Early-onset dementia, a heart-rendering disease that took Dales Judd in his prime

Early-onset dementia, a heart-rendering disease that took Dales Judd in his prime

Greta Judd: early-onset dementia took her husband, Dales, during a physically fit and productive time of his life  |  George Le Masurier photo

Early-onset dementia, a heart-rendering disease that took Dales Judd in his prime

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Before Feb. 11, 2016, Greta Judd, like most people, had only a general awareness of dementia. She just knew Alzheimer’s disease was a form of dementia that affected older people. No one in her family had suffered from dementia. And she had never heard of early-onset dementia.

Many years before, Greta had started to notice subtle changes in Dales, her husband and high school sweetheart. But at first, these seemed simply to be the normal signs of ageing, like needing glasses to read a book.

So when Dales’ anxiety levels started to increase in his early 50s, she wrote it off as getting older and becoming more set in his ways. When the avid cyclist fell off his bike, he was just clumsy. When he couldn’t remember the name of something, he was merely forgetful.

“With dementia, you lose the person in increments”

But over the years, Greta had become increasingly worried about the changes she saw in Dales. She circumvented Dales’ family doctor and pressed for a clinical diagnosis from an Island Health specialist in seniors care.

On Feb. 11, 2016, the Judds learned that Dales was living through Dementia with Lewy Bodies, an incurably rare disease with characteristics of both Alzheimers and Parkinsons, but one that progressed more quickly than both.

“Getting the diagnosis was horrible,” Greta told Decafnation. “It was devastating to realize my husband of 45 years wasn’t coming back. This wasn’t something we could fix.”

She cried a lot at first but hid it from him by going out for walks.

“He fed off my moods and I didn’t want to upset him,” she said.

Lewy Body Dementia represents between five percent to 10 percent of all dementia cases in Canada. Most of the 500,000 Canadians with dementia are over 65 and have Alzheimer’s or vascular dementias. Lewy Body typically exhibits earlier, around age 50, and tends to afflict slightly more men than women.

Dales’ life expectancy was pegged at three to seven years.

After slowly declining over almost 20 years, Dales died exactly on Feb. 11, 2019, at age 68. But he did not die how you might imagine.

 

SEEING THE SIGNS

Looking back, Greta can see now the little signs of dementia that Dales had been exhibiting for more than a decade before his diagnosis.

He always had poor sleep patterns and frequent insomnia and he experienced noticeable weight gains and losses. Both are commonly accepted indications of a propensity to develop dementia.

He started to forget simple words like ‘refrigerator.’ “You know,” he would say, “that place where we keep the food.” Once an avid and daily sudoku puzzler, he suddenly stopped altogether.

Dales Judd: a victim of early-onset dementia

When they went to a restaurant, Dales seemed to always forget his reading glasses. “Just order me something,” he would say. Greta understands now that he couldn’t read the menu because the words weren’t making sense to him any more.

It’s common to develop masking and coping strategies, but as the disease progresses they become harder to hide.

On a driving trip to the Grand Canyon several years before his diagnosis, Dale asked one morning, “Where are we?” Greta took out the map to show the route. But she soon realized his question was more profound than a specific town or campground.

His symptoms worsened. More than once during his sleepless night, Dales flooded the kitchen floor by washing the dishes and leaving the plug in the sink with the water running.

When he left all four elements burning on the stove, about a year before his diagnosis, Greta could no longer leave him alone in the house or outside.

And neither Greta or Dales’ sister, Carol, with whom he was very close, knew until after the diagnosis that he had been having visual hallucinations. They were friendly but frightening.

Dales continued to recognize people right to the end, Greta believes. He just couldn’t say their names or speak.

“He would try. His mouth would open but the words just wouldn’t come,” she said.

Finally, the only way he could communicate or show emotion was to cry.

 

WHO WAS DALES JUDD?

Greta was 18 when she married Dales, 23. They were married for 45 years. They moved to the Courtenay from Canmore, Alberta in 2003. They semi-retired from Dales’ career as the Canmore community services director and previously as director of a YMCA in Calgary. Dales drove a school bus for the Comox Valley Schools.

Greta remembers Dales as a tremendous athlete.

Dales on his ride to Newfoundland

For a while, he mastered all the racquet sports. Then he got into long-distance cycling. He cycled from Canmore to Alaska twice. He cycled once from Canmore to Jasper over to Prince Rupert, ferried down to Port Hardy and cycled down the Island and then back to Canmore. He and his sister, Carol, once cycled from Victoria to Newfoundland.

Dales always needed a goal, something that he was training for. He ran many marathons and half-marathons.

