6 out of 11 Signs Your Parent May Be Ready for Assisted Living
You can gather valuable information by looking for these clues

The decision to help an aging adult move out of a current home is a complex one — both emotionally and practically. Above all, you want your mother or father or another loved one to be safe and well. How can you feel more confident about whether circumstances suggest that he or she should no longer be living alone?

Finding lots of mail scattered around raises concern about how bills, insurance and other matters are being managed.

Although every situation is different, looking at the following 11 signs will give you valuable information to help make the decision:

1. Big-Picture Signs
Keep the big red flags in mind. Certain situations make it more obvious that it’s wise to start thinking about alternate living arrangements.

Look for:
Recent accidents or close calls  Did your loved one take a fall, have a medical scare or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.

A slow recovery  How did the person weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter’s cold develop into untreated bronchitis?

A chronic health condition that’s worsening  Progressive problems such as COPD, dementia and congestive heart failure can decline gradually or precipitously, but either way, their presence means your loved one will increasingly need help.

Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs)  ADLs and IADLs are the skills needed to live independently — dressing, shopping, cooking, doing laundry, managing medications and so on. Doctors, social workers and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert’s view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.

2. Up-Close Signs

Give your loved one a big hug. Clues aren’t always visible from a distance; especially when you don’t see the person every day, you might learn more through touch.

Look for:

Noticeable weight loss  Does the person feel thinner? Are clothes loose or has he added notches to his belt? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight; check the fridge and watch meal-prep skills.

Seeming more frail  Do you feel anything “different” about the person’s strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.

Noticeable weight gain  Common causes include an injury slowing the person down, diabetes and dementia (when someone doesn’t remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.

Strange body odor  Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.

Changes in appearance  Does the person’s hair and makeup look all right? Are clothes clean? Someone known for crisply ironed shirts who’s now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).

3. Social Signs
Think realistically about the person’s social connections. Social circles tend to shrink with age, which can have health and safety implications.

Look for:

Signs of active friendships  Does your loved one still get together for lunches or outings with friends or visits with neighbors or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or moved away, moving to a place where other people are around could be lifesaving.

Signs that your loved one has cut back on activities and interests  Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing interest in almost nothing is a red flag for depression.

Days spent without leaving the house This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being “locked away” in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.

Someone who checks in on a regular basis  If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system, a personal alarm system or a daily calling service?

A plan for a worst-case scenario  If there’s a fire, earthquake, flood or other disaster, is someone on standby to assist? Does your loved one understand the plan?

4. Money Signs
Riffle through the mail. Your loved one’s mail can offer an often-overlooked clue to how he or she is managing money, a common early warning sign of cognitive trouble.

Look for:

Snowdrifts of mail in various places  Finding lots of mail scattered around raises concern about how bills, insurance and other matters are being managed. (Piles of mail are also a potential tripping hazard.)

Unopened personal mail  Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.

Unopened bills  This can indicate that your loved one is having difficulty managing finances — one of the most common first signs of dementia.

Letters from banks, creditors or insurers  Routine business letters aren’t worrisome. But it’s alarming if letters are referring to overdue payments, overdrawn balances, recent accidents or other concerning events.

Thank-you messages from charities  Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they’re having trouble with thinking skills (a common sign of Alzheimer’s disease). Some so-called charities are bogus; other legitimate charities hit up givers over and over, and your loved one may not remember having donating the first time.

Lots of crisp, unread magazines  The person may unknowingly have repeat-renewal subscriptions he or she doesn’t need.

5. Driving Signs
Take a drive — with your loved one behind the wheel, if he or she is still driving. Living independently in our culture often depends on the ability to drive, or the arrangement of alternate transportation options.

Look for:

Nicks or dents on the car Notice the car body as you get in and out. Damage marks can be signs of careless or poor driving.

Whether the person promptly fastens his or her seatbelt  Even people with mild dementia usually follow the rote basics of driving. It’s worrisome if he or she is forgetting this step.

