Tag Archive | vascular dementia

Profiles in Dementia: Bill Guthridge (1937 – 2015)

Bill Guthridge UNC-Chapel Hill Basketball Coach 1997-2000On May 13, 2015, former University of North Carolina – Chapel Hill basketball coach Bill Guthridge died from heart failure. However, it was Coach Guthridge’s incurable heart condition that led to his development of vascular dementia, and with its progression, his placement for the last several years in a Chapel Hill assisted living facility. 

If Bill Guthridge doesn’t look familiar to you as a UNC-Chapel Hill head basketball coach, there’s a very good reason for that. He was and has been overshadowed and a bit lost in the shuffle of UNC basketball coaches by his lifelong friend, former UNC head coach Dean Smith (1961 to 1997), and current UNC head coach Roy Williams, who was an assistant coach along with Guthridge at UNC from 1978 to 1988.

However, Coach Guthridge served as the perfect replacement as head basketball coach when Coach Smith unexpectantly announced his retirement from the University of North Carolina at Chapel Hill in 1997.

UNC Coach Dean Smith and UNC Coach Bill Guthridge 1970'sCoach Guthridge had been Coach Smith’s assistant coach at UNC for 30 years, so he knew Coach Smith’s style, plays, and strategies inside and out. Coach Guthridge was the right choice to lead the transition to another, younger leader of the famed basketball program at the University of North Carolina.

Unfortunately, it took UNC two tries to find that leader.

The university made a huge misstep when it hired former UNC player, Matt Doherty, a young, untested coach in the league of the Atlantic Coast Conference (ACC) and a 180-degree change from the coaching styles of Coach Smith and Coach Guthridge, as its head basketball coach in 2000, when Coach Guthridge retired.

University of North Carolina Chapel Hill Head Coach Roy WilliamsAfter a three-year disastrous tenure under Doherty, the University of North Carolina hired Roy Williams from Kansas and got the leadership and gravitas that had characterized the UNC basketball program under Coach Smith and Coach Guthridge.

After Coach Guthridge’s retirement in 2003, he and Coach Smith stayed in close contact, visiting each other frequently. Ironically, both coaches developed dementia along the way (Coach Smith died in January 2015 of complications from dementia).

Coach Smith began showing signs of cognitive impairment before Coach Guthridge did. It was profoundly hard for Coach Guthridge to watch his lifetime friend become forgetful and lose the memories they shared together, not just as the architects of a fantastic and highly-ethical college basketball program, but as friends who regarded each other and their respective families as their own.

Coach Guthridge Early Years as UNC Assistant CoachWhen Coach Smith died, Coach Guthridge knew that his friend was gone, but he quickly moved back to their time together when they were younger and dementia had not knocked on their doors yet.

My guess is that Coach Guthridge probably never came back from that place after Coach Smith’s death and I would speculate that Coach Smith’s death may have been the final straw of an increasingly-unfamiliar and disconnected life for Coach Guthridge. Perhaps, at last, somewhere in his mind, Coach Guthridge finally made the decision to retire from this physical life.

Perhaps, at last, somewhere in his mind, Coach Guthridge finally made the decision it was time for him to retire from this physical life.

Coach Guthridge made his retirement official on May 13, 2015. 

 

Profiles in Dementia: B. B. King (1925 – 2015)

B. B. King 2014The blues were born in the Mississippi Delta shortly before the dawn of the 20th Century. The genre, known for its stories of hard times and suffering, originated with African-American sharecroppers who endured long, hot and hard labor picking cotton in the sweltering heat of the summer sun, lived in squalid conditions, and were kept in manipulated indentureship and perpetual debt by never quite making enough money to pay off their bills at local merchants.

While a few blues artists – Robert Johnson, W.C. Handy, Bessie Smith, and Billie Holiday – brought the sound of the blues into the mainstream of music during the first half of the 20th Century, it was not until the late 1940’s and early 1950’s that blues blossomed and hit its stride as a bona fide genre of American music.

