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His First Year
January: Suspicions that something is wrong
From the New York Times, 13 July 2010:
The current formal criteria for diagnosing Alzheimer’s require steadily progressing dementia – memory loss and an inability to carry out day-to-day activities, like dressing or bathing – along with a pathologist’s report of plaque and another abnormality, known as tangles, in the brain after death.
But researchers are now convinced that the disease is present a decade or more before dementia.
“Our thinking has changed dramatically,” said Dr. Paul Aisen, an Alzheimer’s researcher at the University of California, San Diego, and a member of one of the groups formulating the new guidelines. “We now view dementia as a late stage in the process.”
The new guidelines include criteria for three stages of the disease: preclinical disease, mild cognitive impairment due to Alzheimer’s disease and, lastly, Alzheimer’s dementia. The guidelines should make diagnosing the final stage of the disease in people who have dementia more definitive.
But this isn't how the disease was viewed, or understood, just a decade ago. As with cancer a generation previously, there was a reluctance to discuss a diagnosis of Alzheimer's “too soon.” Because there was little or nothing that could really be done for the Alzheimer's patient. A diagnosis of Alzheimer's meant little more than consigning a patient to a modern madhouse. So people would tend to write off memory problems as nothing more than typical aging, for as long as they could.
Georgia’s first obvious sign was the computer at work. She was unable to figure it out, and it frustrated her.
Throughout the course of the disease progression, until shortly before she entered the nursing home, she kept experiencing periods where she wanted to learn how to use Kathi's computer. She even went so far as to purchase a computer learning CD from a television commercial – it was one of the two items we noticed that led to our having to remove and cancel her credit card, which was difficult for Kathi. To her, "Mom" had always been a financial whiz, in addition to a very determined and highly intelligent woman who was capable of learning anything she needed or wanted to.
She began to forget little things, and to compensate (and hide the problems) she would compartmentalize areas of her life and reduce the scope of her interactivity as needed in order to keep on top of things.
That was one of the factors that left me as a target for her frustration after I moved in with them, as I was a change element: I was a factor she couldn't directly control or limit, or hadn't included in her initial plans for how she compensated, so she appeared to feel more threatened that her slips would be detected. At least, that's how I'm interpreting some of those initial confrontations we had early on, now in retrospect...
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