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5Fifth*****REVISED DRAFT*****
Sweet Memories
My Mother’'s Life Story and tThe Lessons I Learned from Her Journey with Dementia
by
James C. Neville
To: Clair, Alden, Timothy, Tyson, and Brynn
Continue to Grow in God’'s Light.
Love,
Papa
Contents
Acknowledgements
Preface
Introduction
Chapter I: Prayers Answered
Chapter II: From the Woods to the Hood
Chapter III: Looking for aA Dad
Chapter IV: New Opportunities
Chapter V: RESPECT
Chapter VI: Mother Millie
Chapter VII: Getting Understanding
Chapter VIII: Risk Factors
Chapter IX: Psychological vs. Physiological
Chapter X: The Mind, Tthe Body, and Tthe Spirit
Chapter XI: Reversing the Roles
Chapter XII: Behavior Modification
Chapter XIII: Sweet Memories
Chapter XIV: The Helper and Tthe Cussee
Chapter XV: 24/7 Care
Chapter XVI: Acceptance
Chapter XVII: Prevention
Chapter XVIII: Preparing for Your Future
Chapter XIX: Resources
Works Cited
About the Author
Acknowledgements
I want to first thank my Lord and Savior, Jesus Christ, because without Him
this book would not have been possible. I want to thank my mother for raising,
guiding, and protecting me. Her strength, tough -love, and kindness equipped me
and gave me a great foundation for life. I want to thank my wife of 42 forty-two
years, Dinah, who has been by my side every step of the way. I want to thank our
sons, Mel and Tim, for being great husbands, fathers, and dads! And, our
daughter, Bre, for being a great woman of God and for providing her expertise in
designing the cover of this book through her business at
www.BMariePhotog.com. I want to thank my brother, Rick, and his wife, Yvette,
who both co-labored with us throughout our mom’'s journey. I want to thank my
brother, Jack, for moving mom so many times during her lifetime and his wife,
Mae, for all the wonderful meals, chats, on the phone, and all the quality times
you and mom had together. I want to thank our daughters-in-laws, Trishette and
Tierra, for being great moms and virtuous women of God. I want to thank my
sister-in-law, Linda, for being a beautiful, loving wife to my brother, John. I want
to thank my nieces (John’'s daughters), Karla, Dujuana, Myesha, and Mandesha
for being loving and kind and growing up to be strong and beautiful women in the
absence of their father. I want to especially thank Mandesha for visiting her
grandma and giving her that great little dog named Muffin who brought mom so
much joy. I want to thank my niece, Mia, a.k.a. Tinsey, for loving her grandma
more and more. I want to thank my nieces, Crystal and Jasmine, for loving and
looking after their grandma. I want to thank my niece, Toni, and her husband,
Jason, for the joy they brought to their grandma. I want to thank my nephew,
Rasheed, and his wife, Carlita, for all the good and loving times they had with
their grandma. I want to thank my cousin, Audrey, for her beautiful eulogy and
for the love she had for her Aunt Millie. I want to thank my cousin, Dennis, for
planting the grapevine that brought mom so much joy. I want to thank my cousin,
Elaine, and her husband, Bob, for always making mom laugh when they came to
see her. Last, but not least, I want to thank my cousin, Mac, a.k.a. Kelly, who
always found time to visit Mmom during some of her most difficult times.
Preface
My purpose for writing this book is to share my mother’'s story and the
lessons I learned from her transition through the different stages of dementia. In
essence, by reflecting on my mother’'s life and legacy from a Christian
perspective, I use her story to illustrate the different stages of dementia and the
challenges I faced as a caregiver.
While conducting my research for this book, I noted that some of the charts
list the progression of dementia in five stages, i.e., (1) no impairment, (2)
questionable impairment, (3) mild impairment, (4) moderate impairment, and (5)
severe impairment. Other charts, however, list the progression in seven stages.
And, although the five-stage chart accurately describes the stages of dementia,
the seven-stage chart provided a better description of my mother'’s journey
through the final stages of the disease. Hence, the shift from one stage of the
disease to the other towards the end of my mother’'s journey was not as abrupt as
described in the five-stage chart. In other words, it was more gradual over a
longer period of time, especially after my mother was prescribed the drug
Aerosep.
For example, using a dementia rating scale, both the five-stage and seven-
stage models have the same or similar descriptions for stages one through
three. In stage one, there is are no obvious signs of dementia and the person is
deemed normal, i.e., no impairment. In stage two there is are some signs or
symptoms that may be questionable or very mild, however, the symptoms are
normally associated with old age, such as misplacing or forgetting things, but at
some point the person can locate or remember whatever they misplaced or lost.
And, for the most part, the person can still function independently.
However, the signs of dementia becomes more noticeable in the mild
impairment (stage three ). For example, the person begins to get confused
more often while driving, loses things more frequently, start having problems
managing their finances and medication, etc. However, the person can still
perform many activities of daily living without assistance, i.e., eating, getting
dressed, going to the bathroom, etc.
The five-stage and the seven-stage descriptions differ slightly from this
point on., tTherefore, as I stated, the seven- stage description worked better for
me, i.e., the seven-stage concept breaks moderate and severe into two-part
phases. In the moderate (stage four), a person’'s memory and their ability to
negotiate activities of daily living becomes more difficult.: They may forget how
to safely operate and use appliances, such as a microwave or a stove. They may
forget to pay their bills,; may have less memory of recent events,; have problems
counting backwards by a specific number, or they may withdraw from being
around people.
The signs and symptoms of dementia in the moderately severe (stage
five) are very critical and it becomes more apparent that the person needs
assistance to negotiate their activities of daily living. For example, memory loss
increases to the point where a person cannot remember their own address or
phone number or what day and time it is, etc. They may start putting on multiple
layers of clothing or being inappropriately dressed for the occasion or season.
They may also become confused about activities and events. They may also need
assistance using a phone and doing other things they used to do without
assistance.
In the severe stage (stage six), the person needs total assistance with
their activities of daily living, such as assisting them with cleaning themselves
after they use the restroom. This is also the stage where it becomes apparent
that the person cannot live alone or be left unattended in an unsecure dwelling.
Wandering and other safety concerns becomes an issue at this point. The person
may also forget the names of family members, but can recall a familiar face or
person. And, tThey may not know the meaning of time and their behavior and
personality can drastically change. For example, seeing and hearing things that
are not there,; becoming suspicious of people, etc.
The very severe (stage seven) is the final stage of dementia. The
person’'s language skills diminishes to the point where they become incoherent.;
tThey need help eating, they cannot walk or sit without assistance,; unable to hold
their head up or control their movement. This is also the stage where pre-
arranged tube-feeding or other pre-arranged plans are executed, changed, or
modified. For example, tube-feeding is a form of life support. Therefore, the
patient may have instructed his or her wishes through an advance medical
directive as to whether or not they want to be tube-feed at this stage of life.
However, the doctor(s) and family members may discuss or re-consider the tube-
feeding or other options prior to executing any prearranged plans. Hospice care
is also a factor at this point.
When I introduced my mother at the beginning this book, her dementia iwas
already in stage six, i.e., her condition was severe. From there, I reflected back
over her life beginning when she had no impairment. Then I examined her
lifespan and her legacy to see if there were any connections between her risk
factors, life experiences, and the onset of dementia.
I also discussed the new discoveries regarding the causes and the
prevention of dementia and Alzheimer’'s. However, due to the narrow scope of
my research and the constant advances in the field of medicine, this book is not
intended to be an authority on these diseases. Therefore, the main goal of this
book is to promote awareness by sharing information about dementia and
Alzheimer'’s combined with the lessons I learned from caring for my mother.
This book also addresses some of the signs and symptoms of dementia and
concludes that diet, exercise, and other life-style changes can prevent or slow the
progression of dementia, especially in the areas of early detection and treatment.
And, based on the information I found, the prospective on prevention looks
promising. I also included a list of helpful dementia and Alzheimer’'s resources as
well as other information to assist the reader.
My sources of information include the Journal of the American Geriatrics
Society,; Journal of Alzheimer’'s Disease,; and Nursing and Health Sciences, as
well as several other publications.
Introduction
While sitting next to her during one of my daily visits to the nursing facility,
my mother stared at me unlike any time in the past. Her eyes pierced me. Then
she motioned me with her right hand and whispered, “"Come here. Come here,
Sug.”" I was already sitting close to her, so I leaned over and got closer. With a
gleam in her eyes, she smiled and said in a soft tone, "“I love you. I love you,
Sug.”" As tears began to swell in my eyes, I hugged her tight and kissed her on
her the forehead and said, "“I love you too, mMom.”."
This was indeed an unexpected event because prior to that moment, mMom
had not spoken much in several weeks. a And when she did speak, her words did
not make much sense. Therefore, that moment gave me hope that the mom I
once knew was still with us. I was also very thankful that mMom’'s loving,
“"social butterfly”" spirit was still intact, a. At least for the most part. I say this
because, after mMom’'s dementia diagnosis several years earlier, I found it
difficult to accept the changes that were taking place in her. And, although
mMom was aware of the inevitable, she never wavered in her faith and she
thanked God every day for His grace and mercy.
In retrospect, I truly believe that my mother, through her faith, prayers, and
obedience to God, allowed His angels to perform their assignments in a mighty
way! For example, her favorite scripture was Psalm 23, which she lived by.
Therefore, she walked in the path of righteousness. She feared no evil. And she
surely believed that God’'s "“goodness and mercy”" would follow her all the days
of her life. Most of all, she believed that she would “"dwell in the house of the
Lord forever." .”
This is her story, her legacy, and her journey through the different stages of
dementia and the challenges I faced as a caregiver.
I:
Prayers Answered
My mother always prayed since the time I can remember. Therefore, it was
normal for me to see her on her knees both day and night, praying to the Lord.
Mom not only prayed during the dark days of her life, she also prayed and
thanked God during the good times in her life. And, I know for a fact that her
prayers were answered.: Like the time when my brother, Larry, who had suffered
from epileptic seizures since his childhood, was drafted and subsequently sent to
Vietnam despite our pleas to the draft board.
Mom’'s prayers not only kept Larry safe in Vietnam, her prayers also kept
him safe after he returned home and was attacked by several police officers who
thought he had drugs in his briefcase. Larry did not have any drugs in his
briefcase. He only had the eight-track tapes that he played in his car. The police
arrested him anyway and charged him with assault and battery of a police officer.
The charges were later dismissed after it was learned that, during the melee of
Larry’'s arrest, the assaulted officer’'s teeth got knocked out by his own partner
who accidently hit him in the mouth with his club.
My mother also prayed for me, and I’'m glad she did. For one, I knew about
God, but I did not have a relationship with Him through His son, Jesus Christ. In
other words, I was not saved at the time. Therefore, while growing up in Jersey
City, I engaged in some activities that were contrary to the will of God and the
plans He had for my life. As a result, some of these activities almost got me
killed. For example, when I was nine years old, my brother, Larry, and a few
more kids in our neighborhood found out that the white kids from the other side
of town had hid some of the goods they stole from a freight train. Therefore, we
conspired to steal their stash. And, since I was the smallest, my job was to be the
lookout.
We went to the location and searched along the railroad tracks and did not
find anything. We kept going further and further down the tracks and just as we
got close to a tunnel, a white railroad police officer jumped out of the tunnel and
started shooting at us. We ran for our lives as the bullets flew by us. I ran so
fast, I thought I was flying because I did not feel my feet touch the ground when I
descended down a hill. Thank God none of us got shot and I truly believe that it
was my mother’'s prayers that saved my life.
My mother’'s prayers also helped me on another occasion when I became a
victim of a mugging while we were living in Montgomery Housing Projects in
Jersey City.: It was a Friday evening and I had just picked up my pay from my job
at the local Shop-Rite Supermarket. I worked in the produce department after
school. And, to make matters worse, I had worked some extra hours that week
and my paycheck, which I had already cashed, was a little bit more than usual.
I went back to the projects and I was waiting for the elevator when a guy
named Ernie approached me and asked me if I wanted to buy some weed. I found
it odd for him to ask me something like that because I only knew him from a
distance. In other words, he was someone I chose not to associate with. But,
before I could say no thanks, someone grabbed me from behind and pressed a
big, long, shinny knife to my throat.
Using my peripheral vision and voice recognition, I realized that the mugger
was the infamous drug addict known as the "“Funky Junkie.”" Hence, whereas
some drug addicts were described as having a "“monkey on their back.”" He had
a “"gorilla on his back”" due to his enormous drug habit. And, as a result of his
addiction, he terrorized the projects on a regular basis where he was known to
cut or stab his victims and Ernie was his accomplice.
Thank God I had enough sense to give them my money instead of getting my
throat slashed. I thanked God for the police who later arrested them after I
pressed charges. I thanked God for the jury that eventually convicted them. I
also thanked God for being drafted because I went into the military shortly after I
testified against them idiots. Most of all, I thanked God for my mother’'s prayers!
There were many other accounts of my mother’'s prayers being answered.
And, although my brothers and I did not have a personal relationship with God
while we were growing up in Jersey City, we knew that God was real and He
answered prayer.. However, as Rick and I got older, we developed our own
relationships with God through His son, Jesus Christ. Therefore, we prayed for
our mom after her dementia diagnosis and we continued to believe God for her
healing even after she started forgetting our names. Hence, mom’'s decline did
not get us down or dampen our faith because she continued to use her humor and
loving personality to amaze us. Like the time when my oldest brother, Jack, who
mMom had not seen for a while, came to visit her. I asked her did she know who
he was. She looked at Jack and grinned and said, "“Of course, I do.: He’'s the one
who named himself.”" We could not help but laugh and hug her at the same time.
Mom always had a way of saying things and it was incidents like this that
took the sting out of the reality of her disease . For example, we had a childhood
friend who we nicknamed “"Shoes”" due to the size of his feet. As time went on,
mMom started calling him “"Foots”" instead of "“Shoes.”" She would say, "“I saw
Foots today.”" At first, we didn’'t know who she was talking about until we later
made the connection. And, since “"Foots”" sounded funnier than "“Shoes,”" we
also started calling our friend "“Foots.”"
When the effects of mMom’'s dementia started creeping into our livfes, we
slowly began to see the changes as they blended with her personality. Therefore,
we cherished each day. We laughed and we sang and we did as many things that
we could do together, including taking daily walks and reminiscing on the days
gone by, which caused me to appreciate my mother’'s life and legacy more and
more.
II:
From the Woods to Hood
Mom was a strong, hardworking, God-fearing woman who was born Millie
McDonald Harvey in Enfield, North Carolina on May 10, 1927. She only had a 9th
ninth grade education, but it did not stop her from seeking and achieving a better
life for herself and her children. Most of all, she never gave up even when the
odds were against her, including the effects of a failed marriage.
In 1957, due to the lack of opportunity in the segregated South, mMom
briefly left me and my four brothers with our maternal grandmother while she
went to New York to find work. It did not take mMom long to find a job. She
returned to North Carolina the following year and moved us to New York.
It was one of the happiest days of our lives when mMom came back and got
us. We were also happy to meet her new boyfriend, Al Thompson, whom she had
met in New York. And, although our grandma, who was part Cherokee Indian,
was mean to us at times, we loved her and we were sad about leaving her alone.
While on the other hand, we were not sad about leaving the crowded conditions of
her one-room shack where there was no indoor-plumbing. And we definitely were
not going to miss those long cold walks to the outhouse in the middle of the
winter.
We also knew that gGrandma loved us and that she would miss us too.
Grandpa had died four years earlier, therefore gGrandma welcomed our company
and the time we spent with her drew us closer together. For example, Jack, Tom,
and John slept in one bed while Larry and I alternated between sleeping with
gGrandma and sleeping on the floor. Sometimes gGrandma would ask me to
scratch her back when I slept with her at night. She would say, "“Right there.
Right there . . . Ahhhhhhh . . ."” However,, the greatest thing about all of this was:
Wwe were poor, but we did not know what poor was.; tTherefore, we were
grateful for everything we got, including the clothes our mother made for us out
of rags and other discarded material such as flour bags and potato sacks..
We were also grateful for the Argo laundry starch and the red clay dirt we
used to eat.: One time, Larry ate so much clay dirt he ended up being constipated
for almost two weeks. And, although we had some bad times while staying with
gGrandma, we also had some good times too. Like the times Larry and I
accompanied our older brothers to the creek where we skinny -dipped and swung
butt -naked on vines and hollered like Tarzan before we jumped into the water.
On another occasion, we were sitting inside gGrandma’'s shack with
nothing to eat. And, just when we went to go outside to look for some berries, a
big black crow flew over Ggrandma’'s shack. My brother, Tom, immediately
picked up a stick, and threw it, and knocked that bird out the sky. We took the
crow inside where gGrandma quickly cleaned and cooked it. Grandma also baked
some biscuits and made some gravy. And, about two hours later, we all sat
around gGrandma’'s table and thanked the Lord for our meal, which was mighty
tasty.
Larry and I did not attend school regularly during our time in North
Carolina because most of the time, we literally did not have anything to wear,;
especially shoes. But, on the days we attended school, we were glad to go
because we would get a free pint of milk or a juice drink. Larry and I would put
on whatever clothes we could find, which were mostly hand-me-downs. And,
when gGrandma had it, she would usually put a biscuit or some cornbread in our
lunch bag. And, every now and then, gGrandma would also put a piece of fatback
or an apple in our bag, which sometimes got eaten or traded before we got to the
bus stop.
