MY MOM HAS ALZHEIMER'S - AM I AT RISK?

My mother first showed signs of Alzheimer's Disease probably as early as 2008. She was 82 then. She couldn't remember dates, places and names of family members. She didn't know one day from another, and forgot what she just had for dinner or where she had left her purse.

That was 11 years ago. I had not heard of Alzheimer's Disease (AD) then. Like most people with elderly parents at home, I took these signs as part of the normal ageing process. It was commonly accepted that people turned senile (nyanyok) in their old age, so I wasn't too concerned about it.

My mom would repeatedly ask the same questions even though I had just given the answers. It was almost impossible to hold a simple conversation with her. Her attention would drift off to some distant places in her memory. It was as if a mist had clouded the clarity of the moment. She was there with me but yet not there. I didn't know then how to handle such a situation.

It took a fall at home and hip surgery for my mom before I learned about Alzheimer's. During the ten days my mom was in hospital, her doctor noticed signs of the disease in her behaviour. He suggested I take her to see a geriatrician for a proper examination. A visit to see a geriatrician at UMMC Specialist Hospital and some tests later confirmed my mom had AD.

Thus began my interest in reading up as much as I could about AD. In December 2013, I signed up for an online course on Living with Dementia: Impact on Individuals, Caregivers, Communities and Societies offered by Johns Hopkins University. In 2015, my passion to learn more about AD took me to Hogeweyk, the world's first dementia village in Amsterdam. In 2017, I enrolled for MSc in Applied Gerontology at NTU, Singapore. At 69, I was the oldest in the pioneer class. I attended numerous conferences to learn about the latest developments in AD research and treatment. As my mom's primary caregiver, I wanted to know how to better care for her. At the same time I could learn how to avoid ending up with AD. As a blogger and founder of a seniors' community, I could share what I have learned with others.

The statistics for Alzheimer's are alarming. According to the World Health Organisation Report (WHO) 2019, there are currently 50 million persons with dementia (PWDs). This number is expected to increase to over 150 million in 2050. The World Health Organisation (WHO) 2014 report put the number of people in Malaysia with dementia in 2015 at 123,000. This number was projected to be 261,000 by 2030 and would continue to increase to 590,000 people in 2050.

What's the difference between dementia and Alzheimer's Disease?

I have frequently been asked this question. Put simply, dementia is an umbrella term for a host of diseases that affect the normal functioning of the brain. Depending on which part of the brain is affected, diseases associated with dementia include Alzheimer's Disease, vascular dementia, Lewy bodies (DLB) and frontotemporal dementia. The most common of these is Alzheimer's Disease which affects mostly the elderly. However, early onset dementia affecting adults in their 40s and 50s is on the rise.

Is Alzheimer's Disease hereditary?

This is the golden question for me. My mom has AD. I believe my great grandmother had it too. When I was growing up in the 1950s I recall seeing her playing with a baby doll, and treating it as if it were her own child. Another time I saw her packing a few personal belongings in a sarong, and telling the family she was going to take a trishaw 'home', meaning China. These incidents are etched in my memory. I have at least four members in my extended family who were diagnosed with dementia (AD) in their final years.

Like my mom, one of my aunts also showed signs of behavioural changes in her old age. She would accuse everyone of conspiracy, of hiding her passport and stealing her money. All not true, of course. But when she told me so-and-so had stolen her valuables, I believed her. It was only later when she was diagnosed with AD that everything she said and did began to make sense.

Does that put me at risk? Yes, but at risk does not mean 100% or even 30% certainty. I may or may not develop AD. There are preventive measures I can take to reduce the risks, such as exercises and activities that promote brain health and cognitive functioning.

I am very forgetful. Is this a sign of early Alzheimer's Disease?

