Thread: Alzheimer's lest we forget

I was half listening to a Sanja Gupta report on Alzheimer's this morning while getting ready for work. Something like "the last Alzheimer patient". A lot of focus seemed to be on exercise, diet and meditation alongside mental stimulation.

If you are any good with VPNs you may be able to watch it on the CNN site.

Taking care of a dementia patient is EXTREMELY exhausting, both mentally and physically. If you are doshed up, a live in nurse would be a way forward.

What you need to watch for is simple memory lapses. When I was last back to UK to see my Dad he would ask a question (something like "what are we having for dinner tonight") - then five minutes later ask it again. And then again.

Perhaps a more early sign we missed was his loss of interest in crosswords. He used to do the telegraph cryptic crossword daily (in pen!). Over time the crossword became less filled out, and he eventually "lost interest". I think he just lost the ability to understand it any longer. Cryptics take considerable mental acuity, and that was just - gone.

Thanks for all the info Oggy, hopefully won't happen to me or partner but failing to prepare is preparing to fail.

With so many interesting outdoor hazards I find it prudent to try to minimize those I can controil at home.

I don't know if it is any help to you but I have an 84 year old brother I am responsible for. He is in an aged care home in Lampang and I visit him on a daily basis. He was living large in Chiangmai until just under two years ago when he had a bad fall with most damage to his head. He had just had 5 bottles of Leo and smoked some weed and fell up the stairs to his hotel when returning there with his girlfriend. I only mention this to show that his lifestyle was acceptable for an 82 year old. His behaviour up until that time was reasonably normal but I now recognize that he was exhibiting some early signs of dementia.

He was admitted to Suan Dok Hospital and had a fairly stormy recover with a minor heart attack thrown in. The night was Halloween 2022. I remember that because I was at a party in Lampang and quite elephant's trunk myself when I had to make the dash to Chiangmai at midnight. He spent a couple of months in ICU. I eventually got him moved to an aged care home in Chiangmai and his mental condition had worsened. The neurosurgeon in CM told me that scans revealed that his brain had actually shrunk away from his skull and said this is a normal progression of dementia. He had another fall in the care facility when he was misbehaving, which didn't help anything. He was somewhat mobile and then got worse and complained of pain in his hip and stopped walking.

I was wearing out my car driving to CM 3-4 times a week but then found a very nice care facility in Lampang not far from my house so moved him there just under a year ago. He had to go into hospital for a skin cancer operation so I asked them to check out his hip at the same time. X-rays showed it was broken and had been for some months. This must have happened in Chiangmai at the care home and nobody 'fessed up.

He had a hip replacement but was very apathetic about physio afterwards and can still not walk, basically due to lack of effort. He does not read, won't watch television (even though I set up it up in English for him), and can't even be bothered to keep his phone charged so has lost touch with everybody and everything. He seems OK with this and shows no interest in improving. He recognises me all the time but otherwise has the memory of a goldfish.

The only other information I can give you is that I thought the Suan Dok Hospital did a very good job. The care home in Chiangmai was fine, except for the hip business. He has had very good treatment as an inpatient and outpatient at the Lampang Hospital, including three sizeable skin cancer operations in addition to the hip replacement. He is incontinent and had a Foley catheter for some time. He kept pulling this out requiring emergency admission the private hospital several times. This was a real PITA for us but the urologist eventually bored out his prostate so no more catheter. The care home in Lampang has beautiful grounds, some full time physiotherapists and nurses and a bunch of young assistants. He is in a two person room but usually his roomies ask to be moved out to another room because he is such an arsehole, but it gives him the room to himself most of the time. He is the only farang in the place and his Thai is not so good.

His mental condition fluctuates. You might think he is absolutely normal when talking to him but then he says things that are complete drivel. My belief was that the dementia had started before his fall and then accelerated. As his mental problems prevent a physical recovery, I don't see much upside.

Our mother did not show any signs of dementia until after she had turned 100 and then gradually worsened for the next four years until she forgot to be alive. My bro's condition has been very time consuming for my wife and I and has had a negative impact on my work and business, so I selfishly hope I don't have to do this for another 20 years.

Thanks for sharing such a difficult issue

Originally Posted by Shy Guava

I don't know if it is any help to you but I have an 84 year old brother I am responsible for.
.

I will not reproduce the whole post, but Jesus Christ. People (including myself) always think we have it bad, and then they read something like that. You really have my sincere sympathy, and my admiration for what you have done for your brother. Not sure I could have coped with all that. My pain was short, but your is in a different league.

Just out of curiosity (and feel free to ignore if it is a step too far) but how is this being paid for? Months in an ICU is a HUGE expense. Living homes are expensive, surgery is expensive.

"so I selfishly hope I don't have to do this for another 20 years." Personally, I think that is entirely understandable.

My only comment is 5 large beers at 84 YO, fair fukin play.

Like I’ve mentioned before, I worry about becoming mentally incompetent especially living here in CM by myself.

My brother and I have a plan to make a decision on when it’s time I get outside help. The condition of my feet will give the answer. If it comes to the point that I can’t be bothered with stooping down to care for my feet or can’t arrange a pedicure, my time alone is up.