Among now-familiar names like Lead Belly, Howlin’ Wolf, John Lee Hooker, Elmore James, and Willie Dixon emerged a young Mississippi Delta bluesman named B. B. King

An accomplished guitarist with an one-of-a-kind voice that wrung out every bit of pain, sorrow, and pragmatism that the blues had to offer, King, in many ways, became the face of the blues for a lot of America.

While blues artists had a profound influence on rock – British artists of the 1960’s drew heavily on their influence and vast body of work and groups like the Yardbirds, Cream, and Derek and the Dominos, fronted by Eric Clapton, were the crossroads where blues and rock met and married, producing generations of rock-blues musicians that continue today (listen to Nirvana’s haunting acoustic version of “Where Did You Sleep Last Night?,” and it’s as though you can hear Lead Belly singing along in the background) – in general, they continued to exist, much like jazz musicians, in a popular, but tightly-defined, niche in the landscape of popular American music.

Except for B. B. King. With his famously-named guitar – Lucille – and his showmanship as a guitarist, along with highly-accessible songs, including his eponymous “The Thrill Is Gone,” King managed to gain a large popular audience. 

Young B. B. King B. B. King stayed on the music circuit, performing along the way with artists like Clapton, The Rolling Stones (King opened for them on their 1969 tour), and U2, despite battling diabetes and high blood pressure for decades.

In the last few years, blues fans have consistently pointed out that B. B. King’s performances were erratic at best: King missed musical cues, forgot lyrics, and often went into long, rambling, and random soliloquies while onstage.

B. B. King’s last performance was on October 3, 2014 in Chicago. However, the performance had to be cut short because King wasn’t feeling well enough to continue. He was hospitalized with dehydration and exhaustion.

On May 1, 2015, after two hospitalizations due to complications from diabetes and blood pressure, B. B. King’s website announced that King had entered hospice care at his home in Las Vegas.

On May 14, 2015, B. B. King died. The official cause of King’s death was complications from dementia (vascular dementia).

Sadly, B. B. King’s family has already begun the legal fight over who will control his estate (there are allegations that King’s long-time manager, Laverne Toney, whom King appointed as his power of attorney, mishandled King’s care and money).

It’s a tragic footnote to an incredible life.

 

Profiles in Dementia: Ralph Waldo Emerson (1803 – 1882)

Ralph Waldo Emerson and Concord, MA writersI recently read Susan Cheever’s American Bloomsbury, a compelling account of the interwoven lives of the Concord, MA literary giants of 19th Century literature and, with a notable exception (Nathaniel Hawthorne), the core members of both the Transcendental Movement and the Abolition Movement that saw John Brown as a heroic martyr.

This group of closely-interconnected writers included, among others (Edgar Allan Poe passed through as did Walt Whitman and Herman Melville), Emily Dickinson, Louisa May Alcott, Henry David Thoreau, Nathaniel Hawthorne, and Ralph Waldo Emerson.

Despite all my college studies in English Language and Literature, I have never been able to really like – or even endure – most 19th Century American literature. (Yes, I’m American and, yes, I really loathe this period of American literature for the most part.)

My three exceptions are the three writers in this Concord, MA conclave who never quite fit in with the mindset and the groupthink of the rest of the writers: Nathaniel Hawthorne, Edgar Allan Poe, and Emily Dickinson.

I won’t bore you with all the reasons – and there are many – why I like these three writers and don’t like the rest.  If in another lifetime I decide to start a literary analysis blog, a post with those reasons will definitely make its appearance there.

Ralph Waldo Emerson Dementia and AphasiaSo, although I read my required – and no more – share of Ralph Waldo Emerson, I didn’t know much about him as a person. This book shed a lot of light on that.

Emerson, it turns out, was the financial support for these writers and their families, some for all their lives (Henry David Thoreau) and some until they published successfully (Nathaniel Hawthorne and Louisa May Alcott).

