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Rita Arens authors Surrender, Dorothy and Surrender, Dorothy: Reviews. She is BlogHer.com's senior editor.  Her parenting anthology and BlogHer'...
 
 
 
 

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A Definitive Test for Alzheimer's Disease: Why I'd Want My Parents to Take It

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Rita's Grandparents

My grandmother died of a broken heart. And Alzheimer's.

I choose to remember the woman who lived next door to me my entire childhood, the woman who baked rhubarb pies and sang in a wobbly falsetto as she played hymns on the piano in her sitting room. The woman who read me books over and over and loved opera and always had soft, open arms for her grandchildren. I choose to remember the woman I look so much like, the woman I resemble more with every passing year.

I choose not to remember the disease she became. The empty blue eyes so annoyed with me for interrupting her, for crying at her bedside. The skin flaking off her once-full cheeks and the chapped hands that would never again reach for me. The disease that took so long to kill her I almost forgot who she was.

She didn't know her husband of more than fifty years. She thought he was her boyfriend. She just knew that he came every day to see her after he was forced to put her in a home. The man who cut her toenails and wiped her chin and always, always treated her with respect even when she grew angry and disoriented.

After he was suddenly killed in a car accident, he stopped coming to see her.

She stopped eating. She died a month after he did.

I live in fear any of my other relatives will develop this horrible disease, that I will. I cherish every moment with my parents, knowing it's entirely possible one or both of them could retreat into their minds, into the place of silence and anger that stole my grandmother.

I've been told my whole life that Alzheimer's is technically impossible to diagnose until the autopsy. Then I read in the New York Times that a definitive, 100-percent accurate spinal fluid test has been developed that will reveal if patients with significant memory loss are headed toward Alzheimer's. And I immediately asked myself if I'd want this test done on anyone in my family -- including me -- who began to lose his or her memory.

Absolutely. I would absolutely want to know.

If it were my parents or a relative, I'd want to be forced to say goodbye while they could still hear me, while they still knew me. I'd want to be forced to draw them the pictures, to tell them the stories, to remind them of the wisdom they'd given me, the gift they'd been to me, the love I felt for them. I'd want them to completely understand how much I loved them before they slipped away to that place.

If there were a cure -- anything that could be done to relieve the symptoms -- I'd want to aggressively pursue it. I would give any money I had to contribute to avoiding that fate.

And if it were me? I'd want to sit down with my husband and daughter and prepare them for the disease, exactly what was going to happen to me, how I not only would not know who they were, but I might hate them. I might be angry or irritable on a daily basis. I might push them away as though they were total strangers. I might break their hearts to the extent they wished I would die and leave them alone to grieve who I was instead of having to face every day who I'd become, the thing I'd become. I'd want to tell them over and over how much I loved them, make videos and tape recordings of me saying that, over and over, I love you, I love you, I love you. Please remember me like this. Don't listen to me if I ask you who you are. Remember me like this, full and whole and sharp and soft and here.

On the day when I finally looked at them with vacant eyes, I'd want them to stop visiting me. I'd want them to kiss me and hold me and tell me that they loved me, then I'd want them to go home and mourn me and leave me somewhere that my pain would be eased but my life would not be prolonged one minute longer than it had to be. I would want my body to die alone, because my mind would already have left them.

If I am to get Alzheimer's, I want my friends and family to read this post, to

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dr.leigh 6 pts

The best thing that my sister told me when my mother started getting angry and verbally abusive was "There's nothing to forgive...She earned my love for what she did for us".  I struggle with how to react to my mom every day, when she knocks on my door 12 times on Saturday when I am trying to spend time with my son, or when she calls me 20 times on Friday night when she forgets where we are, and calls me names for keeping the Child out late.  It's so hard.

The Midlife Second Wife 20 pts

Rita, this is one of the most heartrending, honest, inspiring essays I've read on a blog— anywhere, anytime. I'm so sorry for your loss, and I admire your courage in writing about this, and in wanting to pursue the path of knowing. I saw this as a companion article to one of mine about the same subject, and marked it for a time when I WOULD have time to come back and read it carefully. I admire you—and your writing—and hope that you and everyone you love will dodge this awful disease.

