Tag Archives: strokes

Walking with my mother in her heart-breaking decline

All life cycles have watershed moments, times when another bridge has been irrevocably crossed. In the life of a child, that moment is often a joyful one. But for an elderly parent, life proceeds in reverse, leading often to sorrowful conclusions. 

My mother Liz, who is 93 years old, reached one of those watershed moments one night three years ago. 

We had moved my mother from Milwaukee to a senior housing complex near our Madison home five years earlier. My wife Jean and I had visited her twice that Sunday to address various issues. She seemed strange, but we weren’t yet seasoned enough to understand what was wrong.

After her third call, we returned to find Mom sitting in her nightgown on her bed, with three television and cable system remotes and three cordless telephones alongside her. We realized that something was happening.

Jean began to remove the clutter, which snapped Mother out of her stupor,

“Don’t touch those,” she said anxiously. “Those are my phones!”

Some were her phones, and some weren’t. Due to their similar shape and color, she could no longer tell the difference. We bundled her up and took her to the nearest emergency room.

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More than 10 million adult children over 50 care for aging parents, according to a 2011 study by the MetLife Mature Market Institute. Baby Boomers comprise the majority of caregivers. The number of parents cared for both physically and financially by their kids has more than tripled over the past 15 years.

Not surprisingly, daughters tend to provide more care than sons and suffer more financially because of it. On average, the amount of lost wages, pension dollars and Social Security benefits for women forced to leave the workforce early to provide care totals $324,044, according to the study. Men suffer less financially, but it still costs them an average of $283,716 in aggregate salary and benefit losses to care for elderly parents.

A disproportionate number of boomers caring for parents are gay and lesbian, according to John George, health care administrator for Saint John’s On The Lake, a retirement community of 330 residents on Milwaukee’s east side.

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Upon reaching the hospital that Sunday night, my mother was diagnosed with dehydration and a urinary tract infection, both of which accounted for her confusion. But we would soon discover she also suffered from transient ischemic attacks, often called TIAs or “mini-strokes.” Those would lead to more dire consequences. 

TIAs are caused by blood clots that come and go in the brain. Some are relatively harmless, while others can be precursors to larger, fatal strokes. A series of TIAs followed by a large stroke killed Mom’s older brother Harold decades earlier. We felt that a similar outcome was possible, if not imminent, for her.

While doctors worked to get her situation under control, we made arrangements to move Mom temporarily to a nursing home for rehabilitation. A former RN, my mother had worked at Sunrise Care Center on Milwaukee’s south side until she was almost 86. We thought she’d be comfortable with the transition.

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Transitions to some level of assisted living are often the most difficult things for families to cope with, according to Elaine Dyer, a registered nurse and administrator for the Jewish Home and Care Center, a 160-bed retirement community also on Milwaukee’s east side. Large families often have the hardest time agreeing on what should be done with an elderly parent.

“When there’s more than one child, there’s always more than one opinion,” Dyer says. “As caregivers, we need a point person whose guidance we can rely on, and that person needs to be the patient’s health care power of attorney in order to make the right decisions.”

Dyer’s own mother was a resident at the Jewish Home until she passed away from Alzheimer’s disease last October, and the administrator is acutely aware of how hard the “little losses” of cognitive decline can be on family members.

“Watching cognitive decline is harder than watching physical decline,” Dyer says. “The elderly begin to lose the abilities you gain as a child, including swallowing, talking, walking, bowl and bladder control.”

In terms of providing care, Wisconsin’s 323 nursing homes serve only about 5 percent of the state’s population over 65, Dyer says. The surprising statistic is mostly due to finances. Owing to the recent financial recession, admissions to skilled care facilities have declined over the past four to five years, because too many families need their parents’ Social Security checks to make ends meet.

And then there’s the cost of putting those parents in a skilled care facility.

“The cost for nursing home care is $8,000 to $10,000 a month, and even the wealthiest person who has saved for it could one day run out of money,” Dyer says.

But before that happens, adult children should make sure they understand what their aging parents want and then make those ultimate decisions based on that guidance, she adds.

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Mom spent two weeks in the nursing home, eventually returning to a variant of her former self. But we knew that bridges had been crossed and things would never be the same again.

During my mother’s nursing home stay, we found her an assisted living facility on Madison’s west side. We moved her out of her senior apartment, disposing of furniture and other things she no longer needed. During the grueling two-week process, we discovered clues to her cognitive failure that weren’t previously apparent.

Dozens of unopened bottles of generic acetaminophen and countless file cards and paper scraps with duplicate addresses and phone numbers she didn’t want to forget filled nooks and crannies. We discovered boxes of junk mail — her “bills” as she called them — including some stored in the unused dishwasher. We found cash in the refrigerator.

Mom appeared to be settling in nicely to her assisted living facility, making new friends and regularly eating a healthy diet, something she had also stopped doing in her apartment. There were even activities and outings, but over the course of two years we could see that she had started slowing down.

When construction began on the facility’s new addition, we saw her confusion and anxiety increase. A series of three UTIs in as many months seemed to send her to the moon and back again — not to mention the hospital — on a regular basis. 

George notes that a change in a senior’s environment can result in “transfer trauma” and a large percentage of sufferers are usually dead within a year. When her strange behavior continued, we began to wonder just how long her future would be.

My mother called me on the telephone last week. 

“Mike? This is Grandma,” she said. “If you are out can you stop by? I haven’t had a working phone all day.”

And so, once again, it begins. I don’t want to spend Mothers’ Day at the hospital this year, but maybe just having one more Mother’s Day anywhere is the best I can hope for.

Study will test chocolate pills for heart benefits

It won’t be nearly as much fun as eating candy bars, but a big study is being launched to see if pills containing the nutrients in dark chocolate can help prevent heart attacks and strokes.

