5Fifth*****REVISED DRAFT*****

Sweet Memories

My Mother’'s Life Story and tThe Lessons I Learned from Her Journey with Dementia

by

James C. Neville

To: Clair, Alden, Timothy, Tyson, and Brynn

Continue to Grow in God’'s Light.

Love,

Papa

Contents

Acknowledgements

Preface

Introduction

Chapter I: Prayers Answered

Chapter II: From the Woods to the Hood

Chapter III: Looking for aA Dad

Chapter IV: New Opportunities

Chapter V: RESPECT

Chapter VI: Mother Millie

Chapter VII: Getting Understanding

Chapter VIII: Risk Factors

Chapter IX: Psychological vs. Physiological

Chapter X: The Mind, Tthe Body, and Tthe Spirit

Chapter XI: Reversing the Roles

Chapter XII: Behavior Modification

Chapter XIII: Sweet Memories

Chapter XIV: The Helper and Tthe Cussee

Chapter XV: 24/7 Care

Chapter XVI: Acceptance

Chapter XVII: Prevention

Chapter XVIII: Preparing for Your Future

Chapter XIX: Resources

Works Cited

About the Author

Acknowledgements

I want to first thank my Lord and Savior, Jesus Christ, because without Him

this book would not have been possible. I want to thank my mother for raising,

guiding, and protecting me. Her strength, tough -love, and kindness equipped me

and gave me a great foundation for life. I want to thank my wife of 42 forty-two

years, Dinah, who has been by my side every step of the way. I want to thank our

sons, Mel and Tim, for being great husbands, fathers, and dads! And, our

daughter, Bre, for being a great woman of God and for providing her expertise in

designing the cover of this book through her business at

www.BMariePhotog.com. I want to thank my brother, Rick, and his wife, Yvette,

who both co-labored with us throughout our mom’'s journey. I want to thank my

brother, Jack, for moving mom so many times during her lifetime and his wife,

Mae, for all the wonderful meals, chats, on the phone, and all the quality times

you and mom had together. I want to thank our daughters-in-laws, Trishette and

Tierra, for being great moms and virtuous women of God. I want to thank my

sister-in-law, Linda, for being a beautiful, loving wife to my brother, John. I want

to thank my nieces (John’'s daughters), Karla, Dujuana, Myesha, and Mandesha

for being loving and kind and growing up to be strong and beautiful women in the

absence of their father. I want to especially thank Mandesha for visiting her

grandma and giving her that great little dog named Muffin who brought mom so

much joy. I want to thank my niece, Mia, a.k.a. Tinsey, for loving her grandma

more and more. I want to thank my nieces, Crystal and Jasmine, for loving and

looking after their grandma. I want to thank my niece, Toni, and her husband,

Jason, for the joy they brought to their grandma. I want to thank my nephew,

Rasheed, and his wife, Carlita, for all the good and loving times they had with

their grandma. I want to thank my cousin, Audrey, for her beautiful eulogy and

for the love she had for her Aunt Millie. I want to thank my cousin, Dennis, for

planting the grapevine that brought mom so much joy. I want to thank my cousin,

Elaine, and her husband, Bob, for always making mom laugh when they came to

see her. Last, but not least, I want to thank my cousin, Mac, a.k.a. Kelly, who

always found time to visit Mmom during some of her most difficult times.

Preface

My purpose for writing this book is to share my mother’'s story and the

lessons I learned from her transition through the different stages of dementia. In

essence, by reflecting on my mother’'s life and legacy from a Christian

perspective, I use her story to illustrate the different stages of dementia and the

challenges I faced as a caregiver.

While conducting my research for this book, I noted that some of the charts

list the progression of dementia in five stages, i.e., (1) no impairment, (2)

questionable impairment, (3) mild impairment, (4) moderate impairment, and (5)

severe impairment. Other charts, however, list the progression in seven stages.

And, although the five-stage chart accurately describes the stages of dementia,

the seven-stage chart provided a better description of my mother'’s journey

through the final stages of the disease. Hence, the shift from one stage of the

disease to the other towards the end of my mother’'s journey was not as abrupt as

described in the five-stage chart. In other words, it was more gradual over a

longer period of time, especially after my mother was prescribed the drug

Aerosep.

For example, using a dementia rating scale, both the five-stage and seven-

stage models have the same or similar descriptions for stages one through

three. In stage one, there is are no obvious signs of dementia and the person is

deemed normal, i.e., no impairment. In stage two there is are some signs or

symptoms that may be questionable or very mild, however, the symptoms are

normally associated with old age, such as misplacing or forgetting things, but at

some point the person can locate or remember whatever they misplaced or lost.

And, for the most part, the person can still function independently.

However, the signs of dementia becomes more noticeable in the mild

impairment (stage three ). For example, the person begins to get confused

more often while driving, loses things more frequently, start having problems

managing their finances and medication, etc. However, the person can still

perform many activities of daily living without assistance, i.e., eating, getting

dressed, going to the bathroom, etc.

The five-stage and the seven-stage descriptions differ slightly from this

point on., tTherefore, as I stated, the seven- stage description worked better for

me, i.e., the seven-stage concept breaks moderate and severe into two-part

phases. In the moderate (stage four), a person’'s memory and their ability to

negotiate activities of daily living becomes more difficult.: They may forget how

to safely operate and use appliances, such as a microwave or a stove. They may

forget to pay their bills,; may have less memory of recent events,; have problems

counting backwards by a specific number, or they may withdraw from being

around people.

The signs and symptoms of dementia in the moderately severe (stage

five) are very critical and it becomes more apparent that the person needs

assistance to negotiate their activities of daily living. For example, memory loss

increases to the point where a person cannot remember their own address or

phone number or what day and time it is, etc. They may start putting on multiple

layers of clothing or being inappropriately dressed for the occasion or season.

They may also become confused about activities and events. They may also need

assistance using a phone and doing other things they used to do without

assistance.

In the severe stage (stage six), the person needs total assistance with

their activities of daily living, such as assisting them with cleaning themselves

after they use the restroom. This is also the stage where it becomes apparent

that the person cannot live alone or be left unattended in an unsecure dwelling.

Wandering and other safety concerns becomes an issue at this point. The person

may also forget the names of family members, but can recall a familiar face or

person. And, tThey may not know the meaning of time and their behavior and

personality can drastically change. For example, seeing and hearing things that

are not there,; becoming suspicious of people, etc.

The very severe (stage seven) is the final stage of dementia. The

person’'s language skills diminishes to the point where they become incoherent.;

tThey need help eating, they cannot walk or sit without assistance,; unable to hold

their head up or control their movement. This is also the stage where pre-

arranged tube-feeding or other pre-arranged plans are executed, changed, or

modified. For example, tube-feeding is a form of life support. Therefore, the

patient may have instructed his or her wishes through an advance medical

directive as to whether or not they want to be tube-feed at this stage of life.

However, the doctor(s) and family members may discuss or re-consider the tube-

feeding or other options prior to executing any prearranged plans. Hospice care

is also a factor at this point.

When I introduced my mother at the beginning this book, her dementia iwas

already in stage six, i.e., her condition was severe. From there, I reflected back

over her life beginning when she had no impairment. Then I examined her

lifespan and her legacy to see if there were any connections between her risk

factors, life experiences, and the onset of dementia.

I also discussed the new discoveries regarding the causes and the

prevention of dementia and Alzheimer’'s. However, due to the narrow scope of

my research and the constant advances in the field of medicine, this book is not

intended to be an authority on these diseases. Therefore, the main goal of this

book is to promote awareness by sharing information about dementia and

Alzheimer'’s combined with the lessons I learned from caring for my mother.

This book also addresses some of the signs and symptoms of dementia and

concludes that diet, exercise, and other life-style changes can prevent or slow the

progression of dementia, especially in the areas of early detection and treatment.

And, based on the information I found, the prospective on prevention looks

promising. I also included a list of helpful dementia and Alzheimer’'s resources as

well as other information to assist the reader.

My sources of information include the Journal of the American Geriatrics

Society,; Journal of Alzheimer’'s Disease,; and Nursing and Health Sciences, as

well as several other publications.

Introduction

While sitting next to her during one of my daily visits to the nursing facility,

my mother stared at me unlike any time in the past. Her eyes pierced me. Then

she motioned me with her right hand and whispered, “"Come here. Come here,

Sug.”" I was already sitting close to her, so I leaned over and got closer. With a

gleam in her eyes, she smiled and said in a soft tone, "“I love you. I love you,

Sug.”" As tears began to swell in my eyes, I hugged her tight and kissed her on

her the forehead and said, "“I love you too, mMom.”."

This was indeed an unexpected event because prior to that moment, mMom

had not spoken much in several weeks. a And when she did speak, her words did

not make much sense. Therefore, that moment gave me hope that the mom I

once knew was still with us. I was also very thankful that mMom’'s loving,

“"social butterfly”" spirit was still intact, a. At least for the most part. I say this

because, after mMom’'s dementia diagnosis several years earlier, I found it

difficult to accept the changes that were taking place in her. And, although

mMom was aware of the inevitable, she never wavered in her faith and she

thanked God every day for His grace and mercy.

In retrospect, I truly believe that my mother, through her faith, prayers, and

obedience to God, allowed His angels to perform their assignments in a mighty

way! For example, her favorite scripture was Psalm 23, which she lived by.

Therefore, she walked in the path of righteousness. She feared no evil. And she

surely believed that God’'s "“goodness and mercy”" would follow her all the days

of her life. Most of all, she believed that she would “"dwell in the house of the

Lord forever." .”

This is her story, her legacy, and her journey through the different stages of

dementia and the challenges I faced as a caregiver.

I:

Prayers Answered

My mother always prayed since the time I can remember. Therefore, it was

normal for me to see her on her knees both day and night, praying to the Lord.

Mom not only prayed during the dark days of her life, she also prayed and

thanked God during the good times in her life. And, I know for a fact that her

prayers were answered.: Like the time when my brother, Larry, who had suffered

from epileptic seizures since his childhood, was drafted and subsequently sent to

Vietnam despite our pleas to the draft board.

Mom’'s prayers not only kept Larry safe in Vietnam, her prayers also kept

him safe after he returned home and was attacked by several police officers who

thought he had drugs in his briefcase. Larry did not have any drugs in his

briefcase. He only had the eight-track tapes that he played in his car. The police

arrested him anyway and charged him with assault and battery of a police officer.

The charges were later dismissed after it was learned that, during the melee of

Larry’'s arrest, the assaulted officer’'s teeth got knocked out by his own partner

who accidently hit him in the mouth with his club.

My mother also prayed for me, and I’'m glad she did. For one, I knew about

God, but I did not have a relationship with Him through His son, Jesus Christ. In

other words, I was not saved at the time. Therefore, while growing up in Jersey

City, I engaged in some activities that were contrary to the will of God and the

plans He had for my life. As a result, some of these activities almost got me

killed. For example, when I was nine years old, my brother, Larry, and a few

more kids in our neighborhood found out that the white kids from the other side

of town had hid some of the goods they stole from a freight train. Therefore, we

conspired to steal their stash. And, since I was the smallest, my job was to be the

lookout.

We went to the location and searched along the railroad tracks and did not

find anything. We kept going further and further down the tracks and just as we

got close to a tunnel, a white railroad police officer jumped out of the tunnel and

started shooting at us. We ran for our lives as the bullets flew by us. I ran so

fast, I thought I was flying because I did not feel my feet touch the ground when I

descended down a hill. Thank God none of us got shot and I truly believe that it

was my mother’'s prayers that saved my life.

My mother’'s prayers also helped me on another occasion when I became a

victim of a mugging while we were living in Montgomery Housing Projects in

Jersey City.: It was a Friday evening and I had just picked up my pay from my job

at the local Shop-Rite Supermarket. I worked in the produce department after

school. And, to make matters worse, I had worked some extra hours that week

and my paycheck, which I had already cashed, was a little bit more than usual.

I went back to the projects and I was waiting for the elevator when a guy

named Ernie approached me and asked me if I wanted to buy some weed. I found

it odd for him to ask me something like that because I only knew him from a

distance. In other words, he was someone I chose not to associate with. But,

before I could say no thanks, someone grabbed me from behind and pressed a

big, long, shinny knife to my throat.

Using my peripheral vision and voice recognition, I realized that the mugger

was the infamous drug addict known as the "“Funky Junkie.”" Hence, whereas

some drug addicts were described as having a "“monkey on their back.”" He had

a “"gorilla on his back”" due to his enormous drug habit. And, as a result of his

addiction, he terrorized the projects on a regular basis where he was known to

cut or stab his victims and Ernie was his accomplice.

Thank God I had enough sense to give them my money instead of getting my

throat slashed. I thanked God for the police who later arrested them after I

pressed charges. I thanked God for the jury that eventually convicted them. I

also thanked God for being drafted because I went into the military shortly after I

testified against them idiots. Most of all, I thanked God for my mother’'s prayers!

There were many other accounts of my mother’'s prayers being answered.

And, although my brothers and I did not have a personal relationship with God

while we were growing up in Jersey City, we knew that God was real and He

answered prayer.. However, as Rick and I got older, we developed our own

relationships with God through His son, Jesus Christ. Therefore, we prayed for

our mom after her dementia diagnosis and we continued to believe God for her

healing even after she started forgetting our names. Hence, mom’'s decline did

not get us down or dampen our faith because she continued to use her humor and

loving personality to amaze us. Like the time when my oldest brother, Jack, who

mMom had not seen for a while, came to visit her. I asked her did she know who

he was. She looked at Jack and grinned and said, "“Of course, I do.: He’'s the one

who named himself.”" We could not help but laugh and hug her at the same time.

Mom always had a way of saying things and it was incidents like this that

took the sting out of the reality of her disease . For example, we had a childhood

friend who we nicknamed “"Shoes”" due to the size of his feet. As time went on,

mMom started calling him “"Foots”" instead of "“Shoes.”" She would say, "“I saw

Foots today.”" At first, we didn’'t know who she was talking about until we later

made the connection. And, since “"Foots”" sounded funnier than "“Shoes,”" we

also started calling our friend "“Foots.”"

When the effects of mMom’'s dementia started creeping into our livfes, we

slowly began to see the changes as they blended with her personality. Therefore,

we cherished each day. We laughed and we sang and we did as many things that

we could do together, including taking daily walks and reminiscing on the days

gone by, which caused me to appreciate my mother’'s life and legacy more and

more.

II:

From the Woods to Hood

Mom was a strong, hardworking, God-fearing woman who was born Millie

McDonald Harvey in Enfield, North Carolina on May 10, 1927. She only had a 9th

ninth grade education, but it did not stop her from seeking and achieving a better

life for herself and her children. Most of all, she never gave up even when the

odds were against her, including the effects of a failed marriage.

In 1957, due to the lack of opportunity in the segregated South, mMom

briefly left me and my four brothers with our maternal grandmother while she

went to New York to find work. It did not take mMom long to find a job. She

returned to North Carolina the following year and moved us to New York.

It was one of the happiest days of our lives when mMom came back and got

us. We were also happy to meet her new boyfriend, Al Thompson, whom she had

met in New York. And, although our grandma, who was part Cherokee Indian,

was mean to us at times, we loved her and we were sad about leaving her alone.

While on the other hand, we were not sad about leaving the crowded conditions of

her one-room shack where there was no indoor-plumbing. And we definitely were

not going to miss those long cold walks to the outhouse in the middle of the

winter.

We also knew that gGrandma loved us and that she would miss us too.

Grandpa had died four years earlier, therefore gGrandma welcomed our company

and the time we spent with her drew us closer together. For example, Jack, Tom,

and John slept in one bed while Larry and I alternated between sleeping with

gGrandma and sleeping on the floor. Sometimes gGrandma would ask me to

scratch her back when I slept with her at night. She would say, "“Right there.

Right there . . . Ahhhhhhh . . ."” However,, the greatest thing about all of this was:

Wwe were poor, but we did not know what poor was.; tTherefore, we were

grateful for everything we got, including the clothes our mother made for us out

of rags and other discarded material such as flour bags and potato sacks..

We were also grateful for the Argo laundry starch and the red clay dirt we

used to eat.: One time, Larry ate so much clay dirt he ended up being constipated

for almost two weeks. And, although we had some bad times while staying with

gGrandma, we also had some good times too. Like the times Larry and I

accompanied our older brothers to the creek where we skinny -dipped and swung

butt -naked on vines and hollered like Tarzan before we jumped into the water.

On another occasion, we were sitting inside gGrandma’'s shack with

nothing to eat. And, just when we went to go outside to look for some berries, a

big black crow flew over Ggrandma’'s shack. My brother, Tom, immediately

picked up a stick, and threw it, and knocked that bird out the sky. We took the

crow inside where gGrandma quickly cleaned and cooked it. Grandma also baked

some biscuits and made some gravy. And, about two hours later, we all sat

around gGrandma’'s table and thanked the Lord for our meal, which was mighty

tasty.

Larry and I did not attend school regularly during our time in North

Carolina because most of the time, we literally did not have anything to wear,;

especially shoes. But, on the days we attended school, we were glad to go

because we would get a free pint of milk or a juice drink. Larry and I would put

on whatever clothes we could find, which were mostly hand-me-downs. And,

when gGrandma had it, she would usually put a biscuit or some cornbread in our

lunch bag. And, every now and then, gGrandma would also put a piece of fatback

or an apple in our bag, which sometimes got eaten or traded before we got to the

bus stop.