Take care,

Marci

NotJustAnotherJennifer 7 pts

Thank you for sharing, even though it brought me to tears at work. :) My mother is suffering from a type of short-term memory loss. Thankfully she still has her long-term memory and knows us, but it's difficult to see her getting worse.

Jennifer Barr is a working mom of two beautiful girls under the age of three which means she's sleep deprived but constantly kept on her toes! Most of those experiences are chronicled on her blog, Midwest "Mom"ments, http://midwestmomments.blogspot.co

Rita Arens 196 pts

I'm a planner. It's how I am. A friend of mine told me on the phone today I'm a 360-degree person who always looks at everything from all angles. So I guess it's just me.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

So many comments, so many people living the same outcome. I hope we find a cure soon.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

Maybe this test means we will find a cure, a vaccine, a way to reverse it.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I'm so hopeful this test means we are closer to finding a way to reverse or prevent the damage. I'm sorry about your grandma.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

holymonkeys09 5 pts

I've struggled a lot with whether or not I would want to know, or if I would want to know if someone in my family is getting Alzheimer's. I watched my grandma and great-grandma suffer with it. My great-aunt is now showing the beginning signs. It's a terrible, horrible, heart-breaking disease.

I think wanting to know shows courage. I don't know if I've found that courage yet. Thank you for sharing this.

dawnsmith 5 pts

My mother is in OH right now caring for my grandmother who has Alzheimer's. She doesn't know anyone around her any longer...she thinks my mom is her nurse. Like you, I choose to remember who she is in her soul.

I would definitely take the test. I'd want to prepare my family as well. Some days, when my foggy mommy brain sets in, I worry what would happen to my family if Alzheimer's attacks my brain. It's terrifying...but like my grandmother, I would have loving family around me to care for me.

Your post was so moving...Thank you for sharing it with us.

miaarticoli 6 pts

http://1momjustsaying.blogspot.com

My husband's mom and my mom passed away from this disease. They were both only 70 years old when they passed. They had early onset Alzheimer's in their 60's. I'm 44. I feel like I'm running out of time. I watched my dad's heart break for years everytime she didn't know him, then when we had to put her in a home it was awful for him. He misses her so much - they were high school sweethearts. I agree that I do not want my family to visit me at a home if I'm to endure this awful awful disease.

SuburbanCorrespondent 6 pts

Within 10 years, it will be clearer whether they were false positives or not. I'm sure they are following up with all these people in the study. What is amazing about the test is that it seems to give at least a 5-year warning, which is early enough for some of the current drugs to be useful. This is absolutely fantastic news! And, as the article points out, researchers are going full-bore on this subject - there is a lot of reason to be hopeful.

YumYucky 5 pts

My grandmother also died of a broken heart - soon after my grandfather was diagnosed with pancreatic cancer - he died 4 weeks after his diagnosis. My grandmother developed Alzheimer's shortly thereafter. The last time I went to visit her, she kept telling me that I looked like a relative of hers - her granddaughter - and then she'd show me my baby picture. She did not make the connection that I was the same person in the picture.

The resemblance between your and your grandmother is remarkable. Despite my grandmother's death, I have not researched Alzheimer's as you have. I think it's time to do that.

Rita Arens 196 pts

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

We're all different. I certainly wouldn't try to convince anyone to take it if they didn't want to.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I had a picture from when she was a girl that I hung on my cube wall in Chicago right after she died where nobody else could see it. I'd just sit, and stare and cry. It's good to have pictures.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

Believe the broken heart. :) Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

But I don't know. It's all intensely personal.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

court0516 5 pts

I lost a great aunt to this horrible disease and I really have to believe that this is one of the worst diseases ever. It's one thing to suffer from a life-threatening illness. But at least you have the presence of mind to call on your family, friends, etc. to help you through. I can't imagine not knowing your loved ones.

What a heartfelt blog post - thanks so much for sharing.

Kim C.

annabellespeaks 5 pts

I read this post Tuesday night when you first posted it, and it's been haunting me ever since.

