him gratefully, cleared his eyes, swallowed hard and ate his toast. He put the dishes away, poured another cup of coffee and went out to the front porch to finish it. Neighbors out for walks and mowing lawns waved and he smiled and waved back. At least he still had his old familiar neighborhood and the friends that rounded out his life. Eddie, from across the street, ambled up the stairs and past him into the house, knowing the coffee had been made. He returned to “his chair” on the porch and nodded at Robert without a word; their daily ritual very much intact.
“No tie today?” said Eddie. “Getting cold,” Robert replied. “Ah,” Eddie finished and pointed down the street. “Looks like Johnson’s getting aluminum siding put on the house, huh?” Robert shook his head. “They don’t call it aluminum anymore. It’s made of vinyl.”
“You will what?”
Robert exhaled. “Yeah, he’s getting aluminum siding.”
“I know that! I’m the one who told you!”
Robert stood up. “I have to get over to my daughter’s house for dinner. It’s Sunday you know?”
“I know,” said Eddie. “Think I don’t read the paper? My mind’s as sharp as it was when I was in college. Ever tell you about my college days?”
“You have old friend but I’d like to hear about them anyway. Maybe tomorrow you can tell me when we do this again. But don’t hurry to leave – enjoy your coffee. Just leave your mug on the table when you go. I’m going to lock up and head over there,” Robert said as he patted his old friend on the shoulder.
He fed the cat, locked the door and got in his car. He backed out to the end of the driveway and waved to Eddie, who was still on the porch studying Johnson’s “aluminum” siding. He paused a minute and thought about whether or not he had fed the cat. He decided he had and then he thought about which way he was headed. For a minute, he thought it was the old days and he was heading to work, but he knew that wasn’t right. Once he decided which way to go, he forgot to look behind him again and began to back out. He slammed on the brakes suddenly as he realized he had almost hit little Chad from down the street who was pedaling his new bike right behind the car.
Chad hadn’t even noticed the “near miss” and waved to Robert as he came into sight. Robert returned the wave with is heart pounding like a rabbit. He drove to his daughter’s house and he no sooner entered the door when she broke her embrace from him and said, “Dad, what’s wrong?” He led her into the den and closed the door. “Dad, you’re scaring me,” she emitted. “What is it?”
“I want you to me honest with me,” he started. Are you and Tom and the kids starting to repeat things to me that I forget? Are you noticing me getting confused about things now and then? Be honest.”
She began to cry. “Yeah, Pop, there’s definitely a change there. In fact, we were going to talk to you today. God forbid some lapse of memory could cause you to injure yourself or someone else. We’d like to have you tested, professionally reviewed but we were afraid about how you would react.”
Robert fought back tears and nodded. “I almost hurt someone today. I don’t think I should drive until we know if I am just getting absent minded or if it is something worse.” He handed her his keys. She knelt forward into his arms and hugged him. “Tom and I have already talked about this Pop and we have room for you to stay with us right here. The kids adore you and eventually we’re going to add a little efficiency apartment right off the back of the house for you and Charlie so you can have your privacy and still be close to us. No matter what they find – you’re going to with people who love you.”
“I’m so lucky to have you,” he smiled. “Well we feel lucky to have you,” she returned. “Now let’s not talk any more about this. Tom will drive you home tonight and in the morning I’ll drive your car over and we’ll begin to make some appointments and plans.
Robert thought about Eddie, his car, his neighborhood, his familiar routine and his heart was breaking. He smiled at his daughter and said, “Sounds great. What’s for dinner?”
“Beef stew,” she smiled. “Mom’s old recipe, you know. Hey how come no tie today? You’re going to disappoint the kids.”
“Well it’s getting colder now,” he said. “The weather seems to be changing.”
An estimated 5.2 million Americans of all ages have Alzheimer's disease in 2013. This includes an estimated 5 million people age 65 and older and approximately 200,000 individuals younger than age 65 who have younger-onset Alzheimer's.
Alzheimer's is the 6th-leading cause of death in the United States overall and the 5th-leading cause of death for those aged 65 and older. It is the only cause of death among the top 10 in America without a way to prevent it, cure it or even slow its progression. Deaths from Alzheimer's increased 68 percent between 2000 and 2010, while deaths from other major diseases, including the number one cause of death (heart disease), decreased. While ambiguity about the underlying cause of death can make it difficult to determine how many people die from Alzheimer's, there are no survivors. If you do not die from Alzheimer's disease, you die with it. One in every three seniors dies with Alzheimer's or another dementia.
In 2012, 15.4 million family and friends provided 17.5 billion hours of unpaid care to those with Alzheimer's and other dementias — care valued at $216.4 billion, which is more than eight times the total sales of McDonald's in 2011. Eighty percent of care provided in the community is provided by unpaid caregivers.
In 2013, the direct costs of caring for those with Alzheimer's to American society will total an estimated $203 billion, including $142 billion in costs to Medicare and Medicaid. Total payments for health care, long-term care and hospice for people with Alzheimer's and other dementias are projected to increase from $203 billion in 2013 to $1.2 trillion in 2050 (in current dollars). This dramatic rise includes a 500% increase in combined Medicare and Medicaid spending. Nearly 30 percent of people with Alzheimer's and other dementias are on both Medicare and Medicaid, compared to 11 percent of individuals without these conditions. The average per-person Medicare costs for those with Alzheimer's and other dementias are three times higher than for those without these conditions; the average per-person Medicaid spending for seniors with Alzheimer's and other dementias is 19 times higher than average per-person Medicaid spending for all other seniors.
Ron Ciancutti is the Director of Procurement for Cleveland Metroparks. He is not on Facebook, but he can be reached at email@example.com.