On the downside, the segregated schools we attended were supplied with

outdated, hand-me-down text books from the white schools. Furthermore, the

classrooms were extremely cold during the winter time due to a lack of fuel or a

broken furnace. Therefore, I was very happy to leave North Carolina. And,

although gGrandma was rough on us, she did her job well with the resources she

had. As a result, none of us were jailed or kidnapped or lynched for violating the

Jim Crow Laws during our stay with gGrandma, which was the order of the day

during those times in the states below the Mason Dixie Line. Therefore, black

mothers and grandmothers were often rough on their children in order to keep

them from being a victim of the aforementioned consequences for violating the

Jim Crow Laws. In other words, black folks in the South had to "“stay in their

place”." Oor else!

We left North Carolina in April 1958. I tried to stay awake during the entire

trip to New York but, I fell asleep before we arrived. When I woke up, we were

driving through New York City. It was around noon time and one of the first

things I saw was a black boy and a white boy playing together, which both

shocked and frightened me. I was sitting in the front seat between mMom and Al.

I grabbed my mother’'s arm and exclaimed, "“Ma, are blacks and whites friends

up here?!?”" Mom looked at me, and smiled, and she assured me that it was

okay for black children and white children to play together in New York.

Mom had a nice apartment waiting for us in Brooklyn, New York. She

wanted us to have a decent place to live;. uUnfortunately, moving five country

boys into a nice apartment building without any formal training or adjustment to

city life, did not turn out well. For example, while mom was at work, we played in

the elevators,; we ran up and down the fire escape, and swung on the ladder and

hollered like Tarzan, just to name a few of the things we did. The landlord and

our neighbors soon had enough of our country ways and we got evicted within a

few months after we moved to New York.

Although we put mMom through some challenging times, she never gave up

on us and she always tried to find us a better place to live. However, due to her

financial situation at the time of our eviction, we ended up in a ghetto in Jersey

City, New Jersey, which was totally different from the nice neighborhood we had

in Brooklyn. For example, one of the first things I witnessed in Jersey City was a

fight between two winos who almost cut each other to death in broad daylight

after arguing over a bottle of wine. Blood was everywhere. And, the crowd that

had gathered, egged the men on; especially after the victim wrestled the butcher

knife away from his attacker and exclaimed,: "“Now it’'s my turn!”" Thank God

the police and an ambulance arrived before the men bled to death.

III:

Looking for aA Dad

Mom eventually found us a house in a better part of Jersey City. And, as we

moved from place to place, we became acquainted with the different men mmom

brought into of lives. However, long before mMom was diagnosed with dementia,

I asked her about the different men in her life. I also asked her why did she

marry she married my father who ended up being an alcoholic and a deadbeat

dad. She said it all began when she was in the 10tenth grade. World War II had

just broken out and she thought the war would "“kill up all the men.”" As a result,

she fell in love with a young man named, Pete Hawkins. However, Pete skipped

out on her after she became pregnant with my brother Jack.

My mother said that she later found out that Pete went into the aArmy

without telling her or writing her and that was when my father, Johnny Neville,

came along. She thought that Johnny would be a good husband for her and a

great dad for Jack. Unfortunately, due of my father’'s drinking habits and lack of

financial support, the marriage was a failure from the start. Nevertheless, Mmom

said that she tried to make it work. And, although they had several arguments

and fights, they would make up and get back together and have another child.

My mother further stated that she and my father even tried farming together

without success, which had a lot to do with my father’'s drinking habits and lack

of support.

I was 18eighteen months old and the youngest out of five boys when my

mother and father finally broke up in 1954. My mother stated that most of the

men that we met after her and my father separated were just friends. She further

stated that some of those friendships grew into deeper relationships because she

was trying to find us a dad. In other words, she wanted us to experience a

relationship that only a dad could provide. And, at one point, we thought mMom

had found us a dad when Al came along. For example, we started seeing Al on a

regular basis after we moved to Jersey City. Mom would fix him dinner and

sometimes I would shine his shoes and he would give me 25 twenty-five to fifty50

cents. Al also took us on family outings to the beaches and the amusement parks.

And, perhaps because I was the youngest and the smallest, Al and I immediately

connected and he started calling me Peewee.

Al or Big Al, as some called him, was a truck driver who delivered

mattresses for the Crown Mattress Company in New York. He eventually took me

with him on some of his deliveries in the different parts of New York. I was seven

years old and I not only enjoyed riding in Al’'s truck, I also admired Al because he

was big and strong. As a result, I often bragged to some of my friends about how

strong Al was after seeing him carrying mattresses and box springs up the flights

of stairs by himself. Therefore, I wanted to be big and strong like Big Al..

A few years later, our brother, Rick, was born. However, instead of Al being

a full -time dad to Rick and the rest of us, he turned out to be a two-timer. In

other words, Al believed in sowing his seeds in more than one place and mMom

eventually broke up with Al him after she found out about his double- life.

Therefore, aAs a result of my father’'s short-comings and the lack of commitment

on the part of the other men in her life, mMom was the only dad we ever knew.

Mom not only taught us how to cook, clean, and sew, she also taught us how

to drive cars and trucks , including the ones with the manual (stick-shift)

transmissions. And, when it came to cleaning and doing chores around the house,

Mmom was like a drill sergeant who did not allow us to cut corners. Whether it

was washing dishes, scrubbing or cleaning baseboards, walls, floors, and carpets,

mMom made sure we completed each task well. Therefore, no matter where

lived and regardless to the condition of the dwelling, mMom made sure our home

was clean and tidy where the fresh smell of pine or lemon was pretty much the

standard on Saturday mornings.

Not only did I carry these standards into my adulthood, I also learned the

value of teamwork early in life as a result of mMom’'s efforts. For example, by

the time I was four years old, I already knew how to peel potatoes, tie tobacco

stalks, and pick cotton. This was because we often assisted mMom with her tasks

at the different farms and restaurants she worked at in North Carolina. One

time, I peeled so many potatoes, I did not want to ever see another potato again

in my life.

Mom also did not raise any of her sons to be lazy or less than a man. For

example, all of us learned to how to work and earn a living. As a result, I started

my first business when I was seven -years old. It was a shoeshine business and I

was the sole proprietor. I made a shoeshine box out some discarded wood and

purchased my supplies, i.e., shoe polish, rags, and brushes, out of the money I had

saved from running errands or carrying groceries for people in the neighborhood.

It took me no time to start making money. For example, by charging 15

fifteen to 25 twenty-five cents per customer, I learned how to pop my rag and

make shoes shine like glass in less than two minutes, which earned me tips as

much as a dollar per customer. Sometimes I would team -up with and my same

aged friend named Joseph "“Jo Jo”" Menter and we would shine shoes in the local

bars and on street corners where the majority of our customers were white

middle-aged men who all treated us well.

IV:

New Opportunities

After we moved to New Jersey, mMom sometimes worked two to three jobs

in both the garment and restaurant industries where she sewed and cooked

respectively for many years. However, mMom always looked for new

opportunities and ways to improve herself. As a result, in 1974, mMom enrolled

into a Job Corps training program and became one of the first women to be

trained and hired by the Bethlehem Steel Ship Building Division in Hoboken New

Jersey where she performed jobs that were traditionally done by men.

In 1977, mMom was quoted in the Sunday Star-Ledger after she was

interviewed by a reporter who asked her how she felt about her job as a rigger,

i.e., tying hitches to cranes, carrying 40 forty pounds of chain-fall, and signaling

to crane operators to hoist their hauls: . "“It’'s more important to keep warm on

the docks than it is to look attractive. ..Sometimes the men look at me like I’'m

crazy when they see me carrying the chain-fall or eight-foot planks, but I’'m

physically fit to do the work. aAnd the more I do it, the easier it gets.”" (Zepka,

1977, p. 2).

After leaving Bethlehem Steel in 1984, Mmom became a school bus driver

for Jersey City Public Schools. She also baked biscuits in the early morning hours

at a McDonald’'s restaurants while working other jobs. At McDonald’'s, mMom

earned a reputation at the store she worked at and rightfully so., aAfter all, her

middle name was "“McDonald"” and she wanted everyone to know it. The

customers loved her and they would tell my brother, Rick, who was the store

manager, that mMom’'s biscuits were just like the ones their mothers used to

bake.

Mom also enjoyed driving the school bus just as much as she enjoyed baking

biscuits. However, I believe she enjoyed driving the school a little bit more

because she really loved the children and treated them just like they were her

own. And, the children knew that she loved them too. But, they also knew not to

act up on her bus because all she had to do was look at them and they would

straighten up.

My mother was also a master gardener whose plants and flowers brought

joy and hope to an inner city neighborhood that was plagued by crime and blight.

In 1990, for example, her garden drew the attention of The Jersey Journey

newspaper and she was featured in an article titled "“Reaping benefits.”" The

article high-lighted her efforts in transforming a vacant, weed-filled, space in the

Lafayette Gardens Housing Project into a fresh -food resource that produced

peppers, cabbage, squash, tomatoes, and cucumbers, which she shared with her

neighbors (Milian, 1990, p. 13).

1942 1957

Mom and Family Standing Next to Papa’'s 1931 Ford Model A

"“Boys in the Woods”" (Enfield, NC)Left to Right: Niece, Ernestine Snead (Aage 12); Father (Papa), Alexander

Clockwise: Jack (Aage 13), John (Aage 9),Harvey (Aage 61), Mother, Malvina Harvey (Aage 55) & Mom (Aage 15)

James (Aage 5), Larry (Aage 7) & Tom (Aage 11)

1978

Mom (Aage 51) & Fellow Workers at Bethlehem Steel Ship Building Division in Hoboken, NJ

1965 1971

"“Boys in the Hood”" (Jersey City, NJ) Clockwise: Larry

Returns Home from Vietnam Jack (Aage 21), John (Aage 17), James (Aage 13),

Clockwise: James (Aage 19), Larry (Aage 21) Larry (aAge 15), Tom (Aage 19) &and Rick (Aage 2) Rick

(Aage 8) & Mom (Age Aage 44)

V:

RESPECT

I learned early in life not to disrespect my mother. One of the reasons I

learned early resulted from my mother working so much that she did not have a

lot of time to talk about things, not to mention what type of day she may have had

herself. Therefore, if we did something wrong, she often dealt out the

punishment and talked later. And, because we were boys, she often used just

about anything she got her hands on to keep us in line, including belts, sticks, and

extension cords, just to name a few. For example, I remembered when my

brother, Larry, and I were in North Carolina. He was about five years old and I

was about three years old. I was following behind Larry when we decided to play

on a neighbor’'s car while mMom was at work. I don’'t know what made us do it,

but we were having a great time throwing sand on our neighbor’'s car and sliding

down it like a sliding board.

We continued playing on the car until mMom showed up and summoned us

into the house. First of all, we were not supposed to be out of the house. Mom

tore our butts up and we never played on another car again and we never left the

house without her permission. The same thing was true with my brother, Rick,

who wandered away from home at age two.: After Rick was found safe and

returned home by some one people in another neighborhood, mMom first made

sure Rick was all right. She hugged him and kissed him. She cleaned him up and

feed him a nice meal with some dessert. Then she whipped his little butt with a

belt and he never wandered away from home again.

Mom did not care how old you got.: If you were out of line, she whipped

your butt. Like the time I decided to celebrate my graduation from grammar

school, which is considered middle school today. I was thirteen13 years old and

we were living in the Montgomery Housing Projects. Me and a couple of my

friends chipped in our money and we got an older guy to purchase some alcoholic

beverages for us. After we got the alcohol, we gathered near an underpass

where we drank beer, wine, and liquor and smoked cigarettes. We entertained

ourselves with some dirty jokes and we even tried singing some of the popular

Motown songs, like “"My Girl,”" and “"Ooh Baby, Baby.”" Instead of sounding like

the Temptations or Smokey Robinson, we sounded more like a pack of sick

puppies. I was having a great time until my head started spinning,; then all I

wanted to do was go home and lay down.

I left the gathering and staggered home with hopes that my mother was

asleep. The elevators were broken so I had to walk up seven flights of stairs,

which seemed to shift from side to side, just like the ones in the funhouses at the

carnivals., bBut there was nothing funny about this situation. When I finally

arrived at our apartment, I had a hard time getting my key into the lock because

the keyhole seemed to spin around and around. And, because I did not want to

make any noise, the ordeal seemed endless. I don’'t know how long it took, but I

finally got my key into the lock. At last, I unlocked the door and slowly opened it.

I smiled because the lights were off.

I eased my way into our apartment and just as when I was about to close

the door, mMom flicked on the lights from her position behind the door. Without

saying a word or asking me any questions,; mMom took her shoe and whacked me

several times on my head, arms, and shoulders. I saw stars just like the ones in

the cartoons. From the force behind her licks, I could tell mMom was very

disappointed with me., pPerhaps she had a flashback from her experiences with

my father. Nevertheless, she scolded me and whacked me several more times..

I didn’'t have a chance to say anything nor was there much for me to say

because the alcohol on my breath and me coming home late said it all. Thank

goodness this type of punishment is not condoned today. However, on the other

hand, I believe mMom did the best that she could do under the circumstances

with great success, i.e., I did not become an alcoholic or a deadbeat dad like my

father. I also thank God for giving me the wisdom not to repeat the cycle of abuse

that was passed down from my grandmother to my mother to me as a result of

slavery and ignorance.

Mom was also very protective of her children and she did not allow anyone

to exploit us in any way. For example, an incident happened when we were living

in North Carolina.: After our mother and father separated, mMom rented a house

from a white man. We had not been there long. However, all hell broke loose

when mMom came home from work one day and discovered that the white man

had us doing yard work for him in the hot sun without her permission.

Mom was furious.: She jumped out of her car and looked at us and shouted,

“"Get in the house!”" Then she marched up to the white man and told him that

she did not recall him having any black children. The man was speechless

because Mmom was boiling mad. Mom told the man that we would be out of his

house before sundown the next day, which we did.

Mom did not allow the men in her life to disrespect her either. For

example, she got into a relationship and eventually married a guy she met at work

named Willie Evans who came along when we were still living in the Montgomery

Projects. Prior to Willie’'s arrival, my father, who remained absent from us, died a

couple years earlier from cirrhosis of the liver at the age of 48forty-eight. Jack

was married and living with his wife, Mae. Tom was in the Air Force stationed in

Panama. John was station with the Marines in California and Larry was in

Vietnam. As result, Rick and I were the only ones living with mMom when Willie

came on the scene. I was about 17 seventeen years old and Rick was about six

years old. And, if we had a sister named Thelma, our family structure would have

been similar to the Evans family on Good Times. However, we had more "“bad

times"” than “"good times”" after Willie came into our lives.

I was working after school and I was pretty much the man of house when

Willie knocked on our door and asked to see our mom. I did not want him to come

into our apartment because I could tell from the start that he was no good. But,

for some reasons, mMom loved herself some Willie who also smoked and drank,

which was totally contrary to hermom's beliefs and habits. I guess Mmom

thought that she could change Willie even after her supervisor at work told her

that Willie was no good and advised her to stay away from him.

Willie told lies from the start and I will never forget the first lie he told me

after I had asked him where did he geot the scars he had on the side of his neck.

Willie looked at me with his red eyes and told me he got the scars in a battle

during the Korean War. Then he lit a cigarette and took a long drag and slowly

blew out the smoke and said that he was assigned to the 82nd eighty-second

Airborne when he and his unit of 200 two hundred men parachuted into enemy

territory. He went on to say that most of the men in his unit got shot and killed

before they landed. However, he and about 20 twenty other soldiers landed

safely.

Willie further stated that he was seriously wounded after he engaged in

hand-to-hand combat with the enemy. And, while holding his cigarette between

his lips, Willie lifted his shirt and pointed to a wound on his stomach and a wound

on his back stating that the Korean soldier he was fighting, stuck a bayonet in his

stomach and the blade came out through his back. However, he used his knife to

stab the enemy soldier to death. Willie concluded the story by saying that after

he was airlifted off the battle field, he spent 24 twenty-four months laying laid flat

on his back in the vVeterans’ hospital where he recovered from his wounds.

Wow! What a story! And I believed him! However, we found out later that

Willie, who used to wear a lot of army shirts and jackets, never served in the

army. We also found out that he got the wounds from a man who beat the snot

out of him after he caught him fooling around with his wife.

Not only did Willie lie to us. He also stole from us. For example, I was

playing in a band that me and a couple of my friends had formed in the projects.

The name of the band was Sam and the Whole Notes. The band was named after

Sam because he was the drummer and his beats were real funky.; tTherefore, the

band evolved around him. I sometimes played the bongos and the tambourine.

However, my dream was to play the keyboard. Therefore, I was working and

saving my money, which I gave to my mother to hold for me. I had saved about

$400four hundred dollars, however, the money disappeared around the same time

Willie showed up. And, to this day, I don’'t know if Willie sweet -talked my mother

out of the money or if he just outright stole it. All I know is that, mom could not

tell me what happened to the money.

I wasn’'t Willie’'s only victim.: Larry had brought himself a car shortly after

he returned from Vietnam. Somehow another, Larry allowed Willie to borrow his

car. Willie got drunk and wrecked Larry’'s car and left the scene of the accident.

Willie stumbled home and told Larry that his car was wrapped around a telephone

pole in another part of town. Thank God Larry wasn’'t a violent person because I

don’'t know what someone else, including myself, would have done to Willie in

that situation.

If it wasn’'t one thing with Willie, it was another. Like the time Willie got

arrested for walking down the street with a rifle he had found. Adding to our

woes, Willie wasn’'t working and mom used her hard earned money to bail him

out of jail.