My grandfather suffered with some form of dimentia my entire life (his physical body died when I was 19). My grandmother passed away (from suicide) seven months before I was born and he never recovered from that in a lot of ways, and slipped into dimentia before I was in kindergarten. The entirety of my memories of him rang from sad and lonely to angry to scared to ashamed.

I suppose given the choice I would want to know, but I don't know that it would change much of anything. I don't think I could walk away if my mom or dad's mind died, yet they were still physically alive. I don't know that I'm strong enough to make the choice to walk away and preserve the happy memories (and my sanity). I've never been good at goodbyes - they sort of have to be forced on me. I know me, and I know I'd cling to the living shell that once was, too scared to let go.

I think if something like this strikes my family again it isn't my loved ones I need to prepare and coach - it's me.

http://www.annabellespeaks.com/

http://twitter.com/AnnabelleSpeaks

EllenCoyne 5 pts

In addition to the test for biomarkers in the cerebro-spinal fluid, researchers have also just developed a dye that will adhere to plaques in the brain, enabling visualization of the location and density of those plaques.

To me this offers the most hope in finding a cure, as it really will show whether a treatment is working.

More here: http://www.nytimes.com/2010/06/24/health/research/24scans.html

blackbeltmama 5 pts

I lost my grandmother in April and this post has me in tears. Isn't it funny how you can find your loved one in something so simple? There's this one picture of her on my mantle that so captured her and her laugh. I can hear her when I see it. Dusting that mantle almost always makes me cry now because of it. I also have a sweatshirt that was hers and when I wear it, I feel like she is wrapped around me in a giant hug. It helps, but nothing ever really eases the pain of losing someone you loved so very much.

Link Text ( http://www.blackbeltmama.com )Black Belt Mama

vodkamom 5 pts

My grandmother died two months after her husband- and we were always told it was of a broken heart.

Now I wonder.

vodkamom 5 pts

Rita- that was an amazing post. truly.

The Subtle Rudder 5 pts

about what to say to this beautiful post. First, I know. My grandmother died of alzheimers. Second, I saw a special on genetic testing on twitter several months ago--your complete panel for $100. Great, I thought. Sometime soon, they'll be able to look at your genetic profile and give you a definitive look at what foods to eat. So I signed up. In due time, they sent a little kit for me to send a saliva sample back. And I never did it. Just could not do it. Because I could not face knowing that I might have that gene my father's mother had, could not cope with the idea that my father--my brilliant, funny, quirky dad, the man who spoiled me for other men, the man for whom I spent two weeks at the Mayo clinic this spring for--could have passed it to me, because that would mean he might have it too. So I do not think I'd want to know, at least without some clear signs of drift and loss. But as long as we're clicking, as long as we both have passion and recall, I would rather not live with that dire knowledge.

Rita Arens 196 pts

I see such strong hope in this test. If we figure out what causes it, it's a much shorter road to figuring out how to stop it. I hope and pray we can figure it out before my daughter is old enough to wrestle with any of this.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I'm skeptical when I see 100%, too, but since we don't know if those folks will go on to develop AD, it's hard to totally think of them as false positives, more as unknowns until they die, you know?

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I'm sorry you had to go through that.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

ms_lorelei 6 pts

Oh Rita...

I have so much to say here I may send you an email. I hate hijacking a thread.

As a speech pathologist who has spent her career in adult rehab and elder care I have treated literally hundreds of Alzheimer's patients. It *can* be calm, but it can also be nightmarish. It can be both in the same person. And there is no way to know which way it will go. I have some patients convinced they're on a cruise ship. I have some who cry in fear an loneliness hourly. I tell people, if that's ever me, let me be on the damned cruise ship, for heaven's sake DON'T orient me! Or if I am the other kind, give me something for it! Don't let me live in that place!

But one thing that hasn't been mentioned - a hugely controversial topic is - if you knew in the early days where forgetfulness was the only symptom... would you want the option to say goodbye, permanently, before disease ravaged you?

A personal, personal, choice I feel. And one of the problems with early dementia is the differential. So many things cause dementia symptoms, many of them have correctable (or at least improvable) symptoms...but if you knew, for sure?