Tension, preoccupation or being easily distracted  The person may be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain — a safe kind of self-policing but also signals of changing ability.

Signs of dangerous driving  People whose driving ability is impaired are more likely to tailgate, drift from their lane, go below the speed limit, react slowly to lights or other cars and mix up gas and brake pedals.

Warning lights  Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze and windshield-wiper fluid?

6. Kitchen Signs
Go through the kitchen, from fridge to cupboards to oven. Because people spend so much time in this room, you can learn a lot.

Look for:

Stale or expired foods  We all buy more than we need. Look for signs that food is not only old but that this is unnoticed — mold, sour milk that’s still used or expiration dates well past due, for example.

Multiples of the same item Ten bottles of ketchup? More cereal than can be eaten in a year? Multiples often reveal that the shopper can’t remember from one store trip to the next what’s in stock at home.

A freezer full of TV dinners  They might have been bought for convenience, but frozen dinners tend not to make for a healthy diet. If there’s not much fresh food in the house (because it’s too hard to for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.

Broken appliances  Check them all: microwave, coffeemaker, toaster, washer, and dryer — any device you know your loved one uses (or used to use) routinely.

Signs of fire  Are stove knobs charred? Pot bottoms singed badly (or thrown out)? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled or boxes of baking soda near the stove. Accidents happen; ask for the story behind what you see. Accidental fires are a common home danger for older adults.

Increased use of takeout or simpler cooking  A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.

Copyright Caring.com, 2013

Reprinted from: http://www.nextavenue.org/11-signs-might-time-assisted-living/ Article: 11 Signs Your Parent May Be Ready for Assisted Living  by Paula Spencer Scott; July 11, 2016; published on Caring.com

This is the first of 2 segments posted

Reprinted from: http://www.nytimes.com/interactive/2016/05/01/nyregion/living-with-alzheimers.html?_r=0

FRAYING AT THE EDGES Part 5
By N. R. KLEINFIELD

THE CARINGKIND ORGANIZATION is housed in one of those muscular office towers that jut up on Lexington Avenue in Midtown Manhattan. It is where people faced with Alzheimer’s can go for help. About 15,000 or so a year seek something from it.

They make up a sliver of the roughly 250,000 people living in New York City who the group thinks have Alzheimer’s (factor in caregivers and close relatives and the number touched by the disease soars). Many of them throw up their hands, think there is nothing to do. Many deny. Their families deny. They wait too long to find out why their brains aren’t working correctly.

Lou-Ellen Barkan, the chief executive of the group (at the time, it was a chapter of the Alzheimer’s Association but later separated), saw this with her own father. He had some odd symptoms, but he was also odd. What prompted the family to get him to a doctor was when they thumbed through his checkbook, often a giveaway. He hadn’t balanced it in months. He had written checks to charities he had never supported, for instance the Mouth and Foot Painting Artists.

When she mulled over whether the organization had something for her, Geri Taylor was reluctant to visit. She pictured the place as a resource for those sunk much deeper into the disease’s darkening world, that it was too early for her.

Still, one sun-smacked day in March 2014, she went to have a look. Once she mingled a bit, she knew she had been dead wrong. She was not early. She was right on time. In a city of so many, she knew these people; they were alike, all walking in the shadow of Alzheimer’s. “I thought these were my people,” she said. “This is where I belong.”

So she dived in and enrolled in some programs. Discover New York. A photography workshop. And she signed on for one of the continuing Memory Works groups that engaged in mind exercises for those in the early stage of Alzheimer’s. At first, Ms. Taylor was skeptical. She knew all about the memory games that some experts promote to resharpen balky minds, yet the research she had read frowned on their effectiveness. Her own feeling was that they were annoying and pointless.

Yet she gave Memory Works a shot. Surprisingly, she liked it, liked the companionable people, liked the exercises. She became known as the perky one. The moderator was upfront that the games would not cure them or forestall their decline. They were there to have fun. One of them was a marvelous whistler who entertained them while they waited to begin. So every Thursday at 11 a.m. she came, sat among the eight and participated in the swell of games for the hour and a half.

