Marie Marley, Read this article and thank you thank you thank you. It is the first one which I have read (or seen) which handles the topic of psychotropic drugs realistically.
Usually the drugs are condemed for being used to over-sedate a person on behalf of making it easier for the caregiver or caregiving facility. Also the finger is most often pointed at the possibility of causing premature death in the elderly and that the research (and drug company) does not support its use.
With the help of our doctors, nurses, hospice, and health care facility; I decided to put my Gregory on a very low, vary carefully monitored dose of Risperdal. He was becoming more and more unhappy, agressively acting out (but not violent,) and agitated.
We tried to see what we could change in his care routine and in our comminications (given his inability to work much with language) but were not successful being able to help him to be more comfortable with his life.
The mild dose of Risperdal gave him a new life, one in which he was again content and enjoying his life (given the circumstances.)
Showing posts with label Dementia. Show all posts
Showing posts with label Dementia. Show all posts
Wednesday, March 28, 2018
Tuesday, January 5, 2016
TBD (Thanks, Browse, and Defect) To Be Determined
Dear "michael a horvich cares about Alzheimer's" Blog Readers,
I continue to get many hits on the old site http://mhorvichcares.blogspot.com and I am grateful for that. Look around, browse back through the close to 1,500 plus posts which have received over 74,000 hits. and experience the journey of Gregory and my Dementia/ Alzheimer's experiences, observations, lessons learned, etc.
... but I have taken a big risk by beginning to post only to my writer's blog (http://mhorvich.blogspot.com) since the posts are now about me, about grieving Gregory's death, about living beyond Dementia/ Alzheimer's. The risk is that I will loose some of my readership and that loss makes me sad.
So please, please, please enjoy and learn and grow (if I may be so bold) from my posts on the Dementia/ Alzheimer's blog but also come on over to my writer's blog for future adventures with Dementia, Grieving, and learning more about me and my musings, poetry, observations, essays, humor, fiction, etc.
The "michael a. horvich writes" blog is not new and currently has over 608 posts with 19,966 hits so there is a lot to read there. P.S. Feel free to comment on what you read!
Looking forward to seeing you there,
Michael
NEW SITE: http://mhorvich.blogspot.com
I continue to get many hits on the old site http://mhorvichcares.blogspot.com and I am grateful for that. Look around, browse back through the close to 1,500 plus posts which have received over 74,000 hits. and experience the journey of Gregory and my Dementia/ Alzheimer's experiences, observations, lessons learned, etc.
... but I have taken a big risk by beginning to post only to my writer's blog (http://mhorvich.blogspot.com) since the posts are now about me, about grieving Gregory's death, about living beyond Dementia/ Alzheimer's. The risk is that I will loose some of my readership and that loss makes me sad.
So please, please, please enjoy and learn and grow (if I may be so bold) from my posts on the Dementia/ Alzheimer's blog but also come on over to my writer's blog for future adventures with Dementia, Grieving, and learning more about me and my musings, poetry, observations, essays, humor, fiction, etc.
The "michael a. horvich writes" blog is not new and currently has over 608 posts with 19,966 hits so there is a lot to read there. P.S. Feel free to comment on what you read!
Looking forward to seeing you there,
Michael
NEW SITE: http://mhorvich.blogspot.com
Saturday, December 12, 2015
Perspective Changes
Interesting how one's perceptions of life change when an important person in one's life dies.
When my mom and dad died, I wrestled with how someone could be here today and gone tomorrow. Wondered where that energy went. Wonder where our time together went from my being a child, to a teenager, to a young adult, to a full grown adult (if one ever becomes full grown.)
I missed them. I grieved not only their death but what I considered the missed opportunities for parent/son relationships and how different it could have been if they were different, if I was different.
Acknowledged that I was grateful for many opportunities they did provide and for the love that existed. Acknowledged that they did the best job of parenting that they could and that I did the best job of "offspringing" that I could.
Now, with Gregory's passing, my perceptions of time have been shifting and the shift has caused me to do some deeper thinking.
Gregory and I lived, and we worked at living well for twelve years, with his diagnosis of Dementia/Alzheimer's. At times our life felt normal and at times we also felt like we were living on a roller coaster as his needs confounded, our interactions became surreal, his abilities failed and resurfaced only to finally fail again.
Now when I think about those twelve years, it feels like minutes. At the time it felt like forever, but now that the confusion, frustration, anger, sorrow, fear, etc no longer exists, it feels like moments.