A dementia treatment conference I was at two years ago had the keynote speaker stating that he believed, based on current research, that Alzheimer's disease would be curable - or at least stoppable - in ten years.

I would trade many hours of employment if it meant these patients did not need me.

Powerful words. Thank you for sharing them.

Lori, speech pathologist, writer, and business owner, blogs home-family-working-mom drama at In Pursuit of Martha Points. ( http://inpursuitofmarthapoints.com )

pbergson 5 pts

Excellent post. I can identify with your desire to know, to be able to prepare. I think it's really important, not just for Alzheimer's, but that we've talked with our families about what we want, for us and for them. When we actually need them to act on that, it's way too late.

A quick note about the test though - it predicted 100% of the patients with mild dementia who would go on to develop AD, so in that sense, you might think of it as 100% accurate. But it was only positive for 90% of the actual AD patients, and more importantly was positive for 36% of the control patients, who had no symptoms of AD. The authors speculate that these patients might go on to develop AD, but they have no evidence of that, and so at this time those must be regarded as false positives.

So to complicate the decision of whether to get the test, there might be as much as a 35% chance that the test would indicate you have AD when you actually don't. I don't know that it would change my mind about being tested, but it's something to think about.

Judy Schwartz Haley 34 pts

My grandfather had Alzheimers. We lived with him. It was so difficult to watch. People know about losing memory, but the anger and frustration in the patient is also heartbreaking. Their personality completely changes. I too choose to remember my grandfather the way he was before the onset of this disease. And yes, I'm all for testing.

CoffeeJitters.net/blog ( http://coffeejitters.net/blog )

Rita Arens 196 pts

Yes, yes, yes.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I think that's the number one reason why I'd want to know. To not shock my family.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I'm sorry, Sis.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

deew27 5 pts

My grandmother died on my birthday in February of this year from Alzheimer's. In the end, she couldn't even remember how to eat. That's how bad it got. The doctor's went back and forth on her diagnosis for years before they would actually commit to it being Alzheimer's. I saw the signs long before anyone else even questioned it. I would have given anything to have been able to have a definitive test so that she could have received the care she needed. She lived alone, at the insistence of my Aunt, up until the final month or two. I didn't see her much during the last year that she was alive, and when I did it was just so hard. This disease is so difficult, not only for the person who has it, but the entire family surrounding them as well.

I'm glad to know there is a test available now. I will not be at all surprised if my mother follows in my grandmother's footsteps and I would want to know for her as well. If it was me, I would want to know. I would want to prepare my family, to tell them that the anger and hatred was not truly directed at them.

Thank you for writing this.

www.voicesinmymind.com ( http://www.voicesinmymind.com ) - personal ramblings
www.gettingcrafty.com - craft projects and more
www.recipecorner.net - family recipes and quick-fix meals

JennaHatfield 249 pts

Most of my decisions in life are about how they will affect my family, especially my children. I mean, I do things for me, but the big stuff takes their futures into consideration. As my children would be the ones caring for me should something of this nature occur, I'd want them to be prepared. It's kind of not awesome to know that it would be looming, but perhaps I'd be better able to shrug off the small stuff (like LB's 18th costume change of the day by 9:00am) and appreciate the mundane and even annoying (omg, this humidity) a bit more.

As an aside, this post is amazing and heartbreaking and I'm kind of weeping as I comment. What is it about grandparents dying so closely together? Sigh. Anyway, thank you for writing it.

Jenna Hatfield (@FireMom ( http://twitter.com/FireMom )), from Stop, Drop and Blog ( http://stopdropandblog.com ) and The Chronicles of Munchkin Land ( http://thechroniclesofmunchkinland.com ), is a freelance writer and newspaper photographer.

EllenCoyne 5 pts

What a gift - to be able to hear that voice again. I hope someday to hear my mother's voice again, too.

BlondieChicago 24 pts

You sent me into a downward spiral after reading this last night, but it is lovely and I'm proud of you. I love that photo of Grandma and Grandpa. They were so magical.