Mom and Willie continued their relationship long after I received my draft

notice and subsequently went into the military. Unfortunately, Mmom had to find

out for herself what we had been telling her all along about Willie. I was in the

Air Force and stationed in West Germany when mMom and Willie finally broke up.

And, as the story went, Willie showed mMom his true self after she came home

early from work one day and caught him in bed with another woman. Mom was

livid.: She ordered the woman to leave and the woman ran out of the house “"half

-naked.”" Willie, who knew he was in trouble, tried to sweet talk mMom while

attempting to put on his clothes. But mMom wasn’'t having it.

Still in shape from working in the shipyard, mMom pushed Willie out of the

house, and tossed him down a flight of stairs, and threw his clothes behind him.

Willie landed at the bottom of the stairs and before he could get to his feet or

grab his clothes, mMom jumped on top of him and "“worked him over.”" Willie

screamed and begged for his life but mMom would not stop. Fortunately for

Willie, some of mMom’'s neighbors intervened and she eventually stopped her

assault. Willie quickly picked- up his clothes and ran out of the house and never

showed his face again.

This incident was definitely bad,; however, I thank God it did not turn out

any worse. And, I cannot leave this incident without answering the following

questions.s: (1) Did my mother snap or lose her mind? Answer: Yes, she did. (2)

Did it contribute to the onset of dementia later in her life?. Answer: I do not

know, but when you add these incidents to other negative life experiences, it can

contribute to the onset of many illnesses, including dementia. (3) Was my mother

hurt and angry as a result of this incident and did she allow the hurt and anger to

dominate the rest of her life? Answer: My mother was very hurt and very angry,;

however, as a result of her relationship with Jesus Christ, she did not allow the

hurt and anger to dominate her life. (4) Did God forgive my mother after she

came to her senses and asked God to forgive her? Answer: Absolutely! And,

what about Willie? If he had confessed his sins, did God forgive Willie too?

Absolutely! For the Bible says in 1 John 1:9 (NKJV), "“If we confess our sins, He is

faithful and just to forgive us our sins and to cleanse us from all

unrighteousness.”" Lastly,: (5) dDid my mother forgive Willie? Answer:

Absolutely! Jesus said in Luke 6:37 (NKJV), “"Forgive, and you will be forgiven.”"

VI:

Mother Millie

An unknown author once said, "“A man’'s work is from sun to sun, but a

mother’'s work is never done.”" My mother was the epitome of that statement.

Hence, mMom divorced Willie in 1984 and moved on with her life. However,

seven years later, mMom decided to give love another try after she met a widower

named Benjamin (Benny) Torres who happened to be Puerto Rican. They both

lived in the same neighborhood where they eventually became acquainted. Mom

said that she was impressed by the way Benny cared offor his disabled adult

stepson, George (Georgy) Grayson, whose mother had died several years earlier.

Mom and Benny eventually stated dating. And, after almost two years, they

got married in 1991. It met with Benny several times before they were married

because I did not want my mother to get hurt again nor did I want her to

experience anymore domestic violence. Benny turned out to be a nice guy. We

also met his children who lived in New York. They were nice as well, especially

his daughter, Velma. Most of all, Benny and mMom loved each other and mMom

also wanted to help Georgy who could not speak and was very limited with his

sign language.

In 1992, mMom, Benny, and Georgy moved to Richmond, Virginia, and

settled. They moved into a "“fixer-up house"” in the city and they were happy

until my brother, Larry, moved in with them. Larry had been suffering from

undiagnosed and untreated Post Traumatic Stressyndrome Disorder (PTSD) since

his return from Vietnam in 1971, which was compounded by the aforementioned

police brutality incident. However, PTSD had not been identified or recognized

like it is today.; tTherefore, thousands of Vietnam Veterans, like Larry, went

untreated for many years. Larry had also been exposed to Agent Orange during

his tour in Vietnam, which may have caused other medical problems as well.

Mom and other family members, including myself, tried to help Larry.

However, the only thing we knew at the time was, Larry was not the same after

he came home from Vietnam. For example, prior to being drafted, Larry, without

any formal training, was gifted in the area of fixing electronics, especially radios

and televisions. He also owned a repair shop and he had a job at the General

Electric Company. Furthermore, Larry was well-known in the community where

people called him “"The TV Man.”" However, after Larry returned from Vietnam,

he started drinking excessively, mainly wine. Therefore, as a result of his

drinking, Larry could not keep a job and he did not return to fixing televisions and

radios on a regular basis. And, just like our father, Larry became an alcoholic and

a deadbeat dad.

Mom and I talked to Larry after she moved to Richmond. Larry agreed to

come to Richmond to get help at the VA Hospital. This was nothing new because

mMom and other family members took Larry in over the years and, as long as

Larry wasn’'t drinking, he was as gentle as a lamb. But, the moment he took one

sip of alcohol, he was the “"devil untied"” as my mother used to say.

We all loved Larry, but we could not tolerate his behavior and it caused our

mother a lot of grief and pain. To make matters worse, Larry was inconsistent

with his treatment at the VA Hospital and he also rejected the gospel of Jesus

Christ. Therefore, it created problems between mMom and Benny. Larry

eventually moved back to Jersey City, but mMom and Benny’'s relationship had

already soured due to their financial problems and Larry’'s situation. However,

one of the good things that came out of the relationship was the much needed

help mMom found for Georgy in Richmond, which allowed him to live and

function more independently. Nevertheless, Mom and Benny eventually divorced

and Mmom moved back to Jersey City in 1993.

Moving was another one of mom’'s traits. Hence, she would move in a

heartbeat if things or circumstances were not right or if she could do better. As a

matter of fact, mMom moved about ten times before I was born and many more

times after that. She moved so many times during her lifetime, it became her

"“second nature,”" which continued into the later years of her life. For example,

in 1997 at the age of 70seventy, mMom drove from New Jersey to California to

assist my brother, Rick, and his wife, Yvette, who was pregnant with their

daughter, Jasmine. Larry also relocated to California and moved in with mMom

after she got settled.

While in California, mMom restarted the process of getting help for Larry.

aAnd, as a result, she was able to get Larry connected with the VA in Oakland,

California. And, while also seeking to improve herself, mMom completed a Home

Health Care Training Program and became a certified Home Health Care Worker.

She also became an active member of Golden Hills Community Church in Antioch,

California where she participated in both the children and outreach ministries.

I was living in Virginia during the time mMom was in California. We talked

on the telephone regularly and she would tell me how much she loved California.

She was very happy and she told me about all the new friends she made and I was

very happy about her new experiences. Unfortunately, our happiness was cut -

short in 1999 after my brother, Tom, aged 53fifty-three, died from cancer of the

esophagus, which was the result of his many years of smoking and drinking.

Tom and his wife, Anne, and their daughter , Yazmenda (Yazy), had moved

from Jersey City to Crescent City, Florida a few years earlier. However, Tom, like

our father, struggled with alcohol addiction after he was honorablye discharged

from the military. In other words, Tom was not an alcoholic when he went into

the military, but he was one when he got out of the military. Furthermore, Tom

had served in the Air Force during the Vietnam War.; hHowever, he did not go to

Vietnam. But, like our brother, Larry, Tom also suffered from undiagnosed and

untreated PTSD. And, like Larry, Tom self-medicated himself with alcohol on a

regular basis after he was discharged from the Air Force 28 twenty-eight years

earlier.

On one of my many visits with Tom, I asked him what made him drink so

much and when did he start drinking. Tom, who served as a fireman in the Air

Force, stated that his unit responded to a plane crash and he started drinking

after he fought the fire. He further stated that while he was fighting the fire, his

foot slipped on a helmet and when he picked the helmet up to move it out of his

way, the pilot’'s head fell out the helmet and landed at his feet.

Tom stated he had nightmares after the incident and he subsequently

started drinking. Nevertheless, I pleaded with Tom on many occasions to get

some help. And, on one occasion, I angrily took Tom’'s liquor bottle and smashed

it against a wall outside his apartment building and I told him that if he did not

stop drinking, he was going to end up just like our father! Tom’'s response was,

“"So,, you got to die from something.”" Then he went to the store purchased

another bottle of liquor.

Mom did not attend Tom’'s funeral because, a few weeks before Tom

passed away; mMom flew from California to Florida to spend time with Tom while

he was in the hospital. Larry did not come to the funeral either., hHowever, Rick,

Jack, and I attended Tom’'s funeral. We were sad, but we were also glad to see

each other again.

After Tom's death, mMom picked- up where she had left off. And two years

later, mMom met and later married the love of her life, Andy Patrick, a disabled

veteran who happened to be Irish. Ironically, they married on September 11,

2001, which is also known as 9/11. Mom was 74 seventy-four years old and Andy

was 82eighty-two.

Again, never to stay in one spot too long,; in 2002 at the age of 75seventy-

five, mMom left California and drove herself and Andy to Virginia and settled.

Larry stayed in California where he had received some help from the VA

regarding his PTSD. He also eventually stopped drinking. However, Larry chose

to live among the homeless population where he earned a reputation for helping

others.

Mom was very happy and excited about her new life with Andy.;

uUnfortunately, her new life with Andy was short-lived.: Andy passed away on

August 31, 2003, which became a major turning point in mMom’'s life and the

effects of her grief and loneliness were visible. This was understandable because

mMom loved Andy and she cared for him during his battle with chronic

obstructive pulmonary disease also known as COPD. Hence, she took him to his

appointments at the VA hospital and she cared for him in their home and

remained by his side until he passed away.

Although mMom took Andy’'s death pretty hard, she picked herself up and

made progress in other areas of her life. For example, after Andy passed away,

mMom moved out of the home they had shared and found herself a place in a

senior citizens’ complex. She also became an active member of Faith and Family

Church located in North Chesterfield, Virginia, where Pastor Calvin Duncan and

First Lady Barbara Duncan affectionately called her "“Mother Millie.”"

Mom’'s prayers and efforts in helping Larry when she was in California also

began to pay off.: In 2006, Larry celebrated seven years of sobriety and he was

the subject of an East Bay Times news article titled, "“Homeless mMan cCleans

uUp cCommunity.”" The article noted his services to both the community and the

homeless population, e.g., picking up trash, recycling cans and bottles, and

providing food to the homeless. The reporter asked him about the amount of

money he makes from recycling,; Larry responded, "“I don’'t do it for the amount I

make... I do it because it’'s one of my citizen’'s job.”" (Krupp, 2006, p. 3).

Larry further told the reporter that he came to California to get away from the

alcoholic lifestyle he had in New Jersey.

In addition to helping Larry and other family members, mMom continued

doing things to help Rick and meI out, such as putting Jasmine on the school bus

in the morning and/or meeting Jasmine at the bus stop after school and making

sure she ate and did her homework. She also helped our daughter, Bre, by taking

her to or picking her up from her basketball and softball games, including taking

Bre to or picking her up from work or school.

In 2007, mMom brought a small house in Chester, Virginia, and moved

again. She really loved her new home and she often wished that Andy could have

shared it with her. However, not too long after mMom moved into her new home,

my brother’s, John’'s, youngest daughter, Mandesha, and her four children came

from Illinois to visit mMom. Mandesha also brought with her a little black poodle

named Muffin. To our surprise, Mandesha gave Muffin to mMom. This made

mMom so happy because she always loved animals and had many pets throughout

her lifetime.

Seeing Mandesha also made mMom both happy and sad because, at the

time of her visit, Mandesha was almost 30 thirty years old and mMom had not

seen her since John’'s funeral when she was just an infant. Therefore the reunion,

although joyful, also brought back some painful memories because the

circumstances surrounding John’'s death had caused the family much grief and

pain, especially Mmom.

I was still in Germany when mMom called me early one morning and gave

me the news on May 2, 1980. And, in order to get home quickly, I had to leave

Dinah and our oldest son, Mel, in Germany. I knew that I had to get home fast

because John was a Marine Corps Veteran, a husband, and a father,; and a

brother who we all loved dearly. Furthermore, the details of John’'s arrest and

death were sketchy and it gave us no comfort that the coroner’'s report said his

death was caused by hypertensive heart disease. We were skeptical because, at

the time of John’'s death, scores of young black men were frequently dying at the

hands of the Los Angeles Police Department as the result of beatings and

chokeholds.

In retrospect, I believe that the grief my mother endured regarding the

circumstances surrounding John’'s death had a lasting effect on her. Hence, my

mother often told us about the many dreams she had about John. And, almost

always, the central theme of most of her dreams were either about her trying to

save John or John reassuring her that he was okayOK.

I believe one of the reasons mMom kept having those dreams was due to

the special relationship she and John had. For one thing,, John and mMom were

so much alike, i.e., strong, independent, outgoing, etc. John was also the middle

child who longed for mom’'s love and attention. However, I believe that the main

reason the dreams kept recurring were the result of mom’'s motherly love and her

desire to save or rescue her child, which she was unable to do. This condition or

syndrome was worsened by the Rodney King Videotape Beating and the

subsequent acquittal of the white police officers and the riots that followed.

However, the most amazing thing about all of this was: John'’s death did not

cause my mother to hate or stop loving people.

Furthermore, the reunion between my mother and Mandesha was also a

blessing because Mandesha looked such much like John. Plus, John always owned

dogs that he would train to do amazing things. Therefore, by Mandesha giving

mMom Muffin, it created a special connection. As a result, mMom suddenly had a

new lease on life. Muffin was also a blessing to Rick and meI because we had

been talking about getting mMom a pet and Muffin was the perfect fit.

In addition to Muffin’'s company, mMom also enjoyed planting and growing

a variety of vegetables and other plants in her backyard -garden. Gardening and

playing with Muffin kept mMom busy and it also gave her plenty of exercise.

And, up until then, outside of mMom having trouble balancing her checkbook and

paying her bills on time, we did not notice any serious signs of mental decline.

However, little did we know, dementia had already set in.

VII:

Getting Understanding

Despite mMom’'s new lease on life, her mental state gradually declined over

the next three years. For example, mMom suddenly stopped watching TV shortly

after her eightie80th birthday. And, although we found it to be odd, we did not

contribute it to dementia. As a matter of fact, we knew nothing about dementia at

the time.; tTherefore, we could not figure out why she stopped watching TV,

including the three TV shows she really enjoyed watching: The Price Is Right,

Joel Osteen, and Oprah.

Nevertheless, I found it difficult to accept the changes that were taking

place in mMom.; tTherefore, I often dismissed her symptoms or blamed them on

some other factors, such as being tired or having a bad day; especially after Andy

passed away. Hence, her quality and purpose of living sharply diminished and

she would often say that she wanted to be with Andy. However, it wasn’'t until

after mMom started forgetting the meaning of or the use of things;, using

profanity,; and becoming physically aggressive that I finally realized that the

problem was far more serious than I wanted to accept.

In addition, about two years prior to her diagnosis, mMom would say things

that could not be dismissed or rationalized. For example, she started accusing

friends and family members of doing things that did not make much sense. Like

the time she accused a family friend of hiding things in her yard and doing other

things that nobody else saw. However, even after the doctors informed us about

mom’'s dementia, I wanted to learn more about the disease before I was ready to

accept the truth.

The Bible says in Proverbs 4:7 (NJV), "“And in all your getting, get

understanding.”" Therefore, I searched the libraries and the Iinternet for

information on dementia. And, as a result of my efforts, I learned that dementia is

a life altering disease characterized by multiple cognitive impairments (Singh-

Manoux and Mika Kivimäki, 2010, p. 509) that can be caused by Alzheimer’'s

disease or it can be vascular, which is brought on or caused by a blockage in the

brain’'s blood supply (Tse and Benzi, 2004, p. 311). Furthermore, according to the

Alzheimer’'s Foundation of America:

The other most common causes of dementia are vascular dementia,

caused by

stroke or blockage of blood supply, and dementia

with Lewy bodies. Other

types iinclude alcohol dementia, caused by sustained use of alcohol; trauma dementia, caused by head injury; and a rare form of dementia, frontotemporal dementia.

The clinical symptoms and the progression of dementia vary,

depending on the

type of disease causing it, and the location and number of

damaged brain cells.

Some types progress slowly over the years, while others

may result in sudden loss

of intellectual function (http://www.alz.org).

According to data from the 2009 World Alzheimer Report, it was estimated

that there were 36 thirty-six million cases of dementia in 2010 with new cases

doubling every 20 twenty years (Singh-Manoux and Kivimäki, 2010, p. 509).

Therefore, as a result of learning about these staggering statistics combined with

my mother’'s diagnosis, I also enrolled in some classes at a local community

college to learn more about dementia.

Enrolling in these classes also helped me to stay focused in the midst of

caring for my mom, which had become increasingly challenging. One of the

classes that was particularly interesting was a psychology class which, among

other things, covered topics relating to the brain. The information that was

covered in the class gave me a better understanding of the various functions of

the brain. However, the most interesting topic in the class was the neuron and

the role it plays throughout the nervous system and the brain. For example, the

neuron, which requires an electron microscope to see it, is a "“highly specialized

cell that communicates information in electrical and chemical form" (Hockenbury

and Hockenbury, 2011, p.45).”

There are three basic types of neurons: Ssensory neurons that transmit

information about the environment,; mMotor neurons that transmit information to

the muscles and glands,; and interneurons that transmit information between

neurons. And, as it relates to their function, neurons come in different sizes and

shapes. For example, a piece of a brain tissue as small as a grain of rice contains

about 10,000ten thousand neurons (Hockenbury and Hockenbury, 2011, p.45).

And, according to Berk (2010), “"The human brain has 100one hundred to 200

two hundred billion neurons, or nerve cells that store and transmit information,

many of which have thousands of direct connections with other neurons" (p. 94).”