On the downside, the segregated schools we attended were supplied with
outdated, hand-me-down text books from the white schools. Furthermore, the
classrooms were extremely cold during the winter time due to a lack of fuel or a
broken furnace. Therefore, I was very happy to leave North Carolina. And,
although gGrandma was rough on us, she did her job well with the resources she
had. As a result, none of us were jailed or kidnapped or lynched for violating the
Jim Crow Laws during our stay with gGrandma, which was the order of the day
during those times in the states below the Mason Dixie Line. Therefore, black
mothers and grandmothers were often rough on their children in order to keep
them from being a victim of the aforementioned consequences for violating the
Jim Crow Laws. In other words, black folks in the South had to "“stay in their
place”." Oor else!
We left North Carolina in April 1958. I tried to stay awake during the entire
trip to New York but, I fell asleep before we arrived. When I woke up, we were
driving through New York City. It was around noon time and one of the first
things I saw was a black boy and a white boy playing together, which both
shocked and frightened me. I was sitting in the front seat between mMom and Al.
I grabbed my mother’'s arm and exclaimed, "“Ma, are blacks and whites friends
up here?!?”" Mom looked at me, and smiled, and she assured me that it was
okay for black children and white children to play together in New York.
Mom had a nice apartment waiting for us in Brooklyn, New York. She
wanted us to have a decent place to live;. uUnfortunately, moving five country
boys into a nice apartment building without any formal training or adjustment to
city life, did not turn out well. For example, while mom was at work, we played in
the elevators,; we ran up and down the fire escape, and swung on the ladder and
hollered like Tarzan, just to name a few of the things we did. The landlord and
our neighbors soon had enough of our country ways and we got evicted within a
few months after we moved to New York.
Although we put mMom through some challenging times, she never gave up
on us and she always tried to find us a better place to live. However, due to her
financial situation at the time of our eviction, we ended up in a ghetto in Jersey
City, New Jersey, which was totally different from the nice neighborhood we had
in Brooklyn. For example, one of the first things I witnessed in Jersey City was a
fight between two winos who almost cut each other to death in broad daylight
after arguing over a bottle of wine. Blood was everywhere. And, the crowd that
had gathered, egged the men on; especially after the victim wrestled the butcher
knife away from his attacker and exclaimed,: "“Now it’'s my turn!”" Thank God
the police and an ambulance arrived before the men bled to death.
III:
Looking for aA Dad
Mom eventually found us a house in a better part of Jersey City. And, as we
moved from place to place, we became acquainted with the different men mmom
brought into of lives. However, long before mMom was diagnosed with dementia,
I asked her about the different men in her life. I also asked her why did she
marry she married my father who ended up being an alcoholic and a deadbeat
dad. She said it all began when she was in the 10tenth grade. World War II had
just broken out and she thought the war would "“kill up all the men.”" As a result,
she fell in love with a young man named, Pete Hawkins. However, Pete skipped
out on her after she became pregnant with my brother Jack.
My mother said that she later found out that Pete went into the aArmy
without telling her or writing her and that was when my father, Johnny Neville,
came along. She thought that Johnny would be a good husband for her and a
great dad for Jack. Unfortunately, due of my father’'s drinking habits and lack of
financial support, the marriage was a failure from the start. Nevertheless, Mmom
said that she tried to make it work. And, although they had several arguments
and fights, they would make up and get back together and have another child.
My mother further stated that she and my father even tried farming together
without success, which had a lot to do with my father’'s drinking habits and lack
of support.
I was 18eighteen months old and the youngest out of five boys when my
mother and father finally broke up in 1954. My mother stated that most of the
men that we met after her and my father separated were just friends. She further
stated that some of those friendships grew into deeper relationships because she
was trying to find us a dad. In other words, she wanted us to experience a
relationship that only a dad could provide. And, at one point, we thought mMom
had found us a dad when Al came along. For example, we started seeing Al on a
regular basis after we moved to Jersey City. Mom would fix him dinner and
sometimes I would shine his shoes and he would give me 25 twenty-five to fifty50
cents. Al also took us on family outings to the beaches and the amusement parks.
And, perhaps because I was the youngest and the smallest, Al and I immediately
connected and he started calling me Peewee.
Al or Big Al, as some called him, was a truck driver who delivered
mattresses for the Crown Mattress Company in New York. He eventually took me
with him on some of his deliveries in the different parts of New York. I was seven
years old and I not only enjoyed riding in Al’'s truck, I also admired Al because he
was big and strong. As a result, I often bragged to some of my friends about how
strong Al was after seeing him carrying mattresses and box springs up the flights
of stairs by himself. Therefore, I wanted to be big and strong like Big Al..
A few years later, our brother, Rick, was born. However, instead of Al being
a full -time dad to Rick and the rest of us, he turned out to be a two-timer. In
other words, Al believed in sowing his seeds in more than one place and mMom
eventually broke up with Al him after she found out about his double- life.
Therefore, aAs a result of my father’'s short-comings and the lack of commitment
on the part of the other men in her life, mMom was the only dad we ever knew.
Mom not only taught us how to cook, clean, and sew, she also taught us how
to drive cars and trucks , including the ones with the manual (stick-shift)
transmissions. And, when it came to cleaning and doing chores around the house,
Mmom was like a drill sergeant who did not allow us to cut corners. Whether it
was washing dishes, scrubbing or cleaning baseboards, walls, floors, and carpets,
mMom made sure we completed each task well. Therefore, no matter where
lived and regardless to the condition of the dwelling, mMom made sure our home
was clean and tidy where the fresh smell of pine or lemon was pretty much the
standard on Saturday mornings.
Not only did I carry these standards into my adulthood, I also learned the
value of teamwork early in life as a result of mMom’'s efforts. For example, by
the time I was four years old, I already knew how to peel potatoes, tie tobacco
stalks, and pick cotton. This was because we often assisted mMom with her tasks
at the different farms and restaurants she worked at in North Carolina. One
time, I peeled so many potatoes, I did not want to ever see another potato again
in my life.
Mom also did not raise any of her sons to be lazy or less than a man. For
example, all of us learned to how to work and earn a living. As a result, I started
my first business when I was seven -years old. It was a shoeshine business and I
was the sole proprietor. I made a shoeshine box out some discarded wood and
purchased my supplies, i.e., shoe polish, rags, and brushes, out of the money I had
saved from running errands or carrying groceries for people in the neighborhood.
It took me no time to start making money. For example, by charging 15
fifteen to 25 twenty-five cents per customer, I learned how to pop my rag and
make shoes shine like glass in less than two minutes, which earned me tips as
much as a dollar per customer. Sometimes I would team -up with and my same
aged friend named Joseph "“Jo Jo”" Menter and we would shine shoes in the local
bars and on street corners where the majority of our customers were white
middle-aged men who all treated us well.
IV:
New Opportunities
After we moved to New Jersey, mMom sometimes worked two to three jobs
in both the garment and restaurant industries where she sewed and cooked
respectively for many years. However, mMom always looked for new
opportunities and ways to improve herself. As a result, in 1974, mMom enrolled
into a Job Corps training program and became one of the first women to be
trained and hired by the Bethlehem Steel Ship Building Division in Hoboken New
Jersey where she performed jobs that were traditionally done by men.
In 1977, mMom was quoted in the Sunday Star-Ledger after she was
interviewed by a reporter who asked her how she felt about her job as a rigger,
i.e., tying hitches to cranes, carrying 40 forty pounds of chain-fall, and signaling
to crane operators to hoist their hauls: . "“It’'s more important to keep warm on
the docks than it is to look attractive. ..Sometimes the men look at me like I’'m
crazy when they see me carrying the chain-fall or eight-foot planks, but I’'m
physically fit to do the work. aAnd the more I do it, the easier it gets.”" (Zepka,
1977, p. 2).
After leaving Bethlehem Steel in 1984, Mmom became a school bus driver
for Jersey City Public Schools. She also baked biscuits in the early morning hours
at a McDonald’'s restaurants while working other jobs. At McDonald’'s, mMom
earned a reputation at the store she worked at and rightfully so., aAfter all, her
middle name was "“McDonald"” and she wanted everyone to know it. The
customers loved her and they would tell my brother, Rick, who was the store
manager, that mMom’'s biscuits were just like the ones their mothers used to
bake.
Mom also enjoyed driving the school bus just as much as she enjoyed baking
biscuits. However, I believe she enjoyed driving the school a little bit more
because she really loved the children and treated them just like they were her
own. And, the children knew that she loved them too. But, they also knew not to
act up on her bus because all she had to do was look at them and they would
straighten up.
My mother was also a master gardener whose plants and flowers brought
joy and hope to an inner city neighborhood that was plagued by crime and blight.
In 1990, for example, her garden drew the attention of The Jersey Journey
newspaper and she was featured in an article titled "“Reaping benefits.”" The
article high-lighted her efforts in transforming a vacant, weed-filled, space in the
Lafayette Gardens Housing Project into a fresh -food resource that produced
peppers, cabbage, squash, tomatoes, and cucumbers, which she shared with her
neighbors (Milian, 1990, p. 13).
1942 1957
Mom and Family Standing Next to Papa’'s 1931 Ford Model A
"“Boys in the Woods”" (Enfield, NC)Left to Right: Niece, Ernestine Snead (Aage 12); Father (Papa), Alexander
Clockwise: Jack (Aage 13), John (Aage 9),Harvey (Aage 61), Mother, Malvina Harvey (Aage 55) & Mom (Aage 15)
James (Aage 5), Larry (Aage 7) & Tom (Aage 11)
1978
Mom (Aage 51) & Fellow Workers at Bethlehem Steel Ship Building Division in Hoboken, NJ
1965 1971
"“Boys in the Hood”" (Jersey City, NJ) Clockwise: Larry
Returns Home from Vietnam Jack (Aage 21), John (Aage 17), James (Aage 13),
Clockwise: James (Aage 19), Larry (Aage 21) Larry (aAge 15), Tom (Aage 19) &and Rick (Aage 2) Rick
(Aage 8) & Mom (Age Aage 44)
V:
RESPECT
I learned early in life not to disrespect my mother. One of the reasons I
learned early resulted from my mother working so much that she did not have a
lot of time to talk about things, not to mention what type of day she may have had
herself. Therefore, if we did something wrong, she often dealt out the
punishment and talked later. And, because we were boys, she often used just
about anything she got her hands on to keep us in line, including belts, sticks, and
extension cords, just to name a few. For example, I remembered when my
brother, Larry, and I were in North Carolina. He was about five years old and I
was about three years old. I was following behind Larry when we decided to play
on a neighbor’'s car while mMom was at work. I don’'t know what made us do it,
but we were having a great time throwing sand on our neighbor’'s car and sliding
down it like a sliding board.
We continued playing on the car until mMom showed up and summoned us
into the house. First of all, we were not supposed to be out of the house. Mom
tore our butts up and we never played on another car again and we never left the
house without her permission. The same thing was true with my brother, Rick,
who wandered away from home at age two.: After Rick was found safe and
returned home by some one people in another neighborhood, mMom first made
sure Rick was all right. She hugged him and kissed him. She cleaned him up and
feed him a nice meal with some dessert. Then she whipped his little butt with a
belt and he never wandered away from home again.
Mom did not care how old you got.: If you were out of line, she whipped
your butt. Like the time I decided to celebrate my graduation from grammar
school, which is considered middle school today. I was thirteen13 years old and
we were living in the Montgomery Housing Projects. Me and a couple of my
friends chipped in our money and we got an older guy to purchase some alcoholic
beverages for us. After we got the alcohol, we gathered near an underpass
where we drank beer, wine, and liquor and smoked cigarettes. We entertained
ourselves with some dirty jokes and we even tried singing some of the popular
Motown songs, like “"My Girl,”" and “"Ooh Baby, Baby.”" Instead of sounding like
the Temptations or Smokey Robinson, we sounded more like a pack of sick
puppies. I was having a great time until my head started spinning,; then all I
wanted to do was go home and lay down.
I left the gathering and staggered home with hopes that my mother was
asleep. The elevators were broken so I had to walk up seven flights of stairs,
which seemed to shift from side to side, just like the ones in the funhouses at the
carnivals., bBut there was nothing funny about this situation. When I finally
arrived at our apartment, I had a hard time getting my key into the lock because
the keyhole seemed to spin around and around. And, because I did not want to
make any noise, the ordeal seemed endless. I don’'t know how long it took, but I
finally got my key into the lock. At last, I unlocked the door and slowly opened it.
I smiled because the lights were off.
I eased my way into our apartment and just as when I was about to close
the door, mMom flicked on the lights from her position behind the door. Without
saying a word or asking me any questions,; mMom took her shoe and whacked me
several times on my head, arms, and shoulders. I saw stars just like the ones in
the cartoons. From the force behind her licks, I could tell mMom was very
disappointed with me., pPerhaps she had a flashback from her experiences with
my father. Nevertheless, she scolded me and whacked me several more times..
I didn’'t have a chance to say anything nor was there much for me to say
because the alcohol on my breath and me coming home late said it all. Thank
goodness this type of punishment is not condoned today. However, on the other
hand, I believe mMom did the best that she could do under the circumstances
with great success, i.e., I did not become an alcoholic or a deadbeat dad like my
father. I also thank God for giving me the wisdom not to repeat the cycle of abuse
that was passed down from my grandmother to my mother to me as a result of
slavery and ignorance.
Mom was also very protective of her children and she did not allow anyone
to exploit us in any way. For example, an incident happened when we were living
in North Carolina.: After our mother and father separated, mMom rented a house
from a white man. We had not been there long. However, all hell broke loose
when mMom came home from work one day and discovered that the white man
had us doing yard work for him in the hot sun without her permission.
Mom was furious.: She jumped out of her car and looked at us and shouted,
“"Get in the house!”" Then she marched up to the white man and told him that
she did not recall him having any black children. The man was speechless
because Mmom was boiling mad. Mom told the man that we would be out of his
house before sundown the next day, which we did.
Mom did not allow the men in her life to disrespect her either. For
example, she got into a relationship and eventually married a guy she met at work
named Willie Evans who came along when we were still living in the Montgomery
Projects. Prior to Willie’'s arrival, my father, who remained absent from us, died a
couple years earlier from cirrhosis of the liver at the age of 48forty-eight. Jack
was married and living with his wife, Mae. Tom was in the Air Force stationed in
Panama. John was station with the Marines in California and Larry was in
Vietnam. As result, Rick and I were the only ones living with mMom when Willie
came on the scene. I was about 17 seventeen years old and Rick was about six
years old. And, if we had a sister named Thelma, our family structure would have
been similar to the Evans family on Good Times. However, we had more "“bad
times"” than “"good times”" after Willie came into our lives.
I was working after school and I was pretty much the man of house when
Willie knocked on our door and asked to see our mom. I did not want him to come
into our apartment because I could tell from the start that he was no good. But,
for some reasons, mMom loved herself some Willie who also smoked and drank,
which was totally contrary to hermom's beliefs and habits. I guess Mmom
thought that she could change Willie even after her supervisor at work told her
that Willie was no good and advised her to stay away from him.
Willie told lies from the start and I will never forget the first lie he told me
after I had asked him where did he geot the scars he had on the side of his neck.
Willie looked at me with his red eyes and told me he got the scars in a battle
during the Korean War. Then he lit a cigarette and took a long drag and slowly
blew out the smoke and said that he was assigned to the 82nd eighty-second
Airborne when he and his unit of 200 two hundred men parachuted into enemy
territory. He went on to say that most of the men in his unit got shot and killed
before they landed. However, he and about 20 twenty other soldiers landed
safely.
Willie further stated that he was seriously wounded after he engaged in
hand-to-hand combat with the enemy. And, while holding his cigarette between
his lips, Willie lifted his shirt and pointed to a wound on his stomach and a wound
on his back stating that the Korean soldier he was fighting, stuck a bayonet in his
stomach and the blade came out through his back. However, he used his knife to
stab the enemy soldier to death. Willie concluded the story by saying that after
he was airlifted off the battle field, he spent 24 twenty-four months laying laid flat
on his back in the vVeterans’ hospital where he recovered from his wounds.
Wow! What a story! And I believed him! However, we found out later that
Willie, who used to wear a lot of army shirts and jackets, never served in the
army. We also found out that he got the wounds from a man who beat the snot
out of him after he caught him fooling around with his wife.
Not only did Willie lie to us. He also stole from us. For example, I was
playing in a band that me and a couple of my friends had formed in the projects.
The name of the band was Sam and the Whole Notes. The band was named after
Sam because he was the drummer and his beats were real funky.; tTherefore, the
band evolved around him. I sometimes played the bongos and the tambourine.
However, my dream was to play the keyboard. Therefore, I was working and
saving my money, which I gave to my mother to hold for me. I had saved about
$400four hundred dollars, however, the money disappeared around the same time
Willie showed up. And, to this day, I don’'t know if Willie sweet -talked my mother
out of the money or if he just outright stole it. All I know is that, mom could not
tell me what happened to the money.
I wasn’'t Willie’'s only victim.: Larry had brought himself a car shortly after
he returned from Vietnam. Somehow another, Larry allowed Willie to borrow his
car. Willie got drunk and wrecked Larry’'s car and left the scene of the accident.