Name words starting with the letter B.

Name foods starting with the letter M.

The best part was not having to mask her shortcomings, audition for acceptance. In the outside world that was increasingly foreign and fearsome, the pages seemed to turn too fast, and it was a constant struggle to keep up. “People say: ‘What do you mean? There’s nothing wrong with you,’” she would explain. “But I’m always hiding things.”

Outside, people with Alzheimer’s were looked on as broken. In the groups inside these walls, though, everyone had it. Alzheimer’s was normal. In Memory Works, she felt protected. Unhampered. One of the others called it a “safe place,” and that felt right to her. “There is nothing like being different with your own people,” is how she would put it.

More than anything, people with leaky memories came to this sanctuary to find affirmation that they were still a presence in the world, that they were still valid. Ms. Taylor found renewed meaning by being among others like herself.

As Thursdays swept by, the sessions became amazing. Not the games and whether they did any tangible good. But the chumminess and the vibe among these strangers all hijacked by a ghastly disease — the retired software developer and the former lawyer and the bridge writer. They egged one another on. Joked around. It seemed inconceivable, but Ms. Taylor had never belonged to a group that was so much fun.

“It’s like a party,” she would tell others. “Everyone’s laughing. And everyone is happy they are with people just like them who can’t get the words out and can’t find the bus pass.”

Sitting there in the bubbly ambience, she would sometimes think, We shouldn’t be this happy.

It was as if they were all high. High on Alzheimer’s.

Reprinted from: http://www.nytimes.com/interactive/2016/05/01/nyregion/living-with-alzheimers.html?_r=0

FRAYING AT THE EDGES Part 4
By N. R. KLEINFIELD

OTHERS COULD HARDLY see it. She knew better. She was slipping, the disease whittling away at her, leaving her less completely who she was. Certain words became irretrievable, sentences coiled inside her mind and refused to come out, belongings vanished: keys, glasses, earrings. She lost things and then forgot what she had lost. Or that she had lost them.

After returning from a trip, she stowed her suitcase in the closet, still bulging with clothes. Weeks went by. She didn’t miss the items. Then she couldn’t find her glasses. Well, maybe they were in the suitcase. She unzipped it and discovered all of these clothes wedged in there. Hmm.

A fraying at the edges of her life.

“I know the tide is going out on my memory,” she would say.

She had trouble with elapsed time. It was getting impossible for her to distinguish between the past, the present and the future. Blots of time melded together. She seemed forever in the present, as if her life was one jumbled moment — breakfast, shower, lunch, dinner, movie, shopping, everything conflated together and happening right now. It was as if, without even trying, she had become a Buddhist.

“I have no clock in my head anymore,” is how she put it. “The concept of how long it takes to do something has been lost. What an hour feels like is gone. It’s morning and then afternoon, and I think the morning was yesterday. With time, it’s always just the present. If you ask me what I’m doing at 3 p.m., I just have to make it up.”

If she had seen someone that morning, by afternoon she would wonder if it had happened some other day. “I could be talking to you and I could have been shopping, and I won’t be sure if I did that this day,” she said. “Like right now I can’t reconstruct yesterday except that the air-conditioner sounded like it was about to blow up. Because my life was about to end. I’m not able to remember what happened earlier. And I’m not thinking about what will happen next. Because I don’t know.”

She knitted her brow. “The time thing is the part where I feel most alien from myself and alien from other people,” she said. “Sometimes I feel like I’m some sort of loose atom bouncing around. Like I’m not doing anything, because I’m floating from thing to thing and then I don’t remember that I did something. And you’ll say, ‘Well, write it down.’ But then I’ll look at the piece of paper and wonder, What is that?”

To untangle the confusions in the infrastructure of her life, she claimed small victories however she could, savoring them. “I’ve been washing the sheets and towels more often because I’m not sure when I last washed them,” she said. “I forget how much food we have. I check more often. I know Jim is monitoring the food much more.”

