Friday, November 20, 2009

Unmasking AD, spouses, grief.......

Quite often Alzheimer’s slowly takes away the mind of a victim and the life of a spouse, a husband or wife, a life partner. What happens when that life partner whom does not have Alzheimer’s dies first?
So often over the years as a doctor, a have treated someone who has been married forty or fifty or sixty years. What is the secret of them staying together for so many years? In our wondrous day and age and over the last three generations half of all marriages end in divorce. The couple goes their separate ways at least legally from a divorce standpoint.
How do couples stay together till death does them part? No one knows the secret key to that because there is probably no one secret answer to the longevity of a marriage.
When I see a patient and talk with them with their spouse in the room, there is often a certain essence, the union between them; the marriage is the third entity between a man and a woman. One way this manifests, is when a couple has been together so long, they can almost finish each others thoughts and sentences. They learn to think alike and for each other. That can be good and bad, but it does happen.
Often when there is someone with AD that has not been diagnosed, but is “slipping” from AD the spouse picks up the slack. This is where that union, that thinking and answering for one another becomes prominent.
Any professional caregiver has seen this. The spouse answers for the person, thinks for them. It can be quite subtle and as the disease progresses it becomes more pronounced. It can sometimes mask AD. It is a natural process.
When the husband or wife of an AD victim passes away first, the disease becomes unmasked. It tends to accelerate quickly. It becomes more pronounced.
This can often be misleading, the Alzheimer’s victim is now a grieving spouse and may begun to show pronounced changes that are quite obvious. Sometimes we tend to attribute that to grief. When a person looses their lifelong partner they are obviously going to not be as cognitively together and complete.
In the case of my mother, her life partner my father died about a year before she was actually diagnosed in 1979. She most likely had the early stages of the disease for some time before he died, maybe a year or several years, but it was not clearly apparent. After he died it became more pronounced. Is AD accelerated by grief? Probably not, on the other hand can the environment of grief create more of a stressor that does accelerate the biological pathological process of AD? Who knows? That seems a bit unlikely, but on the other hand it is as plausible as “exercising your mind”, living healthy, taking care of yourself as a way to ward of AD. In this popular philosophy and mind set, we are certainly attributing a portion of environment to AD.
When there is a death of a parent and then a surviving spouse, a mother or father now with AD, it is a double kick in the teeth for the children and primary caregiver. It is likely that one never gets a chance to properly grieve, whatever properly grieve actually means.

1 comment:

karen said...

I believe my mom had Alz's for years before we noticed it. After my dad died we took over caring for her more and that is when we started noticeing the changes in her. Before She hid them from us. But she could not hide them forever.

Talking about the book with the Lake Superior wind....... a calm day