Willie stumbled home and told Larry that his car was wrapped around a telephone
pole in another part of town. Thank God Larry wasn’'t a violent person because I
don’'t know what someone else, including myself, would have done to Willie in
that situation.
If it wasn’'t one thing with Willie, it was another. Like the time Willie got
arrested for walking down the street with a rifle he had found. Adding to our
woes, Willie wasn’'t working and mom used her hard earned money to bail him
out of jail.
Mom and Willie continued their relationship long after I received my draft
notice and subsequently went into the military. Unfortunately, Mmom had to find
out for herself what we had been telling her all along about Willie. I was in the
Air Force and stationed in West Germany when mMom and Willie finally broke up.
And, as the story went, Willie showed mMom his true self after she came home
early from work one day and caught him in bed with another woman. Mom was
livid.: She ordered the woman to leave and the woman ran out of the house “"half
-naked.”" Willie, who knew he was in trouble, tried to sweet talk mMom while
attempting to put on his clothes. But mMom wasn’'t having it.
Still in shape from working in the shipyard, mMom pushed Willie out of the
house, and tossed him down a flight of stairs, and threw his clothes behind him.
Willie landed at the bottom of the stairs and before he could get to his feet or
grab his clothes, mMom jumped on top of him and "“worked him over.”" Willie
screamed and begged for his life but mMom would not stop. Fortunately for
Willie, some of mMom’'s neighbors intervened and she eventually stopped her
assault. Willie quickly picked- up his clothes and ran out of the house and never
showed his face again.
This incident was definitely bad,; however, I thank God it did not turn out
any worse. And, I cannot leave this incident without answering the following
questions.s: (1) Did my mother snap or lose her mind? Answer: Yes, she did. (2)
Did it contribute to the onset of dementia later in her life?. Answer: I do not
know, but when you add these incidents to other negative life experiences, it can
contribute to the onset of many illnesses, including dementia. (3) Was my mother
hurt and angry as a result of this incident and did she allow the hurt and anger to
dominate the rest of her life? Answer: My mother was very hurt and very angry,;
however, as a result of her relationship with Jesus Christ, she did not allow the
hurt and anger to dominate her life. (4) Did God forgive my mother after she
came to her senses and asked God to forgive her? Answer: Absolutely! And,
what about Willie? If he had confessed his sins, did God forgive Willie too?
Absolutely! For the Bible says in 1 John 1:9 (NKJV), "“If we confess our sins, He is
faithful and just to forgive us our sins and to cleanse us from all
unrighteousness.”" Lastly,: (5) dDid my mother forgive Willie? Answer:
Absolutely! Jesus said in Luke 6:37 (NKJV), “"Forgive, and you will be forgiven.”"
VI:
Mother Millie
An unknown author once said, "“A man’'s work is from sun to sun, but a
mother’'s work is never done.”" My mother was the epitome of that statement.
Hence, mMom divorced Willie in 1984 and moved on with her life. However,
seven years later, mMom decided to give love another try after she met a widower
named Benjamin (Benny) Torres who happened to be Puerto Rican. They both
lived in the same neighborhood where they eventually became acquainted. Mom
said that she was impressed by the way Benny cared offor his disabled adult
stepson, George (Georgy) Grayson, whose mother had died several years earlier.
Mom and Benny eventually stated dating. And, after almost two years, they
got married in 1991. It met with Benny several times before they were married
because I did not want my mother to get hurt again nor did I want her to
experience anymore domestic violence. Benny turned out to be a nice guy. We
also met his children who lived in New York. They were nice as well, especially
his daughter, Velma. Most of all, Benny and mMom loved each other and mMom
also wanted to help Georgy who could not speak and was very limited with his
sign language.
In 1992, mMom, Benny, and Georgy moved to Richmond, Virginia, and
settled. They moved into a "“fixer-up house"” in the city and they were happy
until my brother, Larry, moved in with them. Larry had been suffering from
undiagnosed and untreated Post Traumatic Stressyndrome Disorder (PTSD) since
his return from Vietnam in 1971, which was compounded by the aforementioned
police brutality incident. However, PTSD had not been identified or recognized
like it is today.; tTherefore, thousands of Vietnam Veterans, like Larry, went
untreated for many years. Larry had also been exposed to Agent Orange during
his tour in Vietnam, which may have caused other medical problems as well.
Mom and other family members, including myself, tried to help Larry.
However, the only thing we knew at the time was, Larry was not the same after
he came home from Vietnam. For example, prior to being drafted, Larry, without
any formal training, was gifted in the area of fixing electronics, especially radios
and televisions. He also owned a repair shop and he had a job at the General
Electric Company. Furthermore, Larry was well-known in the community where
people called him “"The TV Man.”" However, after Larry returned from Vietnam,
he started drinking excessively, mainly wine. Therefore, as a result of his
drinking, Larry could not keep a job and he did not return to fixing televisions and
radios on a regular basis. And, just like our father, Larry became an alcoholic and
a deadbeat dad.
Mom and I talked to Larry after she moved to Richmond. Larry agreed to
come to Richmond to get help at the VA Hospital. This was nothing new because
mMom and other family members took Larry in over the years and, as long as
Larry wasn’'t drinking, he was as gentle as a lamb. But, the moment he took one
sip of alcohol, he was the “"devil untied"” as my mother used to say.
We all loved Larry, but we could not tolerate his behavior and it caused our
mother a lot of grief and pain. To make matters worse, Larry was inconsistent
with his treatment at the VA Hospital and he also rejected the gospel of Jesus
Christ. Therefore, it created problems between mMom and Benny. Larry
eventually moved back to Jersey City, but mMom and Benny’'s relationship had
already soured due to their financial problems and Larry’'s situation. However,
one of the good things that came out of the relationship was the much needed
help mMom found for Georgy in Richmond, which allowed him to live and
function more independently. Nevertheless, Mom and Benny eventually divorced
and Mmom moved back to Jersey City in 1993.
Moving was another one of mom’'s traits. Hence, she would move in a
heartbeat if things or circumstances were not right or if she could do better. As a
matter of fact, mMom moved about ten times before I was born and many more
times after that. She moved so many times during her lifetime, it became her
"“second nature,”" which continued into the later years of her life. For example,
in 1997 at the age of 70seventy, mMom drove from New Jersey to California to
assist my brother, Rick, and his wife, Yvette, who was pregnant with their
daughter, Jasmine. Larry also relocated to California and moved in with mMom
after she got settled.
While in California, mMom restarted the process of getting help for Larry.
aAnd, as a result, she was able to get Larry connected with the VA in Oakland,
California. And, while also seeking to improve herself, mMom completed a Home
Health Care Training Program and became a certified Home Health Care Worker.
She also became an active member of Golden Hills Community Church in Antioch,
California where she participated in both the children and outreach ministries.
I was living in Virginia during the time mMom was in California. We talked
on the telephone regularly and she would tell me how much she loved California.
She was very happy and she told me about all the new friends she made and I was
very happy about her new experiences. Unfortunately, our happiness was cut -
short in 1999 after my brother, Tom, aged 53fifty-three, died from cancer of the
esophagus, which was the result of his many years of smoking and drinking.
Tom and his wife, Anne, and their daughter , Yazmenda (Yazy), had moved
from Jersey City to Crescent City, Florida a few years earlier. However, Tom, like
our father, struggled with alcohol addiction after he was honorablye discharged
from the military. In other words, Tom was not an alcoholic when he went into
the military, but he was one when he got out of the military. Furthermore, Tom
had served in the Air Force during the Vietnam War.; hHowever, he did not go to
Vietnam. But, like our brother, Larry, Tom also suffered from undiagnosed and
untreated PTSD. And, like Larry, Tom self-medicated himself with alcohol on a
regular basis after he was discharged from the Air Force 28 twenty-eight years
earlier.
On one of my many visits with Tom, I asked him what made him drink so
much and when did he start drinking. Tom, who served as a fireman in the Air
Force, stated that his unit responded to a plane crash and he started drinking
after he fought the fire. He further stated that while he was fighting the fire, his
foot slipped on a helmet and when he picked the helmet up to move it out of his
way, the pilot’'s head fell out the helmet and landed at his feet.
Tom stated he had nightmares after the incident and he subsequently
started drinking. Nevertheless, I pleaded with Tom on many occasions to get
some help. And, on one occasion, I angrily took Tom’'s liquor bottle and smashed
it against a wall outside his apartment building and I told him that if he did not
stop drinking, he was going to end up just like our father! Tom’'s response was,
“"So,, you got to die from something.”" Then he went to the store purchased
another bottle of liquor.
Mom did not attend Tom’'s funeral because, a few weeks before Tom
passed away; mMom flew from California to Florida to spend time with Tom while
he was in the hospital. Larry did not come to the funeral either., hHowever, Rick,
Jack, and I attended Tom’'s funeral. We were sad, but we were also glad to see
each other again.
After Tom's death, mMom picked- up where she had left off. And two years
later, mMom met and later married the love of her life, Andy Patrick, a disabled
veteran who happened to be Irish. Ironically, they married on September 11,
2001, which is also known as 9/11. Mom was 74 seventy-four years old and Andy
was 82eighty-two.
Again, never to stay in one spot too long,; in 2002 at the age of 75seventy-
five, mMom left California and drove herself and Andy to Virginia and settled.
Larry stayed in California where he had received some help from the VA
regarding his PTSD. He also eventually stopped drinking. However, Larry chose
to live among the homeless population where he earned a reputation for helping
others.
Mom was very happy and excited about her new life with Andy.;
uUnfortunately, her new life with Andy was short-lived.: Andy passed away on
August 31, 2003, which became a major turning point in mMom’'s life and the
effects of her grief and loneliness were visible. This was understandable because
mMom loved Andy and she cared for him during his battle with chronic
obstructive pulmonary disease also known as COPD. Hence, she took him to his
appointments at the VA hospital and she cared for him in their home and
remained by his side until he passed away.
Although mMom took Andy’'s death pretty hard, she picked herself up and
made progress in other areas of her life. For example, after Andy passed away,
mMom moved out of the home they had shared and found herself a place in a
senior citizens’ complex. She also became an active member of Faith and Family
Church located in North Chesterfield, Virginia, where Pastor Calvin Duncan and
First Lady Barbara Duncan affectionately called her "“Mother Millie.”"
Mom’'s prayers and efforts in helping Larry when she was in California also
began to pay off.: In 2006, Larry celebrated seven years of sobriety and he was
the subject of an East Bay Times news article titled, "“Homeless mMan cCleans
uUp cCommunity.”" The article noted his services to both the community and the
homeless population, e.g., picking up trash, recycling cans and bottles, and
providing food to the homeless. The reporter asked him about the amount of
money he makes from recycling,; Larry responded, "“I don’'t do it for the amount I
make... I do it because it’'s one of my citizen’'s job.”" (Krupp, 2006, p. 3).
Larry further told the reporter that he came to California to get away from the
alcoholic lifestyle he had in New Jersey.
In addition to helping Larry and other family members, mMom continued
doing things to help Rick and meI out, such as putting Jasmine on the school bus
in the morning and/or meeting Jasmine at the bus stop after school and making
sure she ate and did her homework. She also helped our daughter, Bre, by taking
her to or picking her up from her basketball and softball games, including taking
Bre to or picking her up from work or school.
In 2007, mMom brought a small house in Chester, Virginia, and moved
again. She really loved her new home and she often wished that Andy could have
shared it with her. However, not too long after mMom moved into her new home,
my brother’s, John’'s, youngest daughter, Mandesha, and her four children came
from Illinois to visit mMom. Mandesha also brought with her a little black poodle
named Muffin. To our surprise, Mandesha gave Muffin to mMom. This made
mMom so happy because she always loved animals and had many pets throughout
her lifetime.
Seeing Mandesha also made mMom both happy and sad because, at the
time of her visit, Mandesha was almost 30 thirty years old and mMom had not
seen her since John’'s funeral when she was just an infant. Therefore the reunion,
although joyful, also brought back some painful memories because the
circumstances surrounding John’'s death had caused the family much grief and
pain, especially Mmom.
I was still in Germany when mMom called me early one morning and gave
me the news on May 2, 1980. And, in order to get home quickly, I had to leave
Dinah and our oldest son, Mel, in Germany. I knew that I had to get home fast
because John was a Marine Corps Veteran, a husband, and a father,; and a
brother who we all loved dearly. Furthermore, the details of John’'s arrest and
death were sketchy and it gave us no comfort that the coroner’'s report said his
death was caused by hypertensive heart disease. We were skeptical because, at
the time of John’'s death, scores of young black men were frequently dying at the
hands of the Los Angeles Police Department as the result of beatings and
chokeholds.
In retrospect, I believe that the grief my mother endured regarding the
circumstances surrounding John’'s death had a lasting effect on her. Hence, my
mother often told us about the many dreams she had about John. And, almost
always, the central theme of most of her dreams were either about her trying to
save John or John reassuring her that he was okayOK.
I believe one of the reasons mMom kept having those dreams was due to
the special relationship she and John had. For one thing,, John and mMom were
so much alike, i.e., strong, independent, outgoing, etc. John was also the middle
child who longed for mom’'s love and attention. However, I believe that the main
reason the dreams kept recurring were the result of mom’'s motherly love and her
desire to save or rescue her child, which she was unable to do. This condition or
syndrome was worsened by the Rodney King Videotape Beating and the
subsequent acquittal of the white police officers and the riots that followed.
However, the most amazing thing about all of this was: John'’s death did not
cause my mother to hate or stop loving people.
Furthermore, the reunion between my mother and Mandesha was also a
blessing because Mandesha looked such much like John. Plus, John always owned
dogs that he would train to do amazing things. Therefore, by Mandesha giving
mMom Muffin, it created a special connection. As a result, mMom suddenly had a
new lease on life. Muffin was also a blessing to Rick and meI because we had
been talking about getting mMom a pet and Muffin was the perfect fit.
In addition to Muffin’'s company, mMom also enjoyed planting and growing
a variety of vegetables and other plants in her backyard -garden. Gardening and
playing with Muffin kept mMom busy and it also gave her plenty of exercise.
And, up until then, outside of mMom having trouble balancing her checkbook and
paying her bills on time, we did not notice any serious signs of mental decline.
However, little did we know, dementia had already set in.
VII:
Getting Understanding
Despite mMom’'s new lease on life, her mental state gradually declined over
the next three years. For example, mMom suddenly stopped watching TV shortly
after her eightie80th birthday. And, although we found it to be odd, we did not
contribute it to dementia. As a matter of fact, we knew nothing about dementia at
the time.; tTherefore, we could not figure out why she stopped watching TV,
including the three TV shows she really enjoyed watching: The Price Is Right,
Joel Osteen, and Oprah.
Nevertheless, I found it difficult to accept the changes that were taking
place in mMom.; tTherefore, I often dismissed her symptoms or blamed them on
some other factors, such as being tired or having a bad day; especially after Andy
passed away. Hence, her quality and purpose of living sharply diminished and
she would often say that she wanted to be with Andy. However, it wasn’'t until
after mMom started forgetting the meaning of or the use of things;, using
profanity,; and becoming physically aggressive that I finally realized that the
problem was far more serious than I wanted to accept.
In addition, about two years prior to her diagnosis, mMom would say things
that could not be dismissed or rationalized. For example, she started accusing
friends and family members of doing things that did not make much sense. Like
the time she accused a family friend of hiding things in her yard and doing other
things that nobody else saw. However, even after the doctors informed us about
mom’'s dementia, I wanted to learn more about the disease before I was ready to
accept the truth.
The Bible says in Proverbs 4:7 (NJV), "“And in all your getting, get
understanding.”" Therefore, I searched the libraries and the Iinternet for
information on dementia. And, as a result of my efforts, I learned that dementia is
a life altering disease characterized by multiple cognitive impairments (Singh-
Manoux and Mika Kivimäki, 2010, p. 509) that can be caused by Alzheimer’'s
disease or it can be vascular, which is brought on or caused by a blockage in the
brain’'s blood supply (Tse and Benzi, 2004, p. 311). Furthermore, according to the
Alzheimer’'s Foundation of America:
The other most common causes of dementia are vascular dementia,
caused by
stroke or blockage of blood supply, and dementia
with Lewy bodies. Other
types iinclude alcohol dementia, caused by sustained use of alcohol; trauma dementia, caused by head injury; and a rare form of dementia, frontotemporal dementia.
The clinical symptoms and the progression of dementia vary,
depending on the
type of disease causing it, and the location and number of
damaged brain cells.
Some types progress slowly over the years, while others
may result in sudden loss
of intellectual function (http://www.alz.org).
According to data from the 2009 World Alzheimer Report, it was estimated
that there were 36 thirty-six million cases of dementia in 2010 with new cases
doubling every 20 twenty years (Singh-Manoux and Kivimäki, 2010, p. 509).
Therefore, as a result of learning about these staggering statistics combined with
my mother’'s diagnosis, I also enrolled in some classes at a local community
college to learn more about dementia.
Enrolling in these classes also helped me to stay focused in the midst of
caring for my mom, which had become increasingly challenging. One of the
classes that was particularly interesting was a psychology class which, among
other things, covered topics relating to the brain. The information that was
covered in the class gave me a better understanding of the various functions of
the brain. However, the most interesting topic in the class was the neuron and
the role it plays throughout the nervous system and the brain. For example, the
neuron, which requires an electron microscope to see it, is a "“highly specialized
cell that communicates information in electrical and chemical form" (Hockenbury
and Hockenbury, 2011, p.45).”