Her organizational tool had been her mind. But now her mind was a mess, as if a windstorm had upended its contents. “I always remembered phone numbers, addresses, how much people paid for their house,” she said. “I’ve lost all that.”

She knew how to live with a good memory. Who knew how to live without one?

Her new best friend was her iPhone. She fished it out maybe 20 times a day and scrolled through the blocked-off calendar and notes to herself, the lumber of dates and names that never seemed heavier. Have to be where? When? Do what? Call whom? She used the camera to snap pictures of places to remember them. This was a big improvement over the Alzheimer’s experience of her father, who came home several times in a police car.

To navigate day-to-day minefields, she improvised tricks. “I came up the elevator the other day and saw two of the neighbors and I couldn’t remember their names,” she said. “I forgot the whole floor — 14 names — of my apartment building. I thought I better figure out something. So last week I came up with this system. I’ve got everyone associated with someone in my family. And I’ve been practicing. Eric, the next-door neighbor. His name begins with the same letter as my father. Joe is my stepfather. And so on. It’s not foolproof. But it helps.”

Reprinted from: http://www.nytimes.com/interactive/2016/05/01/nyregion/living-with-alzheimers.html?_r=0

FRAYING AT THE EDGES Part 3
By N. R. KLEINFIELD

HIS MOOD IMPROVED, Mr. Taylor drew up an Alzheimer’s to-do list, a way to get things started. This was it:

What tell kids; when; grandkids?

How long keep 2 homes?

Advancing care need?

Revise will

End-of-life decisions

Home care ALZ assistance

Where ALZ units?

They began to sort through it. Would they need a two-bedroom apartment, for when they required live-in help? And to accommodate the fact that people with Alzheimer’s sometimes stay up all night? Should they keep both the apartment and the house? Could they carve out a second bedroom in the L of the living room? They toured an apartment upstairs where that had been done.

They decided to stay put and alter the apartment when necessary.

They were comfortable financially, but the disease can rapidly devour resources toward the end. Ms. Taylor didn’t want to be institutionalized but knew it could happen. In time, they would revise their wills, shielding some assets for their children.

What about telling others? Ms. Taylor had been seeing a therapist, for help decelerating into a jobless life. At one session, she mentioned her Alzheimer’s. The therapist said unequivocally: Tell no one. Friends will fall away from you. Stamp you off-limits. This got Ms. Taylor’s hackles up. It was as if there were something illicit about contracting Alzheimer’s. She dropped the therapist.

The Taylors hated the stealth that encased the disease, how it was treated like an unmentionable cousin. They wanted no part of that. Ms. Taylor decided that she would not show herself as some spackled-over person. “It was my decision to let the disease be alive in my life,” she said. “You don’t have to just throw in the towel.”

She didn’t know the order of whom she would tell, nor how to phrase something so shackled with frightful connotations. Your life becomes a script. Alzheimer’s, she knew, leaves its heavy imprint on everyone.

“I don’t care about what they think of me,” she said. To her, Alzheimer’s was another fact of human life. But she worried about what the news might do to them, caught as they would be in the disease’s undertow. That was her nurse empathy kicking in. And she fretted about how others would view her husband. Would they scratch him off the list for social activities, knowing that, well, with his wife the way she was, they were no longer the same couple, no longer a good fit? She didn’t want him wearing the stigma, too.

They waited six months. She wanted time to try on her new life, acquaint herself with its personality, so she could share the news without an overflow of emotion.

She wanted it evident that she was “still steering the ship.”

Then, over the July 4 weekend in 2013, she told the children: her son from an earlier marriage and Mr. Taylor’s two daughters and son from his previous marriage. It was done systematically, child by child with their spouses or partners.

She intentionally told them each separately. “Every kid wants to feel that you have an individual relationship with them,” she explained. “If you sit them together, you’re treating them like a package of Chiclets. You deny them their individuality. They’re going to be reacting to their siblings and their sibling relationships. Dementia has an ugly picture. I wanted them each to have a chance to react on their own.”