ShoreBookworm 34 pts

That is why your post is so important, to help people understand the disease and how it differs from other forms of dementia. Inappropriate, or out of character, anger is one of the hallmarks.

My father was always a rager behind closed doors, but never let his affable public persona slip. I knew something was up when he started occasionally yelling at his employees about ten years ago, but he has mostly been able to keep a lid on it.

However he cannot keep it together any more at all. Neither of my parents will agree to any interventions at all and they told the nursing home staff they want nothing to do with the four of us, their children.

I don't know how this is going to end, but I know it will not be pretty.

Marie

www.nourishourselves.blogspot.com ( http://www.nourishourselves.blogspot.com )

www.theshorebookworm.blogspot.com ( http://www.theshorebookworm.blogspot.com )

Rita Arens 196 pts

Without crying, that is. My grandparents were an important part of my childhood, not just because they were my grandparents but because they helped fill in when my mom had cancer twice when I was a kid. Losing them was like losing my parents, and it happened when I had just graduated from college and really needed those flagships in my life, for there to be a platform from which to jump beyond myself.

Seeing that I have educated even one person about the anger and fear is enough. This is not a dreamy disease. It's horrible, and now that we have the test, we must find a way to reverse the damage.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

cagey333 5 pts

Rita, I know how hard this post was for you to write and thank you for doing so. I am not familiar with Alzheimer's and thank you for educating us on some of the nuances. I think what struck me the hardest was the fact that the person with Alzheimer's might view a loved one as a thief or intruder. The fact that you might doing your loved one a favor by NOT visiting them. This is an important distinction and it never, EVER occurred to me this could happen - the anger, the fright. I, too, had been lulled into that dreamy stereotype painted for us by all of the Lifetime movies over the years.

Thank you for reaching deep and writing this - I am very close to my paternal grandmother, she has been like a 3rd parent to me. When she is gone, a hole will be in my life and my heart. An empty space that can never be filled because she has been such a large, vibrant, important part of my life.

 Kelli Oliver George

Rancid Raves ( http://rancidraves.blogspot.com/ )

Snapgifts.com ( http://www.snapgifts.com/ )

Rita Arens 196 pts

My grandma wasn't angry all the time -- there were times when she was like what you describe, or when she just kept staring at the wall or the TV not acknowledging your presence. I write of the angry times because it was so shocking to me -- I never heard my grandmother raise her voice until Alzheimer's, and she lived next door to me my entire childhood.

I'm sorry for your loss.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

Your example demonstrates what so many people don't realize about Alzheimer's -- the violence, the anger. It's so hard to reconcile that anger with the person you knew, if the person you knew wasn't angry. And it can make you hate them even though you love them for just being so confusing and angry and difficult and not themselves.

I'm sorry you're going through this.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I understand when you say the woman in the chair replaces the woman you knew in your memories. That's why I was so happy to remember her real voice when I read the book, not the confused, scared voice or the angry voice or the flat voice -- she was none of those things before the disease, ever.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I try not to watch my relatives too closely, because I know when I get tired or stressed, my vocabulary is the first to go. I can't be worrying about Alzheimer's every time I search for words.

But as a word person, it scares me.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

My maternal grandmother's body fell apart for years before she died, but I took her death -- though I also loved her dearly -- much better because she was able to really talk with me until the end.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I had to write this because I'm not sure this disease is really understood. It gets portrayed in movies as sort of peaceful and sunlit. And it's not.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

I want dignity. If you knew, you could prepare with dignity. If you don't know, that all gets stripped away.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

People think Alzheimer's is this sort of foggy peaceful place, but these people are terrified and angry. They don't know what is happening, they don't know who these people are and why they are touching them and coming into their rooms unannounced and without permission. It's like being constantly violated by strangers who think they have the right to be there. Alzheimer's patients can be violent.

They aren't at peace, Morra. That's why it's so hard.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.

Rita Arens 196 pts

Writing this post kind of wrecked me last night. But I'm glad I did it. Thank you.

Rita Arens authors Surrender Dorothy and is the editor of Sleep is for the Weak. She is BlogHer's assignment and syndication editor.