All of us are forgetful, some more than others. How often have we forgotten where we parked our car, the name of someone we have just been introduced to, or the lyrics of songs we used to sing? We refer to these lapses of memory as 'senior moments'. Red flags of AD include repeatedly forgetting recent events and confusion in retrieving them. This Mild Cognitive Impairment (MCI) or lapses in short-term memory may signal early Alzheimer's. Over time as the disease progresses, these memory lapses can potentially have serious consequences. My mom would forget to turn off the gas completely after cooking, forget to lock the front door when she left the house, or forget whether she had taken her medication. The latter could have resulted in a drug overdose. My mom also had mood swings, an obsession with collecting tissue paper and was prone to wandering around the house at wee hours of the morning.

My mom still enjoys browsing through newspapers and magazines. I bought this book for her in the hope the images would stir up fond memories.

We often read in the papers of a missing elderly who later turned out to have forgotten how to get home. There are no statistics on the number of such cases in Malaysia. The Japan Times (June 2019) reported that a record 16,927 dementia patients in Japan went missing in 2018. Alarming indeed. Do not leave an elderly unaccompanied especially in an unfamiliar place e.g. a busy hospital or a noisy mall. My mom had on several occasions stopped midway to our neighbourhood supermarket, unsure whether she was heading in the right direction despite having walked there countless times before. Confusion with directions is common in PWDs.

Can Alzheimer's be prevented?

Thanks to Google and the efforts of the Alzheimer's Disease Foundation of Malaysia (ADFM) over the years to educate the public, we now know more about AD. Not everyone develops the disease in their old age. There are people in their 80s and 90s whose minds continue to remain sharp. 

At present there is no cure for AD. Prescribed medicines for AD can only slow down the progress of the disease. Most of the drugs, e.g. memantine, have side effects. AD is a degenerative disease that can span many years, ultimately ending in death. I have watched my mom slowly change from a lively chatty woman to a shadow of her former self. After suffering a mini-stroke in February 2019, she has lost her ability to speak, and her memory has almost completely left her. She does not know who I am nor does she even ask. She sits in total silence, in a world of her own where no one can enter.

When my mom was discharged from hospital after her second surgery, she was prescribed expensive drugs by one doctor after another. After several years of seeing little improvement in my mom, and on the advice of a doctor friend, I decided to stop all the medication. My mom has been mostly drug-free since. She turned 93 in October 2019, still has a hearty appetite and sleeps well. That is good enough for me.

Preventive steps for dementia do not cost much money. Follow a regular exercise regime and adopt a healthy diet. Monitor your sugar level, blood pressure and weight. Keep your brain actively engaged with mental stimulation such as learning a new language or a new skill. Travelling broadens the mind, so go on trips whenever you can. Finally, build a network of close friends and avoid social isolation.

What preventive measures do I take?

As I am at higher risk than others of getting Alzheimer's, I make sure I stay active physically and mentally. I have always been active, interested in and curious about a lot of things. I read a lot, especially on ageing-related issues. I write a lot too. Curating for news and events to share on Facebook keeps me mentally busy daily. These activities stimulate the brain. That is why I enrolled for my second masters degree. I also took up singing, line dancing and learned to play the ukulele. Memorizing lyrics, dance steps and ukulele chords helps to stimulate my brain cells. I have been attending courses offered by the University of the Third Age (U3A) since 2011. Lifelong learning keeps the brain well-oiled and the social connections I make will hopefully keep AD at bay. 'Never too old to learn new things' has become my mantra for living life with a positive mindset.

KLSings' VoxPop choir performing at ADFM's 'Let's Talk About Alzheimer's' in conjunction with World Alzheimer's Day in September 2019.

If you are curious to know whether you or a family member has early AD, you could try taking the Mini-Mental State Examnation (MMSE). It is a popular test for cognitive functioning, and includes tests on memory recall, language and focus. There is even a Malay version. The scores will provide an indication of whether the person has any cognitive impairment. As it is only a simple diagnostic test, it should be followed up with a visit to the geriatrician for a full examination. 