Gregory spent the last 18 months of his life at the Lieberman Center for Health and Rehabilitation on the Alzheimer's Special Care Unit. At the time it was a day in and day out activity. Grateful to Manny for providing not only care and safety for Gregory but also for the love, socialization, and life enrichment he provided on a day to day basis.
When Gregory's health needed extra attention or his medications needed rebalancing or when his difficult behaviors needed a look see; my life would feel topsy turvy. But once the Lieberman nurses, doctors, hospice care, and I did our problem solving; things settled down for both Gregory and me.
Now, with Gregory on his next adventure, without my daily visits, and the Care Conferences, and the monitoring of his daily needs and treatment; it feels like Lieberman was but a breath.
During the three days it took Gregory to die, I saved many vivid, sometimes difficult and sometimes joyful, memories of the process. None-the-less it feels like those three days were shrouded by a certain numbness.
The planning of two tributes for Gregory was easy. Gregory's Memorial at the condo (attended by over 100 family and friends) was gratifying and consoling as was the Lieberman Memorial to thank them for their care and support (attended by over 150 staff, residents, and families at Lieberman the following week.)
Now, when I think of Gregory, it feels like his dying was but an instant and at the same time that he has always been dead, when if fact it is just over two months since he died. Strange feeling - ALWAYS been dead.
The thoughts which next occupy my mind then ... based on Gregory and my twelve years seeming like a moment, and his Lieberman stay feeling like a breath, and his death feeling like not only an instant but also forever ... are that my life, now, will last just a few moments longer with the lesson being that I must live each day to its fullest doing things that matter to me, spreading joy and love whenever I can, and doing the best I can without being too unforgiving of myself and my weaknesses and being forgiving of others.
In this thinking and these awarenesses, I focus on the buddhist teachings which explain that our suffering is based on permanent attachment to things which are ever changing. Nothing is permanent.
When my mom and dad died, I wrestled with how someone could be here today and gone tomorrow. Wondered where that energy went. Wonder where our time together went from my being a child, to a teenager, to a young adult, to a full grown adult (if one ever becomes full grown.)
I missed them. I grieved not only their death but what I considered the missed opportunities for parent/son relationships and how different it could have been if they were different, if I was different.
Acknowledged that I was grateful for many opportunities they did provide and for the love that existed. Acknowledged that they did the best job of parenting that they could and that I did the best job of "offspringing" that I could.
Now, with Gregory's passing, my perceptions of time have been shifting and the shift has caused me to do some deeper thinking.
Gregory and I lived, and we worked at living well for twelve years, with his diagnosis of Dementia/Alzheimer's. At times our life felt normal and at times we also felt like we were living on a roller coaster as his needs confounded, our interactions became surreal, his abilities failed and resurfaced only to finally fail again.
Now when I think about those twelve years, it feels like minutes. At the time it felt like forever, but now that the confusion, frustration, anger, sorrow, fear, etc no longer exists, it feels like moments.
Gregory spent the last 18 months of his life at the Lieberman Center for Health and Rehabilitation on the Alzheimer's Special Care Unit. At the time it was a day in and day out activity. Grateful to Manny for providing not only care and safety for Gregory but also for the love, socialization, and life enrichment he provided on a day to day basis.
When Gregory's health needed extra attention or his medications needed rebalancing or when his difficult behaviors needed a look see; my life would feel topsy turvy. But once the Lieberman nurses, doctors, hospice care, and I did our problem solving; things settled down for both Gregory and me.
Now, with Gregory on his next adventure, without my daily visits, and the Care Conferences, and the monitoring of his daily needs and treatment; it feels like Lieberman was but a breath.
During the three days it took Gregory to die, I saved many vivid, sometimes difficult and sometimes joyful, memories of the process. None-the-less it feels like those three days were shrouded by a certain numbness.
The planning of two tributes for Gregory was easy. Gregory's Memorial at the condo (attended by over 100 family and friends) was gratifying and consoling as was the Lieberman Memorial to thank them for their care and support (attended by over 150 staff, residents, and families at Lieberman the following week.)
Now, when I think of Gregory, it feels like his dying was but an instant and at the same time that he has always been dead, when if fact it is just over two months since he died. Strange feeling - ALWAYS been dead.
The thoughts which next occupy my mind then ... based on Gregory and my twelve years seeming like a moment, and his Lieberman stay feeling like a breath, and his death feeling like not only an instant but also forever ... are that my life, now, will last just a few moments longer with the lesson being that I must live each day to its fullest doing things that matter to me, spreading joy and love whenever I can, and doing the best I can without being too unforgiving of myself and my weaknesses and being forgiving of others.