Emerson was older than most of the other writers and was treated by them as a father figure and a mentor. Emerson was intelligent (a graduate of Harvard), thoughtful, and a practical intellectual who guided this group in both their literary endeavors and their personal lives.

So I was surprised to learn that Emerson developed dementia (Cheever, perhaps because she has not dealt with dementia in a more personal way, made the common mistake of calling it Alzheimer’s Disease, which is only one type of dementia), accompanied by aphasia during the last decade of his life.

Because aphasia was a key feature of Emerson’s neurological degeneration, it’s very possible that he suffered from vascular dementia, since aphasia is very often a feature of that type of dementia.

One of the devastating aspects of aphasia as it worsened for Emerson was that he had supported his family and, to one degree or another, many of the other Concord writers for decades by conducting a rigorous yearly schedule of paid speaking engagements around the country. Once his ability to communicate coherently was gone, Emerson’s income was gone as well.

In the last couple of years of Emerson’s life, he forgot most of the people and things around him in Concord, MA. Louisa May Alcott, whom Emerson had known for 42 years, watching her grow up from a nine-year-old spunky girl into an equally spunky woman, became a stranger to him, as did his family. 

The Forgetting PBSHowever, and this is fortunate, in the acclaimed PBS documentary, The Forgetting, Emerson is quoted as having remarked, when he was well into the disease, to a friend that, “I have lost my mental faculties but am perfectly well.”

I plan to make “Profiles in Dementia” a regular feature on this blog since I’ve got a lot of stories like these that I’d like to share and will give another dimension, in terms of personal interest, to this blog.

So, if you like this one and you like the idea, let me know by your likes and comments.

This blog’s for you, so you have a voice in what kinds of things are included here.

I appreciate you reading and hope that you will find the extensive body of information here helpful in your journey with dementias and Alzheimer’s Disease, whether that’s as a caregiver for loved ones or it’s you that’s walking the journey yourself.

 

 

Mother’s Day 2014

mama mother's dayToday is the second Mother’s Day since Mama’s death. Grief still lingers and hovers over me, punctuated even more by packing up for the impending sale of my house and subsequent move.

Because packing has brought the inevitable sifting and sorting, which entails opening boxes, containers, and drawers that have sat unopened for a while. And I’ve come across a lot of memories in the process and the tears that they are just memories now have fallen quite frequently.

While some who read this blog knew my mama, most of you don’t. So in honor of Mother’s Day 2014, I would like to briefly introduce you to this wonderful and beautiful lady that I’m honored to have known as “Mama.”

Mama was one of the most intelligent people I’ve ever known. Though beset by a hearing loss – that worsened with time – all her life, she was an excellent student and she loved learning.

Although Mama had completed medical technology training shortly after she and Daddy married, she yearned to go back to college and get more education. At 48, she did just that, ending up with a bachelors of science degree in biology and a bachelor of arts  degree in English. Her cumulative GPA was 3.5, despite the fact that she struggled through two required, but dreaded, math courses. We – she and I – worked together and got her through both of them with a C.

Almost right up until the time of her triple-dementia – vascular dementia, Lewy Body dementia, and Alzheimer’s Disease – diagnosis, Mama was taking classes of some kind. Her last formal classes were sign language classes, which Mama persuaded me to join so that we could learn and practice together.

Mama was also a voracious reader. When Mama was in elementary school, she’d spend every Saturday at the public library in Greenville, SC where she made the pronouncement to the librarians there that she was going to “read every book in the world.” They laughed, but Mama never gave up on that unattainable goal.

Mama, in spite of all the odds against her, was, as an adult, hopeful and optimistic about life. She enjoyed life and made the most of her time on this earth.

Mama had a whole lot of love and she generously poured it out on everybody who intersected with her life and who responded to it. I’m not sure Mama ever met a stranger; of the five of us, she was, even more so than Daddy, the most likely to introduce herself to someone and make them feel welcome in any setting.