Now if I say something that sounds a bit nuts to my brother when we are doing video chat, he asks to see my feet.

So far, so good.

Originally Posted by nidhogg

Just out of curiosity (and feel free to ignore if it is a step too far) but how is this being paid for? Months in an ICU is a HUGE expense. Living homes are expensive, surgery is expensive.

My brother had decent deposit in an account in Chiangmai. In the early days I was able to get that changed to become a joint signatory so his expenses are being taken out of that. We also got him to sign an Enduring Power of Attorney to allow another brother to access his home country funds and investments so he can fund his own treatment for some considerable time. He has no dependants.

Expenses at Public Hospitals in Thailand are very reasonable (in my opinion). The only downside is that several hours are taken with each visit. The cost of the care home is less than 35,000 baht per month for what they call a large airconditioned VIP room with ensuite and includes three meals per day, nursing and physiotherapy care and various activities.

Thank you for your interest.

^ very affordable compared to the west.

Originally Posted by nidhogg

A lot of focus seemed to be on exercise, diet and meditation alongside mental stimulation.

I have come to believe that diet is a very important element in this. The challenge is that there doesn't appear to be a simple fix for all, we probably need tailor made recommendations based on yet-to-be-identified markers in the DNA. Personally I think a few large Leos are key.

@david44 - a few weeks ago, I spoke with a former neighbor who's now a caregiver to a lady who was my high school principal. The former principal is now 94 or 95. Accdg to her caregiver, she was brought to a neurologist because she showed memory issues. She had a CT scan. Accdg to the neurologist, there are meds which can slow down the progression of Alzheimers and it's better to detect earlier/ have the meds & treatment earlier. The principal has monthly checkups & daily meds. The caregiver said she has good & bad days. She can walk around the house using a walker. Her caregiver takes her outside on a wheelchair to see neighbours, fresh air, etc.

This is secondary info, since I spoke with the caregiver, not the patient (the former principal). This caregiver is a former neighbor. She was caregiver to an elderly man living in an apartment building near my parents' house. The old man has died and she was able to find new employment, this time as a caregiver to my former principal. I'm glad for her since her wage is higher and the new employer's family treats her better than her former employer.

Anyway, TLDR: if you or your wife shows signs of memory issues, go to the doctor (neurologist) & have a checkup. Maybe there are treatments/ meds to delay the progression.

Maybe @bsnub can chime in since his mom has Alzheimers, AFAIK.

@shyguava - you're doing a very noble deed for your bro. It's a tough situation & I wish all the best to you & your family.

Originally Posted by katie23

Maybe @bsnub can chime in since his mom has Alzheimers, AFAIK.

We finally had to put her in a care facility. My mother had turned on the shower water in her bath and left it running. It was not caught in time and did considerable water damage to the house. My mom was no longer able to be left unattended for even short periods of time, and the decision was made that it was time for a 24-hour care facility.

In regard to preparing for it, I am afraid I do not have much offer. It was hard to detect early on because it is very slow in the way it creeps in, it really is a nasty ailment. When we look back after the fact, we can see that it may have been years before we actually caught on to what was happening, and that fact makes some kind of preventative treatment next to impossible.

To those in here who are worried about getting dementia/alzhiemers do not let your mind sit idle, do not zone out to the TV, instead play games like cards, puzzles, dice, jigsaw and video games. Yes, I said it, video games. They are greatly helpful in stimulating the brain. This article is a great read, on how they help;

Video games show potential in improving key aspects of memory in older adults

Originally Posted by katie23

@david44 - a few weeks ago, I spoke with a former neighbor who's now a caregiver to a lady who was my high school principal. The former principal is now 94 or 95. Accdg to her caregiver, she was brought to a neurologist because she showed memory issues. She had a CT scan. Accdg to the neurologist, there are meds which can slow down the progression of Alzheimers and it's better to detect earlier/ have the meds & treatment earlier. The principal has monthly checkups & daily meds. The caregiver said she has good & bad days. She can walk around the house using a walker. Her caregiver takes her outside on a wheelchair to see neighbours, fresh air, etc.

This is a very sad article but well worth a read about a woman who was finally diagnosed in her 40s (and who had lived her life convinced it would do for her). They couldn't actually diagnose it at first.

‘It comes for your very soul’: how Alzheimer’s undid my dazzling, creative wife in her 40s | Alzheimer's | The Guardian

A common question is: when did the disease start? There is no neat answer. It’s possible Vanessa could feel it coming on long before any of her symptoms showed. To the outside world, though, Alzheimer’s reveals itself by subtle degrees, each one plausibly dismissed in the early stages as “nothing”. And even when they start to become obviously “something”, there is usually a range of alternative explanations.

The twisted genius of this disease begins with the way it smuggles itself in under the cover of other conditions. Absent-mindedness, ageing, menopause, through depression, anxiety and epilepsy – all would be presented as perfectly plausible explanations, first by me, then by some serious experts in their field.

In retrospect, though, it began with a zit on her chin.