Drop by at ADFM community corner at Wisma Atria, PJ, to find out more about AD. There are weekly group activities there for PWDs (persons with dementia) and their caregivers.

SHARING AWARENESS ABOUT ALZHEIMER'S

September is World Alzheimer's month. We will be featuring articles that will help promote awareness of Alzheimer's and also share stories by carers on how they cope with looking after a loved one with Alzheimer's - the most common form of dementia.

Here's one story published in Alzheimer's Association blog that will resonate with those of us caring for an elderly parent with Alzheimer's. It provides some answers to questions such as:

• How do we cope? 
• Is Alzheimer's hereditary? 
• How should we prepare for our future if tests show that we carry the Alzheimer's gene?

Be the Change You Wish to See in the World
by Daisy Duate

Five years ago, after being diagnosed with Alzheimer’s, my mom Sonia moved from Chicago to Missouri. She lived with my brother for a month and then with my sister for about a week. It was soon obvious that I had to take over the responsibility of being her primary caregiver. We were always inseparable, but now we are more inseparable than ever.

Due to a very long history of Alzheimer’s in my family, I was asked if I wanted to take part in a clinical study, which included a test to see if I carry the gene for early-onset familial Alzheimer’s.* I didn’t think twice. My brother and sister chose not to take it, but the minute it was brought to my attention, I wanted to do it. It was in my head from the beginning – what if I have Alzheimer’s and it is exposed at age 42 or 43? I am almost 40. Who is going to take care of my mother? Who is going to take care of me? I had to prepare myself.

I worked on getting all of my ducks in a row, taking all the proper measures and precautions.  I got life insurance right away so that someone would be able to take care of my mom and not have to put her in a nursing home. In addition to taking care of mom, I had to be willing to accept whether or not I will have the disease. Three-quarters of my family has passed away with Alzheimer’s. I am the only one of my siblings that wanted to be tested. I would like to think that I inspired my cousins – who are now interested in finding out if they carry the gene – as their mother was recently diagnosed as well.

As for me? The test came back positive. One day, I will have Alzheimer’s.

I don’t think of it; I simply shrug it off. I just see what my mom is going through and know I need to take care of her. In my younger years, I was a bit of a party animal – I owned a sports bar – and now my mom is my main focus in life. How can I be a caregiver to someone I love so much and not stand up for her and her needs as someone with the disease? She is what matters the most.

My typical day is very different from what it used to be. I wake up, make coffee and then wake up Mom. I often have to strip the bed and then take her to bathroom and get her into the shower. Then I brush her teeth, dress her and do her hair and makeup. I take her to work with me at my sister’s restaurant, and she is with me all day until I get off work. We often go on a walk to get some ice cream and go to the park. I end the day by taking her home and making her dinner. After she goes to bed, I go to sleep, and I do everything again the next day. It’s a whole new life.

The Alzheimer’s Association has been there for me every step of the way. I had already been on team Sonia’s Angels in the Walk to End Alzheimer’s for the past few years in support of my grandma and my mom. When I was diagnosed by my genetic counselor, I received information about grieving, counseling and caregiving from the Association. In my previous life, I had never been an activist; I was the quiet one. Now I advocate for my mom. If you wish to see a change in the world, you have to step up.

My involvement in the Dominantly Inherited Alzheimer Network (DIAN) study means that I take a variety of medications and skills tests. Although the whole group is supportive and loving, the medication is physically very painful for me. All the same, if my participation helps find a cure for someone in the future – whether it’s me or my nieces and nephews – I will take all of the pain. I try to stay positive. Everything happens for a reason, and life is too short to just mope around.

I help spread awareness because there is a stigma surrounding age and Alzheimer’s. People always tell me that I look 21 years old and can’t imagine that I could develop this disease at any time. The truth right now is that Mom has the disease; I have the gene, but I don’t have the disease yet. That is why I try not to dwell on it.

