Recognizing Alzheimer's Disease in a Relative: Aunt Mary's Homecare

Aunt Mary's Alzheimer's disease started very insidiously, I visited her home at least once a week but it took a couple of months to detect any major changes. When I was young, Aunt Mary was the grumpiest aunt in the family. I remember when I was 10 years old she lent me fifty cents. Being her only close relative in town after mom passed away, I became caregiver. It was during her last 8 years that we had grown closer. I fell back in love with my aunt Mary.

Aunt Mary was 83 when we noticed the changes gradually worsen. Prior to this Aunt Mary's mind was as sharp as a whip. My grandmother (her mom) had Alzheimer's too. She frequently swept the road in front of our house and dressed everyday for church (very nicely I must say), trying to walk there.

When I was 14 years old grandmother always thought, I was a boy walking like a girl stating, "Ooh, look at that boy twisting his butt like a girl." At this age, I decided to become a nurse to care for my mom when she would develop Alzheimer's since it appears to reoccur in our family.

It was difficult to know Aunt Mary was forgetful because she would change the subject or ask me about things she could currently remember. Aunt Mary was extraordinarily adept to filling in the blanks. Moderately severe disorientation and speech stuttering with repetitiveness started toward the middle of her Alzheimer's disease. Amazingly, she held on to her remote memory longer, she was able to speak of her siblings and helped me with our family tree.

Sometimes forgetfulness is a blessing. Aunt Mary forgot that mom and her only brother had already passed away. When aunt Carodell passed away, I took Aunt Mary to her funeral but she never acknowledged the passing. Aunt Mary was too busy looking and talking about the attendees, (she was especially interested in my gay cousin who dressed as a woman). She loudly stated, "Is that a boy dressed like a woman?" She rarely looked at the casket except to once utter, "Is that Carodell in there".

Of course, I did not need to remind her of my aunt's passing, it was not necessary when they lived miles apart and did not visit often. Aunt Mary always talked about Carodell, mom, Uncle Bill as if all were alive, but she was the last living sibling.

I recognized Alzheimer's disease in Aunt Mary when she began to exhibit classic symptoms. While sitting in my living room, I would see aunt Mary driving pass the house and stop briefly, I thought she went on to visit a friend. Before I could go out to greet her, she would pull off, circle the block repeatedly about 4 or more times. I had to stand by the curb waiting for her next round to find out what she wanted. While we talked, she was very good at covering up her forgetfulness and was lucid.

She began pulling off while we were in the middle of a conversation, almost driving over my foot a couple of times. She would make this a habit, driving off during a conversation. It was my aunt's habit to make rounds to homes; she sold Avon for 40 years.

The town's police chief reported he'd seen Aunt Mary run a stop sign, but because of small town courtesy, she wasn't ticketed. I observed small dents and broken driver's mirror on her car; she needed to give up driving. Of course, we revoked her driving privileges and took her car keys. After this, most of Aunt Mary's day was staring out her window looking at highway traffic.

Driving was her daily routine so being grounded to her was like punishment. She was frequently found in her or her boarder's car attempting to start them with the wrong key. She was not the only Alzheimer's victim who lost their driving privileges in town that year, two more would fall victim to the horrible disease.

Aunt Mary called me by my mom's name (her baby sister) for the last 4 years of her life. That made her feel comfortable and I did not find reorienting her was in her best interest. She introduced me as her sister, people always asked if I was in fact her sister (I was 35 and she was in her late 80s), I acknowledged it in Aunt Mary's presence.

We live in a small town but her friends delayed reporting other behaviors to me until she needed care with all her activities of daily living. A long-term boarder lived with her since the 70s when Aunt Mary was shot by an intruder, but he would not be expected to provide personal care, only security. He was forgetful too.

It was later reported that aunt Mary was found parked on the side of the road with about $1,000 sprawled across her passenger side. She still had the wherewithal to withdraw money from her bank. At other times, she sat on the side of the road to eat her lunch when she was lost. She went to church in her nightgown, sometimes soiled.

I started bathing and dressing her for church. Wearing adult diapers was another change she did not adapt to well. I encouraged her to wear them in case she could not make it to the bathroom in time and did not want to mess up her good clothing. I left one side of the diaper loosely attached.

It was strange that some things she did not like throughout her life, she began liking such as babies, rambunctious toddlers, and even pets (she has never owned one). She was a schoolteacher for 45 years! Her last year of teaching, 1978, she lamented that children no longer came to school to learn. She taught six grade English and was known as the teacher who tapped children on their knuckles with a ruler when they misbehaved. Students would kill a teacher for that type of punishment these days.

For the last 5 years of Aunt Mary's life, I had a routine for providing home care. I got off work at 8 am (5 days a week), went to her home to bathe her, wash and dry her clothes, clean her bathroom and bedroom, and then prepare her breakfast. She liked to help me make up the bed so I pretended to help her. I made sure she took her medications as ordered. We had others to come in for the afternoons. As Alzheimer's disease worsens, victim need more care.

Aunt Mary's home was her castle and being away from it for just one day was very disruptive for her. I had to protect my aunt from harming herself just as I would for any other small child/toddler. One must adopt that mindset for the rest of the relative's life. When she began to burn foods (like frying tea and boiling breading shrimp) and charred the kitchen, the fuse to the range was removed until needed.

Once I found her lying in her front yard. Apparently, she left out the back door and attempted to walk to the front door before the boarder awakened. She was locked out of the house. Safety is a big issue at homes so I used to walk around Aunt Mary's house to look for possible things, such as throw rugs and cords, which could cause falling, especially when she started falling. Proper shoes and lighting is necessary.

Aunt Mary's worse problem was loosing her independency, so whenever I could, I would afford her the opportunity to choose her hat, shoes and dress for church. She liked to put the diaper on by herself and to lotion her legs. Aunt Mary was allowed to do whatever she could by herself even though I may have to adjust something, she never noticed. I was careful not to jump in and do things just because it took her longer. That takes skill when the relative has Alzheimer's disease.

Unfortunately, we had no choice but to admit her to a nursing home in 1999, she became bed bound; she passed away at age 94. I never thought Aunt Mary would be so humble and accept my care giving and nursing skills. Alzheimer's disease affects the entire family who must support each other at all times. There are high occurrences of caregiver nervous breakdowns and/or burnout. My sons and I were unfortunate to be the only family members in town but we managed to keep Aunt Mary in her home as long as possible.