We used to go out for dinner at the end of family holidays in Devon. There is a beach cafe overlooking the sea, round the headland from where we were married in 2006. As we sat down for the 2013 edition, I pointed out the zit with much amusement. Vanessa responded in a similar vein. For a minute or so, the repartee was spiky and hilarious. Then we looked at the menu.

At the end of the meal, as we were leaving, I cracked another joke about the monstrous carbuncle.

Vanessa looked at me in horror. “What? I’ve got a zit on my chin?”

I remember the chill. We were well used to her mislaying car keys and sunglasses and whatnot. But this seemed different. This was an entire conversation we had just had.

People can slip under the dementia radar very easily. My mother hid her dementia from her GP for years. Mom never let my father go into her doctors appointments with her, but when I came along to help out, I sat in on her appointments. It was surprising how well my mother could hold herself together in front of the doctor. She was telling the doctor that she drove herself to her appointment and was stopping by the grocery on the way home as she was cooking dinner. Truth was my mother hadn’t driven for YEARS. She had stopped cooking a while back. It really upset the GP, who had known Mom for years, that she didn’t catch it.

Mom at home vs. Mom at the doctor’s office

Originally Posted by S Landreth

For some of you older posters here at TD. Be careful who you select as your healthcare surrogate. In the end, it will scar that person.

So many difficult decisions to be made. Decisions the person under care disagrees with. Not for the faint-hearted.

Thanks everyone, seems many have had contact with the dreaded AZ .
I am working my way through all the attachements and thanks for teh helpful warning signs suggestions.

Be interested if anyone has heard of a diagnosis here inLOS and whether Dr's are aware, From my limited experience it is not obvious from breif ancounters, but when you spend a lot of time wiyh those you know well it soon becomes apparent.

When I used to visit the mothe rof my kate dear friend each week in a UK Surrey care home she would recognise me and chat away as we did for 50 years , my dear old gf was quite upset as sometime her Mum couldn't recognise her own grandchildren who visted regularly from London .

She would be back seat driver as I usually drove her out for lunch her one escape per week. Daughetr told me while she would take a menu and bark at teh waiting staff over trivia she often didn't remember what she had ordered by the time the dishes arrived , in normal 10-20m at the restaurant table.I think she was aawre all was not well.

Any other case studies, anecdotes or scholarly articles welcome. I will update his thread if I come across anything else.

Years ago I read about a group of nuns who agreed to donate their brains to science after they died. They were very mentally active people, and a number of them, upon autopsy, had all the physical characteristics of Alzheimers.

However before death they did not have altered behaviour or memory. In the study they concluded that the nuns were constantly re-wiring their brains by being so active.

There is no treatment for vascular dementia or AlzheimerÂ’s as such, only speculative drugs and allegedly a regime involving exercise and stimulation that may mitigate development. The problem remains, we donÂ’t know why some develop it and others donÂ’t. As Salsa says, the increasing presence of claggy tau proteins in the amygdala, previously thought to be the major cause of Alz,vascular dementia, etc, in healthy brains has confused the issue. What we do know is that late onset of dementia is a product of total cell senescence but why we all do not suffer equally in advanced age is a mystery. Presenile dementia was once thought to have been the consequence of an immoderate lifestyle ( e.g alcoholism ) or possibly because of some Welsh kinship but such theories no longer have a currency. IÂ’m not convinced maintaining an active lifestyle etc is a therapy sufficient to ward off onset of AD or dementia.

I think it is genetic and the incidence of dementia simply reflects we're all living longer.

Originally Posted by misskit

The condition of my feet will give the answer. If it comes to the point that I can’t be bothered with stooping down to care for my feet or can’t arrange a pedicure, my time alone is up.

I have missed something here, may I ask what is the problem with your feet?

I have problems with my feet in Thailand that I don't have in Europe (heat related), not sure if it is due to high blood pressure or diabetes.

Back on topic.
My Dad's mental capacity has started to suffer, although he doesn't have dementia yet. As mentioned in an earlier post by nidhogg, he used to do the DT cryptic everyday, but stopped a few years back. He still enjoys the General Knowledge crosswords and has the books out on the breakfast table, won't do anything else until he's completed it, although he often uses the 'phone a son' option when stuck. He spent most of his life in computing, machine language and COBOL, so refuses to have a smartphone or laptop. He prefers to try and remember things or look them up in books rather than doing a simple google search. It can be infuriating at times but I understand what he means.
Main problem is he's been living alone since the outbreak of Covid (his second wife died in the January, and due to Brexit, we can't come over as a couple to look after him. Wife being a third national has more chance getting to the UK on a rubber boat than being given the free visa she is entitled to.

Originally Posted by Salsa dancer

Years ago I read about a group of nuns who agreed to donate their brains to science after they died. They were very mentally active people, and a number of them, upon autopsy, had all the physical characteristics of Alzheimers.

However before death they did not have altered behaviour or memory. In the study they concluded that the nuns were constantly re-wiring their brains by being so active.

Or could it be that sexual activity brings on dementia?

^^ No feet problems. Long toenails or dirty feet just being a sign of a decline in hygiene. Seems to be common in people with dementia to stop bathing and looking after themselves.