Wow!

I also learned that each neuron has a cell body that processes nutrients and

provides energy for the neuron. I further learned that neurons have a nucleus

that contains chromosomes and dendrites that receive information from other

neurons and sensory receptors. Not only that but, neurons also have an axon,

which carries information to other neurons, muscles, and glands (Hockenbury and

Hockenbury, 2011, p.45). It was also interesting to learned that the axon of

many neurons, but not all, are surrounded by a myelin sheath, which insulates the

axon and increase communication speed (Hockenbury and Hockenbury, 201,

p.45).

This information helped me gain a better understanding about both the

causes and the symptoms that were associated with my mother’'s condition. For

example, I learned about endorphins, which is a collection of chemicals

manufactured by the brain that reduce the perception of pain. And, according to

Hockenbury and Hockenbury, 2011, these chemicals are similar to morphine, but

100 one hundred times more potent (p. 53).

By gaining a better understanding about the different functions of the brain,

I was able to understand, for example, why my mother, during her early stages of

dementia, patted or rubbed her head repeatedly, especially when she was trying

to remember or understand the meaning of things. Her actions (patting or

rubbing her head) were similar to our natural response to hit or thump on a

device that has stopped working or playing properly, like a watch or a radio. And,

after studying images of healthy brain cells, it was easier for me to understand

the effects of brain deterioration when I looked at the images in terms of a circuit

board. Hence , the images of the unhealthy brain cells resembled that of a

damaged or “"blown”" circuit board.

Many of the symptoms of dementia are similar to that of Alzheimer’'s'

patients, i.e., forgetting, wondering, combative, etc. However, the symptoms

relating to the onset of these diseases can vary from person to person. For

example, unlike a late friend of mine named Jimmy, who was diagnosed with

dementia a few years after my mother was diagnosed, my mother did not repeat

things over and over like my friend Jimmy started doing during his early stages of

dementia.

Conversely, unlike my mother, Jimmy, who was several years younger than

my mother, could still engage in meaningful conversations. In another example,

u: Unlike my mother who we stopped from driving during her early 80'seighties,

Jimmy was in his mid- 70's seventies when his family eventually stopped him

driving after he had a couple of accidents, which also included getting lost during

routine trips. However, I believe my mother would have eventually had an

accident if we had not stopped her from driving.

Another factor was my friend’'s health, which may have accelerated his

death,. i.e., Jimmy was a diabetic whereas my mother was not. Furthermore, if I

had known more about the disease earlier, I would have made a better connection

between my friend telling me the same stories over during the onset of his

dementia; especially when he started telling the same stories as if he had never

told them to me before. For example, he would tell me this story about the first

time he moved to Richmond, Virginia, and how upset he was about the city

government.

Jimmy told me that story so many times, I would recite it in my mind, and I

would say to myself, "“hHere we go again.”" However, out of respect for Jimmy,

who was about 20 twenty years older than me, I never mocked or questioned him

about why he kept telling me the same stories. Therefore, I treated him the same

way I treated my mother, i.e.,. I would actively engage in the conversations that I

had with Jimmy. And, I would respond as if I never heard the story before and I

would say,: "“Oh yeah!”" "“Man, you must be kidding me!”" And, Jimmy would

respond accordingly with same answers he gave me before. For example he

would say,: "“I kid you not!”" Or he would say,: "“I was through with them rascals

after that!”"

I also respected Jimmy because he was like a father figure to me. We had a

lot in common and he had given me plenty of good advice prior to his diagnosis.

The same was true about the conversations I had with my mother. For example,

sSometimes my mother would ramble during her stories about what she did that

day. And, although the stories did not make sense to me, they seemed to make

sense to her. Therefore,So if she laughed,. I laughed.

Mom sometimes laughed and laughed when she told some of her stories and

I would laugh along with her and say things this like,: "“What?”" "“You must be

kidding me!”" However, mMy favorite line was, "“Well, I declare!” " Which was

reminiscentce of a response my Aunt Martha, who my mother affectionately

called Sug, used to say. On the other hand, mMom could still remember some of

the jokes that I told. And, she would often blurtb out the punch line before I could

finish telling the joke, especially when I’m telling the joke to someone else. And,

although she spoiled the joke, her actions were funnier than the joke. But, there

was nothing funny about the disease.

It has been said that “"hindsight is 20/20”" and, for most of us, if we knew

in the past what we know now, we may have done more to achieve a better

outcome in every area of our life. Not only for ourselves, but also for friends and

relatives as well. And, although I gained more understanding about dementia, it

did not lessen the pain connected with the reality of the disease.

I also had to face the reality of the things that were beyond my control, ,

i.e., the things that only God or God working through the doctors could change.

Therefore, tThe more I learned about the disease, the more I trusted God

because, according to Berk (2010), "“About a dozen of types of dementia have

been identified. Some are reversible with proper treatment, but most are

irreversible and incurable" (p. 457).” For example, some of the side effects of

certain medication can cause or mimic dementia, which can be reversed.

Bleeding on the brain or an infection or a nutritional deficiency can also cause

dementia. In these cases, the disease can be stopped or reversed if it is properly

diagnosed and treated.

After learning about the types of dementia that could be revered, I was

hoping that my mom’'s dementia matched the criteria. Unfortunately, as I

learned later, the type of dementia my mother had was irreversible. However, I

remained optimistic about my mother’'s prognosies because, for the most part,

she lived a healthy life.: She never smoked. She took vitamins daily. She also ate

healthy foods and she only drank wine on occasions. Therefore, I believed that

other factors could have contributed to the onset of her dementia. For example,

sStatics show that most people over 80 eighty years of age have dementia.

However, dementia is no longer an age-related disease according to Singh-

Manoux and Kivimäki (2004) who also states that, "“tThere is now quite a lot

evidence from both a clinical and neurodegenerative point of view to suggest that

dementia develops over many years" (p. 509).” In some cases, it can take as long

as 20 twenty to 30 thirty years before the symptoms begin to show.

VIII:

Risk Factors

Looking at the research regarding sleep, for example, and the information I

stated earlier concerning the brain and neurons,; it is a medical fact that the

brain needs a sufficient amount of sleep (or rest) in order to remain healthy and

to function properly. Furthermore, although the brain makes up only two2

percent of our body weight, it uses about 20 percent of the oxygen our body

needs when we rest. The brain uses the oxygen to break down glucose, which

supplies the brain with energy (Hockenbury and Hockenbury, 2011, p. 62).

Therefore, getting an adequate amount of sleep is vital to our health. .

In contrast and comparison, my mother rarely got much sleep.: She rose

early each morning during her lifetime to take on the challenges of day, which

normally involved working two or more jobs and caring for others. Therefore, I

believe that the lack of rest, combined with stress, anxiety, and other

environmental factors, did not allow her brain enough time to detoxify or re-

energize itself.

In other words, amyloid plaques and neurofibrillary tangles "“isare also

related to oxidative stress." (Tse and Benzi, 2004, p. 311).” Furthermore, Sam

Gandy (2011), a neurology and psychiatry professor and associate director of the

Alzheimer’'s Disease Research Center at Mount-Sinai School of Medicine and the

James J. Peters VA Medical Center in New York, points out that the accumulation

of amyloid plaque deposits on the brain is associated with dementia (p. 15), which

was the case in my mother’'s diagnosis.

I also found several other risk factors that were relevant to my mother’'s

diagnosis. For example, aAccording to Fredrick Kunkle (2015), “"African-

American are at increased risk of Alzheimer'’s because of a complex mix of factors

- biological, socioeconomic, and cultural" (p. D1).” Other research suggests that

because African-Americans are at a greater risk of diabetes, hypertension, and

cardio vascular disease, it increases their risk of Alzheimer’'s. These factors are

also compounded by inadequate medical care, unhealthy diets, lower education,

and the stress associated with enduring discrimination (Kunkle, 2015, p. D2).

Regarding racism and discrimination, I know for a fact that these elements

can adversely affect your health. For example, I experienced racism and

discrimination during my military career, but none like the ones I experienced at

one particular duty station. Hence, the effects of the environment were so toxic

that my cholesterol levels went from normal to extremely abnormal during the

same time period.

My blood pressure also rose significantly during this period. But, I did not

make the connection between my health and discrimination until I watched the

movie “"42”" which told the story of Jackie Robinson.

The scene that caught my attention in the movie involved the manager of

the Philadelphia Phillies who repeatedly hurled racial slurs at Jackie Robinson

every time he came to bat. For reasons unknown to me at the time, I started

crying when Jackie Robinson got angry and went into the locker room and

repeatedly smashed his bat against a locker until he broke it. Then it occurred to

me a few days later.: I cried because I subconsciously identified with that

moment in the movie. In other words, it brought back many painful experiences

that occurred during my military career, which I suppressed.

These experiences ranged from subtle forms of racism to “"butt-ugly"”

implicit and explicit forms of racism. For example, Like when a white superior

officer, who had only been in my rating chain for two months, once told me that

"“he used to shoot N’'s in Arkansas,"” after I asked during a conference session

why did he downgraded my performance report after my immediate supervisor

and his boss had rated me higher.

On another occasion, a white commanding officer tried to use me as token

to destroy the creditability of a black civilian employee who had filed a class

action discrimination complaint against him. When I refused to go along with his

illegal actions , he tried to destroy my career, which caused me much pain and

suffering. And, just like Jackie Robinson, I bottled up my pain and anger to avoid

being jailed or court-martialed for acting out on my anger. Therefore, I could only

imagine the pain and suffering Jackie Robinson endured during his baseball

career and beyond, which may have adversely affected his health and contributed

to his untimely death at age 53 fifty-three due to complications of diabetes..

My mother was also exposed to some of the aforementioned risk factors

during her lifetime, including several life-changing, traumatic incidents. The first

was an incident she told us many times about her oldest brother, Roger, who died

in an automobile accident at the age of 20twenty. Mom said that she was about

two and a half years old when Roger died. She also said that Roger was her

favorite brother because of the way he treated her as opposed to her other

brothers who treated her mean most of the time. Therefore, iIt really broke her

heart when he was killed within minutes after telling her he was going to the

store. As a result, she kept reliving that moment in time, asking herself why did

he haved to die and what could she have done to prevent it?

The next traumatic incident occurred after my mother became pregnant

with my brother, Jack, at age 15fifteen. My grandmother (her mother) was so

angry about the pregnancy that she threatened to shoot my mother’'s belly off

with a shotgun. My mother stated that she was working in the field when

gGrandma yelled for her to come into the house. My mother said that, by the way

gGrandma was yelling, she thought that her mother needed her to kill a snake or

spider or something. Therefore, So she ran towards the house.; hHowever, no

sooner than she got inside the house, gGrandma pointed a shotgun at her and

ordered her to strip out of her clothes. My mother said that after she took off her

clothes, gGrandma pointed the shotgun at her stomach and told her that she was

going to "“shoot her belly off.”" My mother said that she was shocked and did not

know what to do. So she fell to her knees and cried out, "“Lord, please help me!”"

And, at thate point, gGrandma put the shotgun down.

We never disputed mMom’'s story because our grandmother did some

horrific things to us as well. Like the time she whipped my brother, John, with a

good sized switch after he ran from her. She ordered our brother, Jack, to catch

John. After Jack caught John, she tied John’'s hands and suspended him by his

hands on a hook in the ceiling. Then she whipped John while he screamed and

yelled. Therefore, it was very believable when our mother told us (many times)

about the incident that happened between her and our grandmother who

threatened to shoot her belly off.

Mom stated that she ran away from home after the incident and stayed with

her mother’'s sister, Lottie Nicholson, who lived in Richmond, Virginia. Mom also

stated that during her stay in Richmond, she found a job folding shirts at a

laundry and, after seven months passed, gGrandpa came to Richmond and

brought her back North Carolina. She further stated that she was in the ten10th

grade during the time of the incident and she subsequently dropped out of school

to take care of Jack after he was born.

In addition to the previously described events, mMom also experienced

other traumatic incidents in her life, including several domestic violence incidents

between my father and the other men in her life. She also suffered from high

blood pressure and the associated hypertension, which had to be controlled by

medication. One of the prescribed drugs that my mother took was a combination

of Triamterene and Hydrochlorothiazide, which areis used to treat high blood

pressure and swelling due to excess body water. Some of the possible side effects

of the drugs includes dizziness or lightheadedness when standing or sitting.

Although there were only a few side effects listed for this medication, I still

wanted to know if there were any links between the mediation and the onset of

my mother’'s dementia.

I found several links between my mother’'s blood pressure and the onset of

her dementia due to the weakening of her heart. But, I did not find any

correlation or links between her heart medication and the onset of her dementia.

However, oOn the other hand, I did find some information about some new

studies that suggest a link between a popular class of heartburn drugs and the

risk of dementia in seniors (Thomson, 2016, p. 1). I also read another report

confirming that statin drugs accelerate cardiovascular disease (Mercola, 2012,

p.1), which can subsequently lead to dementia and Alzheimer’'s'. .

It was good to know that my mother was not taking any of these drugs,

which allowed me to eliminate them from the possible causes of her dementia.

Nevertheless, I was more interested in what caused my mother to have high blood

pressure and hypertension in the first place rather than the medicine she was

taking. In other words, I wanted to confirm that if there was a link between my

mother’'s high blood pressure and her dementia. I also wanted to know if her

heart disease was hereditary. Or was it more physiological as a result of her diet?

Or was it psychological as a result of an accumulation of negative life

experiences? Or was it caused by some other environmental factor such as air

pollution or water pollution?

Regarding the other environmental factors, my mother could have been

exposed to asbestos as a result of her working in the shipyard. Therefore, I did

some research to see if there was a correlation between asbestos exposure and

dementia. I found out that, although there were some studies that linked

asbestos exposure to Alzheimer’'s and other related symptoms, most of the

symptoms were secondary to lung disease. Hence, asbestos exposure primarily

eaffects the lungs, which reduces the supply of oxygen to the brain, which can

subsequently cause dementia, but not in all cases. .

For example, Andy was a carpenter most of his life. And, as a result of his

occupation, Andy was exposed to asbestos, which caused him to develop COPD,

which restricted his oxygen supply. However, Andy never exhibited any signs of

dementia nor was he diagnosed with it. As a matter of fact, he laughed and told

great jokes up until the end. The same was true about my mother- in-law and

father in-law who were both smokers. Like Andy, they also died from COPD

related symptoms while they were in their 80's eighties with no signs of dementia.

Air pollution and water pollution are also risk factors that have been linked

to the onset of dementia and Alzheimer’'s. For example, an online article

published in The Telegraph, Health Editor, Laura Donnelly, reported that,

“"Middle-aged and older adults who live in towns and cities suffer ageing of the

brain and increased risk of dementia and strokes because of air pollution "

(Donnelly, 2016, p. 1).” In another online article, ALZinfo.org, published a report

from the Archives of Internal Medicine, which stated, "“Exposure to polluted air

contributed to the equivalent of about a two-year decline in brain function, which

might lead to an earlier onset of Alzheimer’'s and other forms of dementia"

(ALZinfo.org, 2016, p. 1).” The report also says that, "“lLevels of beta-amyloid, a

toxic protein that builds up in the brains of those with Alzheimer’s disease, were

higher among residents of polluted cities" (ALZinfo.org, 2016, p. 1).”

Less data was available linking water pollution to dementia other than the

information that were published by the water filter industry. However, I have

been involved in promoting and selling water purification systems since 1983,;

therefore, I understand the health effects associated with water pollution on

water, tap water, and bottled water. And, one only needs to look at the recent

water pollution problems that surfaced in Flint, Michigan where residents were

exposed to dangerous amounts of lead and other contaminates in their drinking

water. .

Water is a chemical consisting of two parts hydrogen and one part oxygen,

which is expressed as H2O. Water is also known as the universal solvent due to

its polar nature and its ability to form hydrogen bonds with other molecules. Our

body is about 50–-75% percent water, except for infants whose bodies contain

about 75-–78% percent water (Helmenstine, 2015, p.1). A person can live longer

without food than he or she can without water. In other words, our body needs

water for perspiration, respiration, urination, digestion, and defecation purposes.

.

When our body use more fluid than it takes in, we become dehydrated.

Dehydration can cause death. However, God designed our bodies so well that it

tells us when we need more fluid. And, although thirst is normally the first

indicator, other indicators are just as important. For example, we may quench

our thirst with water or other fluids, but our body may not be getting enough

water to function properly. Therefore, So we need to pay close attention to the

other warning signs of dehydration such as, bad breath, extra yellow urine,

headaches, fatigue, constipation, muscle cramps, etc. Furthermore, some people

may think that they are hungry, but, actually, they are dehydrated.

There are other warning signs of dehydration, however, if you wait until it

gets to some of the more severe warning signs, you may need to seek immediate

medical attention. For example, oOur body is just like an automobile whereby it

must contain the proper amount of coolant to prevent it from overheating. If not,

the engine will overheat and it will eventually die. Our body can also overheat

due to dehydration, which can lead to death. Other serious signss of dehydration

areis athe lack of tears when you cry or when you loses some of the elasticity in

your skin. Again, if you allow yourself to dehydrate to this point, seek medical

attention right away. .

As you can see, water is vital to every organ, tissue, bone, and fiber in our

body. Therefore, dehydration, as well as polluted or contaminated water can

cause a number of maladies, including death.

Children are especially vulnerable because their brain and other vital organs

are still developing. For example, it has been proven that lead exposure can

cause learning disabilities and other problems in children. And, although bottled

water is better than most tap water, bottled water also hasve risks due to the

plastic chemical properties found in the bottles and the harmful bacteria than can

form inside the bottle. Another problem associated with bottled water is

consumers may not get the important minerals and trace elements that are

essential to their health like fluoride for example.

