Archive for Dementia

Dementia’s FAST Score

A patient with dementia must have a F.A.S.T. score of seven (7) to qualify for hospice care.

FAST is an acronym for the Reisberg Functional Assessment STaging Scale. A scale nicknamed FAST to determine dementia’s severity is blatantly ironic. As a loved one’s dementia (Alzheimer’s, Lewy Bodies, etc.) worsens, he or she typically becomes, well, slower.

Currently the Reisberg scale (example found here) contains various stages and sub-categories, including these two:

  • Stage 3: Decreased job functioning evident to coworkers; difficulty in traveling to new locations
  • Stage 4: Decreased ability to perform complex tasks (e.g., planning dinner for guests, handling finances)

Those who have cared for someone with dementia usually sense the “slowing down” of a loved one only after he or she has worsened. Read More →

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In Praise of Words and Music for Patients

“I’m still praying the Lord’s Prayer with him,” one of our hospice chaplains said about her patient.

This person’s illness had made it difficult to communicate anymore. Most of his decisions were now made by his loved ones. Often it comes to this, where our beloved spouse or parent and grandparent can no longer effectively communicate. Sometimes it is because of cancer, and a “sudden” turn for the worse means a patient easily conversing in the morning transitions to someone incapable of talking by the evening. Or the patient slowly walks the darkening, years-long road of dementia, eventually unable to speak or comprehend words.

But with many of these folks, certain words, songs and memorabilia will trigger a positive, life-affirming response. As the chaplain reported the situation, when this patient was asked if he wanted to pray, he gave an affirmative nod and then, as the chaplain began, “Our Father, who art in heaven…” the patient joined in.

Did he fully understand the prayer? Probably not. Read More →

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A Cursed, Crushing, Conflicted Concoction of Feelings

Long ago, maybe around Easter, with Dad, my younger sister, and me . . .

When my father bellowed and ordered me to leave his home, it was as if a double-edge knife had penetrated my heart. Like a rusty, bent blade, it twisted with the volume and intensity of Dad’s outburst.

One side of the blade was love. One, hatred.

We did not know then about his dementia.

Odd how, with those we love the most and the surest, we can experience such damning and damaging of reactions.

Dad’s unexpected roar came partway through a mundane visit home, where I balanced time with my parents while attending a conference. Fine! If he didn’t want me around—though I had no clue why—I could find a motel near the downtown conference, crash with a friend attending the event, or head home where my wife and pets would at least treat me with respect.

Mom intervened.

Odd to sit around the old kitchen table, with my parents now married for six decades, and to have your mother forcefully demand that her husband apologize to their son. Dad did. Looking back now, why wasn’t it obvious? He was hardly smiling anymore. His eye contact with others had become random and held no welcome or curiosity. At that table, Mom chided him. Mom warned him. Mom prevailed. Read More →

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