The 85 year old father of a friend showed up at her bedside at 3am one morning. He was fully dressed, shaved, and had shined his shoes. He said he was "ready" to go to a regular 10am coffee hour to meet his buddies. "Could they leave now? he asked." This behavior was extraordinary - nothing like it had ever happened before.
My friend had been visiting for several months to support her father after his wife had died. She had had no inkling that anything about Dad had changed. She couldn't absorb the meaning of it, at first. How could her well-educated, intelligent, and competent father be so "mixed up" and not realize it himself?
Other signs of cognitive impairment appeared in the next few weeks - he couldn't remember having breakfast; he brushed his teeth two or three times within an hour; bill collectors called to dun him for overdue credit card payments; he was baffled by the complexity of the microwave that he had used for years. A doctor diagnosed him as an Alzheimer's patient a short time later.
Situations like this challenge family members to make vast adjustments in a very short space of time. They must simultaneously deal with loss, fear, and massive amounts of information about care giving. There is no slowing down and no turning back. The irony is that the Alzheimer's patient may be much less agitated than the caregiver. (Certainly not in all cases) The patient has been changing and adjusting over time; the family member has been shocked immediately into a different dimension.
Regular visits with an aging parent can help family members stay connected with the parent's baseline behavior and notice incremental changes. Some of the visits should be long - three or four nights - to get a truer picture of the person's functioning. Phone calls alone aren't good enough. Somehow, the social skills for talking on the phone endure long after elements of judgment and memory have deteriorated.
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