There are three basic types of neurons: Ssensory neurons that transmit
information about the environment,; mMotor neurons that transmit information to
the muscles and glands,; and interneurons that transmit information between
neurons. And, as it relates to their function, neurons come in different sizes and
shapes. For example, a piece of a brain tissue as small as a grain of rice contains
about 10,000ten thousand neurons (Hockenbury and Hockenbury, 2011, p.45).
And, according to Berk (2010), “"The human brain has 100one hundred to 200
two hundred billion neurons, or nerve cells that store and transmit information,
many of which have thousands of direct connections with other neurons" (p. 94).”
Wow!
I also learned that each neuron has a cell body that processes nutrients and
provides energy for the neuron. I further learned that neurons have a nucleus
that contains chromosomes and dendrites that receive information from other
neurons and sensory receptors. Not only that but, neurons also have an axon,
which carries information to other neurons, muscles, and glands (Hockenbury and
Hockenbury, 2011, p.45). It was also interesting to learned that the axon of
many neurons, but not all, are surrounded by a myelin sheath, which insulates the
axon and increase communication speed (Hockenbury and Hockenbury, 201,
p.45).
This information helped me gain a better understanding about both the
causes and the symptoms that were associated with my mother’'s condition. For
example, I learned about endorphins, which is a collection of chemicals
manufactured by the brain that reduce the perception of pain. And, according to
Hockenbury and Hockenbury, 2011, these chemicals are similar to morphine, but
100 one hundred times more potent (p. 53).
By gaining a better understanding about the different functions of the brain,
I was able to understand, for example, why my mother, during her early stages of
dementia, patted or rubbed her head repeatedly, especially when she was trying
to remember or understand the meaning of things. Her actions (patting or
rubbing her head) were similar to our natural response to hit or thump on a
device that has stopped working or playing properly, like a watch or a radio. And,
after studying images of healthy brain cells, it was easier for me to understand
the effects of brain deterioration when I looked at the images in terms of a circuit
board. Hence , the images of the unhealthy brain cells resembled that of a
damaged or “"blown”" circuit board.
Many of the symptoms of dementia are similar to that of Alzheimer’'s'
patients, i.e., forgetting, wondering, combative, etc. However, the symptoms
relating to the onset of these diseases can vary from person to person. For
example, unlike a late friend of mine named Jimmy, who was diagnosed with
dementia a few years after my mother was diagnosed, my mother did not repeat
things over and over like my friend Jimmy started doing during his early stages of
dementia.
Conversely, unlike my mother, Jimmy, who was several years younger than
my mother, could still engage in meaningful conversations. In another example,
u: Unlike my mother who we stopped from driving during her early 80'seighties,
Jimmy was in his mid- 70's seventies when his family eventually stopped him
driving after he had a couple of accidents, which also included getting lost during
routine trips. However, I believe my mother would have eventually had an
accident if we had not stopped her from driving.
Another factor was my friend’'s health, which may have accelerated his
death,. i.e., Jimmy was a diabetic whereas my mother was not. Furthermore, if I
had known more about the disease earlier, I would have made a better connection
between my friend telling me the same stories over during the onset of his
dementia; especially when he started telling the same stories as if he had never
told them to me before. For example, he would tell me this story about the first
time he moved to Richmond, Virginia, and how upset he was about the city
government.
Jimmy told me that story so many times, I would recite it in my mind, and I
would say to myself, "“hHere we go again.”" However, out of respect for Jimmy,
who was about 20 twenty years older than me, I never mocked or questioned him
about why he kept telling me the same stories. Therefore, I treated him the same
way I treated my mother, i.e.,. I would actively engage in the conversations that I
had with Jimmy. And, I would respond as if I never heard the story before and I
would say,: "“Oh yeah!”" "“Man, you must be kidding me!”" And, Jimmy would
respond accordingly with same answers he gave me before. For example he
would say,: "“I kid you not!”" Or he would say,: "“I was through with them rascals
after that!”"
I also respected Jimmy because he was like a father figure to me. We had a
lot in common and he had given me plenty of good advice prior to his diagnosis.
The same was true about the conversations I had with my mother. For example,
sSometimes my mother would ramble during her stories about what she did that
day. And, although the stories did not make sense to me, they seemed to make
sense to her. Therefore,So if she laughed,. I laughed.
Mom sometimes laughed and laughed when she told some of her stories and
I would laugh along with her and say things this like,: "“What?”" "“You must be
kidding me!”" However, mMy favorite line was, "“Well, I declare!” " Which was
reminiscentce of a response my Aunt Martha, who my mother affectionately
called Sug, used to say. On the other hand, mMom could still remember some of
the jokes that I told. And, she would often blurtb out the punch line before I could
finish telling the joke, especially when I’m telling the joke to someone else. And,
although she spoiled the joke, her actions were funnier than the joke. But, there
was nothing funny about the disease.
It has been said that “"hindsight is 20/20”" and, for most of us, if we knew
in the past what we know now, we may have done more to achieve a better
outcome in every area of our life. Not only for ourselves, but also for friends and
relatives as well. And, although I gained more understanding about dementia, it
did not lessen the pain connected with the reality of the disease.
I also had to face the reality of the things that were beyond my control, ,
i.e., the things that only God or God working through the doctors could change.
Therefore, tThe more I learned about the disease, the more I trusted God
because, according to Berk (2010), "“About a dozen of types of dementia have
been identified. Some are reversible with proper treatment, but most are
irreversible and incurable" (p. 457).” For example, some of the side effects of
certain medication can cause or mimic dementia, which can be reversed.
Bleeding on the brain or an infection or a nutritional deficiency can also cause
dementia. In these cases, the disease can be stopped or reversed if it is properly
diagnosed and treated.
After learning about the types of dementia that could be revered, I was
hoping that my mom’'s dementia matched the criteria. Unfortunately, as I
learned later, the type of dementia my mother had was irreversible. However, I
remained optimistic about my mother’'s prognosies because, for the most part,
she lived a healthy life.: She never smoked. She took vitamins daily. She also ate
healthy foods and she only drank wine on occasions. Therefore, I believed that
other factors could have contributed to the onset of her dementia. For example,
sStatics show that most people over 80 eighty years of age have dementia.
However, dementia is no longer an age-related disease according to Singh-
Manoux and Kivimäki (2004) who also states that, "“tThere is now quite a lot
evidence from both a clinical and neurodegenerative point of view to suggest that
dementia develops over many years" (p. 509).” In some cases, it can take as long
as 20 twenty to 30 thirty years before the symptoms begin to show.
VIII:
Risk Factors
Looking at the research regarding sleep, for example, and the information I
stated earlier concerning the brain and neurons,; it is a medical fact that the
brain needs a sufficient amount of sleep (or rest) in order to remain healthy and
to function properly. Furthermore, although the brain makes up only two2
percent of our body weight, it uses about 20 percent of the oxygen our body
needs when we rest. The brain uses the oxygen to break down glucose, which
supplies the brain with energy (Hockenbury and Hockenbury, 2011, p. 62).
Therefore, getting an adequate amount of sleep is vital to our health. .
In contrast and comparison, my mother rarely got much sleep.: She rose
early each morning during her lifetime to take on the challenges of day, which
normally involved working two or more jobs and caring for others. Therefore, I
believe that the lack of rest, combined with stress, anxiety, and other
environmental factors, did not allow her brain enough time to detoxify or re-
energize itself.
In other words, amyloid plaques and neurofibrillary tangles "“isare also
related to oxidative stress." (Tse and Benzi, 2004, p. 311).” Furthermore, Sam
Gandy (2011), a neurology and psychiatry professor and associate director of the
Alzheimer’'s Disease Research Center at Mount-Sinai School of Medicine and the
James J. Peters VA Medical Center in New York, points out that the accumulation
of amyloid plaque deposits on the brain is associated with dementia (p. 15), which
was the case in my mother’'s diagnosis.
I also found several other risk factors that were relevant to my mother’'s
diagnosis. For example, aAccording to Fredrick Kunkle (2015), “"African-
American are at increased risk of Alzheimer'’s because of a complex mix of factors
- biological, socioeconomic, and cultural" (p. D1).” Other research suggests that
because African-Americans are at a greater risk of diabetes, hypertension, and
cardio vascular disease, it increases their risk of Alzheimer’'s. These factors are
also compounded by inadequate medical care, unhealthy diets, lower education,
and the stress associated with enduring discrimination (Kunkle, 2015, p. D2).
Regarding racism and discrimination, I know for a fact that these elements
can adversely affect your health. For example, I experienced racism and
discrimination during my military career, but none like the ones I experienced at
one particular duty station. Hence, the effects of the environment were so toxic
that my cholesterol levels went from normal to extremely abnormal during the
same time period.
My blood pressure also rose significantly during this period. But, I did not
make the connection between my health and discrimination until I watched the
movie “"42”" which told the story of Jackie Robinson.
The scene that caught my attention in the movie involved the manager of
the Philadelphia Phillies who repeatedly hurled racial slurs at Jackie Robinson
every time he came to bat. For reasons unknown to me at the time, I started
crying when Jackie Robinson got angry and went into the locker room and
repeatedly smashed his bat against a locker until he broke it. Then it occurred to
me a few days later.: I cried because I subconsciously identified with that
moment in the movie. In other words, it brought back many painful experiences
that occurred during my military career, which I suppressed.
These experiences ranged from subtle forms of racism to “"butt-ugly"”
implicit and explicit forms of racism. For example, Like when a white superior
officer, who had only been in my rating chain for two months, once told me that
"“he used to shoot N’'s in Arkansas,"” after I asked during a conference session
why did he downgraded my performance report after my immediate supervisor
and his boss had rated me higher.
On another occasion, a white commanding officer tried to use me as token
to destroy the creditability of a black civilian employee who had filed a class
action discrimination complaint against him. When I refused to go along with his
illegal actions , he tried to destroy my career, which caused me much pain and
suffering. And, just like Jackie Robinson, I bottled up my pain and anger to avoid
being jailed or court-martialed for acting out on my anger. Therefore, I could only
imagine the pain and suffering Jackie Robinson endured during his baseball
career and beyond, which may have adversely affected his health and contributed
to his untimely death at age 53 fifty-three due to complications of diabetes..
My mother was also exposed to some of the aforementioned risk factors
during her lifetime, including several life-changing, traumatic incidents. The first
was an incident she told us many times about her oldest brother, Roger, who died
in an automobile accident at the age of 20twenty. Mom said that she was about
two and a half years old when Roger died. She also said that Roger was her
favorite brother because of the way he treated her as opposed to her other
brothers who treated her mean most of the time. Therefore, iIt really broke her
heart when he was killed within minutes after telling her he was going to the
store. As a result, she kept reliving that moment in time, asking herself why did
he haved to die and what could she have done to prevent it?
The next traumatic incident occurred after my mother became pregnant
with my brother, Jack, at age 15fifteen. My grandmother (her mother) was so
angry about the pregnancy that she threatened to shoot my mother’'s belly off
with a shotgun. My mother stated that she was working in the field when
gGrandma yelled for her to come into the house. My mother said that, by the way
gGrandma was yelling, she thought that her mother needed her to kill a snake or
spider or something. Therefore, So she ran towards the house.; hHowever, no
sooner than she got inside the house, gGrandma pointed a shotgun at her and
ordered her to strip out of her clothes. My mother said that after she took off her
clothes, gGrandma pointed the shotgun at her stomach and told her that she was
going to "“shoot her belly off.”" My mother said that she was shocked and did not
know what to do. So she fell to her knees and cried out, "“Lord, please help me!”"
And, at thate point, gGrandma put the shotgun down.
We never disputed mMom’'s story because our grandmother did some
horrific things to us as well. Like the time she whipped my brother, John, with a
good sized switch after he ran from her. She ordered our brother, Jack, to catch
John. After Jack caught John, she tied John’'s hands and suspended him by his
hands on a hook in the ceiling. Then she whipped John while he screamed and
yelled. Therefore, it was very believable when our mother told us (many times)
about the incident that happened between her and our grandmother who
threatened to shoot her belly off.
Mom stated that she ran away from home after the incident and stayed with
her mother’'s sister, Lottie Nicholson, who lived in Richmond, Virginia. Mom also
stated that during her stay in Richmond, she found a job folding shirts at a
laundry and, after seven months passed, gGrandpa came to Richmond and
brought her back North Carolina. She further stated that she was in the ten10th
grade during the time of the incident and she subsequently dropped out of school
to take care of Jack after he was born.
In addition to the previously described events, mMom also experienced
other traumatic incidents in her life, including several domestic violence incidents
between my father and the other men in her life. She also suffered from high
blood pressure and the associated hypertension, which had to be controlled by
medication. One of the prescribed drugs that my mother took was a combination
of Triamterene and Hydrochlorothiazide, which areis used to treat high blood
pressure and swelling due to excess body water. Some of the possible side effects
of the drugs includes dizziness or lightheadedness when standing or sitting.
Although there were only a few side effects listed for this medication, I still
wanted to know if there were any links between the mediation and the onset of
my mother’'s dementia.
I found several links between my mother’'s blood pressure and the onset of
her dementia due to the weakening of her heart. But, I did not find any
correlation or links between her heart medication and the onset of her dementia.
However, oOn the other hand, I did find some information about some new
studies that suggest a link between a popular class of heartburn drugs and the
risk of dementia in seniors (Thomson, 2016, p. 1). I also read another report
confirming that statin drugs accelerate cardiovascular disease (Mercola, 2012,
p.1), which can subsequently lead to dementia and Alzheimer’'s'. .
It was good to know that my mother was not taking any of these drugs,
which allowed me to eliminate them from the possible causes of her dementia.
Nevertheless, I was more interested in what caused my mother to have high blood
pressure and hypertension in the first place rather than the medicine she was
taking. In other words, I wanted to confirm that if there was a link between my
mother’'s high blood pressure and her dementia. I also wanted to know if her
heart disease was hereditary. Or was it more physiological as a result of her diet?
Or was it psychological as a result of an accumulation of negative life
experiences? Or was it caused by some other environmental factor such as air
pollution or water pollution?
Regarding the other environmental factors, my mother could have been
exposed to asbestos as a result of her working in the shipyard. Therefore, I did
some research to see if there was a correlation between asbestos exposure and
dementia. I found out that, although there were some studies that linked
asbestos exposure to Alzheimer’'s and other related symptoms, most of the
symptoms were secondary to lung disease. Hence, asbestos exposure primarily
eaffects the lungs, which reduces the supply of oxygen to the brain, which can
subsequently cause dementia, but not in all cases. .
For example, Andy was a carpenter most of his life. And, as a result of his
occupation, Andy was exposed to asbestos, which caused him to develop COPD,
which restricted his oxygen supply. However, Andy never exhibited any signs of
dementia nor was he diagnosed with it. As a matter of fact, he laughed and told
great jokes up until the end. The same was true about my mother- in-law and
father in-law who were both smokers. Like Andy, they also died from COPD
related symptoms while they were in their 80's eighties with no signs of dementia.
Air pollution and water pollution are also risk factors that have been linked
to the onset of dementia and Alzheimer’'s. For example, an online article
published in The Telegraph, Health Editor, Laura Donnelly, reported that,
“"Middle-aged and older adults who live in towns and cities suffer ageing of the
brain and increased risk of dementia and strokes because of air pollution "
(Donnelly, 2016, p. 1).” In another online article, ALZinfo.org, published a report
from the Archives of Internal Medicine, which stated, "“Exposure to polluted air
contributed to the equivalent of about a two-year decline in brain function, which
might lead to an earlier onset of Alzheimer’'s and other forms of dementia"
(ALZinfo.org, 2016, p. 1).” The report also says that, "“lLevels of beta-amyloid, a
toxic protein that builds up in the brains of those with Alzheimer’s disease, were
higher among residents of polluted cities" (ALZinfo.org, 2016, p. 1).”
Less data was available linking water pollution to dementia other than the
information that were published by the water filter industry. However, I have
been involved in promoting and selling water purification systems since 1983,;
therefore, I understand the health effects associated with water pollution on
water, tap water, and bottled water. And, one only needs to look at the recent
water pollution problems that surfaced in Flint, Michigan where residents were
exposed to dangerous amounts of lead and other contaminates in their drinking
water. .
Water is a chemical consisting of two parts hydrogen and one part oxygen,
which is expressed as H2O. Water is also known as the universal solvent due to
its polar nature and its ability to form hydrogen bonds with other molecules. Our
body is about 50–-75% percent water, except for infants whose bodies contain
about 75-–78% percent water (Helmenstine, 2015, p.1). A person can live longer
without food than he or she can without water. In other words, our body needs
water for perspiration, respiration, urination, digestion, and defecation purposes.
.
When our body use more fluid than it takes in, we become dehydrated.
Dehydration can cause death. However, God designed our bodies so well that it
tells us when we need more fluid. And, although thirst is normally the first
indicator, other indicators are just as important. For example, we may quench
our thirst with water or other fluids, but our body may not be getting enough
water to function properly. Therefore, So we need to pay close attention to the
other warning signs of dehydration such as, bad breath, extra yellow urine,
headaches, fatigue, constipation, muscle cramps, etc. Furthermore, some people
may think that they are hungry, but, actually, they are dehydrated.
