Mrs. R was a character. Her natural red hair had changed to gray years earlier, but thanks to the magic of her hairdresser, her hair was again flashy red, and she had a personality to match. She was a feisty, fun and full-blooded woman full of zest and pizzazz. She made me smile whenever I made rounds at the nursing home.
Through the years, Alzheimer’s disease took its toll on her memory, but her spirit, brightness and spark didn’t seem to fade much. Even near the end, as the family stopped the hair coloring, she gave me a charge of energy and vitality whenever we met. However, the neurodegenerative (ND) Alzheimer’s condition didn’t let up and eventually she slipped off this earthly existence gently while family surrounded her with love.
The image of my redheaded friend repeatedly came to me through the years as I cared for people with ND diseases. Neurodegenerative brain loss conditions include Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), Alzheimer’s, Parkinson’s and Huntington’s disease. These heartbreaking conditions happen because of brain cell death but we don’t know what kills the brain cells. We do know that in 2016, 5.4 million Americans were living with Alzheimer’s and we estimate 930,000 people will be living with Parkinson’s in 2020.
Presently a lot of research is being done to look for exposure to certain toxins as cause for ND diseases to include pesticides, fungicides, insecticides, metals like arsenic, lead and manganese, polychlorinated biphenyls (PCBs) and other human-made and natural toxins in the environment including tobacco and some antioxidants. We simply do not know the cause or causes, but we’re looking hard.
When a person has one of these largely untreatable conditions, we utilize tools called “Activities of Daily Living (ADLs)” to define when that person might need more help. The five ADLs include 1. personal hygiene (being able to bath, groom, brush hair and teeth), 2. continence management (being able to independently use the toilet), 3. dressing (selecting and wearing appropriate clothes), 4. feeding oneself, and 5. ambulating (being able to change position and to get around by oneself with or without an assistance device or wheel chair). Losing ability to do one or more ADLs certainly means that help is needed, if not now, around the corner.
Mrs. R had a great life, and although she struggled with an ND brain condition, she didn’t lose her spirit and color until the very end. Miss you, Mrs. R.
Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He was founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook.