It was tough news to hear. It was done tidily. They didn’t need much detail. It was difficult for her, for she knew she was giving them pain.

There were Mr. Taylor’s three children: Mark Taylor, a civil rights lawyer, who lived in Brooklyn with his wife and young daughter; Amy Taylor, a nurse who resided in New Jersey; and Heidi Taylor, a sociology professor who lived in Maine with her two daughters. All had familiarity with the disease. Amy saw it in her work and Heidi in her research in medical sociology. After college, Mark had worked in a nursing home in Maine, and had seen it there.

Ms. Taylor’s son, Lloyd Widmer, a real estate appraiser who lived with his fiancée in Montgomery, N.Y., was not surprised. He had detected glitches in her memory and would tease her about them. Now that he knew their origin, he wasn’t going to back off. He was a verbal person, and they had a talkative relationship. She would joke: “I think he’s been talking to me since before he was born. I heard this tapping sound.”

So he kept teasing her, even more than before, to the extent that his fiancée sometimes grew uncomfortable. Ms. Taylor didn’t mind. They were very close, had been since Mr. Widmer broke his hip in an accident when he was 21. For the first time, he didn’t feel invincible, and it tightened his relationship with his mother.

She postponed informing the grandchildren and moved on to other relatives and close friends, steadily widening the circle. She wasn’t going to take out an ad, “Geri Taylor gets Alzheimer’s,” but she was going to be frank. Her therapist had said: Tell no one. She was going to tell everyone.

Some accepted the news unblinkingly, others quibbled, the glare of the truth too bright for them to stare at. Are you sure … You don’t seem … I didn’t notice. Some practically tried to talk her out of it. She had to argue her case, insist that she had something no one wants.

One friend got worked up, would call her and say, “I’m just so upset and you must be so devastated.”

That stung. Well, thanks for bringing that up, she would think.

Then tell herself: Yes, there are many layers to this. But it’s not all devastating.

A good friend, swept up in concern, combed the Internet for solutions and zeroed in on coconut oil. Some research suggests it may improve cognitive function. A doctor wrote a book about it. She mentioned it to Ms. Taylor.

Considering herself a “medical rules snob,” Ms. Taylor is scornful of charlatan cures and magical thinking. Yet she knew coconut oil was innocuous enough. Out of respect for her friend’s kind intentions, she began drinking it. “At my age, what harm could it do to my system?” she wondered. “It’s good for nails, good for the skin.” She drank it for a few weeks, detecting no benefit, then forgot about it and moved on.

One thing she had noticed during her confession tour left her with a sunken feeling. Some of her friends showed early symptoms. They’re on the path, she thought.

Reprinted from: http://www.nytimes.com/interactive/2016/05/01/nyregion/living-with-alzheimers.html?_r=0

FRAYING AT THE EDGES Part 2
By N. R. KLEINFIELD

HER HUSBAND couldn’t adjust, as if he had stumbled into the wrong life. He wouldn’t meet her eyes. He drew away, sulky, making her feel disowned.

As he would describe it: “I did the usual man thing and went into my cave. Became uncommunicative for two weeks. I thought, this was not what I signed on for. I had married a nurse to take care of me. How’s that for being supportive?”

Two years younger than his wife, Mr. Taylor is a lanky, warm-voiced man with a narrow face and cap of precisely combed snow-white hair.

To unfreeze the chill between them, it took a pep talk that put the present in softer perspective. They sat down and Ms. Taylor said straight off, “This is something that is going to develop, but it hasn’t developed yet.” Just saying that helped.

Yes, something big had happened. She was what she was. Yet they were still alive. Still together, with more mileage in their future. So they moved forward in the first days of their reordered lives.

Not only was her memory leaving her. Many think of Alzheimer’s as a memory disease, but its awful mysteries involve more than that. When she gave the doctor examples of her symptoms, he replied, “That’s not memory; that’s executive function.” In effect, you lose the sequence of steps in a process. Like a man who begins shaving while neglecting to use shaving cream.