Fluoride is essential to healthy teeth and bones. Therefore, fluoride

deficiency can result in badly formed or weak teeth or brittle or weak bones.

Fluoride is found in fluorinated tap water, but it is not found in most bottled

water. Furthermore, tap water if treated properly can be safe, however, many

dangers exist in the use of tap water. For example, wWater is recycled, i.e., the

water that is flushed down the toilet is treated and released back into the same

water source. The water is then treated and reused. However, even if the water

was treated to its purest form, it still have to travel through miles of pipes to get

to your home. Therefore, lead and other contaminates can get into your drinking

water. .

In addition to the problems associated with storm runoffs that wash

chemicals and other pollutants directly into water sources, i.e., rivers and lakes,;

aanother problem associated with tap water is are the chemicals, chlorine and

chloramine, that are used to kill the germs and bacteria in the water. And,

although these chemicals may kill a wide -range of germs and bacteria, a number

of reports have linked the long- -term use of these chemicals to many health

problems, including cancer. .

My mother was very aware of the health problems associated with both tap

water and bottled water. As a result, she used and promoted water purification

systems for many years as both a customer and as a distributor of water

purification products. Therefore, I ruled out water pollution as a link to the onset

of her dementia. However, air pollutions needed further examination because my

mother resided in California for a number aof years and California not only has

the top five most polluted cities in the U.S., it also has the most number of

polluted cities in the nation. At the top of the list was, Fresno-Madero, California;

followed by Visalia-Porterville-Hanford, California; Bakersfield, California; Los

Angeles, California; and Modesto-Merced, California (American, 2014, pp. 13–-

15).

My mother did not live in any of the cities that were on the list. However,

she lived in Antioch, California, which is approximately 60 sixty miles southeast of

El Centro, California. El Centro was rated number seven on the list of worst cities

with year-round particle pollution. Therefore, I investigated further to see if there

were some links between air pollution and the onset of my mother’'s dementia. I

found some information but, I could not completely connect the dots. Hence,

even if my mother resided in the most polluted city in America, without having

any connections to lung disease, it would be difficult to link the onset of her

dementia to air pollution other than it being a probability. For example, if there

were a strong correlation between air pollution and the onset of dementia and

Alzheimer’'s, then it would be logical to assume that the state of California, which

has the highest number of polluted cities on the list; would also have a higher

mortality rate for Alzheimer’'s than the states with less pollution. Not so.

I reviewed a number of air pollution reports, which also listed by

population the number of people with chronic respiratory diseases, such as

asthma and COPD as well the number of the people over age 65sixty-five. And,

according to one report, California ranked high among the national mortality

rates for Alzheimer’'s disease. However, on the other hand, I found very little

correlation matching the states with the worst air pollution to the states with the

highest Alzheimer’'s mortality rate. For example, aAccording to data from the

National Vital Statistics System, Martha Kang (2013) stated that, "“Washington

state has the highest mortality rate for Alzheimer’'s disease in the U.S." (p. 1)

while New York and Nevada were among the lowest (Kang, 2013, p. 1).” Other

less polluted states, including Tennessee, Kentucky, North Dakota, and South

Dakota, ranked higher than California in Alzheimer’'s mortalities. Therefore, as I

stated earlier, I have concluded that there is only a small probability that the

onset of my mother’'s dementia was caused by her exposure to air pollution. .

Research has also proven that obesity in midlife increases dementia risk

factors, but obesity is not a dementia risk factor at an older age. Rather, it is low

body weight that is associated with dementia at older ages (Singh-Manoux

and Kivimäki, 2010, p. 510). My mother did lose weight during the later stages of

dementia as a result of the effects of the disease. HoweverNeither, obesity nor

low body weight were risk factors in my mother’'s case regarding the onset of her

dementia. .

Another risk factor is family history. And, while examining to see if there

were any connections between my mother’'s dementia and our family history, I

noted that two of her sisters suffered from dementia prior to their death.

However, one of her sisters lived well into her 80's eighties before she was

diagnosed with dementia while the other sister lived well into her 90's nineties

before she was diagnosed. On the other hand, two of my mother’'s other sisters

lived well into their 90's nineties without any significant signs or symptoms of

dementia. And, except for my uncle Roger who was killed in an automobile

accident, all of my mother’'s brothers died from non-dementia related health

problems, i.e., COPD, cancer, etc. Furthermore, nNone of them lived to be 80

eighty years old, which seems to be the standard age for the onset of dementia.

I also noted that both of my maternal grandparents were born in the

1880’'s. They were both sharecroppers who had little or no access to medical

care. Therefore, mMany of their diseases or injuries were self-treated with home

remedies consisting of roots and herbs or first -aid techniques that were passed

down through generations. For example, lLike the time my grandmother

accidently injured her knee with the axe while she was driving a stake toin the

ground to secure a cow. Grandma dressed her wound and wrapped her knee in a

homemade tourniquet and returned to her chores. Unfortunately, the injury

caused my gGrandma problems for the rest of her life, including her having to

walk with a cane.

My grandfather was the same way. Like the time he was attacked by two

men who cut him from one side of his chest to his lower belly. And, according to

my mother, gGrandpa fought gallantly and survived the ordeal by biting off one of

his attacker’'s ears. And, just like the old western movies, gGrandma cleaned and

dressed gGrandpa’'s wounds and he took it easy until he recovered. .

I also noted that my grandfather passed away a few months after he had a

stroke at the age of 76 seventy-six and my grandmother died as a result of heart

failure at the age of seventy-eight78. Therefore, iIt is more than likely that

heredity or our family medical history was a factor in my mother’'s high blood

pressure and the associated hypertension. .

It was further noted that my mother was the 11eleventh child born to our

grandparents when our grandmother was 40forty years old and our grandfather

was 46forty-six years old. And, although there is ample evidence that suggests

the risk of birth defects increases with parental age, I found no conclusive

evidence to link the age of my grandparents to my mother’'s dementia. For

example, tThe risk of a child being born with Down Syndrome increases with the

age of the mother while the risk of a child developing schizophrenia increases

with the father’'s age.

IX:

Psychological vVs. Physiological

As I mentioned earlier, psychological factors can adversely impact

physiological factors such as the case of my elevated cholesterol that was caused

by the stress I experienced in the military. Therefore these factors may have also

played a role in my mother’'s high blood pressure and dementia. For example,

mMy mother-in-law’'s blood pressure rose every time she visited her doctor. We

later discovered that there was a correlation between my mother in-law’'s fear of

going to the doctor and her blood pressure,. i.e., iIt rose sharply because she

feared what the doctor might find or what he might tell her about her health. .

The same was true about the psychological factors that aeffected my

mother’'s blood pressure, including the stress associated with the negative events

that impacted her life. Consequently, my mother’'s physiological factors also

impacted her psychological factors. Furthermore, aAccording to Segal, et al.,

(2010):

Mental health and mental illness can be viewed as being on a

continuum.

Few people are completely mentally healthy all the time. All have

times of

impaired functioning when they are less able to have fulfilling

relationships, adapt to change, or cope with adversity.

..The U.S. surgeon general’'s 1999 report

emphasized that mental illness and physical illness are inseparable...

There

is no real split between mind and body or between mental health and

physical

health (p. 270-–271).

Outside of my mother’'s high blood pressure, the only other physiological

factor I really wanted to examine was concussions, which have been found to

contribute to the onset of dementia and Alzheimer'’s. In doing so, I did not know

if my mother had suffered any concussions during her lifetime as a result of her

occupation or from a domestic violence incident. I did recall , however, that my

mother along with the rest of us were involved in a car accident over 50 fifty

years ago when another driver rear- ended us on the highway. .

Neither I nor my brothers could remember if mMom suffered a concussion

as a result of the accident. . However, my mother may have suffered from a

concussion later on in life. For example, aAbout a year prior to her diagnosis,

mMom fell and bumped her head on a concrete floor at a store. She refused

medical attention and drove herself home, which was typical of her. Rick and I

did not find out about the incident until we noticed a knot on her forehead. She

said she was OK okay and refused to go to the hospital. We subsequently

reported the incident to her doctor who ordered a CAT scan on her head. And,

although the scan did not reveal any fractures or any other serious injuries, we

believe that the fall could have exacerbated her dementia.

X:

The Mind, t The Body, and Tthe Spirit

Looking at the inseparable relationship between physiological and

psychological health issues, i.e., mind and body. As a Christian, I believe that our

spirit is intertwined with our mind and body. Like my mother, I also believe that

our spirit is the part that keeps our mind and body in sync , but most importantly,

it is the part that communicates with God. The Bible says in Job 32:8 (NIV), "“But

it is the spirit in a man, the breath of the Almighty, that gives him understanding."

.”

I thank God that my mother’'s spirit and faith in God always remained high,

which helped her to endure the problems she faced in life, including her high

blood pressure and discrimination. And, just like the stories she shared about her

trial and tribulations, my mother also shared stories about how God blessed her,

kept her, and guided her through life. For example, sShe told us about the story

when she was just a little girl and she looked up in sky and saw a vision of Jesus

holding a lamb, which she interpreted as her being the lamb in His arms. .

Mom also told us about another incident that happened while we were

living in Montgomery Projects. : She was alone in the elevator and a man dressed

in a dark coat and hat got on the elevator just before the door closed. Sensing

danger, my mother said she began praying in the spirit. The man suddenly

shouted out that he had intended to rob her but he couldn’'t because the power of

the Holy Ghost was upon her. She further stated that the man immediately exited

the elevator when it stopped and he ran from the building.

There were many similar stories my mother told us about how the Spirit of

the Lord was upon her and how she was able to communicate with God through

her spirit, which also helped her mind and her body. The Bible says that Jesus

"“sighed deeply in His spirit”" (Mark 8:12 NKJV) and "“Jesus rejoiced in the

Spirit”" (Luke 10:21 NKJV ). Therefore, I believe that the spirit is an essential

part of our being, which is not too complicated to comprehend even when you

think of it in natural terms. For example, bad news or unfairness can bring your

spirits down to the point where you can become sick in your stomach or your

head might ache or both.. And, vice versa, you can be having a bad day until you

receive some good news like a job promotion. All of a sudden, you feel much

better and your spirits are up.

Another example is the endorphins I previously spoke about that the brain

manufactures to reduce the perception of pain. Therefore, these chemicals make

you feel better. Unfortunately, some people resort to drugs and/or alcohol to feel

better, which they should not do, but they do. Nevertheless, whatever is in our

mind, including that which we do to our mind, good or bad, can affect our body

and spirit. On the other hand, when you know the Lord, like my mother knew

Him, you not only feel better, you look better, and you act better. The Bible says

in Proverbs 17:22 (NKJV), “"A merry heart does good, like medicine, bBut a

broken sprit dries the bones." .”

Because of the relationship she had with the Lord, my mother had a certain

peace about her up until her last days, including a joyful heart. And, just like the

vision she saw as a child,: God wrapped His arms around her and kept her safe.

Therefore, aAs a result of my analysis of the mind, the body, and the spirit in

regards to sickness and disease, I have concluded that my mother’'s special

relationship with God gave her an advantage over the disease. Hence, as the

quality of her mental and physical health decreased, the capacity of her spirit

increased, which resulted in joy, peace, and happinessy throughout her journey.

In other words, my mother did not suffer at any point during her sickness. Praise

the Lord! And, thank you, Jesus!

XI:

Reversing the Roles

In the past, a lot of people including myself, would have mislabeled my

mother’'s symptoms as being "“old and senile.”" However, with the new

breakthroughs in the medical field and the ease of access to information, we now

have a better understanding about the disease than ever before. Therefore, after

researching my mother’'s medical diagnosis and learning that my mother was

already in the advanced stages of dementia, I knew that the role of son and

mother had to be reversed. .

As I launched into my new role, one of the first and most difficult tasks I had

to do was to stop my mother from driving. The decision took an emotional toll on

me, but I had no other choice after my mother failed to stop at a red light on one

occasion and after she kept getting lost during routine trips from my brother’'s

house to her house. Furthermore, I had often heard or read reports about senior

citizens getting lost and sometimes having accidents resulting from them driving

the wrong way on a street or highway. Therefore, I did not want my mother to

hurt herself or anyone else so I disabled her car to prevent her from driving. .

It was indeed a painful experience watching my mMom trying to start her

car. And, on many occasions, I wanted to enable her car so she could drive, but

the risk was too dangerous. The main reason I kept revisiting my decision to stop

my mother from driving was because her inability to drive was contributing to her

decline. Nevertheless, I eventually found peace with my decision after I gained

possession of her car and told her that I would be her chauffeur for life and that I

would take her anywhere she wanted to go, which I did. As a result, mMom and I

spent a lot of quality time together and it was a joy to see her warm the hearts of

the people we met on the streets, in the parks, in the stores, etc.

Mom really loved people and she never met a stranger. As a result, I would

take her to the local Wal-Mart at least two to three times a week, mainly for

exercise and socialization. And, it was a blessing that several of the cashiers at

the store got to know my mother, which enhanced her shopping experience., i.e.,

tThe cashiers would laugh and talk with mMom. Most of all, the cashiers were

patient and kind to my mother, which both my mMom and I greatly appreciated.

.

Initially, this was a very enjoyable experience but, little by little, it became

more challenging. For example,Like in the beginning mMom would pick out the

things she wanted to buy and she would pay for them at the register. . But as her

cognitive abilities declined, she started forgetting how to make transactions at

the register and she also developed a habit of repeatedly buying things she

already had. .

For example: One day, while we were at the local Wal-Mart, I tried to

convince mMom that she had already purchased a particular item the day before

and that she had plenty of them at home. However, there was no reasoning with

mMom. She got angry and started fussing at me. And, before I knew it, I was

surrounded by several older women who began scolding me for being such a

mean son for not allowing my mother to have “"whatever”" she wanted! To

alleviate the scolding and the possibility of being wacked by a cane or an

umbrella, I smiled and allowed my mother to put the item in her cart. .

Mom also started forgetting where she put her house keys and/or purse,

which caused our trips or outings to be delayed or cancelled. One time mMom

hid her purse so well, it took us two weeks to find it. I also had to look after

Muffin more because mMom started putting orange juice and other inappropriate

foods in Muffin’'s dish, which he was smart enough not to eat or drink. And, the

more I reversed the roles, the more mMom resisted me telling her what she could

or could not do. As a result, I had to adapt new strategies to deal with my

mother’'s behavior.

XII:

Behavior Modification

I learned some valuable lessons from my initial experiences with mMom’'s

dementia. For one, it wasn’'t my mother’'s behavior that needed to be modified or

changed,. Iit was mine. Secondly, I had to learn how to be more patient and not

to dwell on or get too upset over the little things that I could not change. Thirdly,

I had to find new ways to achieve the desired results. For example, Like instead

of confronting my mother about repeatedly buying the same thing, I learned how

to remove the duplicate item(s) from her cart before we got to the register. In

other words, I learned how to turn my mother’'s short-term memory lapse into an

asset because she no longer remembered the item by the time we got to the

register.

Mom also forgot how to write checks. Therefore, tTo avoid problems at the

register, I would put some money in her purse before we left the house. I also

took possession of mom’'s house key's and purse to avoid having to look for them

every time we left the house. I did, however, let her manage the Christmas

stocking she used for a purse, which did not contain any valuables or personal

information. Therefore, it would not have been a big deal if she lost or misplaced

it. .

I had to also modify my attitude concerning my mother eating everything

with her hands, including mash potatoes and gravy. .

For example, wWhen the problem first developed, it would have been both

dumb and dangerous to challenge her or chastise her about it. Instead, I would

politely ask my mother, “"Do you want to use a spoon or a fork?”" She would then

lift up her hands and wiggle her fingers and say, “"I already got one.”" Again, it

was not my mother’'s behavior that required modification, it was mine.

Therefore, tTo avoid a confrontation with my mother and to respect her decision

to eat with her hands,; I made sure her hands and finger nails were clean before

she ate, which greatly reduced my anxiety.

I also had to change my attitude towards the things my mother would say

or do because I knew that it was not her, it was the disease. Therefore, it is

critical that caregivers and family members have an understanding about the

symptoms of the disease. Hence, if someone does not understand the disease,

they may have difficulty dealing with the person’'s changing behavior. And, like

child abuse, senior abuse is both real and problematic.

Thank God I was able to eventually understand my role and limitation in

caring for my mother. . However, the key part involved me changing my behavior

and embracing each stage of my mother’'s decline as a rewarding challenge. In

other words, I had to find new ways to make lemonade out of a bitter situation.

XIII:

Sweet Memories

We took mMom on numerous trips to North Carolina to visit her only living

sibling at that time, Bessie Harris, and her niece, Ernestine Snead- Day, both of

whom have since gone home to be with the Lord. Ernestine was almost like

mMom’'s little sister because they were only three years apart. These visits

exposed mom’'s long-term memory recollection versus her short-term memory

loss. And, whether it was telling stories about how she had to carry Ernestine on

her back to avoid getting a whipping from her mother for coming home late from

school or the spats she had with Bessie and her other siblings, mMom always

made us laugh.

These stories highlighted our visits, especially the stories about gGrandpa

who made moonshine that he also sold it to the sheriff. According to mMom,

gGrandpa was well respected by both black and whites, which was uncommon in

those days. For example, older black men were often called "“uncle”" or "“boy.”"

Mom also stated that whenever she and gGrandpa went to town, white men would

tip their hat's and say, "“Hello, Mr. Harvey.”" "“Hi, you doing, Mr. Harvey?”"