The pills are so packed with nutrients that you’d have to eat a gazillion candy bars to get the amount being tested in this study, which will enroll 18,000 men and women nationwide.

“People eat chocolate because they enjoy it,” not because they think it’s good for them, and the idea of the study is to see whether there are health benefits from chocolate’s ingredients minus the sugar and fat, said Dr. JoAnn Manson, preventive medicine chief at Harvard-affiliated Brigham and Women’s Hospital in Boston.

The study will be the first large test of cocoa flavanols, which in previous smaller studies improved blood pressure, cholesterol, the body’s use of insulin, artery health and other heart-related factors.

A second part of the study will test multivitamins to help prevent cancer. Earlier research suggested this benefit but involved just older, unusually healthy men. Researchers want to see if multivitamins lower cancer risk in a broader population.

The study will be sponsored by the National Heart, Lung and Blood Institute and Mars Inc., maker of M&M’s and Snickers bars. The candy company has patented a way to extract flavanols from cocoa in high concentration and put them in capsules. Mars and some other companies sell cocoa extract capsules, but with less active ingredient than those that will be tested in the study; candy contains even less.

“You’re not going to get these protective flavanols in most of the candy on the market. Cocoa flavanols are often destroyed by the processing,” said Manson, who will lead the study with Howard Sesso at Brigham and others at Fred Hutchinson Cancer Research Center in Seattle.

Participants will get dummy pills or two capsules a day of cocoa flavanols for four years, and neither they nor the study leaders will know who is taking what during the study. The flavanol capsules are coated and have no taste, said Manson, who tried them herself.

In the other part of the study, participants will get dummy pills or daily multivitamins containing a broad range of nutrients.

Participants will be recruited from existing studies, which saves money and lets the study proceed much more quickly, Manson said, although some additional people with a strong interest in the research may be allowed to enroll. The women will come from the Women’s Health Initiative study, the long-running research project best known for showing that menopause hormone pills might raise heart risks rather than lower them as had long been thought. Men will be recruited from other large studies.

Manson also is leading a government-funded study testing vitamin D pills in 26,000 men and women. Results are expected in three years.

People love vitamin supplements but “it’s important not to jump on the bandwagon” and take pills before they are rigorously tested, she warned.

“More is not necessarily better,” and research has shown surprising harm from some nutrients that once looked promising, she said.

Nostalgic for the ’90s?


Nick Cave and The Bad Seeds

On the expanded and re-mastered CD/DVD reissues of The Bad Seeds’ “Let Love In” (1994) and “The Boatman’s Call” (1997), Nick Cave comes off as the Australian Leonard Cohen. Where “Let Love In” balances balladry with bluster, “The Boatman’s Call” is exquisite from start to finish, beginning with the to-hell-with-hallelujah “Into My Arms.” This is utterly essential listening.

The Strokes

The worldly music influence of “Machu Picchu,” the opening track of “Angles” (RCA), suggests The Strokes have been listening to Vampire Weekend (or could that be vice versa?). Regrouping after pursuing solo and side projects, The Strokes sound revitalized on this release. The angle here tilts toward fun, from the bouncy and light “Under Cover of Darkness” to the dance rock of “Two Kinds of Happiness” to the potential dance-floor smash of “Games.” Welcome back, Strokes!

Beady Eye

Anyone possessing the least bit of familiarity with the brawling Gallagher brothers of Oasis knew that the band was doomed. The fact that they lasted as long as they did (15 years or so) is something of a miracle. Liam Gallagher has returned with a new band, called Beady Eye, and a new album, titled “Different Gear, Still Speeding” (Dangerbird). You don’t have to dig deeply to hear the similarities between Gallagher’s previous band and the current one. His distinctive vocals alone have the power to conjure up Oasis. But he sounds – dare I say it? – less snarly and somewhat more at ease.

Pearl Jam

After Pearl Jam’s grunge-metal debut disc, the group veered in a slightly more commercial direction with 1993’s “Vs.” There is still a vocal chord-shredding and head-bobbing rawness to tracks such as “Go,” “Animal” and “Blood.” But then you have “Daughter” and “Elderly Woman Behind the Counter in a Small Town” to give you more to ponder. Next up was 1994’s “Vitalogy,” containing the band’s most punk rock cut – “Spin the Black Circle” – alongside rave-ups such as “Whipping,” “Nothingman” and “Better Man.”

Both “Vs.” and “Vitalogy” have been reissued and repackaged in expanded editions, along with the “Live at the Orpheum Theater April 12, 1994” disc, in an Epic/Legacy box set.

Foo Fighters

Out of the premature ashes of Nirvana sprang Foo Fighters, led by Dave Grohl. He’s still “gathering the ashes,” as he sings on “Bridge Burning,” the first track on “Wasting Light” (RCA/Roswell). That’s one of 11 songs that listeners are encouraged to “play at maximum volume.” In the midst of all the FF-style chaos, there’s much radiance, including “Rope,” “Arlandria” and the luminescent “Walk.”

Ben Ottewell

Even if you don’t know the name Ben Ottewell, you’ll probably recognize his voice as the lead vocalist of the British band known as Gomez. Ottewell steps out on his own on “Shapes and Shadows” (ATO). While it’s a pleasant exercise, it’s clearly not meant to be taken as a sign that Gomez fans should worry about the group disbanding.

Ted Leo and the Pharmacists

Since their late 1990s debut, Ted Leo and the Pharmacists have been mining the political pop/punk vein. Their latest, “The Brutalist Bricks” (Matador), continues the tradition on tracks such as “Mourning In America,” “Bottled in Cork,” “Buzzing of Bees” and “Last Days.” Leo delivers revolution rock in all its glory.