She also remembers Dales “big sense of humor and he was incredibly funny.” Greta says he was “kind, generous and a superb father. He was proud of his children. He made it a point to expose his children to as many activities and experiences as he could.”

 

THE END IN A CARE HOME

The tragedy of Dales Judd’s death was not that he died. Greta, her sister-in-law and their children all knew the end was coming.

“I had been grieving for three years already,” she said. “With dementia, you lose the person in increments.”

When Dales’ physical deterioration became too difficult to manage safely, Greta made the difficult decision to move him into a residential care home.

And that’s when the tragedy of Dale’ death occurred. He did not die from his dementia. He died from the Norwalk virus that had spread through the Comox Valley Seniors Village for the second time in 10 months.

Dales with his grandchildren in the care home

Dale had survived the first outbreak, but he and the residents of three adjoining rooms, none of whom were mobile, all died from the second virus outbreak at about the same time.

Because the restrictions of the coming COVID virus pandemic were not yet underway, Greta and Dale were able to spend the last hours of his life together.

But Greta and the family members of the other victims were angry.

“His life in the Seniors Village was horrible,” she said. “Staff all did their own thing then. There was no leadership. Some of the staff even resented family members’ visits.”

Greta was doing all of Dales’ person care and even feeding him. That was common among the residents, she said because the facility was so short-staffed.

She says family members had become the privately-owned facilities’ essential workers even though they were paying the care home $7,000 a month (family cost plus public subsidy).

“I think it’s better now,” she said. “But by the time he died I was grateful that he didn’t have to live that way any longer. It was a demoralizing, demeaning way to live.”

 

MOVING FORWARD

There is another tragedy that accompanies all forms of dementia: the toll it takes on family caregivers.

According to B.C. Seniors Advocate Isobel Mackenzie, there are roughly one million unpaid caregivers in B.C. Ninety-one percent of them are family members, usually adult children (58 percent) or spouses (21 percent).

In a report, “Caregivers in Distress: A Growing Problem,” Mackenzie said 31 percent of unpaid caregivers were in distress in 2016, which represented a 14 percent increase in the actual number of distressed caregivers over the previous year.

She defined ‘distress’ as anger, depression and feeling unable to continue.

Fortunately for Greta, Dales was able to age in place at home for a while with the help of some friends, family and Island Health home care aides. But even so, she says, the burden of having to do everything from pay the bills to take the car in for repairs while providing almost 24/7 personal care took its toll.

“The home care we did get was wonderful, but it was only minimal care. They would sit with him so I could go to buy groceries or run other errands. But it was just to make sure he was safe. They didn’t shower him or do any personal care,” she said.

Greta and Dales Judd

What Greta really needed was longer-term mental health breaks for herself so she could recharge. She was able to get a week-long respite bed only two times in three years, one each in Cumberland and Glacier View Lodge.

But she eventually connected with a group of five other women while taking their husbands to a weekly Minds in Motion dementia program at the Lower Natives Sons Hall. The group continued to have coffee regularly after their spouses were in care homes.

Now, the women have all taken up the ukulele and formed a group called the Uke-A-Ladies and they play together via Zoom.

And Greta has become active in other groups lobbying the BC government for more long-term care beds and respite beds for the Comox Valley.

Now, she’s thinking of selling the travel trailer the couple purchased long ago with intentions to explore North America. She might trade it for a travel van and make a few trips with her dog.

“We can’t move on,” Greta said. “But we have to move forward with our lives.”

 

 

 

 

 

 

WHAT IS LEWY BODY DEMENTIA?

People with dementia with Lewy bodies have a decline in thinking ability that may look somewhat like Alzheimer’s disease. But over time they also develop movement and other distinctive symptoms of Parkinson’s disease that suggest dementia with Lewy bodies.

Dementia in British Columbia Dementia is a broad term used to describe the symptoms of a number of illnesses that cause a loss of memory, judgment and reasoning, as well as changes in behaviour and mood. These changes result in a progressive decline in a person’s ability to function at work, in social relationships, or to perform regular daily activities.

In British Columbia, current estimates of the numbers of people with dementia vary between 60,000 and 70,000. As the numbers of seniors grow, dementia cases will rise.

 

TYPES OF DEMENTIA

Alzheimer disease: A progressive disease of the brain featuring memory loss and at least one of the following cognitive disturbances that significantly affects activities of daily living: Language disturbances (aphasia); An impaired ability to carry out motor activities despite intact motor function (apraxia); A failure to recognize or identify objects despite intact sensory function (agnosia); and Disturbance in executive functions such as planning, organizing, sequencing, and abstracting.

Vascular Dementia: A dementia that is a result of brain cell death that occurs when blood circulation is cut off to parts of the brain. This may be the result of a single stroke or multiple strokes, or more diffusely as the result of small vessel disease.