And, according to mMom, some people called gGrandpa, "“Uncle Ellick"” while

some of his buddies affectionately called him "“Alexander the Great Commander

who kilt’' (killed) the goose and shot the gander,.”" Which was a spin off the old

saying, "“What’'s good for goose is good for the gander.”" However, mMom and

her siblings, including her niece, Ernestine, all called grandpa “"Papa." .”

Ernestine said that what she admired the most about gGrandpa was his

ability to calculate numbers in his head while he was doing business with the

white land owner. Hence, gGrandpa was a sharecropper who did not have any

formal education.; hHowever, gGrandpa knew what was due to him versus what

he owed the land owner, which wasn’'t always the case in those days because the

sharecropper often ended up owning the land owner more than he was able to

earn. .

Looking back over some of the other stories mMom told us about gGrandpa,

perhaps some of the respect my grandfather earned may have resulted from the

quality of his moonshine or it could have resulted from him biting off the ear of

one those men who had attacked him. Nevertheless, iIt is my hope that gGrandpa

was respected because of the way he carried himself or by the way he lived his

life versus the moonshine and violence. Nevertheless, mMom was part of

gGrandpa’'s legacy.

Mom was also a part of gGrandma’'s legacy. For one, my mother could

bake the most mouth-watering bread, but not like gGrandma. And, according to

mMom, gGrandma baked bread and made soup, which she placed in tubs and

buckets. Then, while carrying some of the tubs on her head, gGrandma walked

along the railroad tracks and sold the bread and soup to the men working on the

railroad. Mom further stated that gGrandma had five siblings, Carrie Bell,

Walter, Edna Blake, Annie, and Lottie who all different complexion. .

Therefore, while growing up, I was often wondered why some of my

relatives’' complexions were lighter than others, including some who could pass

for white. Unfortunately, you could not ask a lot of questions back then because

some things just weren’'t talked about or discussed. As a result, I had to do some

research on my own to understand this phenomenon. Fortunately, I did not have

to search far. Hence, looking at the pictures in my photo albums, the evidence of

both Native American and European traits are clearly visible in my African-

American lineage. For example, my gGrandma’'s complexion was darker than her

sister, Lottie. That is, Aunt Lottie more than likely looked very much like her

mother who was said to be a Cherokee Indian, i.e., with real light complexion,

long black hair, and high cheek bones. Likewise, my mother’'s reddish

complexion and high cheek bones are also linked to her Indian heritage.

Furthermore, aAn ancestor search revealed that in 1896 both my great

grandparents, Blake Williams and Ann (Manley) Williams, submitted their Native

American Application for Enrollment in the Cherokee Tribe, which was considered

one of the "“Five Civilized Tribes.”"

In addition to being labeled a "“civilized tribe”" the Cherokees, Chickasaws,

Choctaws, Creeks, and Seminoles also held Bblack slaves. The Seminoles, for

example, held the least Bblack slaves, and they were said to be more sympathetic

to causes of bBlack people. The Cherokees, on the other hand, held the most

Bblack slaves. And, according to Barbara-Shae Jackson, "“By 1860, the Cherokee

had 4,600four thousand six hundred slaves. Those Bblack people held captive

revolted against the Cherokee in 1842" (Jackson, 2014, p. 3).” It was further

noted that the Indian slave owners, just like the European slave owners, also

exploited bBlack women. Hence, race mixing also thrived under these conditions.

However, when the mixed blood descendants, like my ancestors, filed for

inclusion in the Cherokee Nation, the Cherokee’'s denied them their rights. .

Mom’'s stories were not only unique because of her heredity, they were also

unique because she was the youngest out of 11 eleven children who, as she would

say, was born during her mother’'s "“change of life”" at age 40forty. Therefore, I

could only imagine the challenges that my grandparents had raising my mother

during those times at their ages. For one, based on some of the things I knew or

heard about my mother, my mother she never blindly followed orders. For

example, mMom said that one of the first problems that developed between her

and our grandmother resulted from an incident that occurred when our

grandmother was working as a domestic for a white family.: Our grandmother

insisted that my mother call the white family’'s little daughter, "“Miss Louise,”"

which was the expected behavior for bBblacks or "“colored people"” during the

Jim Crow Era in the South. And, in many cases, bbBlacks were arrested or

lynched for simple or perceived violations of the Jim Crow Laws. Like in the case

of Rosa Parks, Emmett Till, Army Cpl. Roman Ducksworth Jr., and so many others.

.

My mother refused to conform to the social order that she was born into

even after our grandmother tried to beat it into her. Mom said that she could not

bring herself to call that little girl Miss Louise because they were the same age.

The final straw came after gGrandma instructed my mother to wash the white

people’'s clothes. Mom stated that after she washed all the white clothes

together with the colored clothes, they did not want her to ever wash their clothes

again, which was fine with her.

Undoubtedly, mMom’'s age, and the social and economic factors that

impacted her family, created many challenges for her and her aging parents.

However, most of the other stories my mother told us involved her siblings. Like

the times gGrandma would use her to spy or tattle-tale on her sisters when their

boyfriends came to visit. And, how her sisters would retaliate against her when

gGrandma wasn’'t looking; especially when they slept together at night. Mom

said that her sisters would put her in the middle and threatened to smother or

squish her to death for telling on them. .

No matter how many stories my mother told us about her parents and her

siblings, the story she enjoyed telling the most was about how long she nursed

me, which always caused lots of laughter. As the story went, I was the youngest

out of five boys. And, according to mMom, I was a sickly child and because my

father was an alcoholic who failed to provide for his family,; food was scarce.

Therefore, mMy mother said she continued nursing me beyond the average

breastfeeding age. However, the funny part about this story is, it was just like the

story about the man who caught the fish,, i.e., my nursing age kept growing over

time. For example, iIt started out with me being eighteen18 months old and still

nursing. How it grew from 18 eighteen months to thirty-eight38 months is

beyond me. Nevertheless, mMom enjoyed telling the story.

Mom would work the story up with accounts of how she had to sneak away

to nurse me to avoid being chastised by her mother and siblings. And, how our

grandmother once threatened to whip both of us for her nursing me. My

grandmother'’s response was understandable due to her lack of knowledge.

Hence, the World Health Organization recommends breastfeeding up to two years

of age or beyond and some societies in the world breastfeed their children until

they are four to five years old. However, I don’'t think my grandmother or my

other relatives were aware of it, including my mother who undoubtedly nursed me

out of necessity, which I am glad she did. Therefore, I can only guess that the

naysayers were comparing my nursing age to the norms and standards within

their community. .

Whatever my nursing age was, I did not recall any of it. And, because the

story made my mother happy, I just went along with it. But, the story did get old

at times, especially since I was the brunt of the joke. Therefore,So I tried to

change the subject about nursing during one of our visits to Aunt Bessie’'s house

by taking the focus off me and putting it on my brother, Rick. For example, I

complained to Aunt Bessie about how Rick always talked about them Coca -Colas

she used to give him when he was a child, which was a real treat for a poor

bBblack kid back then, especially if you had a five cent bag of peanuts to go along

with it:. You not only had a treat, you also had a meal. And, just to "“mess with”"

Aunt Bessie, I said, "“I don’'t recall you ever giving me a Coca- Cola when I was a

child.”" Well, what did I say that for? I walked myself right into it.: Aunt Bessie

said, "“James, I wanted to give you a Coca- Cola, but you were too busy nursing!”"

Everyone burst into laughter and some laughed until they cried.

XIV:

The Helper and Tthe Cussee

Mom really enjoyed the trips to North Carolina and the laughter she and

Aunt Bessie and Ernestine shared., hHowever, her activities of daily living

continued to decline. For example, mMom almost caused two fires in her house by

leaving things on the stove too long or by putting metal objects in the microwave.

As a result, Rick and I disconnected both the stove and microwave and hired a

home health aide worker to help us out. .

Finding a reliable home health aide worker was not an easy task. And, no

matter what agency they came from or represented, they all had their flaws. For

example, oOne of the aides connected well with my mother, but her character was

shady. Therefore,So Rick and I took turns checking on the aide. Checking

on the aide included coming back unexpectedly or showing up at the places the

aide was supposed to take mMom, i.e., stores, restaurants, doctor’'s office, etc.

And, although some workers provided better services than others, for the most

part, the home health workers were very helpful. They not only kept mMom

company during our absences, they also helped mMom manage her medication

and other activities of daily living. Furthermore, bBeing that, Rick and I

dominated mMom’'s life,. sShe welcomed the services and the company of the

female aides as a result of their gender. For example, the aide would take mMom

to the local McDonald’'s Rrestaurant where they would sit and talk and enjoy a

small country and western band that entertained senior citizens on Thursdays.

Mom would laugh and dance and talk to the other senior citizens, especially those

who looked like they needed help. She would ask them,: "“You need my help?”"

Regardless of what I was doing,: cutting grass, fixing a car, etc., mMom

would always say, "“You need my help?”" And, like a father allowing his small

child to participate, I would often let mMom help me with some of the small safe

tasks, even when her cognitive abilities prevented her from understanding or

completing the task. .

As time passed, I became more and more involved in caring for my mother.

And, although I had both a military and a social work background, none of it

prepared me for the changes that were rapidly taking place in my mother. For

example, mMy brother and I decided to put depends on mom after she kept

having accidents. She did all right the first couple of weeks. However, she soon

started wearing the depends on the outside of her garments and she would go out

the house in that fashion. Mom also started cussing more. And, during one

incident, Mmom got angry and socked me on the side of my head with her fist

after I tried to calm her down.

Nevertheless and tThrough it all, we still managed to laugh. For example,

wWhen my God-fearing mother first cussed me out, I was shocked. I exclaimed,

"“mMom, you cussed at me!”" With a serious look on her face, she pointed her

finger at me and replied, "“If I cussed, then you are the cussee!”" I had no choice

but to laugh because I had never been called a “"cussee”" before.

On the other hand, this was indeed a serious matter. And, although I did

not do any research to see if there was any correlation between cussing and the

onset of dementia, I did talk with a number of health care professionals who said

that this type of behavior was common in dementia patients. For example, mMost

of them said that if the patient never cussed (or cursed), some start cussing

during the different phases of dementia. One of the nurses said she had a patient

who used to be a Sunday school teacher. Over time, the patient started

complimenting her by calling her a "“pretty little B." .”

In contrast, they say, if the person routinely used profanity prior to the

onset of dementia, they stop cussing. Nevertheless, cussing or using profanity is

not of God and it definitely falls under the "“undesirable behavior”" category.;

tTherefore, no additional research was needed in this area.

Thank God my mother’'s cussing phase was short-lived because it was not in

her spirit. The Bible says in Psalm 51:10 (NKJV), "“Create in me a clean heart, O

God, Aand renew a steadfast spirit within me.”" Therefore, aAs a result of our

prayers, mMom was quickly delivered that behavior and her sweet and loving

spirit remained with her until the end of her journey with dementia.

XV:

24/7 Care

The sudden changes in the behavior of Alzheimer’'s and dementia patients

can catch you off guard, like they did me. Therefore, recognizing the early signs

and symptoms of dementia and Alzheimer’'s can help you to prepare for the

different stages of the disease. For example, I recall an incident that happened to

me while I was stationed in California back in the early 80'seighties. At that time,

I was familiar the term “"old and senile”" but I never met or knew anyone who fit

that description nor did I know anything about dementia or Alzheimer’'s until the

following incident occurred. .

It was a bright sunny day. I was driving through Riverside, California with

my wife, Dinah, and we came upon an elderly bBblack woman walking along the

highway. We were never quick to stop or pick up hitch hikers or strangers even

in those days, but seeing an elderly woman walking along a highway in the middle

of nowhere did not seem quite right., pPlus, she reminded me of my grandmother.

.

I immediately turned onto the shoulder of the road and asked the woman if

she needed a ride. She said yes and thanked us for stopping. The woman got in

the car and sat in back seat. I noticed that she was perspiring so I asked her if

she was thirsty and she said that she was fine. Then we asked her what was her

name and where was she going. The first words out of her mouth were, "“I just

had lunch with President Ford and I was on my way home.”"

A red flag went up and Dinah and I looked at each other. Then we both took

turns trying to engage the lady into a meaningful conversation. Unfortunately, we

could not make much sense out of anything she said nor could she tell us how to

get to her house. And, at one point, it seemed like she was just enjoying the ride

without a care or sense of urgency. For example, hHours had passed and while

we were still trying to locate her house,; the elderly woman smiled and said to

Dinah, "“That James sure can drive." .”

To make a long story short, the elderly woman had wandered miles away

from her home and after a five-hour search and contact with the local sheriff and

strangers, we finally located her family who thanked us for bringing their mMom

back home. The family fed us dinner and shared stories about how their mother

had wandered in the past. Unfortunately, they nor we had little or no

understanding about Alzheimer’'s or dementia. But, we thanked God for using us

to get the woman home safe. .

We did not know it at the time that we were paying it forward because my

mother also wandered away from home and God sent His angels to protect her as

well. For example, oOn some occasions, there would be a few minutes gap

between the time the aide left my mother’'s house and the time I would bring

mMom her dinner. And, it was during a couple of those gaps that my mother

waondered away from home. .

Thank God my mother had a good neighbor named Mr. James Lively who

kept an eye out for us. Like the time Mr. Lively called me and told me that my

mother was walking towards the highway. Thank God I arrived within minutes

and found my mother before she got too far from home. I also thanked God for

Mr. Lively who has since gone home to be with the Lord. .

It was at that point that Rick and I realized that we could no longer leave

our mother unattended at any time. We considered getting a monitoring device

that could alert us and help us find her in the event that she wandered. However,

mMom had other safety concerns that required constant monitoring. Therefore, I

moved mMom and Muffin into our house. .

To help me and Dinah out, Rick would take mMom to his house on the

weekends that he was off from work. And like Dinah and Ime, Rick and Yvette,

took turns caring and keeping an eye on mMom day and night, which became

increasingly challenging over time. Hence, we had to sleep with one eye open

because mMom had lost all meaning of time. Plus, mMom was very mobile.

Therefore, So I installed devices on our doors to alert us if they were opened.

This was very critical because one of Rick’'s neighbor’s mom also had dementia. .

And, not too long after they moved their mom in with them, she walked out the

house one night and she was found dead the next day lying in a pond. In another

similar case, the woman was never found.

To make matters worse, mMom had not been prescribed any sleep

medication prior to moving her into our house. However, she was prescribed the

drug Aerosep, which she had been taking for about a year prior to moving into

our house. And, although the drug slows the progression of the disease, it does

not reverse the effects of the disease; especially the problems associated with

short-term memory and other cognitive deficiencies. As a result, my mother’'s

mental health continued to decline, which not only affected her activities of daily

living, but also her continence and ambulation factors as well. In other words, my

mother needed total assistance in going to the bath room, changing her clothes,

washing up, etc. .

We also stopped telling mMom when friends and relatives passed away

because she had reached the point where she no longer understood the meaning

of death or other events. However, her spirit allowed her to connect with the

atmosphere that was created or associated with an event. As a result, we kept

mMom away from funerals and other events that caused grief. On the other

hand, we always told mMom the good news, whether she understood it or not.

And we always included mMom in all of our celebrations, where she would smile,

laugh, clap her hands, and sing along with everyone else. .

On the downside, the task of getting mMom to these events became

increasingly difficult. However, But seeing the smile on her face was well worth

the effort it took to get her there. It was also a blessing that mMom was still

physically strong and mobile. However, , on the other hand, her strength and

mobility made it more difficult to assist her with certain activities. Therefore, I

had to improvise methods to get her to do things to make it easier to take off her

clothes and wash her body. For example, I devised a method to get her to laugh

while I removed her dentures. Or I would tickle her to move her arms while I

removed her sweater or blouse.

Unfortunately, most of the methods I devised were short-lived, therefore, so

old methods had to be modified or new methods had to be developed. For

example, iIt became increasingly difficult to put my mother’'s dentures back into

her mouth.: She would mistake the dentures for food or she would not position

her head correctly or she would scream as if she was in a lot of pain. But,

because of the benefits associated with her dentures, i.e., chewing, smiling, etc., I

was determined to get her dentures back into her mouth, which I was able to do

most of the time. .

Rick and I soon realized that we were unable to provide the “"professional”"

round-the-clock care and assistance that mMom needed. And, after much prayer

and research, we located a skilled nursing facility we felt comfortable with and

could afford. However, deep down inside, I did not want to put my mother into a

facility. But, we did not have the benefits of a large family like the ones that

existed during my mother’'s generation; especially like the people who lived in

rural communities where everybody knew each other and where family members

took turns caring for gGrandma or Aunt Annie. .

Unfortunately, those days are long gone and the world is far more

dangerous than it was 50 fifty years ago, i.e., drugs, crime, urbanization, etc.

Nevertheless, Rick and I had to make a decision about placing mMom into a

nursing facility because we realized that despite our good intentions, finding

professional care for mMom outweighed keeping her at home with us. For

example, wWe found out that most of the facilities had a dementia care unit that

was staffed and maintained 24/7. Some facilities were setup and better

maintained than others but the cost and the distance were always deciding

factors. This was important because we wanted to be able get to Mmom as

quickly as possible at an affordable cost. Hence, some of the facilities were miles

away while others were too expensive. .

After touring the facility we chose, I was amazed to find that the rooms

resembled the apartment mMom had described that she wanted for her next

move. In other words, before her diagnosis, mMom had talked about finding a

one-room apartment for herself and Muffin. However, I was not too anxious for

mMom to go into a facility. Therefore, So I told Rick that he could take her there

and I would visit her the next day.