There is simply not enough money or exposure for Alzheimer’s. We have to get the word out in order to save the future for others. The more awareness we can raise, the better it is for the disease. We need to find – and fund – a cure. Alzheimer’s is currently the 6th leading cause of death; we must make strides to end it now.

*Younger/Early-onset Alzheimer’s caused by a genetic mutation is rare and the vast majority of early-onset and late-onset cases cannot be determined by a genetic test. Health professionals do not currently recommend routine genetic testing for Alzheimer’s disease, although testing for APOE-e4 is sometimes included as a part of research studies. For more information on Genetic testing, click here.

About the Author: Daisy Duarte, 39, is a caregiver for her mother Sonia, 59. Daisy speaks to colleges and other groups to raise awareness in the fight to end Alzheimer’s. Daisy and Sonia live in Missouri.

Your local Alzheimer's Organization:

Malaysia
Alzheimer's Disease Foundation Malaysia (ADFM)
14, Lorong Utara A, 46200, Petaling Jaya, Selangor, 46200
Phone:03-7958 1522

Alzheimer's Caregivers Network Malaysia

Singapore
Alzheimer's Disease Association Singapore
New Horizon Centre - Toa Payoh
Blk 157, Toa Payoh Lorong 1
#01-1195, Singapore 310157
Tel: 6353 8734

Dementia Helpline (Singapore): 6377 0700 (Mon to Fri, 9.00am - 6.00pm)

A NEW HOME FOR MOM

Who among us would not want to live a long and happy life? We all want to enjoy our golden years in good health, and that means being able to take care of ourselves and remaining physically active and mentally sound. 

But life does not always give us what we want. What happens when old age brings with it a host of health problems? What do we do if our elderly parents are in this situation and we are unable to look after them for one reason or another? Or for that matter, where do we go when we ourselves reach old age, and we too need to be looked after?

This is where daycare centres for the elderly, residential homecare centres and nursing homes come in. They play a vital role in providing care for the elderly who require assistance with activities of daily living.

Mom (photo taken on 26/11/14)

Unfortunately, the number of care centres and homes for the elderly in the country has not risen in tandem with the rapid rise in the ageing population. According to the Department of Statistics, Malaysia, life expectancy has increased from 63.1 to 71.9 years for male, and 66 to 76.6 for female, from 1966 to 2010. It is projected to increase further in 2040 when men can expect to live to 78 years and women to 83.

Between 2010 and 2040, the number of Malaysians aged 65 years and above are projected to triple. Based on these figures, Malaysia will become an ageing country as early as 2021 when the population aged 65 years and over reach 7.1 per cent.

These figures are a cause for concern. Will the number of aged care facilities be able to cope with the surge in the elderly population?

Socio-economic changes have resulted in smaller family size. While in the past there was always someone at home to look after the elderly parents, today they are often left alone at home to fend for themselves when their adult children are at work. What if they fall and hurt themselves? What if they suffer a stroke or a heart attack? Who is there to send them to the hospital or call for an ambulance?

That was exactly what happened one Sunday evening in March 2011. I came home to find my mother sprawled on the floor unable to move. I had left her on her own to attend a workshop in another state. I dread to think of what would have happened if I had returned a day later. It was a traumatic experience for me.

At the hospital x-rays confirmed that my mom had sustained a hip fracture and would require surgery. During her 10-day post-surgery recovery in the hospital, the doctor informed me that my mom was showing signs of Alzheimer’s Disease (AD). He advised me to get her examined by a geriatrician at Universiti Malaya Medical Centre (UMMC). All along I had assumed that her memory lapses and occasional odd behavior were due to old age. My mom was 85 at the time.

The six months of post-surgery rehabilitation was a most trying period for both of us. It was my first experience of being the sole caregiver and it left me physically exhausted and emotionally drained. My mom’s failing memory plus her limited mobility meant that she needed constant supervision which I was unable to provide for the long term.