There are other warning signs of dehydration, however, if you wait until it
gets to some of the more severe warning signs, you may need to seek immediate
medical attention. For example, oOur body is just like an automobile whereby it
must contain the proper amount of coolant to prevent it from overheating. If not,
the engine will overheat and it will eventually die. Our body can also overheat
due to dehydration, which can lead to death. Other serious signss of dehydration
areis athe lack of tears when you cry or when you loses some of the elasticity in
your skin. Again, if you allow yourself to dehydrate to this point, seek medical
attention right away. .
As you can see, water is vital to every organ, tissue, bone, and fiber in our
body. Therefore, dehydration, as well as polluted or contaminated water can
cause a number of maladies, including death.
Children are especially vulnerable because their brain and other vital organs
are still developing. For example, it has been proven that lead exposure can
cause learning disabilities and other problems in children. And, although bottled
water is better than most tap water, bottled water also hasve risks due to the
plastic chemical properties found in the bottles and the harmful bacteria than can
form inside the bottle. Another problem associated with bottled water is
consumers may not get the important minerals and trace elements that are
essential to their health like fluoride for example.
Fluoride is essential to healthy teeth and bones. Therefore, fluoride
deficiency can result in badly formed or weak teeth or brittle or weak bones.
Fluoride is found in fluorinated tap water, but it is not found in most bottled
water. Furthermore, tap water if treated properly can be safe, however, many
dangers exist in the use of tap water. For example, wWater is recycled, i.e., the
water that is flushed down the toilet is treated and released back into the same
water source. The water is then treated and reused. However, even if the water
was treated to its purest form, it still have to travel through miles of pipes to get
to your home. Therefore, lead and other contaminates can get into your drinking
water. .
In addition to the problems associated with storm runoffs that wash
chemicals and other pollutants directly into water sources, i.e., rivers and lakes,;
aanother problem associated with tap water is are the chemicals, chlorine and
chloramine, that are used to kill the germs and bacteria in the water. And,
although these chemicals may kill a wide -range of germs and bacteria, a number
of reports have linked the long- -term use of these chemicals to many health
problems, including cancer. .
My mother was very aware of the health problems associated with both tap
water and bottled water. As a result, she used and promoted water purification
systems for many years as both a customer and as a distributor of water
purification products. Therefore, I ruled out water pollution as a link to the onset
of her dementia. However, air pollutions needed further examination because my
mother resided in California for a number aof years and California not only has
the top five most polluted cities in the U.S., it also has the most number of
polluted cities in the nation. At the top of the list was, Fresno-Madero, California;
followed by Visalia-Porterville-Hanford, California; Bakersfield, California; Los
Angeles, California; and Modesto-Merced, California (American, 2014, pp. 13–-
15).
My mother did not live in any of the cities that were on the list. However,
she lived in Antioch, California, which is approximately 60 sixty miles southeast of
El Centro, California. El Centro was rated number seven on the list of worst cities
with year-round particle pollution. Therefore, I investigated further to see if there
were some links between air pollution and the onset of my mother’'s dementia. I
found some information but, I could not completely connect the dots. Hence,
even if my mother resided in the most polluted city in America, without having
any connections to lung disease, it would be difficult to link the onset of her
dementia to air pollution other than it being a probability. For example, if there
were a strong correlation between air pollution and the onset of dementia and
Alzheimer’'s, then it would be logical to assume that the state of California, which
has the highest number of polluted cities on the list; would also have a higher
mortality rate for Alzheimer’'s than the states with less pollution. Not so.
I reviewed a number of air pollution reports, which also listed by
population the number of people with chronic respiratory diseases, such as
asthma and COPD as well the number of the people over age 65sixty-five. And,
according to one report, California ranked high among the national mortality
rates for Alzheimer’'s disease. However, on the other hand, I found very little
correlation matching the states with the worst air pollution to the states with the
highest Alzheimer’'s mortality rate. For example, aAccording to data from the
National Vital Statistics System, Martha Kang (2013) stated that, "“Washington
state has the highest mortality rate for Alzheimer’'s disease in the U.S." (p. 1)
while New York and Nevada were among the lowest (Kang, 2013, p. 1).” Other
less polluted states, including Tennessee, Kentucky, North Dakota, and South
Dakota, ranked higher than California in Alzheimer’'s mortalities. Therefore, as I
stated earlier, I have concluded that there is only a small probability that the
onset of my mother’'s dementia was caused by her exposure to air pollution. .
Research has also proven that obesity in midlife increases dementia risk
factors, but obesity is not a dementia risk factor at an older age. Rather, it is low
body weight that is associated with dementia at older ages (Singh-Manoux
and Kivimäki, 2010, p. 510). My mother did lose weight during the later stages of
dementia as a result of the effects of the disease. HoweverNeither, obesity nor
low body weight were risk factors in my mother’'s case regarding the onset of her
dementia. .
Another risk factor is family history. And, while examining to see if there
were any connections between my mother’'s dementia and our family history, I
noted that two of her sisters suffered from dementia prior to their death.
However, one of her sisters lived well into her 80's eighties before she was
diagnosed with dementia while the other sister lived well into her 90's nineties
before she was diagnosed. On the other hand, two of my mother’'s other sisters
lived well into their 90's nineties without any significant signs or symptoms of
dementia. And, except for my uncle Roger who was killed in an automobile
accident, all of my mother’'s brothers died from non-dementia related health
problems, i.e., COPD, cancer, etc. Furthermore, nNone of them lived to be 80
eighty years old, which seems to be the standard age for the onset of dementia.
I also noted that both of my maternal grandparents were born in the
1880’'s. They were both sharecroppers who had little or no access to medical
care. Therefore, mMany of their diseases or injuries were self-treated with home
remedies consisting of roots and herbs or first -aid techniques that were passed
down through generations. For example, lLike the time my grandmother
accidently injured her knee with the axe while she was driving a stake toin the
ground to secure a cow. Grandma dressed her wound and wrapped her knee in a
homemade tourniquet and returned to her chores. Unfortunately, the injury
caused my gGrandma problems for the rest of her life, including her having to
walk with a cane.
My grandfather was the same way. Like the time he was attacked by two
men who cut him from one side of his chest to his lower belly. And, according to
my mother, gGrandpa fought gallantly and survived the ordeal by biting off one of
his attacker’'s ears. And, just like the old western movies, gGrandma cleaned and
dressed gGrandpa’'s wounds and he took it easy until he recovered. .
I also noted that my grandfather passed away a few months after he had a
stroke at the age of 76 seventy-six and my grandmother died as a result of heart
failure at the age of seventy-eight78. Therefore, iIt is more than likely that
heredity or our family medical history was a factor in my mother’'s high blood
pressure and the associated hypertension. .
It was further noted that my mother was the 11eleventh child born to our
grandparents when our grandmother was 40forty years old and our grandfather
was 46forty-six years old. And, although there is ample evidence that suggests
the risk of birth defects increases with parental age, I found no conclusive
evidence to link the age of my grandparents to my mother’'s dementia. For
example, tThe risk of a child being born with Down Syndrome increases with the
age of the mother while the risk of a child developing schizophrenia increases
with the father’'s age.
IX:
Psychological vVs. Physiological
As I mentioned earlier, psychological factors can adversely impact
physiological factors such as the case of my elevated cholesterol that was caused
by the stress I experienced in the military. Therefore these factors may have also
played a role in my mother’'s high blood pressure and dementia. For example,
mMy mother-in-law’'s blood pressure rose every time she visited her doctor. We
later discovered that there was a correlation between my mother in-law’'s fear of
going to the doctor and her blood pressure,. i.e., iIt rose sharply because she
feared what the doctor might find or what he might tell her about her health. .
The same was true about the psychological factors that aeffected my
mother’'s blood pressure, including the stress associated with the negative events
that impacted her life. Consequently, my mother’'s physiological factors also
impacted her psychological factors. Furthermore, aAccording to Segal, et al.,
(2010):
Mental health and mental illness can be viewed as being on a
continuum.
Few people are completely mentally healthy all the time. All have
times of
impaired functioning when they are less able to have fulfilling
relationships, adapt to change, or cope with adversity.
..The U.S. surgeon general’'s 1999 report
emphasized that mental illness and physical illness are inseparable...
There
is no real split between mind and body or between mental health and
physical
health (p. 270-–271).
Outside of my mother’'s high blood pressure, the only other physiological
factor I really wanted to examine was concussions, which have been found to
contribute to the onset of dementia and Alzheimer'’s. In doing so, I did not know
if my mother had suffered any concussions during her lifetime as a result of her
occupation or from a domestic violence incident. I did recall , however, that my
mother along with the rest of us were involved in a car accident over 50 fifty
years ago when another driver rear- ended us on the highway. .
Neither I nor my brothers could remember if mMom suffered a concussion
as a result of the accident. . However, my mother may have suffered from a
concussion later on in life. For example, aAbout a year prior to her diagnosis,
mMom fell and bumped her head on a concrete floor at a store. She refused
medical attention and drove herself home, which was typical of her. Rick and I
did not find out about the incident until we noticed a knot on her forehead. She
said she was OK okay and refused to go to the hospital. We subsequently
reported the incident to her doctor who ordered a CAT scan on her head. And,
although the scan did not reveal any fractures or any other serious injuries, we
believe that the fall could have exacerbated her dementia.
X:
The Mind, t The Body, and Tthe Spirit
Looking at the inseparable relationship between physiological and
psychological health issues, i.e., mind and body. As a Christian, I believe that our
spirit is intertwined with our mind and body. Like my mother, I also believe that
our spirit is the part that keeps our mind and body in sync , but most importantly,
it is the part that communicates with God. The Bible says in Job 32:8 (NIV), "“But
it is the spirit in a man, the breath of the Almighty, that gives him understanding."
.”
I thank God that my mother’'s spirit and faith in God always remained high,
which helped her to endure the problems she faced in life, including her high
blood pressure and discrimination. And, just like the stories she shared about her
trial and tribulations, my mother also shared stories about how God blessed her,
kept her, and guided her through life. For example, sShe told us about the story
when she was just a little girl and she looked up in sky and saw a vision of Jesus
holding a lamb, which she interpreted as her being the lamb in His arms. .
Mom also told us about another incident that happened while we were
living in Montgomery Projects. : She was alone in the elevator and a man dressed
in a dark coat and hat got on the elevator just before the door closed. Sensing
danger, my mother said she began praying in the spirit. The man suddenly
shouted out that he had intended to rob her but he couldn’'t because the power of
the Holy Ghost was upon her. She further stated that the man immediately exited
the elevator when it stopped and he ran from the building.
There were many similar stories my mother told us about how the Spirit of
the Lord was upon her and how she was able to communicate with God through
her spirit, which also helped her mind and her body. The Bible says that Jesus
"“sighed deeply in His spirit”" (Mark 8:12 NKJV) and "“Jesus rejoiced in the
Spirit”" (Luke 10:21 NKJV ). Therefore, I believe that the spirit is an essential
part of our being, which is not too complicated to comprehend even when you
think of it in natural terms. For example, bad news or unfairness can bring your
spirits down to the point where you can become sick in your stomach or your
head might ache or both.. And, vice versa, you can be having a bad day until you
receive some good news like a job promotion. All of a sudden, you feel much
better and your spirits are up.
Another example is the endorphins I previously spoke about that the brain
manufactures to reduce the perception of pain. Therefore, these chemicals make
you feel better. Unfortunately, some people resort to drugs and/or alcohol to feel
better, which they should not do, but they do. Nevertheless, whatever is in our
mind, including that which we do to our mind, good or bad, can affect our body
and spirit. On the other hand, when you know the Lord, like my mother knew
Him, you not only feel better, you look better, and you act better. The Bible says
in Proverbs 17:22 (NKJV), “"A merry heart does good, like medicine, bBut a
broken sprit dries the bones." .”
Because of the relationship she had with the Lord, my mother had a certain
peace about her up until her last days, including a joyful heart. And, just like the
vision she saw as a child,: God wrapped His arms around her and kept her safe.
Therefore, aAs a result of my analysis of the mind, the body, and the spirit in
regards to sickness and disease, I have concluded that my mother’'s special
relationship with God gave her an advantage over the disease. Hence, as the
quality of her mental and physical health decreased, the capacity of her spirit
increased, which resulted in joy, peace, and happinessy throughout her journey.
In other words, my mother did not suffer at any point during her sickness. Praise
the Lord! And, thank you, Jesus!
XI:
Reversing the Roles
In the past, a lot of people including myself, would have mislabeled my
mother’'s symptoms as being "“old and senile.”" However, with the new
breakthroughs in the medical field and the ease of access to information, we now
have a better understanding about the disease than ever before. Therefore, after
researching my mother’'s medical diagnosis and learning that my mother was
already in the advanced stages of dementia, I knew that the role of son and
mother had to be reversed. .
As I launched into my new role, one of the first and most difficult tasks I had
to do was to stop my mother from driving. The decision took an emotional toll on
me, but I had no other choice after my mother failed to stop at a red light on one
occasion and after she kept getting lost during routine trips from my brother’'s
house to her house. Furthermore, I had often heard or read reports about senior
citizens getting lost and sometimes having accidents resulting from them driving
the wrong way on a street or highway. Therefore, I did not want my mother to
hurt herself or anyone else so I disabled her car to prevent her from driving. .
It was indeed a painful experience watching my mMom trying to start her
car. And, on many occasions, I wanted to enable her car so she could drive, but
the risk was too dangerous. The main reason I kept revisiting my decision to stop
my mother from driving was because her inability to drive was contributing to her
decline. Nevertheless, I eventually found peace with my decision after I gained
possession of her car and told her that I would be her chauffeur for life and that I
would take her anywhere she wanted to go, which I did. As a result, mMom and I
spent a lot of quality time together and it was a joy to see her warm the hearts of
the people we met on the streets, in the parks, in the stores, etc.
Mom really loved people and she never met a stranger. As a result, I would
take her to the local Wal-Mart at least two to three times a week, mainly for
exercise and socialization. And, it was a blessing that several of the cashiers at
the store got to know my mother, which enhanced her shopping experience., i.e.,
tThe cashiers would laugh and talk with mMom. Most of all, the cashiers were
patient and kind to my mother, which both my mMom and I greatly appreciated.
.
Initially, this was a very enjoyable experience but, little by little, it became
more challenging. For example,Like in the beginning mMom would pick out the
things she wanted to buy and she would pay for them at the register. . But as her
cognitive abilities declined, she started forgetting how to make transactions at
the register and she also developed a habit of repeatedly buying things she
already had. .
For example: One day, while we were at the local Wal-Mart, I tried to
convince mMom that she had already purchased a particular item the day before
and that she had plenty of them at home. However, there was no reasoning with
mMom. She got angry and started fussing at me. And, before I knew it, I was
surrounded by several older women who began scolding me for being such a
mean son for not allowing my mother to have “"whatever”" she wanted! To
alleviate the scolding and the possibility of being wacked by a cane or an
umbrella, I smiled and allowed my mother to put the item in her cart. .
Mom also started forgetting where she put her house keys and/or purse,
which caused our trips or outings to be delayed or cancelled. One time mMom
hid her purse so well, it took us two weeks to find it. I also had to look after
Muffin more because mMom started putting orange juice and other inappropriate
foods in Muffin’'s dish, which he was smart enough not to eat or drink. And, the
more I reversed the roles, the more mMom resisted me telling her what she could
or could not do. As a result, I had to adapt new strategies to deal with my
mother’'s behavior.
XII:
Behavior Modification
I learned some valuable lessons from my initial experiences with mMom’'s
dementia. For one, it wasn’'t my mother’'s behavior that needed to be modified or
changed,. Iit was mine. Secondly, I had to learn how to be more patient and not
to dwell on or get too upset over the little things that I could not change. Thirdly,
I had to find new ways to achieve the desired results. For example, Like instead
of confronting my mother about repeatedly buying the same thing, I learned how
to remove the duplicate item(s) from her cart before we got to the register. In
other words, I learned how to turn my mother’'s short-term memory lapse into an
asset because she no longer remembered the item by the time we got to the
register.
Mom also forgot how to write checks. Therefore, tTo avoid problems at the
register, I would put some money in her purse before we left the house. I also
took possession of mom’'s house key's and purse to avoid having to look for them
every time we left the house. I did, however, let her manage the Christmas
stocking she used for a purse, which did not contain any valuables or personal
information. Therefore, it would not have been a big deal if she lost or misplaced
it. .
I had to also modify my attitude concerning my mother eating everything
with her hands, including mash potatoes and gravy. .
For example, wWhen the problem first developed, it would have been both
dumb and dangerous to challenge her or chastise her about it. Instead, I would
politely ask my mother, “"Do you want to use a spoon or a fork?”" She would then
lift up her hands and wiggle her fingers and say, “"I already got one.”" Again, it
was not my mother’'s behavior that required modification, it was mine.
Therefore, tTo avoid a confrontation with my mother and to respect her decision
to eat with her hands,; I made sure her hands and finger nails were clean before
she ate, which greatly reduced my anxiety.
I also had to change my attitude towards the things my mother would say
or do because I knew that it was not her, it was the disease. Therefore, it is
critical that caregivers and family members have an understanding about the
symptoms of the disease. Hence, if someone does not understand the disease,
they may have difficulty dealing with the person’'s changing behavior. And, like
child abuse, senior abuse is both real and problematic.
Thank God I was able to eventually understand my role and limitation in
caring for my mother. . However, the key part involved me changing my behavior
and embracing each stage of my mother’'s decline as a rewarding challenge. In
other words, I had to find new ways to make lemonade out of a bitter situation.