I had already made up my mind that if mMom showed any signs of wanting

to leave the facility when I visited her the next day, I was prepared to take her

home in a heartbeat. But, to my surprise, mMom was very happy and content

when I visited her the next day. She had a roommate and they got along fine.

However, But I was still not comfortable, therefore, I made going to the nursing

home a daily routine, including making surprise visits at night. Rick, Yvette, and

Dinah also made visits and we sometimes made visits back to back.

In addition to our visits, I would take mMom out of the facility once or twice

a week and we would go to different places for lunch or we would go shopping or

both. On some occasions, we would go to a Wal-MartWal-Mart store where

mMom would push her cart and put things in it. Sometimes I would buy mMom

ice cream bars and other goodies for her to take back to the facility where she

would share them with her roommate. . On other occasions, I would sign mMom

out for the entire weekend. Mom would stay at our house over the weekend and

we would return her to the facility after dinner on Sundays. We also signed

mMom out of the facility during holidays and other special occasions like

birthdays and graduations. .

As a result of our visits to the nursing facility, we became well- known and

we received many compliments about the way we took care of our mom. For

example, I continued to feed and change mMom as necessary and I often took her

outside for walks when the weather permitted. However, as nice as the staff were

at facility, we learned that we had to check behind them regarding mMom’'s

medication and daily care. We also discovered that the facility often rotated or

changed staff; therefore, so the new staff had to get used to mMom’'s behavior

and medical needs. .

Mom thrived in the facility for about 18 eighteen months before she started

experiencing some serious problems, including a couple of unexplained falls.

And, on one occasion, the staff could not explain why my mother had a black eye

and a bump on her head. I asked mMom what happened, but she was unable to

tell me anything. So I asked the floor supervisor what happened. She told me

that my mother fell and hit her head, but no one saw her fall. I wasn’'t satisfied,

especially after they told me that they did not think my mother needed to see a

doctor. I was livid.: I told the staff that if they didn’'t call an ambulance, I was

going to call the police. Not for them, but for me because I was about to lose

control. The staff quickly called an ambulance and mMom was taken to the

hospital where she checked out. .

The hospital took X-rays, which did not reveal any factures or broken bones.

They kept mMom for observation and released her the same day. As a result, of

this and other incidents, Rick and I conceded that the nursing facility had some

benefits but, it also had some problems too. For example, because the facility

knew that we would frequently check on our mMom, they took extra care to do

things right. However, other patients were often neglected, like our mother’'s

first roommate who did not have any friends or relatives to check on her.

Therefore,So we adopted mom’'s roommate and treated her like family, including

letting the staff know when she needed assistance. And, if we brought mMom

some treats, we brought her roommate some treats too. Mom’'s first roommate

eventually passed away and her new roommate was just as nice and we adopted

her too. .

Although mMom’'s stay at the nursing facility presented many new

challenges, the benefits of the facility continued to outweigh the options of

keeping mMom at home. Hence, in addition to the around-the-clock care, mMom

also benefited from the activities at the nursing facility, especially activities

involving multisensory therapy (also known as Snoezelen). For example, I later

learned that one of the reasons my mother’'s dementia often caused her to have

undesirable behavior was related to her inability to articulate her needs, which is

considered a developmental disability. .

Multisensory therapy was designed to help patients with developmental

disabilities so that they can enjoy a better quality of life by enhancing their

sensation and emotions (Effects, 2009, p. 2508). For example, dDementia

patients may become aggressive or agitated in the afternoon because they may

not be able to articulate their desire for food or any other things that might

bother them. Therefore, multisensory therapy uses different techniques and

activities to improve their quality of life. Some facilities, for example, have

calming rooms that are equipped with controlled lighting features and textured

walls, which is another benefit of a 24/7 care facility.

XVI:

Acceptance

The services that were provided in the skilled nursing facility, including the

multisensory therapy, improved my mother’'s emotions and quality of life.

However,, mMom’'s overall condition steadily declined over a period of time.

And, as I dreadfully predicted and anticipated, the day finally came when I was no

longer able to put mMom’'s dentures back into her mouth even with the

assistance of the nursing staff. . However, the funny thing about this situation

was, my mother enjoyed not having the dentures in her mouth. . And, although it

bothered me more than it bothered her, I eventually looked past the reality that

mMom would never wear her dentures again and I accepted her toothless grin

and loved her just the same. Again, it was my behavior and attitude that needed

to change instead of my mother’'s behavior.

Mom eventually lost her ability to walk and, within a month after that, she

lost her ability to eat. The latter was the most painful part to bearare because

mMom’'s appetite was one of the things we all cherished during her journey.

Hence, while everything else was declining, as long as mMom was eating, we

were OK okay and counted it as a blessing. But, as hopeful as we were, mMom’'s

ability to eat stopped. Therefore, we had to prepare mMom and ourselves for the

next level of care for our mother. And, through God’'s grace and mercy, we were

able to move mMom to a facility that was closer to our house. .

The new facility was much nicer than the other facility. For example, iIt

was a lot cleaner and the staff to patient ratio was much smaller than the other

facility. However, despite the resources at the new facility, mMom’'s health

continued to decline to the point where she was unable to hold her head up. But,

to God be the glory, mMom could still respond to praise and worship music by

wiggling her shoulders from side to side, including sometimes momentarily

raising her head and smiling. Therefore, we were still hopeful despite the

doctor’'s report. .

On one particular day, I was approached by one of the staff members at the

new facility who had observed me on several occasions trying to coach my mother

to eat. The staff member pulled me aside, and with tears in her eyes, she

explained to me that my mother was in the final stages of the disease and she no

longer possessed the ability to eat on her own. She further stated that she

understood how I felt because she went through the same thing with her mom.

Again, it was my behavior that had to be modified because mMom, through

her advance medical directive, had already prepared us for that moment in time.

Therefore, tube- -feeding, which is a form of life- support, was not an option.

Instead, we honored mMom’'s wishes and followed her instructions.

Nevertheless, I had to modify my behavior in order to accept hospice care but, I

never stopped loving, believing, and caring for my mom as she bravely progressed

through the final stage of the disease. Therefore, wWe assisted the staff in

making mMom as comfortable as possible through the last leg of her journey.

The scripture that helped me the most throughout mMom’'s journey can be

found in Proverbs 3:5-–6 (NKJV), which says, "“Trust in the Lord with all your

heart, Aand lean not on your own understanding.; In all your ways, acknowledge

Him, aAnd He shall direct your paths.”" The Serenity Prayer was also helpful,

i.e., "“God grant me the serenity to accept the things I cannot change.; Courage

to change the things I can,; Aand the wisdom to know the difference.”"

2000 2008

Happy Mother'’s Day! Mom (aAge 73) standing near the rose bush she planted in California. Proud Grandmother at Granddaughter's (In years like 1992, 1998, and 2009, Graduation Mom (aAge 81)

&and Bre (Aage 17) (Mom’'s dementia was in Stage 2: The changes werebecoming more noticeable.

mMom’'s birthday came on the same day as Mother’'s Day, and wemade sure

we celebrated both days!) Mom suddently stopped watching TV, and we had to stop

her from driving four months after this picture was taken.)

2009

Mom (Aage 82) In Front of Her House During the Christmas Season

(Mom’'s dementia was in early Stage 5: Her manner of dress had become

more noticeable; however, her bubbly spirit was still very much intact.)

2012 2013

Happy Reunion: Mom (aAge 85) with nieces Elaine andErnestine enjoying lunch at Ralph’'s Barbecue in RoanokeRapids, NC.(Mom's dementia was in early Stage 6: She passed away two months before her 87th birthday.)

Happy 86th Birthday Mom! Mom and& Son Jack (Picture was taken in mMom’'s room at the nursing facility. Mom's dementia was in late Stage 6: She did not know or recognize Jack, and she could not recall her nieces’' names, but she recognized gradually their faces. She also ate everything with her hands.) She slipped into Stage 7 within three months after her birthday.

Rapids, NC.

XVII

: Prevention

After witnessing my mother and other relatives go through the various

stages of Alzheimer’'s and dementia, I could not help but wonder if it could

happen to me or any of my other family members. And, as I mentioned earlier,

statistics show that most people in the 80's eighties suffer from some forms of

dementia or Alzheimer’'s. Furthermore, people are living longer than in the past.

Therefore, I became very interested in learning more about preventing and

delaying the onset of dementia. .

The information I found on prevention was very helpful. It was also good to

know that disease prevention continues to be a top priority among healthcare

providers around the world. For example, iIn response to the growing incidence

of age-related illnesses, researchers Tse and Benzi (2004) reported that, “"Nurses

form the largest professional healthcare group in the world, and the professional

code of the modern day nurse advocates health promotion as a primary role.”"

Tse and Benzi (2004) go on to say that nurses, due to their close relationship with

the community and their clients, are in a great position to educate the aging

population with the goal of achieving functional longevity (p. 309)..

The country of Malaysia is a good example of countries taking measures to

improve the lives of their aging population. The guidelines they published on

aging were adopted from the criteria that was set at the 1982 World Assembly on

Aging (Arabi et al., 2013, p. 1). For example, Malaysia classifiesy people over 60

sixty years of age as being elderly, therefore, age-related diseases, such as

dementia, can manifest sooner in some countries than in others. However, based

on the new research and data that links concussions to dementia and

Alzheimer’'s, the onset of these diseases can occur in more countries much

sooner. In other words, patients of all ages can experience dementia or

Alzheimer’'s related symptoms as a result of a traumatic brain injury. For

example, the facility that my mother was in had several dementia patients who

were in their 40's forties and 50'sfifties.

To reduce this growing trend, researchers from around the world have been

working together and comparing their notes in an effort to combat a common

enemy,: dementia. And, as a result of this concerted effort, we are much further

along than we were in the past in the areas of prevention. For example, nNew

rules and standards have been adapted in all levels of contact sports, ranging

from improved helmets to stiffer penalties for illegal hits to the head. But, is it

that enough?

The solution may be to ban or significantly modify some of these sports

altogether. And, knowing what I know now, I am more reserved than ever before

about promoting or participating in contact sports, especially for my

grandchildren. Therefore, parents and guardians must also play a greater role

than ever before to protect their children from needless and senseless head

trauma.

Nevertheless, the solutions for preventing dementia range from simple to

scientific. Some researchers , for example, suggest that moderate bi-weekly

activities, like dancing or walking, will reduce your chances of developing

dementia and Alzheimer’'s disease by as much as 52%  percent and 60% percent

respectively (Corbett, 2006, p.1).  Thomas Foster, PhD, the Evelyn F. McKnight

chair for brain research in memory loss at the University of Florida College of

Medicine states that, "“eExercise maintains the mind’'s cognitive abilities by

triggering the release of brain-protecting molecules, and guards against the

decrease of neurons "(Corbett, 2006, p.1).”  

Another study suggests that a person in their twenties or thirties who

participates in physical activities may lower their chances of developing

Alzheimer’'s disease (Effects, 2009, p. 2510). Furthermore, mMany studies have

proven that adopting a healthy lifestyle early in life, and staying with it, will

produce many health benefits. . Unfortunately, because my mother worked most

of her life, she did not have time to focus on activities strictly to improve her

health. But, on the other hand, she did maintain a healthy lifestyle.

Other researchers point toward diet as a key element in preventing

dementia. And, as noted in the aforementioned discussions on amyloid plaque

deposits and vascular dementia,; there are some dietary factors that can

contribute to the disease. Conversely, other dietary factors can prevent the

disease. For example, sSome studies reported the success of dietary supplements

such as vitamin E and gingko biloba in preventing or slowing the progression of

dementia (Tse and Benzi, 2004, p. 311). And, in a study conducted by Ozawa et

al., (2012), it was reported that higher dietary intake of potassium, calcium, and

magnesium significantly reduced the hazardous ratio for the development of

dementia (p. 1518).

While some researchers concentrate on diet and exercise, others take a

more holistic approach to preventing dementia. For example, The Middleton and

Yaffe (2010), published an article titled "“Targets for the Prevention of

Dementia”" suggesting that multi-level intervention such as cognitive, physical,

and social activity,; vascular risk factors, and diet all play a role in preventing

dementia (p. 915). This strategy of dementia prevention made the most sense to

me. Therefore, after learning about the benefits of the holistic approach, I

immediately increased and/or modified some of the things I was already doing to

improve my health.

I also adopted some new habits. For example, I eliminated a lot of junk and

fatty foods from my diet and added more fruits and vegetables. I routinely and

purposely drink more water and, to exercise my brain, I purposely engage in

remembering new names and phone numbers without writing them down. I also

increased my reading activities and added more sleep and exercise to my daily

routine. Writing this book is another example of the activities I engage in to

exercise my brain. These things may not prevent or delay dementia but, I feel

much better and my mind is much sharper as a result of these activities. .

There have been many new breakthroughs regarding dementia prevention.;

hHowever, some of these breakthroughs are nothing more than old remedies with

new twists. For example, in an article, published in Consumer Reports on Health,

titled, "“Aspirin: Pain Reliever, Lifesaver,”" it not only lists the benefits of aspirin

associated with a broad range of disorders, such as reducing pain, and reducing

heart attacks and strokes. . The article also presented evidence showing the

benefits of aspirin on dementia patients. For example, iIt included a study that

was conducted by the Department of Veterans Affairs where researchers gave a

daily tablet or no aspirin to 70 seventies patients who had dementia that was

caused by repeated mild strokes. After three years of treatment, it was noted that

the patients who were administered a daily dose of aspirin had a positive blood

flow to the brain, which increased their intellectual capacity (Aspirin, 1997, p. 5).

In another study, experiments conducted on mice brains concluded that statins

(cholesterol medication) was effective in reducing the accumulation of amyloid

plaques (Harder, 2004, p. 3).

Early detection seems to be the best argument for preventing or delaying

dementia.; tTherefore, any research that will assist in early detention will be

beneficial. For example, a A study was conducted using a newly developed Early

Dementia Questionnaire (EDQ) to screen elderly patients for dementia in primary

care and comparing the results to the widely used Mini Mental State Examination

(MMSE) assessment tool. The study concluded that the EDQ offers an alternative

for assessing early dementia. Therefore, bBetter treatment options and outcomes

can be achieved by using more than one assessment instrument for detecting

early signs of dementia (Arabi et al., 2013, p. 49–-57).

In another example on how early detection and treatment seems to be the

best option, researcher Ben Harder (2004) believes that there is new hope for

drugs that failed as cures for Alzheimer’'s disease in the past, but may now be

seen as drugs that may help prevent or delay the disease’'s onset (p. 1-–3).

Hence, researchers now believe that at least some of these old approaches may

have new value if they are administered sooner or prior to the disease’'s onset.

For example, aAs I mentioned earlier, some researchers believe statins used to

treat cholesterol have been found to be effective in reducing amyloid plaque

buildup in the brain (Harder, 2004, p. 1-–3). However, as I also mentioned

earlier, a recent report confirmed that statin drugs accelerate cardiovascular

disease (Mercola, 2012, p.1), which can subsequently lead to dementia and

Alzheimer’'s.'.

So what do you do when one report says statins are good for preventing the

onset of dementia, while another report says that statins could indirectly

contribute to the onset of dementia by accelerating a cardiovascular disease? I

do not know because it happens all the time.: One day someone says something is

good for you. The next day, someone else says it is bad for you. For example,

antioxidants have been found to be effective in reducing dementia if taken prior to

the onset of the disease. The keyword is "“if.”" Therefore, no matter what type of

drug or product you use or stop using,; timing is critical because once the malady

is present, it may be too late to cure the disease.

As you can see, most of the solutions to preventing dementia rest heavily on

human behavior. Therefore, fFor any prevention method to work, people must be

willing to change or modify their behavior to get the best results, which may

require some additional help or therapy. For example, iIn an article published in

the Richmond Times Dispatch, it was reported that, "“Americans are eating their

worst since 2008" (Chew on this: p. A4).” This negative trend does little to

diminish the obesity problem we already have in this country. Therefore, it will

take a "“wrap-around approach"” that involves the individual, his or her family,

and the health care community to accomplish the mission. .

Again, looking at the nursing field I mentioned earlier, nurses do play a key

role in getting the word out and reinforcing positive health choices that can

prevent or reduce age-related diseases, including dementia. . However,

according to Tse and Benzi (2004), "“This requires that nurses themselves

increase their awareness, knowledge, and understanding of relevant

interdisciplinary research findings" (p. 309).” Likewise, family members also play

a very important role regarding dementia prevention and treatment. However,

jJust like nurses, family members must also educate themselves on the proper

care and treatment of their aging parent(s) or relative(s), including knowing the

risks of poor diets, lack of exercise, and declining health qualities. .

In other words, the more we know about the causes and effects of dementia,

the better we can respond to ensure our aging parent(s) or relative(s) don’'t

become a statistic due to inadequate care or counseling. . Unfortunately,

effective treatment is often expensive and affordable treatment may be hard to

find, which I experienced firsthand. However, the more we know about

prevention and treatment, the more informed will be in our decision making. .

Poverty and low income continue to be a problem associated with dementia

treatment options. On top of that, it has been reported that the majority of the

increase in dementia cases will come from low- income countries (Singh-Manoux

and Kivimäki, 2010, p. 309). However, these statistics are not limited to low -

income countries., iIt’'s a global problem that is common to many countries where

people have to choose between healthy food and limited resources. For example,

iIn the aforementioned Richmond Times Dispatch article, Valerie Ruelas, who is

the director of the Community Diabetes Initiative of the University of Southern

California and Children’'s Hospital Los Angeles states that, "“Pproduce sold in

impoverished communities is often of poorer quality, making it less appealing to

strapped consumers" (p. A4).”

