Emotional Decline – The Tribulations

Stages of Decline Outline: Eleventh Installment

The totality of Cindy’s physical decline created some health and comfort problems for her care.  Without any emotional or verbal feedback these Tribulations required guesswork that added to the Trials of her emotional decline.

  • Feeding Cindy could take as long as two hours because of her lack of focus while eating.
  • Undetected food sitting in her gums for long periods led to advanced teeth decay.
  • Failures to swallow liquids, saliva and mucus led to occasional coughing fits.
  • Being confined to a hospital bed led to hot spots that increasingly took longer to heal.
  • We dealt with constant turnover of the people assisting with Cindy’s care.
  • So far I have spent more than 40% of my married life as a caregiver for relatives with dementia.

What is known as cognitive empathy allows one to compartmentalize sad emotions to focus dispassionately on what needs to be done for the care of another person.  This type of empathy has to replace emotional empathy for a caregiver to survive the emotional stage of decline and be effective.

You might think that with the list of Trials and Tribulations during this final stage of decline there could be no Triumphs, but there were.  In homage to our motto of living well in the face of adversity, I present the Triumphs next time as the final installment.

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Emotional Decline – The Trials

Stages of Decline Outline:  Tenth Installment

All previous stages of decline overlapped gradually with each other, not so with the final stage of emotional decline.  In March of 2019 Cindy had her first ever and still most severe seizure.  From that moment on her total physical decline was complete and the Trials of her emotional decline began.

  • Cindy no longer could stand or sit up.
  • Cindy no longer uttered one word responses to the television.
  • Cindy no longer stayed alert during our outdoor strolls/jogs.
  • Cindy no longer smiled.

Because of the lack of expression and alertness, this final stage of decline is in different aspects both the easiest and hardest for a caregiver.  I started Cindy’s hospice care, receiving regular assistance from home health aides, while adopting a constant routine that checked all the other caregiver boxes.  Yet the lack of emotion from a once warm and joyful person has been the saddest part of this whole ordeal.

Additional Tribulations accompanied Cindy’s emotional decline in this final stage of dementia.  Those will be covered in the next installment.

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Physical Decline – The Triumphs

Stages of Decline Outline:  Ninth Installment

  • We came up with means for Cindy to be mobile outside.
  • Friends and family provided a supportive network.
  • I always could make Cindy smile.
  • Cindy’s mind stayed in the present.
  • I was able to manage our finances.
  • I researched and practiced good brain health habits.
  • I kept my blood pressure down through lifestyle factors only.

The lesson to be learned here is another life lesson which can be broadly applied.  Perseverance and an active, positive social network are the keys to any kind of success, including caregiving.  In particular, a caregiver needs to persevere with creative problem solving for ever changing conditions, often with the necessary assistance of supportive friends and family.

If you can do that; if you can persevere with the help of others to find new ways to live well in the face of adversity, then you can experience Triumphs even during this tragic period of decline.  However, the decline will continue as you enter a final stage.

That will be the topic of the next installment:  Emotional Decline – The Trials.

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Physical Decline – The Tribulations

Stages of Decline Series Outline:  Eighth Installment

Cindy’s steady physical decline correlated with ever changing conditions in other ways as well.  Both Cindy as patient and myself as caregiver experienced added Tribulations tacked on to the Trials of her physical decline.

  • Cindy’s ability to say names and talk steadily decreased.
  • Cindy’s ability to sit upright without support decreased.
  • Cindy could not be left alone for long.
  • I realized our bucket list could not be completed.
  • Our finances became tenuous.
  • My blood pressure started increasing.

The lesson learned from these Tribulations, particularly the stress and increasing blood pressure, was that of the “oxygen mask.”  I knew I had to take steps to preserve my own health first and foremost for both of us.  My blood pressure became my “canary in the coal mine” and I acquired a blood pressure monitor that was crucial with keeping me on task.

By checking all the boxes necessary for maintaining my own health, I could persevere with both of us living well in the face of our tragic condition.  That will be the topic of the next installment:  Physical Decline – The Triumphs.

The video podcast of this will be posted in a few months.  Please subscribe to be alerted to each post and video in the series, and to help generate search engine publicity.

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Physical Decline – The Trials

Stages of Decline Series Outline:  Seventh Installment

Though we associate Alzheimer’s and dementia with cognitive decline, Cindy’s physical decline caused me greater sadness.  Known as an Expedition Woman by her long distance hiking peers, and a woman with the best stride ever by her future husband, we continued to go for walks as long as she was able, despite the Trials that occurred.

  • Cindy’s balance steadily decreased.
  • The distance Cindy could walk decreased by 60% every six months.
  • Cindy’s muscle mass steadily decreased.
  • Cindy’s dentures steadily decreased in health and structure.
  • Cindy’s control of body movement steadily decreased.

For the most part the lesson to be learned from this ongoing physical decline was one I heeded before learning it.  As you seek to make the most out of your time left with a loved one afflicted with dementia, make sure you get to the more challenging physical activities first.

The consequences of Cindy’s physical decline created other heartaches as well, covered in:  Physical Decline – The Tribulations.

The video podcast of this will be posted in a few months.  Please subscribe to be alerted to each post and video in the series, and to help generate search engine publicity.

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Cognitive Decline – The Triumphs

Stages of Decline Series Outline: Sixth Installment.

Once Cindy was officially diagnosed with Alzheimer’s we decided we would share our experiences on the Humanity Hiker blog.  We faced the customary trials and tribulations of people with Alzheimer’s, but determined we would live as well as we could.  That provided a few Triumphs despite our adversity.  

  • After the diagnosis we created a bucket list of things to do.
  • We agreed to use the blog to inform and inspire others to live well.
  • Friends and family joined us on our final long distance hike.
  • I learned that the secret to living well through adversity was joy.
  • Cindy became the only person awarded the Honorary Triple Crown.
  • A gathering of friends and family honored Cindy on her 56th birthday.