XIII:
Sweet Memories
We took mMom on numerous trips to North Carolina to visit her only living
sibling at that time, Bessie Harris, and her niece, Ernestine Snead- Day, both of
whom have since gone home to be with the Lord. Ernestine was almost like
mMom’'s little sister because they were only three years apart. These visits
exposed mom’'s long-term memory recollection versus her short-term memory
loss. And, whether it was telling stories about how she had to carry Ernestine on
her back to avoid getting a whipping from her mother for coming home late from
school or the spats she had with Bessie and her other siblings, mMom always
made us laugh.
These stories highlighted our visits, especially the stories about gGrandpa
who made moonshine that he also sold it to the sheriff. According to mMom,
gGrandpa was well respected by both black and whites, which was uncommon in
those days. For example, older black men were often called "“uncle”" or "“boy.”"
Mom also stated that whenever she and gGrandpa went to town, white men would
tip their hat's and say, "“Hello, Mr. Harvey.”" "“Hi, you doing, Mr. Harvey?”"
And, according to mMom, some people called gGrandpa, "“Uncle Ellick"” while
some of his buddies affectionately called him "“Alexander the Great Commander
who kilt’' (killed) the goose and shot the gander,.”" Which was a spin off the old
saying, "“What’'s good for goose is good for the gander.”" However, mMom and
her siblings, including her niece, Ernestine, all called grandpa “"Papa." .”
Ernestine said that what she admired the most about gGrandpa was his
ability to calculate numbers in his head while he was doing business with the
white land owner. Hence, gGrandpa was a sharecropper who did not have any
formal education.; hHowever, gGrandpa knew what was due to him versus what
he owed the land owner, which wasn’'t always the case in those days because the
sharecropper often ended up owning the land owner more than he was able to
earn. .
Looking back over some of the other stories mMom told us about gGrandpa,
perhaps some of the respect my grandfather earned may have resulted from the
quality of his moonshine or it could have resulted from him biting off the ear of
one those men who had attacked him. Nevertheless, iIt is my hope that gGrandpa
was respected because of the way he carried himself or by the way he lived his
life versus the moonshine and violence. Nevertheless, mMom was part of
gGrandpa’'s legacy.
Mom was also a part of gGrandma’'s legacy. For one, my mother could
bake the most mouth-watering bread, but not like gGrandma. And, according to
mMom, gGrandma baked bread and made soup, which she placed in tubs and
buckets. Then, while carrying some of the tubs on her head, gGrandma walked
along the railroad tracks and sold the bread and soup to the men working on the
railroad. Mom further stated that gGrandma had five siblings, Carrie Bell,
Walter, Edna Blake, Annie, and Lottie who all different complexion. .
Therefore, while growing up, I was often wondered why some of my
relatives’' complexions were lighter than others, including some who could pass
for white. Unfortunately, you could not ask a lot of questions back then because
some things just weren’'t talked about or discussed. As a result, I had to do some
research on my own to understand this phenomenon. Fortunately, I did not have
to search far. Hence, looking at the pictures in my photo albums, the evidence of
both Native American and European traits are clearly visible in my African-
American lineage. For example, my gGrandma’'s complexion was darker than her
sister, Lottie. That is, Aunt Lottie more than likely looked very much like her
mother who was said to be a Cherokee Indian, i.e., with real light complexion,
long black hair, and high cheek bones. Likewise, my mother’'s reddish
complexion and high cheek bones are also linked to her Indian heritage.
Furthermore, aAn ancestor search revealed that in 1896 both my great
grandparents, Blake Williams and Ann (Manley) Williams, submitted their Native
American Application for Enrollment in the Cherokee Tribe, which was considered
one of the "“Five Civilized Tribes.”"
In addition to being labeled a "“civilized tribe”" the Cherokees, Chickasaws,
Choctaws, Creeks, and Seminoles also held Bblack slaves. The Seminoles, for
example, held the least Bblack slaves, and they were said to be more sympathetic
to causes of bBlack people. The Cherokees, on the other hand, held the most
Bblack slaves. And, according to Barbara-Shae Jackson, "“By 1860, the Cherokee
had 4,600four thousand six hundred slaves. Those Bblack people held captive
revolted against the Cherokee in 1842" (Jackson, 2014, p. 3).” It was further
noted that the Indian slave owners, just like the European slave owners, also
exploited bBlack women. Hence, race mixing also thrived under these conditions.
However, when the mixed blood descendants, like my ancestors, filed for
inclusion in the Cherokee Nation, the Cherokee’'s denied them their rights. .
Mom’'s stories were not only unique because of her heredity, they were also
unique because she was the youngest out of 11 eleven children who, as she would
say, was born during her mother’'s "“change of life”" at age 40forty. Therefore, I
could only imagine the challenges that my grandparents had raising my mother
during those times at their ages. For one, based on some of the things I knew or
heard about my mother, my mother she never blindly followed orders. For
example, mMom said that one of the first problems that developed between her
and our grandmother resulted from an incident that occurred when our
grandmother was working as a domestic for a white family.: Our grandmother
insisted that my mother call the white family’'s little daughter, "“Miss Louise,”"
which was the expected behavior for bBblacks or "“colored people"” during the
Jim Crow Era in the South. And, in many cases, bbBlacks were arrested or
lynched for simple or perceived violations of the Jim Crow Laws. Like in the case
of Rosa Parks, Emmett Till, Army Cpl. Roman Ducksworth Jr., and so many others.
.
My mother refused to conform to the social order that she was born into
even after our grandmother tried to beat it into her. Mom said that she could not
bring herself to call that little girl Miss Louise because they were the same age.
The final straw came after gGrandma instructed my mother to wash the white
people’'s clothes. Mom stated that after she washed all the white clothes
together with the colored clothes, they did not want her to ever wash their clothes
again, which was fine with her.
Undoubtedly, mMom’'s age, and the social and economic factors that
impacted her family, created many challenges for her and her aging parents.
However, most of the other stories my mother told us involved her siblings. Like
the times gGrandma would use her to spy or tattle-tale on her sisters when their
boyfriends came to visit. And, how her sisters would retaliate against her when
gGrandma wasn’'t looking; especially when they slept together at night. Mom
said that her sisters would put her in the middle and threatened to smother or
squish her to death for telling on them. .
No matter how many stories my mother told us about her parents and her
siblings, the story she enjoyed telling the most was about how long she nursed
me, which always caused lots of laughter. As the story went, I was the youngest
out of five boys. And, according to mMom, I was a sickly child and because my
father was an alcoholic who failed to provide for his family,; food was scarce.
Therefore, mMy mother said she continued nursing me beyond the average
breastfeeding age. However, the funny part about this story is, it was just like the
story about the man who caught the fish,, i.e., my nursing age kept growing over
time. For example, iIt started out with me being eighteen18 months old and still
nursing. How it grew from 18 eighteen months to thirty-eight38 months is
beyond me. Nevertheless, mMom enjoyed telling the story.
Mom would work the story up with accounts of how she had to sneak away
to nurse me to avoid being chastised by her mother and siblings. And, how our
grandmother once threatened to whip both of us for her nursing me. My
grandmother'’s response was understandable due to her lack of knowledge.
Hence, the World Health Organization recommends breastfeeding up to two years
of age or beyond and some societies in the world breastfeed their children until
they are four to five years old. However, I don’'t think my grandmother or my
other relatives were aware of it, including my mother who undoubtedly nursed me
out of necessity, which I am glad she did. Therefore, I can only guess that the
naysayers were comparing my nursing age to the norms and standards within
their community. .
Whatever my nursing age was, I did not recall any of it. And, because the
story made my mother happy, I just went along with it. But, the story did get old
at times, especially since I was the brunt of the joke. Therefore,So I tried to
change the subject about nursing during one of our visits to Aunt Bessie’'s house
by taking the focus off me and putting it on my brother, Rick. For example, I
complained to Aunt Bessie about how Rick always talked about them Coca -Colas
she used to give him when he was a child, which was a real treat for a poor
bBblack kid back then, especially if you had a five cent bag of peanuts to go along
with it:. You not only had a treat, you also had a meal. And, just to "“mess with”"
Aunt Bessie, I said, "“I don’'t recall you ever giving me a Coca- Cola when I was a
child.”" Well, what did I say that for? I walked myself right into it.: Aunt Bessie
said, "“James, I wanted to give you a Coca- Cola, but you were too busy nursing!”"
Everyone burst into laughter and some laughed until they cried.
XIV:
The Helper and Tthe Cussee
Mom really enjoyed the trips to North Carolina and the laughter she and
Aunt Bessie and Ernestine shared., hHowever, her activities of daily living
continued to decline. For example, mMom almost caused two fires in her house by
leaving things on the stove too long or by putting metal objects in the microwave.
As a result, Rick and I disconnected both the stove and microwave and hired a
home health aide worker to help us out. .
Finding a reliable home health aide worker was not an easy task. And, no
matter what agency they came from or represented, they all had their flaws. For
example, oOne of the aides connected well with my mother, but her character was
shady. Therefore,So Rick and I took turns checking on the aide. Checking
on the aide included coming back unexpectedly or showing up at the places the
aide was supposed to take mMom, i.e., stores, restaurants, doctor’'s office, etc.
And, although some workers provided better services than others, for the most
part, the home health workers were very helpful. They not only kept mMom
company during our absences, they also helped mMom manage her medication
and other activities of daily living. Furthermore, bBeing that, Rick and I
dominated mMom’'s life,. sShe welcomed the services and the company of the
female aides as a result of their gender. For example, the aide would take mMom
to the local McDonald’'s Rrestaurant where they would sit and talk and enjoy a
small country and western band that entertained senior citizens on Thursdays.
Mom would laugh and dance and talk to the other senior citizens, especially those
who looked like they needed help. She would ask them,: "“You need my help?”"
Regardless of what I was doing,: cutting grass, fixing a car, etc., mMom
would always say, "“You need my help?”" And, like a father allowing his small
child to participate, I would often let mMom help me with some of the small safe
tasks, even when her cognitive abilities prevented her from understanding or
completing the task. .
As time passed, I became more and more involved in caring for my mother.
And, although I had both a military and a social work background, none of it
prepared me for the changes that were rapidly taking place in my mother. For
example, mMy brother and I decided to put depends on mom after she kept
having accidents. She did all right the first couple of weeks. However, she soon
started wearing the depends on the outside of her garments and she would go out
the house in that fashion. Mom also started cussing more. And, during one
incident, Mmom got angry and socked me on the side of my head with her fist
after I tried to calm her down.
Nevertheless and tThrough it all, we still managed to laugh. For example,
wWhen my God-fearing mother first cussed me out, I was shocked. I exclaimed,
"“mMom, you cussed at me!”" With a serious look on her face, she pointed her
finger at me and replied, "“If I cussed, then you are the cussee!”" I had no choice
but to laugh because I had never been called a “"cussee”" before.
On the other hand, this was indeed a serious matter. And, although I did
not do any research to see if there was any correlation between cussing and the
onset of dementia, I did talk with a number of health care professionals who said
that this type of behavior was common in dementia patients. For example, mMost
of them said that if the patient never cussed (or cursed), some start cussing
during the different phases of dementia. One of the nurses said she had a patient
who used to be a Sunday school teacher. Over time, the patient started
complimenting her by calling her a "“pretty little B." .”
In contrast, they say, if the person routinely used profanity prior to the
onset of dementia, they stop cussing. Nevertheless, cussing or using profanity is
not of God and it definitely falls under the "“undesirable behavior”" category.;
tTherefore, no additional research was needed in this area.
Thank God my mother’'s cussing phase was short-lived because it was not in
her spirit. The Bible says in Psalm 51:10 (NKJV), "“Create in me a clean heart, O
God, Aand renew a steadfast spirit within me.”" Therefore, aAs a result of our
prayers, mMom was quickly delivered that behavior and her sweet and loving
spirit remained with her until the end of her journey with dementia.
XV:
24/7 Care
The sudden changes in the behavior of Alzheimer’'s and dementia patients
can catch you off guard, like they did me. Therefore, recognizing the early signs
and symptoms of dementia and Alzheimer’'s can help you to prepare for the
different stages of the disease. For example, I recall an incident that happened to
me while I was stationed in California back in the early 80'seighties. At that time,
I was familiar the term “"old and senile”" but I never met or knew anyone who fit
that description nor did I know anything about dementia or Alzheimer’'s until the
following incident occurred. .
It was a bright sunny day. I was driving through Riverside, California with
my wife, Dinah, and we came upon an elderly bBblack woman walking along the
highway. We were never quick to stop or pick up hitch hikers or strangers even
in those days, but seeing an elderly woman walking along a highway in the middle
of nowhere did not seem quite right., pPlus, she reminded me of my grandmother.
.
I immediately turned onto the shoulder of the road and asked the woman if
she needed a ride. She said yes and thanked us for stopping. The woman got in
the car and sat in back seat. I noticed that she was perspiring so I asked her if
she was thirsty and she said that she was fine. Then we asked her what was her
name and where was she going. The first words out of her mouth were, "“I just
had lunch with President Ford and I was on my way home.”"
A red flag went up and Dinah and I looked at each other. Then we both took
turns trying to engage the lady into a meaningful conversation. Unfortunately, we
could not make much sense out of anything she said nor could she tell us how to
get to her house. And, at one point, it seemed like she was just enjoying the ride
without a care or sense of urgency. For example, hHours had passed and while
we were still trying to locate her house,; the elderly woman smiled and said to
Dinah, "“That James sure can drive." .”
To make a long story short, the elderly woman had wandered miles away
from her home and after a five-hour search and contact with the local sheriff and
strangers, we finally located her family who thanked us for bringing their mMom
back home. The family fed us dinner and shared stories about how their mother
had wandered in the past. Unfortunately, they nor we had little or no
understanding about Alzheimer’'s or dementia. But, we thanked God for using us
to get the woman home safe. .
We did not know it at the time that we were paying it forward because my
mother also wandered away from home and God sent His angels to protect her as
well. For example, oOn some occasions, there would be a few minutes gap
between the time the aide left my mother’'s house and the time I would bring
mMom her dinner. And, it was during a couple of those gaps that my mother
waondered away from home. .
Thank God my mother had a good neighbor named Mr. James Lively who
kept an eye out for us. Like the time Mr. Lively called me and told me that my
mother was walking towards the highway. Thank God I arrived within minutes
and found my mother before she got too far from home. I also thanked God for
Mr. Lively who has since gone home to be with the Lord. .
It was at that point that Rick and I realized that we could no longer leave
our mother unattended at any time. We considered getting a monitoring device
that could alert us and help us find her in the event that she wandered. However,
mMom had other safety concerns that required constant monitoring. Therefore, I
moved mMom and Muffin into our house. .
To help me and Dinah out, Rick would take mMom to his house on the
weekends that he was off from work. And like Dinah and Ime, Rick and Yvette,
took turns caring and keeping an eye on mMom day and night, which became
increasingly challenging over time. Hence, we had to sleep with one eye open
because mMom had lost all meaning of time. Plus, mMom was very mobile.
Therefore, So I installed devices on our doors to alert us if they were opened.
This was very critical because one of Rick’'s neighbor’s mom also had dementia. .
And, not too long after they moved their mom in with them, she walked out the
house one night and she was found dead the next day lying in a pond. In another
similar case, the woman was never found.
To make matters worse, mMom had not been prescribed any sleep
medication prior to moving her into our house. However, she was prescribed the
drug Aerosep, which she had been taking for about a year prior to moving into
our house. And, although the drug slows the progression of the disease, it does
not reverse the effects of the disease; especially the problems associated with
short-term memory and other cognitive deficiencies. As a result, my mother’'s
mental health continued to decline, which not only affected her activities of daily
living, but also her continence and ambulation factors as well. In other words, my
mother needed total assistance in going to the bath room, changing her clothes,
washing up, etc. .
We also stopped telling mMom when friends and relatives passed away
because she had reached the point where she no longer understood the meaning
of death or other events. However, her spirit allowed her to connect with the
atmosphere that was created or associated with an event. As a result, we kept
mMom away from funerals and other events that caused grief. On the other
hand, we always told mMom the good news, whether she understood it or not.
And we always included mMom in all of our celebrations, where she would smile,
laugh, clap her hands, and sing along with everyone else. .
On the downside, the task of getting mMom to these events became
increasingly difficult. However, But seeing the smile on her face was well worth
the effort it took to get her there. It was also a blessing that mMom was still
physically strong and mobile. However, , on the other hand, her strength and
mobility made it more difficult to assist her with certain activities. Therefore, I
had to improvise methods to get her to do things to make it easier to take off her
clothes and wash her body. For example, I devised a method to get her to laugh
while I removed her dentures. Or I would tickle her to move her arms while I
removed her sweater or blouse.
Unfortunately, most of the methods I devised were short-lived, therefore, so
old methods had to be modified or new methods had to be developed. For
example, iIt became increasingly difficult to put my mother’'s dentures back into
her mouth.: She would mistake the dentures for food or she would not position
her head correctly or she would scream as if she was in a lot of pain. But,
because of the benefits associated with her dentures, i.e., chewing, smiling, etc., I
was determined to get her dentures back into her mouth, which I was able to do
most of the time. .