• • •
In this thinking and these awarenesses, I focus on the buddhist teachings which explain that our suffering is based on permanent attachment to things which are ever changing. Nothing is permanent.
Thus early Buddhism declares that in this world there is nothing that is fixed and permanent. Every thing is subject to change and alteration. "Decay is inherent in all component things," declared the Buddha and his followers accepted that existence was a flux, and a continuous becoming.
According to the teachings of the Buddha, life is comparable to a river. It is a progressive moment, a successive series of different moments, joining together to give the impression of one continuous flow. It moves from cause to cause, effect to effect, one point to another, one state of existence to another, giving an outward impression that it is one continuous and unified movement, where as in reality it is not. The river of yesterday is not the same as the river of today. The river of this moment is not going to be the same as the river of the next moment. So does life. It changes continuously, becomes something or the other from moment to moment.
Take for example the life of an individual. It is a fallacy to believe that a person would remain the same person during his entire life time. He changes every moment. He actually lives and dies but for a moment, or lives and dies moment by moment, as each moment leads to the next. A person is what he is in the context of the time in which he exists. It is an illusion to believe that the person you have seen just now is the same as the person you are just now seeing or the person whom you are seeing now will be the same as the person you will see after a few moments.
Even from a scientific point of view this is true. We know cell divisions take place in each living being continuously. Old cells in our bodies die and yield place continuously to the new ones that are forming. Like the waves in a sea, every moment, many thoughts arise and die in each individual . Psychologically and physically he is never the same all the time. Technically speaking, no individual is ever composed of the same amount of energy. Mental stuff and cellular material all the time. He is subject to change and the change is a continuous movement.
Impermanence and change are thus the undeniable truths of our existence. What is real is the existing moment, the present that is a product of the past, or a result of the previous causes and actions. Because of ignorance, an ordinary mind conceives them all to be part of one continuous reality. But in truth they are not.
The various stages in the life of a man, the childhood, the adulthood, the old age are not the same at any given time. The child is not the same when he grows up and becomes a young man, nor when the latter turns into an old man. The seed is not the tree, though it produces the tree, and the fruit is also not the tree, though it is produced by the tree.
Taken from:
Friday, November 6, 2015
Aging vs Dementia vs Life
Periodically I post comments on my friend Kate in Australia's blog and then post them here as well. I do this because I find that I have shared something that might be important to share with you as well.
Kate, Kate, Kate,
Not easy. Your post's ending shows you still have your sense of humor. Very important to keep that:-)
I personally believe, based on my observations of Gregory and on my own aging brain and memory (although I do not believe that I am experiencing Dementia but did notice more forgetting begin since I was 40 - thirty years ago,) that when I fight the loss of memory, fight the inability to recall pieces of information, am under a lot of stress, or am tired ... it gets worse. When I relax and release it, I have an easier time. So differentiating between your public self and the ability to relax at home is good.
Since both Gregory and I were 40, we invented what we called, "The Noun Disease." When we had trouble recalling a proper noun or someone's name we just announced "NOUN" and keep on with the sentence. Sometimes it would come later, sometimes the other person would substitute the noun, and sometimes it didn't matter.
In many ways there is so much of my past that I do not (or have chosen not to) remember. For the most part that doesn't matter. I am not trying to compare myself to you but in some ways there are similarities to "getting older" and "having dementia." We both know which one we would choose if we could.
Hang in there (as I picture that famous poster of the cat hanging from the window sill by its toenails!)
Kate, Kate, Kate,
Not easy. Your post's ending shows you still have your sense of humor. Very important to keep that:-)
I personally believe, based on my observations of Gregory and on my own aging brain and memory (although I do not believe that I am experiencing Dementia but did notice more forgetting begin since I was 40 - thirty years ago,) that when I fight the loss of memory, fight the inability to recall pieces of information, am under a lot of stress, or am tired ... it gets worse. When I relax and release it, I have an easier time. So differentiating between your public self and the ability to relax at home is good.
Since both Gregory and I were 40, we invented what we called, "The Noun Disease." When we had trouble recalling a proper noun or someone's name we just announced "NOUN" and keep on with the sentence. Sometimes it would come later, sometimes the other person would substitute the noun, and sometimes it didn't matter.
In many ways there is so much of my past that I do not (or have chosen not to) remember. For the most part that doesn't matter. I am not trying to compare myself to you but in some ways there are similarities to "getting older" and "having dementia." We both know which one we would choose if we could.
Hang in there (as I picture that famous poster of the cat hanging from the window sill by its toenails!)