Mama cared very deeply about humanity and often cried tears for the most vulnerable among us – children and the elderly – when she learned of hurts, sorrows, and oppressions that had befallen them.

Mama also loved all the four-legged friends that accompanied her and us as a family throughout her lifetime. She also cried tears for them when it was time for her and us to say goodbye to them.

Mama was the enthusiastic cheerleader in our family. Whenever any of us expressed a desire to do or try something, Mama was right behind us encouraging us to go for it, assuring us that she’d be with us all the way.

Sometimes if we were too reluctant or refused to do something and Mama believed it was something we needed to do, she’d give us an “or else” ultimatum. My only jump ever, tear-laden though it was, off a diving board into the deep end of a swimming pool when I was 9 was the result of one of Mama’s ultimatums. 🙂

mama-entertaining-bday-2003Mama had a fantastic sense of humor that always had the edge of mischief around it. She laughed easily and often and her blue eyes sparkled with joy most of the time, although dementias and Alzheimer’s Disease took more than their fair share of that away as they progressed.

Mama was always up for adventures with her family and her friends. When she and I were both in college at the same time, we arranged our schedules so that our Tuesday and Thursday classes were done by noon.

At least once a week, we’d go to lunch together, then go to Baskin-Robbin’s and get three-scoop sundaes to take to the movie theater to eat while we caught the afternoon matinee of whatever new movie was out.

On days we didn’t go to the movies, we’d either spend the afternoon walking and talking out at Wrightsville Beach (North Carolina) or Fort Fisher or in downtown Wilmington or we would go bowling or go to shoot pool (Mama never quite mastered the technique of shooting pool, but she was a pretty decent bowler back in the day).

I cannot tell you how much I treasure those memories, nor how much I miss those times. When we traveled together in subsequent years, we’d always spend a lot of time exploring together, until the last few years, when Mama’s energy and heart was winding down and she simply couldn’t manage long exploratory walks and strolls.

It broke my heart when it happened. I guess I believed she’d be enthusiastically keeping pace with me, taking two steps to every one of mine (her legs were shorter), until the day she died.

Mama was also a talented writer and storyteller. One of the memories I’ve encountered as I’ve been packing is the reminder of how much she wrote over the years of her life. 

One of those pieces of writing reminded me, though, that Mama experienced a lot of grief during her life, including the worst grief, I believe, of her life after Daddy’s death in October 1998.

She wrote these words six months after Daddy had died:

“This is the eve of the sixth month since my husband’s death. I have come a long way since that fatal day in October. I need to pause and take stock of where I’ve been and what I’ve learned since that time…

…At first the pain of my loss was indescribable and unrelenting. I was locked into my grief, unable to think or act on anything. When everyone [us kids] returned to their daily routine, I was in an abyss of hopelessness. The pain had even paralyzed my tear ducts…

…While sharing activities with others or hearing some interesting information, I could hardly wait to tell my husband and had the shock of realizing that would never again happen. When writing, I kept expecting him to knock on the office door and I’d look up and see that crooked grin and hear him say: ‘Just checking on you.’

I found myself talking to him about my problems and asking him how I’d ever solve them without him. I’d fuss at him for keeping every key he had ever possessed and I had no idea what they fit. Or I’d rage at him for saving every rubber band, paper clip, and ad infinitum.

I’d tell him he was right, I was the messiest person alive and I had to change, but I’d show him that I could. At night, I’d reach over to touch him, but only felt his robe that I left on his pillow. Those were the times the flood gates opened.”

Reading Mama’s words about her grief after Daddy’s death reminded me both of my grief after he died and my grief since her death. Somehow Mama’s words reflected much of what I’ve experienced since her death. It’s not in my face all the time, but it still hits me like a ton of bricks out of the blue more often than not.

mama-bday-2003I miss you, Mama, just like I miss Daddy. I’m a little lost at times with both of you gone and I’m often struggling with the idea of being all alone in the world, humanly-speaking.