She couldn’t know the speed of her decline. It is different with everyone, until the disease realizes its ultimate purpose. The impact, she had learned, in part appears determined by the amount of cognitive reserve, the mental capabilities of the brain that accumulate over a lifetime and are related to intelligence and stimulation. She felt she had plenty of that — at least she hoped so.

Her doctor put her on Aricept, a drug designed to improve cognitive performance. It seemed to sharpen her thinking, especially in the morning, but she couldn’t really gauge how much good it did. There were some side effects. She abandoned drinking when she kept getting nauseated. She was never a big drinker, but, as she put it, “I liked to party.”

Fully aware that an earthquake had occurred in her life, she knew this disease was bottomless in its unhappiness if you let it take you there. Yet her belief system was optimism. She never cried. Depression, she knew, would lead her down alleys she didn’t want to visit and held nothing for her. (“I can think of 10 things that would get me more upset. My son could get hurt. My sister could.”) Instead, the disease made her hungry for living.

“I don’t have very typical reactions,” she explained. “There was actually a sense of relief because of doing something about it. I intellectualize things, so it gave me a false sense of control. I knew I had a tremendous amount of family and friend support. I knew my husband doesn’t run away from things.”

She vowed to plunge ahead and accelerate her longtime interest in photography. See friends more. Mr. Taylor had his Friday morning foreign affairs group at the Jewish Community Center but planned to indulge his interest in acting before he would be conscripted into doing more and more for his wife. He signed up for some acting lessons. Doing these things, they felt, would make the disease more coherent in their lives. Somehow they aimed to live the most fulfilling days they could at what seemed the bleakest possible time.

What It's Like to Live With Early Alzheimer's Part 1

Reprinted from: http://www.nytimes.com/interactive/2016/05/01/nyregion/living-with-alzheimers.html?_r=0

FRAYING AT THE EDGES
By N. R. KLEINFIELD

A withered person with a scrambled mind, memories sealed away: That is the familiar face of Alzheimer’s. But there is also the waiting period, which Geri Taylor has been navigating with prudence, grace and hope.

A LIFE-CHANGING DIAGNOSIS

IT BEGAN WITH what she saw in the bathroom mirror. On a dull morning, Geri Taylor padded into the shiny bathroom of her Manhattan apartment. She casually checked her reflection in the mirror, doing her daily inventory. Immediately, she stiffened with fright.

Huh? What?

She didn’t recognize herself.

She gazed saucer-eyed at her image, thinking: Oh, is this what I look like? No, that’s not me. Who’s that in my mirror?

This was in late 2012. She was 69, in her early months getting familiar with retirement. For some time she had experienced the sensation of clouds coming over her, mantling thought. There had been a few hiccups at her job. She had been a nurse who climbed the rungs to health care executive. Once, she was leading a staff meeting when she had no idea what she was talking about, her mind like a stalled engine that wouldn’t turn over.

“Fortunately I was the boss and I just said, ‘Enough of that; Sally, tell me what you’re up to,’” she would say of the episode.

Certain mundane tasks stumped her. She told her husband, Jim Taylor, that the blind in the bedroom was broken. He showed her she was pulling the wrong cord. Kept happening. Finally, nothing else working, he scribbled on the adjacent wall which cord was which.

Then there was the day she got off the subway at 14th Street and Seventh Avenue unable to figure out why she was there.

So, yes, she had had inklings that something was going wrong with her mind. She held tight to these thoughts. She even hid her suspicions from Mr. Taylor, who chalked up her thinning memory to the infirmities of age. “I thought she was getting like me,” he said. “I had been forgetful for 10 years.”

But to not recognize her own face! To Ms. Taylor, this was the “drop-dead moment” when she had to accept a terrible truth. She wasn’t just seeing the twitches of aging but the early fumes of the disease.