Food desert is another name for this phenomenon or trend that affect many

urban and densely populated areas where there is little or no access to fresh or

affordable healthy foods. As I pointed out earlier, we were blessed in this area

because my mother was able to grow her own fresh produce, including the

cantaloupes and watermelons she grew in the summer. However, as I have seen

too often in many urban communities around the country and, it is sad.: You can

find a liquor store on just about every other corner, but fresh food markets are

often hard to find or nonexistent. Speaking of alcohol, the best way to prevent

the onset of alcohol dementia and other alcohol-related diseases, including cancer

and cirrhosis of the liver,; is to refrain from drinking alcohol in excess, especially

binge drinking. Better yet, avoid drinking alcohol altogether. You will be amazed

at the results. .

The effects of water pollution, tap water, and bottled water that I mentioned

earlier should not be overlooked because they can also adversely affect your

health in many ways, especially children and the elderly. That is why, in this day

and age, many health experts recommend a point-of-use water purification system

that has been certified by NSF International to remove a wide range of volatile

organic chemicals and other contaminates from your drinking water. Therefore,

once you obtain clean and safe drinking water be sure to drink plenty of it

because, as I discussed earlier, our body needs water to live and function the way

God designed it. Most of all, stay hydrated and adhere to the warning signs of

dehydration, i.e., bad breath, extra yellow urine, constipation, headache, fatigue,

muscle cramps, etc. .

Air pollution is another factor that we must consider. Hence, not only

should we do our part to reduce air pollution,; we also must be mindful of the

dangerous effects of air pollution and the impact it has on our health, including

the onset of dementia. And, like water, our body needs clean air to live and

function the way God designed it. Therefore, it is essential to your health to

protect your lungs from dangerous chemicals and other pollutants that are

avoidable. For example, burn pits, indoor garages with running gasoline engines,

second-hand smoke, etc. And, if you smoke, quitting will greatly improve your

health, including reducing or eliminating the onset of dementia, COPD,

emphysema, cancer, and other diseases.

According to the American Lung Association, some of the things we can do

to reduce air pollution, include: Uusing less electricity,; driving less by car

pooling or using public transportation,; refraining from burning wood or trash,;

making sure your local school system requires clean school buses that reduce

emission,; and, get involved in clean -air efforts (American, 2014, pp. 10-–11).

Furthermore, pPeople residing in cities or towns with poor air qualities should

seriously consider air pollution as a deciding factor before moving into or out of a

particular locality. This should be especially important for people who are

considering moving or relocating as a result of retirement or a job change.

Hence, you may achieve a short-term financial gain. But, is it worth gaining a

long-term illness resulting from the effects of air pollution?

There is still much more work to be done in the area of disease prevention,

however, the possibilities of finding ways to prevent dementia or slow its

progression are greater than before. The Bible says in Hosea 4:6 (NKJV), "“For

my people are destroyed for lack of knowledge. Because you have rejected

knowledge.”" As a believer, I do not reject knowledge, therefore, I applaud the

new breakthroughs that shed light on how diet, exercise, and other life-style

changes can prevent dementia, especially in the areas of early detection and

treatment. And, I don’'t believe you have to be a “"biophysicist”" or a

"“nutritionist”" to figure out why people in some countries do better than people

in other countries regarding age-related illnesses. .

The seventeen17-year Hisayama Study on the self-reported dietary intake of

potassium, calcium, and magnesium and risk of dementia in Japanese people that

was conducted by Ozawa et. al (2012) to explain their effects on the development

of dementia is a good example. Their study reported that, “"hHigher self-reported

dietary intakes of potassium, calcium, and magnesium reduce the risk of all-cause

dementia,”" (p. 1516) especially vascular dementia. So why aren’'t we doing the

same? ?

The answer to this question can be found in the fact that our country, as a

whole, has a problem when it comes to diet and exercise, which are also related

to our obesity problem. And, although it is an individual’'s responsibility to

maintain a healthy lifestyle, some people may need assistance to combat dementia

and other age-related illnesses; not just in this country but also world-wide. In

doing so, the road to preventing dementia will become shorter and shorter until it

is no longer a fatal age-related disease.

XVIII: Preparing for Your Future

My mother’'s journey through the different stages of dementia taught me

many lessons about life and it really opened my eyes. Therefore, outside of

establishing and maintaining a relationship with God through His son, Jesus

Christ,; I believe that it is also important to make the following preparations while

you, your spouse, and/or your aging parent(s) or other family members are still

competent:

1. Will: Make sure you have a will prepared, even if you don’'t have nothing

anything more than a comb or brush that you want someone or some organization

to have. It will help prevent conflicts and confusion among your survivors.

Review and update your will as often as necessary but at least every five years or

when significant changes occur, e.g., death, divorce, etc. .

2. Advance Health Care Directive: You need to have an advance health

care directives, which includes a power of attorney that appoints a health agent.

The directive also includes a living will to convey instructions for end-of-life care,

which will allow you, your parents, and/or your spouse to appoint a health care

agent to make decisions on their or your behalf. For example, the directive

conveys a patient’'s specific instructions regarding their care, such as, if they

want to be placed on life support, be resuscitated, etc. And, just like a will,

advance health care directives should be reviewed and updated when significant

changes occur l: Like death or a divorce,; change in health, etc. .

3. Power of Attorney: You may also want to designate a Power of Attorney

to act on your behalf regarding your legal matters, i.e., someone to close your

bank account(s), pay your bills, sell your property, etc. However, spouses and

other people with joint -bank accounts and joint -vehicle registrations can act on

each other’'s behalf. But, at the same, they must return or stop the deceased’'s

Social Security payments that are deposited in their account after the time -limit

imposed by law.

4. Life Insurance and/or Burial Plan: Unless you have a substantial

amount of money set aside, you need to make sure you have enough life insurance

or a burial plan to take care of your bills and final expenses. This will not only

reduce the pain and suffering of your loveds ones, it will also allow you to convey

your wishes regarding funeral arrangements. Keep in mind that the older you get

the more these plans will cost you. Therefore, invest in life insurance and/or a

burial plan as soon as you can and at the price and amount you can afford. Term

insurance is generally cheaper than whole life insurance. A good strategy is to

buy term insurance and invest the difference, which allows you to have some

living benefits instead of just death benefits. However, regardless of the plan you

chose, do not allow your policy to lapse due to non-payments, which could result

in no benefits.

5. Long-Term Care Insurance: Last, but not least, you may want to

seriously consider getting some long-term care insurance if you can afford it,

especially if you can sign up for it through your place of employment. I say this

because times have certainly changed during these 60 sixty plus years I have

been living. . For one, the rising cost of healthcare can wipe you out financially in

one episode. Therefore, you need long-term care insurance to cover the cost

associated with nursing homes, assisted living facilities, and/or extended

hospitalization. Furthermore, attitudes have changed.: Millennials are much

different than their Generation X and Boomer predecessors. As a result, the

concept of large extended families taking care of one another, especially the

elderly, have almost become a thing of the past. For example, a A friend who

have two sons once told me that if he became incapacitated, he believes one of his

sons would probably wipe his backside while the other son would probably pay

two people do it. .

7. Personal Asset Inventory: In addition to the aforementioned

documents, which should be stored in a fireproof safe or cabinet. You also need

to make sure you also have a personal asset inventory so that your loved ones

can locate them. As a minimum, the inventory should include your bank accounts

(checking and savings),; certificates of deposit,; investment accounts,; insurance

policies,; and mortgages, loans and credit cards. A list that includes the name

and contact information of your financial advisor, accountant, and legal advisor

will also be helpful. Like the other documents, your personal asset inventory

should be stored in a safe and secure place.

My mother made all of these preparations, which made it easier to make

decisions concerning her health and legal matters. I thank her for everything she

taught me in life, including that which I learned from her journey through the

different stages of dementia. .

Mom lived a full life before she went to her heavenly home on March 7,

2014 at the age of 86eighty-six. Thanks to God and His son, Jesus Christ, we did

not walk the journey alone. And, yes, mMom will "“dwell in the house of the Lord

forever”" and ever. Amen. .

XIX:

Resources

The following organizations can help you find resources or assistance

regarding your

aging parent(s), relative(s), or friend(s):

Alzheimer ’ ' s Foundation of America (AFA) (http://www.alzfdn.org)

The AFA provides a wide range of services through their toll free

helpline. The AFA has a team of licensed social workers who take calls and

respond to questions regarding individuals living with Alzheimer’s and

other Dementia related illnesses. They also provide assistance via Skype,

live chat and email. In addition, AFA website contains an array of

information on Alzheimer’'s, dementia and care giving.

The American Bar Association (ABA) (http://www.americanbar.org)

The ABA has a resource link where you can find legal information

relating to aging. For

example, yYou can find information on elder abuse, health care

decision - making, long-

term care services and support, etc.

The American Geriatrics Society (AGS)

(http://www.americangeriatrics.org)

According to their website, the AGS vision for the future is to ensure

older Americans receive

h high-quality, person- centered care. They also provide leadership to

healthcare professionals,

policy makers, and the public by implementing and advocating for

programs in patient care,

research, professional and public education, and public policy

(www.americangeriatrics.org).

The Better Business Bureau (BBB):

When looking for services, it would not hurt to contact the

BBB to see if there are any complaints on a particular doctor or

business organization. .

The Centers for Medicare and Medicaid (CMS) (http://www.cms.gov)

The CMS website provides a list of contact phone numbers and web

links to help you find answers

to questions relating to Medicare and Medicaid.

The Department of Social Services (DSS):

Your local DSS can also assist you with Medicaid

and Medicare related issues, including valuable information and

assistance regarding elderly care, ;

reporting elderly abuse;, nursing home placement,; and long-term care.

The Department of Health in your state or local jurisdiction can

provide you with information

r regarding the status of hospitals, nursing facilities, funeral homes,

e.g., licensing, complaints,

violations, etc.

The Department of Health Professions in your state is the organization

you need to contact if you want to check the status or the credentials of a

particular doctor or practitioner.

For example: Is the

doctor or practitioner licensed to practice in your state? Does he or she

have any complaints or

violations on his or her record? ?

Local Support Groups may also be helpful. Support groups connect

you with people in your area

who are experiencing similar challenges regarding care giving, hospice

care, grief, etc.

Works Cited

American Lung Association. Most Polluted Cities. State of the Air (2014), pp. 10-–11, 13–-15.

Arabi, Z., Aziz, N., Aziz, A., Razali, R., & Puteh, S. (2013). Early Dementia Questionnaire (EDQ): A new screening instrument for early dementia in primary care practice. BMC Family Practice, 14(1), 49-–57. doi:10.1186/1471-2296-14-49

Aspirin: Pain reliever, lifesaver. (1997, March). Consumer Reports on Health, 9(3), 30.

Retrieved from http://web.ebscohost.com

Berk, L. E. (2010). Exploring Lifespan Development (2nd ed.). Boston, MA: Ally & Bacon

Chew on this: Healthful eating declines in U.S. (2013, December 2) Richmond Times Dispatch, p. A4.

Corbett, H. C. (2006). bulk up your brain, to boot. Prevention, 58(4), 156.

Donnelly, L. (2016, March 5). Air pollution could increase risk of dementia. The Telegraph, p. 1.

Effects of multisensory therapy on behavior of adult clients with developmental disabilities; Physical leisure activities and their role in preventing dementia: a systematic review; Brief interventions for heavy alcohol users admitted to general.. (2009). Effects, 65(12), 2508–-2513. doi:10.1111/j.1365-2648.2009.05151.x

Gandy, S. (2011). Perspective: Prevention is better than cure. Nature, 475(7355), S15. doi:10.1038/475S15a

Harder, B. (2004). Delaying Dementia. Science News, 165(19), 296–-298.

Helmenstine, A.M. (2015, November 6). Question: How Much of Your Body Is Water? About.com, p. 1.

Hockenbury, D. H. & S.E., (2011). Discovering Psychology (5th ed.). New York, NY: Worth Publishers.

Jackson, B. (2014, April 9). 5 Native American Communities Who Owned Enslaved Africans. Atlantic Blackstar, p. 3.

Kang, M. (2013, March 21). Wash. state has the highest Alzheimer's death rate in U.S. KPLU 88.5, p. 1.

Krupp, S., (2006, January 11). Homeless man cleans up community. East Bay Times, p. 3.

Kunkle, F., (2015, February 16). Alzheimer's and blacks: higher risk, challenge. Richmond Times Dispatch, p. D1–-2.

Mercola, J. (2012, October 15). Confirmed Again: Statin Drugs Accelerate Cardiovascular Disease. Mercola.com. p. 1.

Middleton, L. E., & Yaffe, K. (2010). Targets for the Prevention of Dementia. Middleton and Yaffe, 20(3), 915-924. doi:10.3233/JAD-2010-091657

Milian, C. (1990, August 21). Reaping benefits. The Jersey Journal, p. 13.

Ozawa, M., Ninomiya, T., Ohara, T., Hirakawa, Y., Doi, Y., Hata, J., &... Kiyohara, Y. (2012). Self-Reported Dietary Intake of Potassium, Calcium, and Magnesium and Risk of Dementia in the Japanese: The Hisayama Study. Journal Oof tThe American Geriatrics Society, 60(8), 1515-1520. doi:10.1111/j.1532-5415.2012.04061.x

Sega, E. A.,Gerdes, K. E., & Steiner, S., (2010). An Introduction to the Profession of Social Work (3rd ed.). Belmont, NY: Brooks/Cole.

Singh-Manoux, A., & Kivimäki, M. (2010). The importance of cognitive ageing for understanding dementia. Age, 32(4), 509-512. doi:10.1007/s11357-010-9147-7

Thompson, D. (2016, February 15). Popular Heartburn Drugs Linked To Risk of Dementia. CBS News.com, p. 1

Tse, M. Y., & Benzie, I. F. (2004). Diet and health: Nursing perspective for the health of our aging population. Nursing & Health Sciences, 6(4), 309-314. doi:10.1111/j.1442-2018.2004.00189.x

Zepka, J. (1977, April 10). Women make ship shapes an everyday labor. Sunday Star-Ledger, p. 2.

About the Author

James Neville was born in Halifax County, North Carolina. He grew

up in Jersey City,

New Jersey where he learned to cuss and fight just like some of the

other kids in his neighborhood.

However, he thanks God for His son Jesus Christ who delivered him out

of those conditions. He also

thanks his mother for praying for him and keeping him in line.

James always had a thirst for knowledge; however, he did not let

poverty or the effects of an

absent father stop him being successful. As a result, he successfully

completed 21 years of service

in the U.S. Air Force and retired in 1993 as a Senior Master Sergeant.

After he left the military, James first worked as a substitute teacher

for Richmond Public Schools

before he was hired by the Richmond City Department of Social

Services as a Benefits Programs

Specialist. He was subsequently promoted twice during a seven-year

period. First, as a Case Manager

for the Family Violence Prevention Program and then to a Social Work

Specialist in the same program.

In 2009, after 14 years of service; James took an early retirement to

devote full-time care to

his mother who was diagnosed with dementia. He currently serves as a

member of the Healthy Families

Richmond Advisory Committee and volunteers his time and services to

the Richmond City Neighbor to

Neighbor Program, the Junior Achievement Program, his church, and

other community organizations.

James and his wife Dinah, who met in high school, have been married

for over 42 years. They

have three wonderful children; two wonderful daughter-in-laws and five

wonderful grandchildren.

About Tthe Author:

James Neville was born in Halifax County, North Carolina. He grew up in

Jersey City,

New Jersey, where he learned to cuss and fight just like some of the other

kids in his neighborhood.

However, he thanks God for His son, Jesus Christ, who delivered him out of

those conditions. He also

thanks his mother for praying for him and keeping him in line. .

James always had a thirst for knowledge.; hHowever, he did not let poverty

or the effects of an

absent father stop him from being successful. As a result, he successfully

completed 21 twenty-one years of service

in the U.S. Air Force and retired in 1993 as a Senior Master Sergeant.

After he left the military, James first worked as a substitute teacher

for Richmond Public Schools

before he was hired by the Richmond City Department of Social Services as a

Benefits Programs

Specialist. He was subsequently promoted twice during a seven-year period.

First, as a Case Manager

for the Family Violence Prevention Program and then to a Social Work Specialist

in the same program.

In 2009, after 14 fourteen years of service,; James took an early retirement

to devote full -time care to

his mother who was diagnosed with dementia. He currently serves as a

member of the Healthy Families Richmond Advisory Committee and volunteers

his time and services to the Richmond City Neighbor to Neighbor Program, the

Junior Achievement Program, his church, and other community organizations.

James and his wife, Dinah, who met in high school, have been married for

over 42 forty-two years. They have three wonderful children;, two wonderful

daughters-in-laws and five wonderful grandchildren.

Blurb:

The author shares his mother’'s story and the lessons he learned from her

transition through the different stages of dementia. By reflecting on his mother’'s

life and legacy from a Christian perspective, the author uses her story to illustrate

the different stages of dementia and the challenges he faced as a caregiver. With

goal of promoting awareness, the author discusses some of the new discoveries

regarding the causes and the risk factors associated with dementia and

Alzheimer’'s. He includes some helpful resource information; and he also

addresses some of the signs and symptoms of dementia and concludes that diet,

exercise, and other life-style changes can prevent or slow the progression of

dementia, especially in the areas of early detection and treatment.