This Mother’s Day will be bittersweet like last year’s was and all the ones in the future will be until I see you again. For you now, it is just the blink of an eye. For me, it’s a little bit longer than that.

I love you, Mama! Until we see other again, sleep well.

Going Gentle Into That Good Night – The Book is a finalist in the SeniorHomes.com Best Senior Living Awards 2014

Thank all of you who have voted so far for my book, Going Gentle Into That Good Night BookI wanted to pass what I learned on, so I wrote Going Gentle Into That Good Night .

It’s a finalist in the SeniorHomes.com Best Senior Living Awards 2014 books categories.

A panel of judges will determine the SeniorHomes.com expert winner, but your votes will determine the People’s Choice winner. Voting is open until May 12, 2014. So, if you haven’t had a chance to vote yet, I’d certainly appreciate you doing some research into my book and giving me a vote if you think it’s a good offering in this category.

Going Gentle Into That Good Night – the book – is a finalist in the SeniorHomes.com Best Senior Living Awards 2014.

In God’s Country: Northeast Tennessee and Mama

This is a remembrance of Mama (written at the blog I created for the memoir I wrote about our family), who would have been 85 today. She fought with strength, dignity, and bravely in all the journeys of her life – including vascular dementia, Lewy Body dementia, Alzheimer’s Disease, and congestive heart failure – and left an example showing us, her kids and grandkids, how to walk and endure our own journeys. Miss my mama and love her dearly. ♥

Fields of Gold: A Love Story - The Book

Eighty-five years ago today, about nine months before the Great Depression began, in Flag Pond, Tennessee, Muriel Foster Ross – my mama – was born to Samuel and Ennis Foster.

A doctor and both grandmothers were there attending the long and arduous birth that was taking a fatal toll on Mama’s mother and led the doctor, upon delivery, to dismissively say “that baby’s going to die” as he handed an underweight and frail Mama to her paternal grandmother, Grandma Foster, and turned his attention to trying to save Ennis Foster’s life.

Grandma Foster countered, “This baby’s going to live!,” and put Mama in the warming bin of the oven in the kitchen – a primitive incubator. Grandma Foster hovered over Mama through that afternoon and night, feeding her and wrapping her up in fresh towels every few hours.

By the next morning, Mama was stronger, had color, and it was…

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If You Needed Help, Does Anyone Have What They Need From You to Step Up to the Plate?

Kay Bransford and I seem to be on the same page a lot these days, but I see that we seem to be the only ones willing to tackle these subjects, so I guess we will keep sounding the drums that all of us need to be preparing in advance for the possibility that something – whether it’s Alzheimer’s Disease, dementias, other life-threatening illnesses, or simply time and chance – could suddenly and dramatically or slowly and insidiously render us incapable of taking care of our own affairs.

It seems to me that the very thing we try most to avoid thinking about, talking about, planning for is the very thing that will eventually happen to us all. And that is death.

Denial is, in my opinion, stronger and more pervasive in this area of life than in any other. “If I don’t think about it, then it isn’t real” seems to be the underlying thinking of this denial. I’m here to tell you that all the denial in the world won’t take away its inevitability of happening.

None of us, except those who chose to usurp God’s will and end their own lives, know how or when we’re going to die.

I believe most of us assume it will be quick and instantaneously, but the reality is that, in all likelihood, most of us will probably have a period of decline in which we will need help handling our financial, legal, and medical affairs before we take our last breaths.

And, after we take our last breaths, someone will have to take care of getting us buried and ending our financial, legal, and medical status among the living.

Who would that be for you? Yes, you, the one who is reading this post. Do you know? Does that person know? If that person knows, have you made this as easy as possible for him or her by doing your part and making sure he or she has everything he or she needs to do what needs to be done?

Or, because you don’t want to think about it or talk about, will that person have the burdensome responsibility of trying to figure it out all on his or her own?