Rick and I soon realized that we were unable to provide the “"professional”"
round-the-clock care and assistance that mMom needed. And, after much prayer
and research, we located a skilled nursing facility we felt comfortable with and
could afford. However, deep down inside, I did not want to put my mother into a
facility. But, we did not have the benefits of a large family like the ones that
existed during my mother’'s generation; especially like the people who lived in
rural communities where everybody knew each other and where family members
took turns caring for gGrandma or Aunt Annie. .
Unfortunately, those days are long gone and the world is far more
dangerous than it was 50 fifty years ago, i.e., drugs, crime, urbanization, etc.
Nevertheless, Rick and I had to make a decision about placing mMom into a
nursing facility because we realized that despite our good intentions, finding
professional care for mMom outweighed keeping her at home with us. For
example, wWe found out that most of the facilities had a dementia care unit that
was staffed and maintained 24/7. Some facilities were setup and better
maintained than others but the cost and the distance were always deciding
factors. This was important because we wanted to be able get to Mmom as
quickly as possible at an affordable cost. Hence, some of the facilities were miles
away while others were too expensive. .
After touring the facility we chose, I was amazed to find that the rooms
resembled the apartment mMom had described that she wanted for her next
move. In other words, before her diagnosis, mMom had talked about finding a
one-room apartment for herself and Muffin. However, I was not too anxious for
mMom to go into a facility. Therefore, So I told Rick that he could take her there
and I would visit her the next day.
I had already made up my mind that if mMom showed any signs of wanting
to leave the facility when I visited her the next day, I was prepared to take her
home in a heartbeat. But, to my surprise, mMom was very happy and content
when I visited her the next day. She had a roommate and they got along fine.
However, But I was still not comfortable, therefore, I made going to the nursing
home a daily routine, including making surprise visits at night. Rick, Yvette, and
Dinah also made visits and we sometimes made visits back to back.
In addition to our visits, I would take mMom out of the facility once or twice
a week and we would go to different places for lunch or we would go shopping or
both. On some occasions, we would go to a Wal-MartWal-Mart store where
mMom would push her cart and put things in it. Sometimes I would buy mMom
ice cream bars and other goodies for her to take back to the facility where she
would share them with her roommate. . On other occasions, I would sign mMom
out for the entire weekend. Mom would stay at our house over the weekend and
we would return her to the facility after dinner on Sundays. We also signed
mMom out of the facility during holidays and other special occasions like
birthdays and graduations. .
As a result of our visits to the nursing facility, we became well- known and
we received many compliments about the way we took care of our mom. For
example, I continued to feed and change mMom as necessary and I often took her
outside for walks when the weather permitted. However, as nice as the staff were
at facility, we learned that we had to check behind them regarding mMom’'s
medication and daily care. We also discovered that the facility often rotated or
changed staff; therefore, so the new staff had to get used to mMom’'s behavior
and medical needs. .
Mom thrived in the facility for about 18 eighteen months before she started
experiencing some serious problems, including a couple of unexplained falls.
And, on one occasion, the staff could not explain why my mother had a black eye
and a bump on her head. I asked mMom what happened, but she was unable to
tell me anything. So I asked the floor supervisor what happened. She told me
that my mother fell and hit her head, but no one saw her fall. I wasn’'t satisfied,
especially after they told me that they did not think my mother needed to see a
doctor. I was livid.: I told the staff that if they didn’'t call an ambulance, I was
going to call the police. Not for them, but for me because I was about to lose
control. The staff quickly called an ambulance and mMom was taken to the
hospital where she checked out. .
The hospital took X-rays, which did not reveal any factures or broken bones.
They kept mMom for observation and released her the same day. As a result, of
this and other incidents, Rick and I conceded that the nursing facility had some
benefits but, it also had some problems too. For example, because the facility
knew that we would frequently check on our mMom, they took extra care to do
things right. However, other patients were often neglected, like our mother’'s
first roommate who did not have any friends or relatives to check on her.
Therefore,So we adopted mom’'s roommate and treated her like family, including
letting the staff know when she needed assistance. And, if we brought mMom
some treats, we brought her roommate some treats too. Mom’'s first roommate
eventually passed away and her new roommate was just as nice and we adopted
her too. .
Although mMom’'s stay at the nursing facility presented many new
challenges, the benefits of the facility continued to outweigh the options of
keeping mMom at home. Hence, in addition to the around-the-clock care, mMom
also benefited from the activities at the nursing facility, especially activities
involving multisensory therapy (also known as Snoezelen). For example, I later
learned that one of the reasons my mother’'s dementia often caused her to have
undesirable behavior was related to her inability to articulate her needs, which is
considered a developmental disability. .
Multisensory therapy was designed to help patients with developmental
disabilities so that they can enjoy a better quality of life by enhancing their
sensation and emotions (Effects, 2009, p. 2508). For example, dDementia
patients may become aggressive or agitated in the afternoon because they may
not be able to articulate their desire for food or any other things that might
bother them. Therefore, multisensory therapy uses different techniques and
activities to improve their quality of life. Some facilities, for example, have
calming rooms that are equipped with controlled lighting features and textured
walls, which is another benefit of a 24/7 care facility.
XVI:
Acceptance
The services that were provided in the skilled nursing facility, including the
multisensory therapy, improved my mother’'s emotions and quality of life.
However,, mMom’'s overall condition steadily declined over a period of time.
And, as I dreadfully predicted and anticipated, the day finally came when I was no
longer able to put mMom’'s dentures back into her mouth even with the
assistance of the nursing staff. . However, the funny thing about this situation
was, my mother enjoyed not having the dentures in her mouth. . And, although it
bothered me more than it bothered her, I eventually looked past the reality that
mMom would never wear her dentures again and I accepted her toothless grin
and loved her just the same. Again, it was my behavior and attitude that needed
to change instead of my mother’'s behavior.
Mom eventually lost her ability to walk and, within a month after that, she
lost her ability to eat. The latter was the most painful part to bearare because
mMom’'s appetite was one of the things we all cherished during her journey.
Hence, while everything else was declining, as long as mMom was eating, we
were OK okay and counted it as a blessing. But, as hopeful as we were, mMom’'s
ability to eat stopped. Therefore, we had to prepare mMom and ourselves for the
next level of care for our mother. And, through God’'s grace and mercy, we were
able to move mMom to a facility that was closer to our house. .
The new facility was much nicer than the other facility. For example, iIt
was a lot cleaner and the staff to patient ratio was much smaller than the other
facility. However, despite the resources at the new facility, mMom’'s health
continued to decline to the point where she was unable to hold her head up. But,
to God be the glory, mMom could still respond to praise and worship music by
wiggling her shoulders from side to side, including sometimes momentarily
raising her head and smiling. Therefore, we were still hopeful despite the
doctor’'s report. .
On one particular day, I was approached by one of the staff members at the
new facility who had observed me on several occasions trying to coach my mother
to eat. The staff member pulled me aside, and with tears in her eyes, she
explained to me that my mother was in the final stages of the disease and she no
longer possessed the ability to eat on her own. She further stated that she
understood how I felt because she went through the same thing with her mom.
Again, it was my behavior that had to be modified because mMom, through
her advance medical directive, had already prepared us for that moment in time.
Therefore, tube- -feeding, which is a form of life- support, was not an option.
Instead, we honored mMom’'s wishes and followed her instructions.
Nevertheless, I had to modify my behavior in order to accept hospice care but, I
never stopped loving, believing, and caring for my mom as she bravely progressed
through the final stage of the disease. Therefore, wWe assisted the staff in
making mMom as comfortable as possible through the last leg of her journey.
The scripture that helped me the most throughout mMom’'s journey can be
found in Proverbs 3:5-–6 (NKJV), which says, "“Trust in the Lord with all your
heart, Aand lean not on your own understanding.; In all your ways, acknowledge
Him, aAnd He shall direct your paths.”" The Serenity Prayer was also helpful,
i.e., "“God grant me the serenity to accept the things I cannot change.; Courage
to change the things I can,; Aand the wisdom to know the difference.”"
2000 2008
Happy Mother'’s Day! Mom (aAge 73) standing near the rose bush she planted in California. Proud Grandmother at Granddaughter's (In years like 1992, 1998, and 2009, Graduation Mom (aAge 81)
&and Bre (Aage 17) (Mom’'s dementia was in Stage 2: The changes werebecoming more noticeable.
mMom’'s birthday came on the same day as Mother’'s Day, and wemade sure
we celebrated both days!) Mom suddently stopped watching TV, and we had to stop
her from driving four months after this picture was taken.)
2009
Mom (Aage 82) In Front of Her House During the Christmas Season
(Mom’'s dementia was in early Stage 5: Her manner of dress had become
more noticeable; however, her bubbly spirit was still very much intact.)
2012 2013
Happy Reunion: Mom (aAge 85) with nieces Elaine andErnestine enjoying lunch at Ralph’'s Barbecue in RoanokeRapids, NC.(Mom's dementia was in early Stage 6: She passed away two months before her 87th birthday.)
Happy 86th Birthday Mom! Mom and& Son Jack (Picture was taken in mMom’'s room at the nursing facility. Mom's dementia was in late Stage 6: She did not know or recognize Jack, and she could not recall her nieces’' names, but she recognized gradually their faces. She also ate everything with her hands.) She slipped into Stage 7 within three months after her birthday.
Rapids, NC.
XVII
: Prevention
After witnessing my mother and other relatives go through the various
stages of Alzheimer’'s and dementia, I could not help but wonder if it could
happen to me or any of my other family members. And, as I mentioned earlier,
statistics show that most people in the 80's eighties suffer from some forms of
dementia or Alzheimer’'s. Furthermore, people are living longer than in the past.
Therefore, I became very interested in learning more about preventing and
delaying the onset of dementia. .
The information I found on prevention was very helpful. It was also good to
know that disease prevention continues to be a top priority among healthcare
providers around the world. For example, iIn response to the growing incidence
of age-related illnesses, researchers Tse and Benzi (2004) reported that, “"Nurses
form the largest professional healthcare group in the world, and the professional
code of the modern day nurse advocates health promotion as a primary role.”"
Tse and Benzi (2004) go on to say that nurses, due to their close relationship with
the community and their clients, are in a great position to educate the aging
population with the goal of achieving functional longevity (p. 309)..
The country of Malaysia is a good example of countries taking measures to
improve the lives of their aging population. The guidelines they published on
aging were adopted from the criteria that was set at the 1982 World Assembly on
Aging (Arabi et al., 2013, p. 1). For example, Malaysia classifiesy people over 60
sixty years of age as being elderly, therefore, age-related diseases, such as
dementia, can manifest sooner in some countries than in others. However, based
on the new research and data that links concussions to dementia and
Alzheimer’'s, the onset of these diseases can occur in more countries much
sooner. In other words, patients of all ages can experience dementia or
Alzheimer’'s related symptoms as a result of a traumatic brain injury. For
example, the facility that my mother was in had several dementia patients who
were in their 40's forties and 50'sfifties.
To reduce this growing trend, researchers from around the world have been
working together and comparing their notes in an effort to combat a common
enemy,: dementia. And, as a result of this concerted effort, we are much further
along than we were in the past in the areas of prevention. For example, nNew
rules and standards have been adapted in all levels of contact sports, ranging
from improved helmets to stiffer penalties for illegal hits to the head. But, is it
that enough?
The solution may be to ban or significantly modify some of these sports
altogether. And, knowing what I know now, I am more reserved than ever before
about promoting or participating in contact sports, especially for my
grandchildren. Therefore, parents and guardians must also play a greater role
than ever before to protect their children from needless and senseless head
trauma.
Nevertheless, the solutions for preventing dementia range from simple to
scientific. Some researchers , for example, suggest that moderate bi-weekly
activities, like dancing or walking, will reduce your chances of developing
dementia and Alzheimer’'s disease by as much as 52% percent and 60% percent
respectively (Corbett, 2006, p.1). Thomas Foster, PhD, the Evelyn F. McKnight
chair for brain research in memory loss at the University of Florida College of
Medicine states that, "“eExercise maintains the mind’'s cognitive abilities by
triggering the release of brain-protecting molecules, and guards against the
decrease of neurons "(Corbett, 2006, p.1).”
Another study suggests that a person in their twenties or thirties who
participates in physical activities may lower their chances of developing
Alzheimer’'s disease (Effects, 2009, p. 2510). Furthermore, mMany studies have
proven that adopting a healthy lifestyle early in life, and staying with it, will
produce many health benefits. . Unfortunately, because my mother worked most
of her life, she did not have time to focus on activities strictly to improve her
health. But, on the other hand, she did maintain a healthy lifestyle.
Other researchers point toward diet as a key element in preventing
dementia. And, as noted in the aforementioned discussions on amyloid plaque
deposits and vascular dementia,; there are some dietary factors that can
contribute to the disease. Conversely, other dietary factors can prevent the
disease. For example, sSome studies reported the success of dietary supplements
such as vitamin E and gingko biloba in preventing or slowing the progression of
dementia (Tse and Benzi, 2004, p. 311). And, in a study conducted by Ozawa et
al., (2012), it was reported that higher dietary intake of potassium, calcium, and
magnesium significantly reduced the hazardous ratio for the development of
dementia (p. 1518).
While some researchers concentrate on diet and exercise, others take a
more holistic approach to preventing dementia. For example, The Middleton and
Yaffe (2010), published an article titled "“Targets for the Prevention of
Dementia”" suggesting that multi-level intervention such as cognitive, physical,
and social activity,; vascular risk factors, and diet all play a role in preventing
dementia (p. 915). This strategy of dementia prevention made the most sense to
me. Therefore, after learning about the benefits of the holistic approach, I
immediately increased and/or modified some of the things I was already doing to
improve my health.
I also adopted some new habits. For example, I eliminated a lot of junk and
fatty foods from my diet and added more fruits and vegetables. I routinely and
purposely drink more water and, to exercise my brain, I purposely engage in
remembering new names and phone numbers without writing them down. I also
increased my reading activities and added more sleep and exercise to my daily
routine. Writing this book is another example of the activities I engage in to
exercise my brain. These things may not prevent or delay dementia but, I feel
much better and my mind is much sharper as a result of these activities. .
There have been many new breakthroughs regarding dementia prevention.;
hHowever, some of these breakthroughs are nothing more than old remedies with
new twists. For example, in an article, published in Consumer Reports on Health,
titled, "“Aspirin: Pain Reliever, Lifesaver,”" it not only lists the benefits of aspirin
associated with a broad range of disorders, such as reducing pain, and reducing
heart attacks and strokes. . The article also presented evidence showing the
benefits of aspirin on dementia patients. For example, iIt included a study that
was conducted by the Department of Veterans Affairs where researchers gave a
daily tablet or no aspirin to 70 seventies patients who had dementia that was
caused by repeated mild strokes. After three years of treatment, it was noted that
the patients who were administered a daily dose of aspirin had a positive blood
flow to the brain, which increased their intellectual capacity (Aspirin, 1997, p. 5).
In another study, experiments conducted on mice brains concluded that statins
(cholesterol medication) was effective in reducing the accumulation of amyloid
plaques (Harder, 2004, p. 3).
Early detection seems to be the best argument for preventing or delaying
dementia.; tTherefore, any research that will assist in early detention will be
beneficial. For example, a A study was conducted using a newly developed Early
Dementia Questionnaire (EDQ) to screen elderly patients for dementia in primary
care and comparing the results to the widely used Mini Mental State Examination
(MMSE) assessment tool. The study concluded that the EDQ offers an alternative
for assessing early dementia. Therefore, bBetter treatment options and outcomes
can be achieved by using more than one assessment instrument for detecting
early signs of dementia (Arabi et al., 2013, p. 49–-57).
In another example on how early detection and treatment seems to be the
best option, researcher Ben Harder (2004) believes that there is new hope for
drugs that failed as cures for Alzheimer’'s disease in the past, but may now be
seen as drugs that may help prevent or delay the disease’'s onset (p. 1-–3).
Hence, researchers now believe that at least some of these old approaches may
have new value if they are administered sooner or prior to the disease’'s onset.
For example, aAs I mentioned earlier, some researchers believe statins used to
treat cholesterol have been found to be effective in reducing amyloid plaque
buildup in the brain (Harder, 2004, p. 1-–3). However, as I also mentioned
earlier, a recent report confirmed that statin drugs accelerate cardiovascular
disease (Mercola, 2012, p.1), which can subsequently lead to dementia and
Alzheimer’'s.'.
So what do you do when one report says statins are good for preventing the
onset of dementia, while another report says that statins could indirectly
contribute to the onset of dementia by accelerating a cardiovascular disease? I
do not know because it happens all the time.: One day someone says something is
good for you. The next day, someone else says it is bad for you. For example,
antioxidants have been found to be effective in reducing dementia if taken prior to
the onset of the disease. The keyword is "“if.”" Therefore, no matter what type of
drug or product you use or stop using,; timing is critical because once the malady
is present, it may be too late to cure the disease.
As you can see, most of the solutions to preventing dementia rest heavily on
human behavior. Therefore, fFor any prevention method to work, people must be
willing to change or modify their behavior to get the best results, which may
require some additional help or therapy. For example, iIn an article published in
the Richmond Times Dispatch, it was reported that, "“Americans are eating their
worst since 2008" (Chew on this: p. A4).” This negative trend does little to
diminish the obesity problem we already have in this country. Therefore, it will
take a "“wrap-around approach"” that involves the individual, his or her family,
and the health care community to accomplish the mission. .
