My Mom - Alzheimer's Disease (Senile Dementia of the Alzheimer's Type)

On February 10, 2006, my Mom Gracia Schulte died at the age of 93.  She was diagnosed at the age of 80 with Alzheimer’s disease and spent the last thirteen years of her life at The Catholic Care Center in Wichita, KS.  The mother of eight children including two sets of twins, she was a passionate woman who had her licensed day care center for thirty-seven years prior to her admission to the Independent Living Unit.  Gracia was a meticulous record keeper because of her licensed day care center.  Impromptu State Inspections were the norm in the early years of in-home day care centers.  We noticed that bills were not being paid and that she was losing her patience with the toddlers she took care of and she wasn’t keeping the books for her childcare center.  She lived in Garden Plain, Kansas a rural town twenty-four miles west of Wichita.  Her house was next to the Bank and the Catholic Church where she attended Mass for over 50 years was next door. One day she was found in the church with her checkbook in her hand and asked the priest if he knew where the bank was located.  Two days later at dusk she was found in her nightgown wandering up Main Street to cross Highway 54 to go “home.”  We had sold the farmhouse where she was returning at least ten years prior.  During the three months prior to her admission, she was not bathing, had left the coffee maker on the stove, and had wrecked her car.  My sisters were taking turns checking in on her, Patricia her oldest daughter had taken over paying the bills.  They took her to her doctor who told her that she could no longer live by herself.  Patricia was a social worker and knew residents who were at the Catholic Care Center and they scheduled a luncheon visit.  My Mom was forgetful, but knew why they were going to lunch.  She walked into the dining room and shook her head and made the “crazy” sign with her hand circling her head.  She shouted: “I’m not living with a bunch of crazy old goof balls!”  Lunch never happened!  

They filled out the paper work and within a week she was in the Independent Care Unit at Catholic Care Center.  The “mean” Gracia came out!  She had lived by herself for the last twenty-six years.  My Dad died at the age of fifty-four from chronic bronchitis and emphysema.  She was a fiercely independent woman.

In the coming weeks her activities of daily living declined even more and she had increased confusion and disorientation.  She would try to bite or hit my sisters when they tried to help her bathe.  She told them that they were trying to steal her money and sell her house.  The onset of Alzheimer’s disease is insidious and the individual begins to slowly lose their short term memory, may have word finding problems, and may become withdrawn and isolated because they are aware of their memory loss and their inability to track conversations.  

Mom not only had periods of being angry but she also had periods of depression.  She didn’t want to go down to the dining room for meals; she refused to have family members visit and would spend long periods of time in bed.  She had periods of paranoia, i.e., believing other residents were coming into her room and taking her things.  She would use a felt tip marker and write “Gracia Schulte!” on her copy of Reader’s Digest.  She also started hoarding Kleenex, sweeteners and packets of jam.  When we finally decided to sell her little house in Garden Plain, we opened the tool shed and found hundreds of empty plastic gallon milk containers tied together with twine.  We also realized that we had to go through every book and every magazine because she had hidden cash in a number of them.  I don’t know who thought to check the toilet water tank, but we found a baggy of gold coins and silver dollars.  The hoarding and hiding is not unusual for patients in the early to moderate stages of dementia.

As time progressed Mom did not recognize her grandchildren.  She needed more help with dressing and bathing and her agitation had increased to the point that she needed Risperdal to keep her from lashing out verbally and physically to the staff.  Home was no longer Garden Plain, Kansas; it was Milan, Kansas where she was born.  Her memory faded back to when she was a child and eventually over a period of years she could not carry on a conversation and her talk became gibberish.  In one of the last lucid visits with my Mom I had spent about an hour talking to her about my private practice, and Cynthia’s different jobs in the Entertainment Industry.  I left her room to go to the car and get my camera and when I returned she cupped her hands to her mouth and said: “Oh My Lord when did you get into town.” Alzheimer’s disease often referred to as the “ongoing funeral” or “the long goodbye.”

I will never forget my last visit with my Mom.  Cynthia and I flew into Wichita from Los Angeles and went to visit Mom.  I knew that she could not talk and that she needed to be bathed, dressed, and fed.  I opened the door and saw a small, fragile, very thin woman lying in a fetal position.  This is one of the hallmarks of the final stage of Alzheimer’s disease.  I went to the nurse’s station and asked if Gracia could even sit up in a wheel chair.  The nurse looked away and said, “We can try, it may be difficult for her to hold her body up. We can prop her up but she can only tolerate about 15 minutes.”  I helped lift my Mom into the wheelchair.  I knew she didn’t recognize me by the quizzical look on her face.  I was also informed that she was having problems swallowing, but she might take a sip of water or coffee.  As I pushed her wheelchair down the hall she took her right hand and reached across her chest to hold my left hand.  I tried to give her some tepid coffee, but she truly could not swallow it and she appeared to be uncomfortable.

We took her back to her room and waited for the nurse to help me put her back in bed.  She never let go of my hand until I knelt down in front of her and told her we were going to put her back in her bed.  She started to lean forward and I knew that she could not hold herself up anymore.  I put my arms around her and she whispered:  “My son.”  Those were the last words she ever said to me.