By Nishi Pulugurtha
Amma was diagnosed with Alzheimer’s Disease in November 2010. She continued her usual activities for quite some time. There was always someone at home to see that she was alright. She enjoyed walking and took frequent walks in the compound under constant supervision, as she had the tendency to wander off. After walking for a while she would get indoors and again later would want to go out and walk. She enjoyed this activity immensely. When I shifted home, she missed the compound but walked a lot indoors. She went on walking, through this door and the next and the next. I am sure she was looking for something or someone. She did not seem to get tired. When she felt tired, she sat down for a while and then resumed her walking. During summers, the walking got lesser, the heat made it difficult for her to walk for long stretches of time. When I took her out for walks, she enjoyed it the way she always did.
On an afternoon in December 2014, I got a call from home telling me that Amma had a fall while walking in the house. I rushed home to see that she was sitting on the sofa, her usual smiling self. She had a cut on the back of the head and there was bleeding. The doctor came and had a look. He did suggest a CT scan, if possible, in case we noticed a change in her usual pattern of daily tasks. The wound on her head needed to be dressed. Amma seemed a bit calmer that day, but in a couple of days, she was back on her feet, walking the way she did. This fall perturbed me, it took me some time to realise that people with Alzheimer’s are prone to such falls. There was no recurrence of it for over a year.
In January 2016, once again I got a call telling me that Amma had fallen on the floor while walking about. The doctor read the signs narrated by the carers and corroborated the fact that she had a convulsion, the first one. As has been my practice, I turned to the one person whose practical advice on all matters on Azheimer’s Disease has been a great help, Nilanjana Maulik, the secretary of ARDSI Kolkata chapter. Nilanjana was abroad at the time, but she immediately replied to my Whatsapp messages telling me that convulsions were a common thing that could happen to people with Amma’s stage of Alzheimer’s. There was really nothing one could do; the convulsion had to pass; she was not to be moved till it was over. We needed to make sure she was comfortable the way she was and, most importantly, we needed to see that she did not hurt herself. That day, Amma, was not her usual self. She ate normally but it was evident that she was not feeling well. It took her a couple of days to become her normal self and the walking resumed. I did notice a change in her walking, too. She was not walking the way she used to. Her walking was much slower at times, at times the pace was as fast as it used to be earlier. It was clear that the progression of the disease was taking its toll on her.
A few months later, she had a fall again. She was walking and then the fall occured. Thankfully she did not hurt herself anywhere. However, I noticed that she had this tendency of not noticing things that came in the path of her walking. We had to make sure that nothing would come in her way when she walked. She did get up after a few attempts and then walked down a little before sitting down again. After each of these incidents, I noticed a physical change come over her. For a few days after the fall or the convulsion she would not get up and walk at all. It was difficult making her stand up. Then she would slowly start to get up and walk.
Last month, at around ten in the morning, Amma was walking about and then she just fell to the floor. I was home at the time. It was not a convulsion. She sat on the floor and had to be lifted up. Her vitals seemed alright. We made her sit on the sofa for a while; she ate a sweet and drank water after a little while. She wanted to sleep and after an hour or so, she got up feeling much better, I guess. There was a bruise on the back side of her left ear which healed in a couple of days. The doctor who keeps a check on her noticed her gait that day and said that it was similar to someone with Parkisnon’s. She bent down more, bent slightly to one side and, when she walked, she shuffled her steps and it seemed as if she would fall. Amma could now never be left alone. She had to have constant supervision. When she walks a little, a very wobbly, unsteady walk, there is an attendant by her side always. The walking has reduced a lot; it is just a small fraction of what she used to earlier.
Physical manifestations of Alzheimer’s were becoming more and more prominent in Amma. This was another difficult thing to deal, more so since Amma is completely quiet. There is no way one can know what is troubling her; we can only guess. When I cleaned the blood from her wound on the ear the day she fell, all she did was push my hand away. It hurt her but there was no cry of pain. Today I tried to walk her in the morning and found her very unsteady. She prefers to sit down most of the time. I realise that she does not feel fit enough to get up and walk. Just hoping that she continues the walk, maybe not the way she did it before, but a small, little walk, a few steps at a time.
Dr. Nishi Pulugurtha is Associate Professor, Department of English, Brahmananda Keshab Chandra College, Kolkata. She is an academic with varied interests and writes on travel, too. Twitter: @nishipulu
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