Again, looking at the nursing field I mentioned earlier, nurses do play a key
role in getting the word out and reinforcing positive health choices that can
prevent or reduce age-related diseases, including dementia. . However,
according to Tse and Benzi (2004), "“This requires that nurses themselves
increase their awareness, knowledge, and understanding of relevant
interdisciplinary research findings" (p. 309).” Likewise, family members also play
a very important role regarding dementia prevention and treatment. However,
jJust like nurses, family members must also educate themselves on the proper
care and treatment of their aging parent(s) or relative(s), including knowing the
risks of poor diets, lack of exercise, and declining health qualities. .
In other words, the more we know about the causes and effects of dementia,
the better we can respond to ensure our aging parent(s) or relative(s) don’'t
become a statistic due to inadequate care or counseling. . Unfortunately,
effective treatment is often expensive and affordable treatment may be hard to
find, which I experienced firsthand. However, the more we know about
prevention and treatment, the more informed will be in our decision making. .
Poverty and low income continue to be a problem associated with dementia
treatment options. On top of that, it has been reported that the majority of the
increase in dementia cases will come from low- income countries (Singh-Manoux
and Kivimäki, 2010, p. 309). However, these statistics are not limited to low -
income countries., iIt’'s a global problem that is common to many countries where
people have to choose between healthy food and limited resources. For example,
iIn the aforementioned Richmond Times Dispatch article, Valerie Ruelas, who is
the director of the Community Diabetes Initiative of the University of Southern
California and Children’'s Hospital Los Angeles states that, "“Pproduce sold in
impoverished communities is often of poorer quality, making it less appealing to
strapped consumers" (p. A4).”
Food desert is another name for this phenomenon or trend that affect many
urban and densely populated areas where there is little or no access to fresh or
affordable healthy foods. As I pointed out earlier, we were blessed in this area
because my mother was able to grow her own fresh produce, including the
cantaloupes and watermelons she grew in the summer. However, as I have seen
too often in many urban communities around the country and, it is sad.: You can
find a liquor store on just about every other corner, but fresh food markets are
often hard to find or nonexistent. Speaking of alcohol, the best way to prevent
the onset of alcohol dementia and other alcohol-related diseases, including cancer
and cirrhosis of the liver,; is to refrain from drinking alcohol in excess, especially
binge drinking. Better yet, avoid drinking alcohol altogether. You will be amazed
at the results. .
The effects of water pollution, tap water, and bottled water that I mentioned
earlier should not be overlooked because they can also adversely affect your
health in many ways, especially children and the elderly. That is why, in this day
and age, many health experts recommend a point-of-use water purification system
that has been certified by NSF International to remove a wide range of volatile
organic chemicals and other contaminates from your drinking water. Therefore,
once you obtain clean and safe drinking water be sure to drink plenty of it
because, as I discussed earlier, our body needs water to live and function the way
God designed it. Most of all, stay hydrated and adhere to the warning signs of
dehydration, i.e., bad breath, extra yellow urine, constipation, headache, fatigue,
muscle cramps, etc. .
Air pollution is another factor that we must consider. Hence, not only
should we do our part to reduce air pollution,; we also must be mindful of the
dangerous effects of air pollution and the impact it has on our health, including
the onset of dementia. And, like water, our body needs clean air to live and
function the way God designed it. Therefore, it is essential to your health to
protect your lungs from dangerous chemicals and other pollutants that are
avoidable. For example, burn pits, indoor garages with running gasoline engines,
second-hand smoke, etc. And, if you smoke, quitting will greatly improve your
health, including reducing or eliminating the onset of dementia, COPD,
emphysema, cancer, and other diseases.
According to the American Lung Association, some of the things we can do
to reduce air pollution, include: Uusing less electricity,; driving less by car
pooling or using public transportation,; refraining from burning wood or trash,;
making sure your local school system requires clean school buses that reduce
emission,; and, get involved in clean -air efforts (American, 2014, pp. 10-–11).
Furthermore, pPeople residing in cities or towns with poor air qualities should
seriously consider air pollution as a deciding factor before moving into or out of a
particular locality. This should be especially important for people who are
considering moving or relocating as a result of retirement or a job change.
Hence, you may achieve a short-term financial gain. But, is it worth gaining a
long-term illness resulting from the effects of air pollution?
There is still much more work to be done in the area of disease prevention,
however, the possibilities of finding ways to prevent dementia or slow its
progression are greater than before. The Bible says in Hosea 4:6 (NKJV), "“For
my people are destroyed for lack of knowledge. Because you have rejected
knowledge.”" As a believer, I do not reject knowledge, therefore, I applaud the
new breakthroughs that shed light on how diet, exercise, and other life-style
changes can prevent dementia, especially in the areas of early detection and
treatment. And, I don’'t believe you have to be a “"biophysicist”" or a
"“nutritionist”" to figure out why people in some countries do better than people
in other countries regarding age-related illnesses. .
The seventeen17-year Hisayama Study on the self-reported dietary intake of
potassium, calcium, and magnesium and risk of dementia in Japanese people that
was conducted by Ozawa et. al (2012) to explain their effects on the development
of dementia is a good example. Their study reported that, “"hHigher self-reported
dietary intakes of potassium, calcium, and magnesium reduce the risk of all-cause
dementia,”" (p. 1516) especially vascular dementia. So why aren’'t we doing the
same? ?
The answer to this question can be found in the fact that our country, as a
whole, has a problem when it comes to diet and exercise, which are also related
to our obesity problem. And, although it is an individual’'s responsibility to
maintain a healthy lifestyle, some people may need assistance to combat dementia
and other age-related illnesses; not just in this country but also world-wide. In
doing so, the road to preventing dementia will become shorter and shorter until it
is no longer a fatal age-related disease.
XVIII: Preparing for Your Future
My mother’'s journey through the different stages of dementia taught me
many lessons about life and it really opened my eyes. Therefore, outside of
establishing and maintaining a relationship with God through His son, Jesus
Christ,; I believe that it is also important to make the following preparations while
you, your spouse, and/or your aging parent(s) or other family members are still
competent:
1. Will: Make sure you have a will prepared, even if you don’'t have nothing
anything more than a comb or brush that you want someone or some organization
to have. It will help prevent conflicts and confusion among your survivors.
Review and update your will as often as necessary but at least every five years or
when significant changes occur, e.g., death, divorce, etc. .
2. Advance Health Care Directive: You need to have an advance health
care directives, which includes a power of attorney that appoints a health agent.
The directive also includes a living will to convey instructions for end-of-life care,
which will allow you, your parents, and/or your spouse to appoint a health care
agent to make decisions on their or your behalf. For example, the directive
conveys a patient’'s specific instructions regarding their care, such as, if they
want to be placed on life support, be resuscitated, etc. And, just like a will,
advance health care directives should be reviewed and updated when significant
changes occur l: Like death or a divorce,; change in health, etc. .
3. Power of Attorney: You may also want to designate a Power of Attorney
to act on your behalf regarding your legal matters, i.e., someone to close your
bank account(s), pay your bills, sell your property, etc. However, spouses and
other people with joint -bank accounts and joint -vehicle registrations can act on
each other’'s behalf. But, at the same, they must return or stop the deceased’'s
Social Security payments that are deposited in their account after the time -limit
imposed by law.
4. Life Insurance and/or Burial Plan: Unless you have a substantial
amount of money set aside, you need to make sure you have enough life insurance
or a burial plan to take care of your bills and final expenses. This will not only
reduce the pain and suffering of your loveds ones, it will also allow you to convey
your wishes regarding funeral arrangements. Keep in mind that the older you get
the more these plans will cost you. Therefore, invest in life insurance and/or a
burial plan as soon as you can and at the price and amount you can afford. Term
insurance is generally cheaper than whole life insurance. A good strategy is to
buy term insurance and invest the difference, which allows you to have some
living benefits instead of just death benefits. However, regardless of the plan you
chose, do not allow your policy to lapse due to non-payments, which could result
in no benefits.
5. Long-Term Care Insurance: Last, but not least, you may want to
seriously consider getting some long-term care insurance if you can afford it,
especially if you can sign up for it through your place of employment. I say this
because times have certainly changed during these 60 sixty plus years I have
been living. . For one, the rising cost of healthcare can wipe you out financially in
one episode. Therefore, you need long-term care insurance to cover the cost
associated with nursing homes, assisted living facilities, and/or extended
hospitalization. Furthermore, attitudes have changed.: Millennials are much
different than their Generation X and Boomer predecessors. As a result, the
concept of large extended families taking care of one another, especially the
elderly, have almost become a thing of the past. For example, a A friend who
have two sons once told me that if he became incapacitated, he believes one of his
sons would probably wipe his backside while the other son would probably pay
two people do it. .
7. Personal Asset Inventory: In addition to the aforementioned
documents, which should be stored in a fireproof safe or cabinet. You also need
to make sure you also have a personal asset inventory so that your loved ones
can locate them. As a minimum, the inventory should include your bank accounts
(checking and savings),; certificates of deposit,; investment accounts,; insurance
policies,; and mortgages, loans and credit cards. A list that includes the name
and contact information of your financial advisor, accountant, and legal advisor
will also be helpful. Like the other documents, your personal asset inventory
should be stored in a safe and secure place.
My mother made all of these preparations, which made it easier to make
decisions concerning her health and legal matters. I thank her for everything she
taught me in life, including that which I learned from her journey through the
different stages of dementia. .
Mom lived a full life before she went to her heavenly home on March 7,
2014 at the age of 86eighty-six. Thanks to God and His son, Jesus Christ, we did
not walk the journey alone. And, yes, mMom will "“dwell in the house of the Lord
forever”" and ever. Amen. .
XIX:
Resources
The following organizations can help you find resources or assistance
regarding your
aging parent(s), relative(s), or friend(s):
Alzheimer ’ ' s Foundation of America (AFA) (http://www.alzfdn.org)
The AFA provides a wide range of services through their toll free
helpline. The AFA has a team of licensed social workers who take calls and
respond to questions regarding individuals living with Alzheimer’s and
other Dementia related illnesses. They also provide assistance via Skype,
live chat and email. In addition, AFA website contains an array of
information on Alzheimer’'s, dementia and care giving.
The American Bar Association (ABA) (http://www.americanbar.org)
The ABA has a resource link where you can find legal information
relating to aging. For
example, yYou can find information on elder abuse, health care
decision - making, long-
term care services and support, etc.
The American Geriatrics Society (AGS)
(http://www.americangeriatrics.org)
According to their website, the AGS vision for the future is to ensure
older Americans receive
h high-quality, person- centered care. They also provide leadership to
healthcare professionals,
policy makers, and the public by implementing and advocating for
programs in patient care,
research, professional and public education, and public policy
(www.americangeriatrics.org).
The Better Business Bureau (BBB):
When looking for services, it would not hurt to contact the
BBB to see if there are any complaints on a particular doctor or
business organization. .
The Centers for Medicare and Medicaid (CMS) (http://www.cms.gov)
The CMS website provides a list of contact phone numbers and web
links to help you find answers
to questions relating to Medicare and Medicaid.
The Department of Social Services (DSS):
Your local DSS can also assist you with Medicaid
and Medicare related issues, including valuable information and
assistance regarding elderly care, ;
reporting elderly abuse;, nursing home placement,; and long-term care.
The Department of Health in your state or local jurisdiction can
provide you with information
r regarding the status of hospitals, nursing facilities, funeral homes,
e.g., licensing, complaints,
violations, etc.
The Department of Health Professions in your state is the organization
you need to contact if you want to check the status or the credentials of a
particular doctor or practitioner.
For example: Is the
doctor or practitioner licensed to practice in your state? Does he or she
have any complaints or
violations on his or her record? ?
Local Support Groups may also be helpful. Support groups connect
you with people in your area
who are experiencing similar challenges regarding care giving, hospice
care, grief, etc.
Works Cited
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Arabi, Z., Aziz, N., Aziz, A., Razali, R., & Puteh, S. (2013). Early Dementia Questionnaire (EDQ): A new screening instrument for early dementia in primary care practice. BMC Family Practice, 14(1), 49-–57. doi:10.1186/1471-2296-14-49
Aspirin: Pain reliever, lifesaver. (1997, March). Consumer Reports on Health, 9(3), 30.
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Berk, L. E. (2010). Exploring Lifespan Development (2nd ed.). Boston, MA: Ally & Bacon
Chew on this: Healthful eating declines in U.S. (2013, December 2) Richmond Times Dispatch, p. A4.
Corbett, H. C. (2006). bulk up your brain, to boot. Prevention, 58(4), 156.
Donnelly, L. (2016, March 5). Air pollution could increase risk of dementia. The Telegraph, p. 1.
Effects of multisensory therapy on behavior of adult clients with developmental disabilities; Physical leisure activities and their role in preventing dementia: a systematic review; Brief interventions for heavy alcohol users admitted to general.. (2009). Effects, 65(12), 2508–-2513. doi:10.1111/j.1365-2648.2009.05151.x
Gandy, S. (2011). Perspective: Prevention is better than cure. Nature, 475(7355), S15. doi:10.1038/475S15a
Harder, B. (2004). Delaying Dementia. Science News, 165(19), 296–-298.
Helmenstine, A.M. (2015, November 6). Question: How Much of Your Body Is Water? About.com, p. 1.
Hockenbury, D. H. & S.E., (2011). Discovering Psychology (5th ed.). New York, NY: Worth Publishers.
Jackson, B. (2014, April 9). 5 Native American Communities Who Owned Enslaved Africans. Atlantic Blackstar, p. 3.
Kang, M. (2013, March 21). Wash. state has the highest Alzheimer's death rate in U.S. KPLU 88.5, p. 1.
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Kunkle, F., (2015, February 16). Alzheimer's and blacks: higher risk, challenge. Richmond Times Dispatch, p. D1–-2.
Mercola, J. (2012, October 15). Confirmed Again: Statin Drugs Accelerate Cardiovascular Disease. Mercola.com. p. 1.
Middleton, L. E., & Yaffe, K. (2010). Targets for the Prevention of Dementia. Middleton and Yaffe, 20(3), 915-924. doi:10.3233/JAD-2010-091657
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About the Author
James Neville was born in Halifax County, North Carolina. He grew
up in Jersey City,
New Jersey where he learned to cuss and fight just like some of the
other kids in his neighborhood.
However, he thanks God for His son Jesus Christ who delivered him out
of those conditions. He also
thanks his mother for praying for him and keeping him in line.
James always had a thirst for knowledge; however, he did not let
poverty or the effects of an
absent father stop him being successful. As a result, he successfully
completed 21 years of service
in the U.S. Air Force and retired in 1993 as a Senior Master Sergeant.
After he left the military, James first worked as a substitute teacher
for Richmond Public Schools
before he was hired by the Richmond City Department of Social
Services as a Benefits Programs
Specialist. He was subsequently promoted twice during a seven-year
period. First, as a Case Manager
for the Family Violence Prevention Program and then to a Social Work
Specialist in the same program.
In 2009, after 14 years of service; James took an early retirement to
devote full-time care to
his mother who was diagnosed with dementia. He currently serves as a
member of the Healthy Families
Richmond Advisory Committee and volunteers his time and services to
the Richmond City Neighbor to
Neighbor Program, the Junior Achievement Program, his church, and
other community organizations.
James and his wife Dinah, who met in high school, have been married
for over 42 years. They
have three wonderful children; two wonderful daughter-in-laws and five
wonderful grandchildren.
About Tthe Author:
James Neville was born in Halifax County, North Carolina. He grew up in
Jersey City,
New Jersey, where he learned to cuss and fight just like some of the other
kids in his neighborhood.
However, he thanks God for His son, Jesus Christ, who delivered him out of
those conditions. He also
thanks his mother for praying for him and keeping him in line. .
James always had a thirst for knowledge.; hHowever, he did not let poverty
or the effects of an
absent father stop him from being successful. As a result, he successfully
completed 21 twenty-one years of service
in the U.S. Air Force and retired in 1993 as a Senior Master Sergeant.
After he left the military, James first worked as a substitute teacher
for Richmond Public Schools
before he was hired by the Richmond City Department of Social Services as a
Benefits Programs
Specialist. He was subsequently promoted twice during a seven-year period.
First, as a Case Manager
for the Family Violence Prevention Program and then to a Social Work Specialist
in the same program.
In 2009, after 14 fourteen years of service,; James took an early retirement
to devote full -time care to
his mother who was diagnosed with dementia. He currently serves as a
member of the Healthy Families Richmond Advisory Committee and volunteers
his time and services to the Richmond City Neighbor to Neighbor Program, the
Junior Achievement Program, his church, and other community organizations.
James and his wife, Dinah, who met in high school, have been married for
over 42 forty-two years. They have three wonderful children;, two wonderful
daughters-in-laws and five wonderful grandchildren.
Blurb:
The author shares his mother’'s story and the lessons he learned from her
transition through the different stages of dementia. By reflecting on his mother’'s
life and legacy from a Christian perspective, the author uses her story to illustrate
the different stages of dementia and the challenges he faced as a caregiver. With
goal of promoting awareness, the author discusses some of the new discoveries
regarding the causes and the risk factors associated with dementia and
Alzheimer’'s. He includes some helpful resource information; and he also
addresses some of the signs and symptoms of dementia and concludes that diet,
exercise, and other life-style changes can prevent or slow the progression of
dementia, especially in the areas of early detection and treatment.