Wednesday, November 4, 2015
Interesting
For the first third of Gregory and my 40+ year relationship, he was diagnosed with Atrial Fibrillation but then it seemed to correct itself and disappear.
A recent study adds to growing evidence linking atrial fibrillation is linked to dementia. In the latest study, researchers found that participants who had the condition were 33% more likely to develop dementia than participants who did not have atrial fibrillation.
In atrial fibrillation, the upper chamber flutter irregularly, resulting in an abnormal heart rhythm and decreased blood flow. While medication or shock treatment can help the heart return to its normal rhythm, atrial fibrillation is an ongoing condition for many people. The decreased blood flow and ineffective pumping of the heart can cause blood to clot, which can lead to stroke, which is why many people with atrial fibrillation take anticoagulants to prevent blood clots.
Researchers believe that even small strokes or a tiny amount of clotted matter can lead to cognitive decline and dementia, but it was the connection between atrial fibrillation and stroke that left researchers wondering about a potential link between atrial fibrillation and dementia.
Researchers also note that atrial fibrillation was a stronger risk factor for younger participants with the risk of dementia, doubling for those under the age of 67 who had atrial fibrillation. They also noted that the longer a participant had atrial fibrillation, the higher the risk of dementia. Conversely, they found that atrial fibrillation did not increase the risk of dementia for older participants. (Doubling of 33% "more likely" means 66% for Gregory!)
While the study suggests that there is a link between atrial fibrillation and that it may be a risk factor for dementia, researchers are not sure exactly what that link may be. It could be that the condition led to mini strokes that then brought on cognitive decline. Another theory is that the condition lowered blood flow to the brain which, in turn, could hasten cognitive decline.
Monday, November 2, 2015
Types of Dementia and More
Just read an interesting article about a variation of Dementia/ Alzheimer's in which the person affected had difficulties with vision. I saw a lot of this with Gregory as he progressed through his journey. Sometimes he could not see the fork sitting next to the plate in front of him. In the later stages of his Dementia, he had a difficult time focusing on things like the TV, a book of photographs, and at times on me!
As I have continued to study his "symptoms" it looks to me like he was affected by several types of dementia at one time including: Posterior Cortical Atrophy, Lewy Body, Frontotemporal, and Primary Progressive Aphasia which affects language.
A new type of Dementia is being called "Mixed Dementia." In mixed dementia abnormalities linked to more than one type of dementia occur simultaneously in the brain. Recent studies suggest that mixed dementia is more common than previously thought.
Recently, there has been a lot of activity and discussion in the following areas: 1) Types of Dementia, 2) Appropriate language to discuss Dementia and the people affected with it, 3) Including people with Dementia in decisions about caring for the needs of people with Dementia, and 4) A more careful use (if any) of psychotropic drugs with people diagnosed with Dementia.
As recently as ten years ago, not much was known about Dementia/ Alzheimer's. People were embarrassed to discuss the disease. Little was known about how to care for people with Dementia. While the knowledge base is increasing exponentially, much still needs to be done to understand the disease and to support people who have been diagnosed with one form or another of Dementia.
Perhaps one of Gregory's legacy's, through my blogging, can be to help "fight these battles" for understanding, equality, and support!
Sunday, October 18, 2015
Tuesday, October 6, 2015
Whose Dementia Is This Anyway?
Kate discusses in a recent post on her blog, which originates in Australia, the idea that "the person living with someone who is diagnosed with dementia, is not living with dementia, but instead they are living with someone diagnosed and living with dementia."
See Kate's full post by clicking here. Opens in a .new window
Here is my reply:
Wow. What a thought provoker. I hate you for my having to sit down and think about this and clarify my thoughts :-) I often have said that Gregory and I are living with Dementia/ Alzheimer's. I have also referred to: "Living with and loving someone with dementia."
Yes, I will never know what Gregory really went through, experienced, thought about, feared, etc. Also, Gregory was never really able to verbally share that with me through the protective buffer which the Dementia/ Alzheimer's placed between his inside and his outside world.
But in our strong strong relationship; during the forty years of which we always discussed, shared, negotiated, evaluated and re-evaluated roles, and more; as I watched his decline, watched his abilities diminish and eventually disappear; as we worked together with love and respect to support each other; as I tried my best not underestimate or prematurely suggest or force his disengagement from the activities of life ... wow that is a dense sentence ... I would have to say that both of us WERE LIVING WITH DEMENTIA!
When you so truly and strongly love love someone, how can you separate who is who? Semantics maybe, but hard at least for me to separate! Kate, with respect to you :-) Gregory and I lived with dementia. Especially if you see it as Gregory and Michael living their life with a third party intruder! As you say, "IT!"