She had no further issues with mirrors, but there was no ignoring that something important had happened. She confided her fears to her husband and made an appointment with a neurologist. “Before then I thought I could fake it,” she would explain. “This convinced me I had to come clean.”

In November 2012, she saw the neurologist who was treating her migraines. He listened to her symptoms, took blood, gave her the Mini Mental State Examination, a standard cognitive test made up of a set of unremarkable questions and commands. (For instance, she was asked to count backward from 100 in intervals of seven; she had to say the phrase: “No ifs, ands or buts”; she was told to pick up a piece of paper, fold it in half and place it on the floor beside her.)

He told her three common words, said he was going to ask her them in a little bit. He emphasized this by pointing a finger at his head — remember those words. That simple. Yet when he called for them, she knew only one: beach. In her mind, she would go on to associate it with the doctor, thinking of him as Dr. Beach.

He gave a diagnosis of mild cognitive impairment, a common precursor to Alzheimer’s disease. The first label put on what she had. Even then, she understood it was the footfall of what would come. Alzheimer’s had struck her father, a paternal aunt and a cousin. She long suspected it would eventually find her.

Every 67 seconds, with monotonous cruelty, Alzheimer’s takes up residence in another American. Degenerative and incurable, it is democratic in its reach. People live with it about eight to 10 years on average, though some people last for 20 years. More than five million Americans are believed to have it, two-thirds of them women, and now Ms. Taylor would join them.

The disease, with its thundering implications, moves in worsening stages to its ungraspable end. That is the familiar face of Alzheimer’s, the withered person with the scrambled mind marooned in a nursing home, memories sealed away, aspirations for the future discontinued. But there is also the beginning, the waiting period.

That was Geri Taylor. Waiting.

Right now, she remained energized, in control of her life, the silent attack on her brain not yet in full force. But what about next week? Next month? Next year? The disease would be there then. And the year after. And forever. It has no easy parts. It nicks away at you, its progress messy and unpredictable.

“The beginning is like purgatory,” she said one day. “It’s kind of a grace period. You’re waiting for something. Something you don’t want to come. It’s like a before-hell purgatory.”

Ms. Taylor is an effervescent woman, with a round face and a froth of swirling hair. Well spoken and ruminative, she evinces a nimble wit and a droll manner. She is 72. She and her husband, also retired, live near Lincoln Center, and they keep a weekend place in Sherman, Conn.

In her health care career, she had seen Alzheimer’s in action. Now she would live it, in high resolution. Those who learn they have the disease often sink into a piercing black grief, try to camouflage their symptoms from a dismissive world as they backpedal from life. Ms. Taylor was wired to absorb adversity, and she pictured Alzheimer’s differently, with gumption and defiance and through a dispassionate, unblinking lens.

As she crossed the pitted terrain of Alzheimer’s, she would find surprises. Disturbing ones and ironic ones, but also uplifting ones. Many days she would not only experience wells of frustration, but also discover wisps of joy. The disease, her new invisible companion, was much larger than she was, and she would have to live submerged in its shell. It made her question her purpose and hunt for possibility.

Her career was concluded. Mortality was pressing in. Was she simply a woman with Alzheimer’s, limited to backward glances, or could this be a new beginning?

Mother's Day & Alzheimer's

Mother's Day is an opportunity to reflect on the special women who've made an impact on our lives. And with more than 3 million mothers, grandmothers, daughters and sisters in the United States living with Alzheimer's, fighting this disease has never been more important. Today, we invite you to watch our new Mother's Day video series, featuring women in the early stage of Alzheimer's disease talking with their daughters. The videos shed light on the impact of Alzheimer's on the mother-daughter relationship.  With the Alzheimer's epidemic on the rise, it's crucial that we continue creating awareness about the day-to-day effects of this disease. Together, we can get closer every day to our vision of a world without Alzheimer's disease.  Sincerely,

Donna McCullough Chief Development Officer To See the videos please paste the link into your browser from below: http://blog.alz.org/mothers-daughters-and-alzheimers/ Thank you the Alzheimer's association for this blog