Mom at the ADFM Day Care Center in Section 11, PJ

I was fortunate to discover the ADFM daycare centre in PJ, near UMMC. I had read an announcement in the papers of a talk to be held at the centre. I visited the centre and liked what I saw. The facility was clean and elder-friendly. There were daily activities to engage the clients physically and mentally. The staff were trained and qualified. My mom would be in the company of people her age group, and she wouldn’t have only me for company.

The centre could do with a name change, but the facilities and care provided are excellent.

My mom was at the PJ daycare centre for three months. When the Dementia Homecare Centre at Telok Panglima Garang started accepting admissions in September 2011, my mom moved in there. She has since settled in comfortably and enjoys the peace and quiet of the place.

It has been three years now and my mom regards the centre as her home. She is well taken care of by the staff. I visit her regularly to make sure she has everything she needs. We enjoy chatting and sharing stories. I am also aware that one day she may no longer recognize me. As her condition advances, she will require more nursing care. I am confident ADFM will be able to provide the care and attention she needs. I know I can’t.

The proposed ADFM training and care centre to be built in PJ Old Town. (Photo: The Star)

The traditional family unit has changed with the times. These changes necessitate a change in our mindset too. Does placing an elderly parent in a home reflect a lack of filial piety? I have thought long and deep about this. And the answer is No. Not if they need professional nursing care and we are unable to provide that at home. Not if they have dementia and must be supervised 24/7. Not if it is no longer safe for them to be left alone.

There are so many things to worry about when an elderly parent with dementia is left alone at home. Did mom remember to take her medication? What if she took more than prescribed and overdosed? What if she fell and lost consciousness? What if she forgot to turn off the gas stove, or lock the front door? What if she wandered off and couldn’t remember her way back?

It is our responsibility to make sure that we choose the right home where our parents get the best possible care. I am happy to say ADFM’s Dementia Homecare is the home sweet home for my mom. She is happy there and no longer remembers where her own home is.

Find out more about Alzheimer's and ADFM at http://www.adfm.org.my/Home/foundation 

Ultimately, it is an individual decision. Each family has to decide what to do when the time comes for mom and dad to be looked after 24/7. But just remember the dire consequences should anything disastrous happen to an elderly parent who lives alone.

One day it will be our adult children to worry about us. What will their decision be then? How will we react to their decision? Only time will tell.

The above article (text only) first appeared in ADFM's special limited edition of "Sharing" magazine that was published in conjunction with the "Forget-Me-Not" concert held on 5 Dec 2014 in honour of the Sultan of Selangor's 69th birthday, and also to raise funds for the building of ADFM's new training and care centre in PJ.

Updated on 6 Dec 2020: 

Less than a year after the above concert at KLCC on 5 Dec 2014, the residential Dementia Care Home at Teluk Panglima Garang closed on 31 August 2015. Most unfortunate as my mom loved the place and was really happy there. In my opinion, it remains the best dementia care home I have visited. 

I have blogged about my mom's first and second falls and the rehabilitation and care that followed, as well as the costs incurred. The articles can be assessed on SeniorsAloud blog archives for March 2011, and for July 2015.

ALZHEIMER'S DISEASE - ARE YOU AT RISK?

Alzheimer's Disease is a disease that robs a person of his mind and dignity, and takes him away from his loved ones. He is there physically, yet not there as the person you once knew.

AD afflicts mostly older people. We can take preventive measures like keeping ourselves mentally active and taking certain supplements, but there is no guarantee we won't have AD in our old age. There is as yet no cure for AD. The AD patient can live on for ten years or more, before he fades away into the twilight.

Do you or your elderly parent display any of these warning signs?

In the US, according to the Alzheimer's Association, more people die of AD than of breast cancer and prostate cancer combined (see video below). The Alzheimer's Disease Foundation Malaysia (ADFM) reports that an estimated 50,000 people have the disease. However, most of them are not diagnosed, because relatives think that the symptoms displayed are a normal part of growing old and thus do not seek medical advice for it.

Residents at a dementia facility in Malaysia playing a game of Bingo. Women are at a much higher risk of getting AD than men.