Let me reflect on your third party "it" with a poem of mine:
Would I be insulting your intelligence to tell you that Ménage à trois is a French term which originally described a domestic arrangement, in which three people having sexual relations occupy the same household? The phrase literally translates as "household of three.” This poem is called:
MÉNAGE Á TROIS
By Michael A. Horvich
Over twenty five years and their relationship was as strong as ever,
Their love continuing to grow, change, and adjust to the times.
Same sex love was not fashionable when they first met in the 70’s.
It was known as "the love that dare not speak its name."
Most churches will not recognize nor bless their love, their union.
Slowly society has acknowledged it out loud but for the most part still in whispers.
Each partner was very much unlike the other.
He was tall and he was short. He was fair and he was dark.
He was slender and he was bulky.
He was a recovering Catholic. He was a recovering Jew.
He was calm, thoughtful, and orderly.
He was animated, impulsive, and random.
Often he described him as a “stick” meaning hard, formed, and inflexible.
In turn, he described him as a “sponge” meaning soft, malleable, absorbing.
Over time the stick became more sponge-like
And the sponge became more stick-like.
One day, twelve years ago, uninvited and unannounced,
Unasked, a third partner joined the relationship.
Alzheimer’s does not discriminate against same sex relationships,
Nor seek permission to join the party.
So it became a ménage à trois.
Three entities occupying the same household.
Now, he is becoming less, and he is having to become more.
Now he has difficulty communicating, and he has to tell both of their stories.
Slowly while he has been becoming the back partner in this ménage à trios
And while he has been becoming the forward partner …
Alzheimer’s is becoming the dominant partner.
(RIP Gregory L. Maire October 4, 2015)
See Kate's full post by clicking here. Opens in a .new window
Here is my reply:
Wow. What a thought provoker. I hate you for my having to sit down and think about this and clarify my thoughts :-) I often have said that Gregory and I are living with Dementia/ Alzheimer's. I have also referred to: "Living with and loving someone with dementia."
Yes, I will never know what Gregory really went through, experienced, thought about, feared, etc. Also, Gregory was never really able to verbally share that with me through the protective buffer which the Dementia/ Alzheimer's placed between his inside and his outside world.
But in our strong strong relationship; during the forty years of which we always discussed, shared, negotiated, evaluated and re-evaluated roles, and more; as I watched his decline, watched his abilities diminish and eventually disappear; as we worked together with love and respect to support each other; as I tried my best not underestimate or prematurely suggest or force his disengagement from the activities of life ... wow that is a dense sentence ... I would have to say that both of us WERE LIVING WITH DEMENTIA!
When you so truly and strongly love love someone, how can you separate who is who? Semantics maybe, but hard at least for me to separate! Kate, with respect to you :-) Gregory and I lived with dementia. Especially if you see it as Gregory and Michael living their life with a third party intruder! As you say, "IT!"
Let me reflect on your third party "it" with a poem of mine:
Would I be insulting your intelligence to tell you that Ménage à trois is a French term which originally described a domestic arrangement, in which three people having sexual relations occupy the same household? The phrase literally translates as "household of three.” This poem is called:
MÉNAGE Á TROIS
By Michael A. Horvich
Over twenty five years and their relationship was as strong as ever,
Their love continuing to grow, change, and adjust to the times.
Same sex love was not fashionable when they first met in the 70’s.
It was known as "the love that dare not speak its name."
Most churches will not recognize nor bless their love, their union.
Slowly society has acknowledged it out loud but for the most part still in whispers.
Each partner was very much unlike the other.
He was tall and he was short. He was fair and he was dark.
He was slender and he was bulky.
He was a recovering Catholic. He was a recovering Jew.
He was calm, thoughtful, and orderly.
He was animated, impulsive, and random.
Often he described him as a “stick” meaning hard, formed, and inflexible.
In turn, he described him as a “sponge” meaning soft, malleable, absorbing.
Over time the stick became more sponge-like
And the sponge became more stick-like.
One day, twelve years ago, uninvited and unannounced,
Unasked, a third partner joined the relationship.
Alzheimer’s does not discriminate against same sex relationships,
Nor seek permission to join the party.
So it became a ménage à trois.
Three entities occupying the same household.
Now, he is becoming less, and he is having to become more.
Now he has difficulty communicating, and he has to tell both of their stories.
Slowly while he has been becoming the back partner in this ménage à trios
And while he has been becoming the forward partner …
Alzheimer’s is becoming the dominant partner.
(RIP Gregory L. Maire October 4, 2015)
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