The Beginnings

Diagnosis
My mother is 81 years old. She's had a very full life raising eight children. About four or five years ago, there were several changes in her behavior. The first change I recall is depression. She has probably been depressed since 1983 when my father died, but she never really expressed it. She became more openly emotional. She would get very tearful and tell me how lonely she felt now that her husband, sister, mother, and brother were deceased. This in spite of having at many of her children and grandchildren around her almost all the time. She expressed a real sense of lose and longing for another time in her life. This was a conversation that would happen almost every single time I saw her or talked to her on the phone.

Another big change was in her ability to communicate. At first, she couldn't remember the simplest words, like "store" or "car". I found myself alternating between helping her complete the thought or patiently waiting to give her time to do it herself. It progressively got to the point that it was very difficult for her to have a conversation.

She also became defensive and fairly rigid. I remember suggesting that she should drink more water and she picked up her 6 oz cup and adamantly told me that one was plenty. She complained that several of her children owed her money and it made her life difficult. When I suggest that "we" talked to them about it, she became very flustered and refused to address it directly with the offending children. Her stove stopped working. I took her to buy a new one and once it was in, she had to call someone to help her turn it on, even though it was very simple to operate. She started having moments of explosive anger. They were fairly harmless verbal outbreaks, but not typical. All of these changes came about very slowly.

She told me one December that she was going to retire. This at 78. My brother Steve had generously let her keep her position as office manager at his law practice three days a week. Toward the end, I think her contribution was to pick up and open the mail. This gave a her a reason to get up, get dressed and get out in the world. It was truly a gift. She made the right decision the quit, but it was so sad that her capacity had diminished to the point that she had to give that up.

I think she began to decline more rapidly once she stopped working.