In Singapore, the statistics provided by the Alzheimers Disease Association (ADA)are equally alarming. In 2005, an estimated 22,000 people aged 65 years and above had AD. By 2020, the figure will increase to 53,000 and by 2050 the projected figure will further increase to 187,000.

Fortunately, public awareness of AD is slowly spreading, thanks to books, movies and documentaries about the disease. You might have seen the movie 'The Iron Lady' starring Meryl Streep in the role of Margaret Thatcher. The former PM of Britain was an AD patient, so was former US President Ronald Reagan.

It helps when celebrities come forward to announce that they have AD, and are supporting fund-raising efforts for AD research. And when families share their challenges caring for a loved one with AD, it gives strength to others going through the same journey.

Glen Campbell, now 78, was diagnosed with AD in 2011. Many of us still remember his hit songs of the 60s and 70s like 'Rhinestone Cowboy' and 'Wichita Lineman'. He gave his last concert the same year, together with his children who were his back-up band. In April 2014, he was moved from his family home to an Alzheimer's facility, reports The Rolling Stone magazine.

If you are an AD caregiver, you might want to attend this talk (see below) organized by ADFM, and join the AD care-givers network.

For more previous posts about Alzheimer's Disease and Dementia (and there are plenty!), please type in the key word in the search box on the side column.

A HOME SWEET HOME FOR MY MOM

Take note of the address and contact number. Not many people know of this centre. It's about 45-60 minutes drive from  KL/PJ.

Ever since I wrote in an earlier post that my mother has dementia and is currently staying in a home-care centre specially catering for folks with dementia, I have received many requests for more information on the place.

I hope the pictures below as well as my comments will provide some answers to the frequently asked questions about the home. For more about dementia or Alzheimer's, just type either word in the search box in the side column. I have done a lot of research on the topic and am happy to share with those who are interested. Happy reading!

A view of the centre from the outside. Well-kept garden, fresh air, peace and quiet and the sound of running water from the fountain to the left (not in view). There is a pre-school in the same compound. I think it's great to have the bookend generations sharing space. The sight and sound of children helps to liven up the place.

Spacious, clean, bright and well-ventilated. Such conditions are almost non-existent in most care centres that I have visited.

Some of the residents having lunch. Through the windows, you can catch a glimpse of the dragon fruit orchard at the back of the centre. There is also a swiftlet farm in the same back compound. Most of the residents are able to feed themselves and move around on their own.

The dormitory with six beds and two attached bathrooms. Rooms with two beds and three beds are also available as well as single rooms. All rooms have attached bathrooms and toilets. I have seen centres where as many as 20 beds are crammed into a similar-sized room, with barely two feet of space separating the beds.

There are different activities on weekends which are also the days when family members usually visit. They are encouraged to make regular visits to the centre and spend time with their parent.

One reason why I chose this home-care centre for my mom is the structured programme of daily activities to stimulate the mind and keep the residents occupied. It's like going back to kindergarten for them. They learn the 3Rs all over again to help boost their memory. In most homes, the residents are left to themselves to do their own thing. Most end up either lying in bed all the time or starring blankly into space. How utterly depressing!

Jigsaw puzzles, card games and many more. Going through a second childhood for the residents.

An hour of singing the oldies and playing percussion before lunch. Not everyone is into singing, but everyone tries. The residents are encouraged to participate in all the activities. No one is forced to do anything against their will.

The daily menu. My mom has a very healthy appetite. She enjoys every meal at the centre.

Morning exercises to improve flexibility and balance. The staff are all trained nurses. Staff to resident ratio is 1:2.

Members of the Philharmonic Orchestra performing at the centre in May. Special events are organized for the residents. The Alzheimer's Disease Foundation of Malaysia (ADFM) is organizing an overnight trip to Genting Highlands for the residents and their carers from 12-13 October in conjunction with World Alzheimer's Day. (See poster below for more details).