We say we don’t want to be burdens to our loved ones. By taking care of this, you and I – we – have taken a big step toward easing the magnitude of that burden that, if we live long enough, will be shouldered by our loved ones.

I did my first will and living will shortly after I turned 21. I had just graduated from college, but not before having a very serious car accident (one that I miraculously survived with some significant injuries, but nothing like what I should have suffered) just before I graduated.

I’d never been that close to being face-to-face with death before, but it made me realize that I needed to make sure that my affairs – and they were paltry in those days but even then I had life insurance – were in order for the ones I’d leave behind.

From that point on, I have been meticulous about keeping my will up-to-date, the beneficiaries on my insurance policies up-to-date, and all the information my executor will need to take care of things up-to-date. I added a DNR to my medical wishes about 20 years ago, I got my cemetery plot 15 years ago, and I wrote out my funeral service and burial wishes about 10 years ago. 

Additionally, my executor has updated access and account information to everything online and offline to finish up my earthly affairs when I’m gone.

preparation-death-alzheimer's-disease-dementias-age-related-illnessesThis, in my opinion, is the last act of kindness I can do in this physical life. It is also one of the greatest.

Mama used to worry that something would happen to me (i.e., that I would die before she did) and then about what would happen to her. There were times in our lives together that could have been a possibility, but I always reassured her that I’d be there with her to the end. And I was by the grace of God.

Of my parents, Daddy was a paradox when it came to this subject. On the one hand, he had life insurance that would take care of Mama after his death and he insisted, in the year before his death, that Mama get her own checking and savings accounts and get credit cards in her name only.

On the other hand, there were other areas in which he had great difficulty facing his mortality. I remember Mama suggesting that they start getting rid of clothes and other things they weren’t wearing or using anymore and Daddy’s response: “the girls can take care of that.”

The will that Daddy had in effect, until shortly before his death, was the one that he had drawn up just after he and Mama adopted us. None of the information was pertinent or relevant anymore.

After much and extended (I’m talking a couple of years) discussion between Mama and him, they finally went to a lawyer, about six weeks before he died, to have a current will drawn up.

Mama was just the opposite. Somehow, I think all the deaths of close and beloved relatives in her early years made the inevitability of death more real to her. She, primarily, during our growing up years, talked on a regular basis about what would happen to us if she and Daddy died and how we needed to take care of each other and be good kids so the road without them would be easier for us.

Not long after Daddy died, she and I sat down together (I was now checking in daily and helping her navigate through some of the things that Daddy had done and offering advice and assistance as she needed it) and she told me what she wanted – and didn’t want – as far as end-of-life wishes.

We went to an attorney together and she did a will (which she later changed to a revocable living trust), living will, and all the POA paperwork. I had copies, she had copies, and she put copies in a safety deposit box at the bank.

At that time, I didn’t need or want knowledge or access to her financial accounts, but as time went on, she needed more of my help in dealing with them, so she gave me access to get into the accounts and help her (we always sat down and did this together until she wasn’t able to anymore) keep up with bills and what she had. 

By doing this with me, Mama made things much easier for me when the time came that I had to step in because she couldn’t do it.

I can’t thank Mama enough for her foresight with this gift. Instead of having to focus on everything brand new coming at me at once, I could focus on what was most important, and that was Mama: loving her, caring for her, being there for her.

The last couple of months Mama was alive, we’d be sitting close, holding hands, and talking and suddenly she’d say “I don’t want be a burden on you,” with tears rolling down her cheeks. I’d squeeze her hands and pull her closer in a hug, kissing the tears away from her cheeks, saying, “Mama, you’re not a burden to me. I love you unconditionally. I wouldn’t be anywhere else doing anything else but right here doing this with you.”

Mama would relax in my embrace and I would hold her tighter as I said these words because they were true and we both recognized that they were true, but most of all, I recognized how easy Mama had made things for me by equipping me with what I needed to step in easily and take care of the routine things so that I could save my energy, my focus, and my love for taking care of her.