The Stages of Alzheimer's Disease and How It Progressed With My Friend Over the Years

It has become more difficult these past months to visit my friend at the memory care center where she has been living.  As she declines, the good days are less frequent and the bad days expand to fill the empty space. Each time I go I hope for just one more bit of insight that can help me understand what is going on inside as her mind gradually loses it's foothold. Now...all of the things that have caused both of us angst in the past seem totally meaningless. For the most part, she has lost her ability to speak, remember past experiences or people, recognize food or care about where her dog is. Without a past, who are we?  I seek the answer at every visit.

          This morning's sunrise on the hike I always made my friend take with me when she visited. She would  humorously complain the entire time until we finished with a latte from Dutch Brothers.  

There is a certain look she always gave me that made my heart dance. She would tuck her chin down and raise her eyebrows, tilting her head then look into my eyes as a way to separate herself from the other residents, as if to tell me she was not one of them.  That was my cue to give her a conspiratorial smile and nod. It was something we did in college.  No words necessary.

I knew my friend had memory issues when she was in her 40's. She had always had a voracious appetite for words, spoken or written.  We both saved our books, trading bags of them several times a year when we visited each other. Then suddenly she didn't bring any more books and wasn't interested in taking any of mine. She was unable to keep the story line straight any longer, having to start at the beginning each time she picked up the book.

She began asking simple questions, repeatedly with no recollection of having ask the same thing just a few minutes earlier. Even hearing the answer over and over didn't trigger her memory.  At one visit, each time she ask me where I got my sweater, I asked if she recalled having ask me that earlier.  Even though her declining short term memory was frightening for us both, her sense of humor showed when from then on she began saying after every question, "I already asked you that, right?" followed by a gale of laughter.

We had many conversations about what her future looked like after she was diagnosed with Alzheimer's.  At first she insisted it wasn't true but there was no denying the scan that showed her brain beginning to atrophy.  She was angry with many people. She was resentful and depressed at times. She was upset when the woman who coordinated the local Alzheimer's Association told her there would be a day when she would not be able to find her car in the parking lot of the grocery store.  She talked with me about what this would mean as she aged.  She obsessed about where she would live, what would happen to her dog and how she would spend her days, afraid of not knowing what was going on around her.  All I could say was "You are my friend. I will be there. I will hold your hand and make you laugh like we did in college".

Today I was there as her future became the present. I held her hand and tried my best to make her laugh but it wasn't what we had pictured years ago when she first learned of her disease. Tears ran down my face as I watched her struggling, drifting in and out of sleep.  It seemed best to tell her the story of her life as I knew it, about how we met in college and the crazy things we did and how hard we laughed, how our lives evolved with each other through

The sunset from the deck where my friend and I sat many times

relationships, job changes, moving closer to each other then farther away and then finally closer again. I spoke about how we ended up right here...right now.  I  told her about the journey she was on and that I would be waiting for her to let me know she arrived safely.  She squeezed my hand as she tucked her chin down, raised her eyebrows, tilted her head and looked into my eyes.  I gave her that conspiratorial smile and nodded just like we did in college.  Yes, you are my special friend.  No words necessary.