I was against our primary care provider informing Cindy of her official diagnosis.  I already served as Cindy’s full time caregiver, taking care of her needs without her concern, why deprive her of hope?  The primary lesson learned from our Triumphs was that knowing the diagnosis allowed us to live life fully, making the most of the challenges we faced, as well as enabling us to share that with you.

Here is a related blog post: Alzheimer’s: To Know or Not to Know

Unfortunately, as Cindy’s decline continued new challenges occurred, such as the ones in the next installment:  Physical Decline – The Trials.

The video podcast of this will be posted in a few months.  Please subscribe to be alerted to each post and video in the series, and to help generate search engine publicity.

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Cognitive Decline – The Tribulations

<Stages of Decline series outline: fifth installment.  Please subscribe to be alerted to each post and video in the series, and to help generate search engine publicity.>

I am shifting the order within each stage of decline to present “Triumphs” last.  This better represents our mission of living well despite Alzheimer’s.  Every stage represents two steps backwards in terms of decline, yet there remains a step forward for making the best of the situation.  Some of the previous outlines will be adjusted for this new philosophy when the video podcasts are presented.

Once we knew that Cindy’s dementia was irreversible from the official diagnosis, we experienced the following “Tribulations.”

  • Cindy attempted to divvy up her belongings for her daughters to inherit.
  • Attempts at pursuing her hobbies with the help of others ended up in frustration.
  • We faced economic hardships as we adapted to our new life.
  • In anguish over her cognitive shortcomings she suggested I get a mistress.
  • Unlike our ADT journey, our Pacific Crest Trail journey would bring no improvement.
  • Early obstacles meant Cindy would not fulfill her dream of completing the Triple Crown.

As a caregiver I learned from these Tribulations what the secret is to living well under the circumstances of irreversible dementia, indeed, the secret to living well under any circumstance.  I will share that secret in the next installment:  Cognitive Decline – The Triumphs.

The video podcast of this installment will be posted in a few months.  Please subscribe.

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Cognitive Decline – The Trials

Stages of Decline series outline: fourth installment.  After these outlines are posted I will provide video podcasts of the same themes in a more entertaining and informational format. Please subscribe to this blog to be alerted to each post in the series, and to help generate search engine publicity.

People associate dementia mainly with cognitive decline throughout the affliction, this stage corresponds to when that decline becomes irreversible.  The following bullet points reveal the “Trials” that signaled Cindy’s cognitive decline would be permanent.

  • A year after our hike across the country we still did not know the cause of decline. 
  • I left an important decision up to Cindy that she was not capable of making.
  • In an effort to give Cindy more independence her condition worsened.
  • Failing badly on a cognitive test for disability income devastated Cindy.
  • Cindy was diagnosed with Alzheimer’s a month after qualifying for disability income.

The lesson I learned from these “Trials” is to assume the worst and become the decision maker for someone whose cognitive decline is not improving.  The next installment in the series will be “Cognitive Decline – The Tribulations.”  The video podcast of this installment will be posted in a few months.  Please subscribe.

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Behavioral Decline – The Tribulations

This is the third outline for the Stages of Decline series.  Our experiences as a dementia patient and caregiver spouse are condensed into bullet points to provide helpful insights for others who might find themselves in a similar situation.  After presenting outlines for the twelve themes of the series, video podcasts will then cover each theme in a more entertaining and informational format.  Please subscribe to this blog to be alerted to each post in the series, and to help generate search engine publicity.

People naturally think that early onset dementia begins with cognitive decline, but there are earlier warning signs in regards to behavioral changes in how people respond to stress.  These “Tribulations” bullet points reveal how Cindy’s decline resumed after the walk across the country was over.

  • Cindy’s “Triumphs” from the walk across America ended with the “Tribulation” of Lyme disease.
  • Despite chronic stress being eliminated, no further cognitive improvement occurred.
  • Cindy experienced occasional heartbreaks due to her cognitive decline.
  • Cindy had few opportunities to socialize.
  • Cindy had trouble with daily living tasks.
  • I experienced the heartbreak of false hope.

The most important lesson from these “Tribulations” bullet points is that early onset dementia cannot be permanently cured, but rather needs to be permanently prevented through lifestyle factors.  The next installment in the series will be “Cognitive Decline – The Trials.”  The video podcast of this installment will be posted in a few months.  Please subscribe.

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Behavioral Decline – The Triumphs

This is the second outline for the Stages of Decline series.  Our experiences as a dementia patient and caregiver spouse are condensed into bullet points to provide helpful insights for others who might find themselves in a similar situation.  After presenting outlines for the twelve themes of the series, video podcasts will then cover each theme in a more entertaining and informational format.  Please subscribe to this blog to be alerted to each post in the series, and to help generate search engine publicity.

People naturally think that early onset dementia begins with cognitive decline, but there are earlier warning signs in regards to behavioral changes in how people respond to stress.  These “Triumphs” bullet points reveal that the early cognitive decline which occurs during the behavioral decline stage can be reversed.

  • We assumed Cindy had an anxiety disorder from too much stress.
  • We turned to our passion of long distance hiking for a cure.
  • We chose the American Discovery Trail for its length and towns.
  • The journey provided lifestyle factors that benefit brain health.
  • Cindy improved at doing daily tasks, recalling events and being social.
  • Cindy became optimistic about her future.

The most important lesson from these “Triumphs” bullet points is that dementia during the first stage of decline can be reversed, though a comprehensive shift in lifestyle factors may be required.  The next installment in the series will be “Behavioral Decline – Tribulations.”  The video podcast of this installment will be posted in a few months.  Please subscribe.

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