Research experts tell us for the medications recently approved by the FDA to be effective in slowing the degenerative effects of Alzheimer’s or in curing the disease, they must be started in this earliest stage. Thus, early recognition of minor indicators of behavioral changes leading to a timely diagnosis and prompt treatment will be critical for a successful outcome.
The behavior changes I saw in Judy in this early stage I now consider were early indicators that seemed trivial at the time if considered in isolation, but, when taken together, could argue for the early testing now used only in research.
I first noticed these minor behavioral changes as early as 2004, nine years prior to Judy’s diagnosis when we began planning for retirement and visited several over-fifty-five communities; when I drove through the gate-guarded entrance to Regency at Dominion Valley in Northern Virginia, Judy perked up in the car next to me.
“Now this is more like it,” she said.
The entrance to Regency dead-ended into the number one golf course’s tee box. Tall trees skirted the fairway’s left edge and multi-colored pansies, and verdant lawns adorned empty spaces along the entrance road and around the model homes. In the Regency sales office, Judy and I sat at a three-dimensional mock-up that highlighted lots available for sale; we chose a lot facing a wooded area along the fourteenth fairway on a road that looped around back to parallel the main drag, promising to limit automobile traffic on our street to those who lived there. We selected the model home with master suite, large den, separate living and dining rooms, kitchen and bath on the first level with two large bedrooms, a private bath, and a sitting in the loft area. The upstairs would accommodate family members and friends we expected as visitors during retirement. We signed the contract in June of 2004 for our new home to be delivered in April 2005.
#
Three weeks after we signed the contract, we visited our lot and found the concrete floor poured and construction on our new home moving rapidly along. I began repairs and upgrades to our Centreville home preparing it for the market; I filled nail holes in the wallboard, removed wallpaper, sanded and painted the interior.
When we prepared our previous homes to go on the market, Judy had shopped for paint, brushes, rollers, turpentine, or anything needed for that evening’s tasks while I was at work. In the evening, we worked side by side on the next repair project; Judy was part of the process. But this time in Centreville, while I did the repairs, Judy watched TV. I thought something was wrong.
“Are you OK?” I asked.
“I’m fine,” she said, but continued watching TV.
Taken in isolation, this behavioral change didn’t rise to my level of concern. Judy was sixty-four years old and had some indication of arthritis, so I chalked it up to her getting older. I later realized Judy may have forgotten that she had ever helped with the work in preparation for putting our previous houses on the market. I now see this behavior as a possible early indicator of Alzheimer’s.
#
In December, I took a break before sprucing up the yard to attend a Cajun party at my boss’ house the week before Christmas; we were both from Louisiana. When we arrived, the guests were enjoying heavy hors d’oeuvres; Judy and I made our rounds talking to couples. Then Judy, tired from standing, found a sofa in the den at the back of the house. Judy’s friendly face invited conversation.
“Boy, do my feet hurt,” the younger woman sitting next to her said. “We spent the whole day house-hunting, my husband and me.” She extended her hand to Judy. “Joycelyn’s my name.”
Judy introduced herself. “Where are you moving from?”
“Ontario,”
“And you are house-hunting where?”
“Today, Great Falls. Tomorrow, we’re gonna try Centreville. It’s further out, but more affordable.”
“We’re about to put our Centreville house on the market,” Judy said. “Would you like to come by for a walk-through to see what’s available in the area? No strings attached.”
“Why are you selling?”
Judy pointed in my direction. “That’s my husband, Paul.”
I nodded.
“Paul’s retiring next year. We’re scheduled to move into our retirement home in April.”
The next day, the couple visited our house for a walk-though, including the basement. They spent a long time in the master bedroom suite discussing furniture placement. On the sidewalk in front of the house on their way out, they both commented on how beautiful the place looked. (They later commented to my boss that, “the house was impeccably clean,” a testament to Judy’s housekeeping.)
“How much are you asking?” the husband asked.
I mentioned the price Judy and I had been discussing. The couple huddled together for a moment and made an offer on the spot close to our price. We accepted.
Judy sold our house before we put it on the market and saved us the realty fee in the process. She then orchestrated this sale herself; the closing went smoother than any of the four homes we had previously sold. How could someone who had succeeded in pulling off what Judy had done be suffering cognitive impairment? That’s one thing I learned about Alzheimer’s; one day things appear perfectly normal, and then out of the blue comes the unexpected.
We scheduled the closing on our new home for April 15, 2005, and began planning for the move. To decorate our earlier homes, Judy took advantage of sales to stretch the dollar and produced impressive interior decors on a tight budget.
“Why don’t you decorate this house the way you’ve always wanted to but, due to career relocations, couldn’t because we’d have to sell in two or three years,” I told Judy. “I cashed in my stock options. The money’s in our checking account.”
A few days later, Judy told me, “I signed a contract with Next-Day Blinds to do the window coverings in the master bedroom suite, the living and dining rooms; I having shutters installed in the den, the breakfast nook, and the sliding door to the patio.”
“Shouldn’t you have waited until after we closed to do that,” I said. “What if we don’t go to closing?”
“I’ve signed the contract,” Judy said. “Installation’s set for Saturday, the day after we close.”
She had done an impressive job with the interior decorating. In the living and dining rooms, a sky-blue two-inch stripe across the beige curtain valence matched the exact color of the walls. In the master bedroom, a detailed floral design in the queen-sized bedspread and pillow coverings repeated in the custom curtains and valence across the triple window. Judy had decorated our previous homes beautifully, but this home reflected her superb taste.
When I saw the bills for the interior decorations, I was shocked. Judy had gone first class all the way. In the past, she would have never spent so much money on her own. Neither one of us made such large purchases without consulting with the other for concurrence. This was out-of-character and a major aberration from her normal behavior. Committing so much money on her own wasn’t something I could get used to.
At the time, I did not see the connection between this aberration and dementia. Her going out on her own and signing a contract and following through coordinating the deal in her mind was doing what I had suggested. I consider this to have been a possible early indicator of Alzheimer’s that in a future scenario might call for follow-up action. She forgot a process that had long ago proven acceptable to both of us over the years.
Researchers believe that once neurons are destroyed that enable communication between elements of the brain and the rest of the body, they cannot be repaired. That’s why recognizing early indicators as such will be critical to bring about early testing for implementing any new medications that come available to cure or slow the degenerative nature of Alzheimer’s if they prove effective.