Dementia with Lewy Bodies: This disease often has features of both Alzheimer disease and Parkinson’s disease. Microscopic ‘Lewy bodies’ are found in affected parts of the brain. Common symptoms include visual hallucinations, fluctuations in alertness and attention, and a tendency to fall.

— Internet sources

 

BY THE NUMBERS

Over 500,000 — The number of Canadians living with dementia today.
912,000 — The number of Canadians living with dementia in 2030.
25,000 — The number of Canadians diagnosed with dementia every year.
65% — Of those diagnosed with dementia over the age of 65 are women.
1 in 5 — Canadians have experience caring for someone living with dementia.

Over $12 billion — The annual cost to Canadians to care for those living with dementia.
$359 million — The cost to bring a dementia-treating drug from lab to market.

56% — of Canadians are concerned about being affected by Alzheimer’s disease.
46%  — of Canadians admit they would feel ashamed or embarrassed if that they had dementia.
87%  — of caregivers wish more people understood the realities of caring for someone with dementia.

— Alzheimers Society of Canada

 

 

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A caregiver’s hard decision: help wanted

A caregiver’s hard decision: help wanted

A caregiver’s hard decision: help wanted

Is it okay to strap a loved one into a wheelchair?

BY DELORES BROTEN

So we have come to a point where my love is walking … meandering, staggering … around with his eyes sometimes closed. His legs are buckled, he leans sideways or backwards and it is truly scary. It looks like he could fall any minute, and he could. Not all the time but a lot. And he sometimes does fall, and quite often nearly does. He usually won’t sit down for long.

The care home aides and nurses want … or suggest, that he needs to be strapped into a wheelchair. To prevent falls. They are as terrified as I am when walking beside or behind him. He could hurt himself or them.

And he has fallen a few times … kind of sliding to the ground in confusion when his legs don’t work. No injuries yet. “I don’t know what is wrong with my leg,” he says.

Neither does anyone. It is a guess but probably it is a possible bout of sciatica, part the pain meds, possibly the dementia closing down another segment of the mind, but mostly because he can no longer orient vertical, up and down. That was an early problem. Now he doesn’t know where is upright and can’t tell his legs what to do. The dementia is taking away even that.

Top photo: Don Broten at Miracle Beach in better days. Above photo: A more recent image

So it is a safety issue. But I cannot see the advantage or the care in strapping him down like the worst kind of tortured prisoner and I am refusing to sign the paper.

It is illegal to restrain him without my okay.

And I am NOT okay with this.

Over the two-and-a-half years we have been there I have seen this. The patient starts strapped down for safety but is taken out and up on their feet for a walk 20 minutes a day. At most. Soon of course they can’t walk at all and life becomes a Brody chair. Where they lie swearing and trying to get out, while the care machine rolls on around them and staff gossip and go for breaks.

Then, unlike when they were mobile, the patient-victims really ARE swiftly parked and ignored. Oh fed and cleaned and cooed at from time to time, but that’s about it. No interaction except with family. Even the recreation aides don’t have much to offer once they are parked.

I want to puke. This is not humane.

Many of the parked recognize that I am a friendly face and make some kind of happy contact. But like everyone, I walk on by, with other things to do.

Part of me thinks wildly that i could bring him home, transform our house … foam on the floors and clear out the furniture such as it is, and extra care aides. Let him wander and fall safely in his strange fragmented world. Bring him home.

But foam doesn’t clean well and it is not that simple. It is the 36-hour job.

We don’t have family willing or able to take shifts and we don’t have that much money to get a suitable house, transform it and hire help. That is for the one percenters. For us, we are beyond lucky to have public care. Many don’t.

There is also my own slowly eroding remnant of a life to consider – although at moments like this it doesn’t count for much, and those who depend on my work. That must count too.

On the other hand my own mother was strapped in a chair because she kept trying to walk when she was totally paralysed on the left side, with resultant dementia. And there was no other choice. But she was not drugged and never parked. She had my father with her 24/7.

I have no idea what kind of love and determination that took. After she died he regained a huge amount of mental capacity and resilience. He did see what was coming for my love and me and told me not to do as he had done.

Comments and advice are welcome, here (on her blog), on Facebook, or by personal email. I need some help with this.

Delores Broten is one of British Columbia’s many thousands of unpaid caregivers. She is the editor of the award-winning Watershed Sentinel magazine published in Comox. She wrote this for her blog “CaringCV,” and is reprinted here with permission. She may be contacted at editor@watershedsentinel.ca. 

 

FURTHER READING: Read Delores Broten’s blog, “CaringCV”