My 86-year old mom with Angela Lee who manages the centre. Angela holds a degree in Nursing Science and was a lecturer at a nursing college before she took up her current post. She is pursuing her Masters on a part-time basis. I personally find Angela very knowledgeable, experienced, and caring - important attributes for anyone looking after the elderly.

Me and my mom. I try to visit as often as I can. I am glad I have found a place for my mom that she is happy with. I must have checked out a dozen or more homes before my search led me first to the Alzheimer's Daycare Centre in PJ . My mom was there for three months before she moved to the Dementia Homecare Centre in Telok Panglima Garang in September 2011. Both homes are run by the Alzheimer's Disease Foundation of Malaysia (ADFM). Please click on the links for more about the daycare centre in Section 11, PJ.

Admission to either centre is strict. You need a doctor's referral, preferably from a geriatrician who will have to verify that your parent does have dementia or Alzheimer's. This is done through a series of cognitive tests. My mother was seen by Dr Philip Poi of Universiti Malaya Medical Centre. She was examined and put through tests at the Memory Clinic and diagnosed as having signs of Alzheimer's Disease. 

If you wish to know more, please contact the centres directly or email me at seniorsaloud@gmail.com

Update: The Dementia Homecare Centre (DHC) closed its doors on 31 Aug 2015. Two months earlier my mom had a fall and broke her left femur. After she was discharged from hospital, there was no point for her to return to DHC. Instead she was admitted to a nursing home for post-surgery rehabilitation. She has remained there since. My mom was the happiest at DMC, often inviting her visitors to 'come and stay here. It's so quiet and peaceful.'

Related article:

Am I just forgetful or do I have dementia? 

MARKING TIME IN HOSPITAL...

Today is Day 7 of my mother's hospitalization. She had an angioplasty done on her last Tuesday. She's doing fine, eating well and enjoys being pampered by her visitors and the nurses. Still, she is impatient to go home. She has been lying in bed 24/7, unable to move much as her right leg is in traction. The doctors are waiting till her heart is strong enough for the hip surgery. Although she is generally cheerful especially when she has visitors, I know she feels depressed sometimes. That's when she talks about joining my younger sister who has passed on. We haven't told her about the hip surgery scheduled for next Tuesday, or she will worry no end about it.

Blocked arteries are not the only setback that my mother has. Dr Tiang suspects she also has early signs of dementia. She can't differentiate between night and day. She sleeps more during the day than at night. Her room-mates have complained that she keeps them up during the night. She's either snoring loudly or pleading with the nurses to allow  her to go home. Having a family member stay the night with her compounds the problem, as she keeps up a running conversation with whoever is by her bedside. Mom just loves to chat.

To solve the problem, every night at about 11pm, the nurses move mom to the treatment room next to the reception counter. She has the room all to herself, and the nurses are close enough to hear her when she calls for assistance. In the morning before the doctors make their rounds, the nurses move her back to her 2-bed room across the hallway. I have told the nurses I am not too happy with this arrangement.

Mom says the smile is to let family and friends know that she's fine except for her immobility.

It didn't surprise me at all to hear that mother is in the early stages of dementia. In the past two years, I've noticed she's become increasingly confused about dates, faces, and places. She can't remember where she leaves her things, and accuses people of stealing them. She is easily suspicious.

To understand my mother's ailments better, I have been reading books on caring for elderly parents, in particular, parents with Alzheimer's Disease. Looking back, I wonder if in my sub-conscious mind I was perhaps preparing myself for a time when my mother would be needing specialized care-giving beyond what I am able to provide on my own.

If you are looking for an insight into the ageing process, and how to cope with elderly parents with special needs, I would recommend the above books. I am not sure if "You and Your Aging Parent" is available now. I bought my copy years ago. "The Alzheimer's Caregiving Puzzle" is on loan from the National Library Singapore. I'm still reading it.

I shall be sharing what I've gleaned from my readings in future posts on this blog.