Alzheimer's Disease Must Not Define the Person We Love
My Dad with Nurse Mimi Hawkes, Beth Israel Hospital, Boston, 1987.
Definition of Alzheimer's Disease
Alzheimer’s was first identified by Dr. Alois Alzheimer in 1906, at a time when dementia was well known, but its causes were not easily pinpointed. He discovered what would be later referred to as the two hallmarks of the disease. The first hallmark is "plaques": multiple, tiny and dense protein deposits throughout the brain that in large levels become toxic. The second hallmark is “tangles” of the nerve cells, called neurofibrillary tangles, that interfere with vital processes, and eventually kill off living cells. When brain cells break down and die, brain scans have shown a noticeable "shrinkage" in some areas.
The result of this degeneration of the brain is dementia, and Alzheimer’s is the most common form.
Memory loss is easily the most common symptom of this disease. At the beginning, it is new information that is usually the type that suffers. Alzheimer’s degeneration usually occurs first in the part of the brain that affects learning. Newly learned information becomes difficult to retain whereas older, more ingrained memories are usually left intact. However, it is important to note that due to the progressive nature of the disease, in time, even older memories will likely begin to fade.
In the early stage of Alzheimer's, a person may function independently. He or she may still drive, work and be part of social activities. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects. Friends, family or others close to the individual notice difficulties.
At age 68 my father, Caperton Horsley, was still working full time, trying desperately to get some of his inventions developed and marketed. He was making presentations and meeting with executives from Exxon, General Motors, Union Carbide, and other companies. He was under tremendous stress and seemed justifiably frustrated. He would forget where he left things, and his secretary would remind him of many details.
Moderate Alzheimer's is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer's will require a greater level of care.
People with Alzheimer's will find that they are confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks.
By age 72, my father was still working and having some significant issues that the family wanted to ignore. On one occasion, he came home from work on the train, and reported his car stolen the next morning, only to find out that he had driven to work the day before and left the car at work. On another occasion, he got up at midnight, thinking it was noon and he was late for work. He stopped a local police officer to inquire why it was so dark! The officer advised him that it was the middle of the night and he went home. He continued to hold his job.
At age 74, it became impossible for him to remember tasks and details needed for work. He poured over his files repeatedly but could not produce a report. He was frustrated, depressed and frightened when he retired,
My mother was extremely protective of my father and supportive at the same time. No one could mention the word dementia, much less Alzheimer’s. He was having “memory issues and a bit of confusion.” They were a devoted couple and assisted each other as best they could. Once he was no longer able to drive a car they were confined to an apartment. Over the next several years the two spent their waking hours reading to each other and watching television. He could walk to the corner store and back, take care of his personal hygiene and other simple tasks.
Eventually, at the age of 83, a bout of pneumonia put my father in the hospital. It was downhill from there on. The nurses at Boston’s Beth Israel Hospital were extremely compassionate, allowing him to get dressed including his customary jacket and tie. He was allowed to walk within the hospital. The nurses put a large sign on the back of his sports jacket that read, “Return to 7th Floor. Do not allow to leave building.” He stayed up late at night visiting the nurses in the nurses’ station where he sang to them and recited poetry that he could remember.
In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive help with daily activities.
After six weeks at Beth Israel Hospital, my father was discharged to a nursing home, where he was extremely confused and became almost mute. Within two weeks, he had fallen down a flight of steps and was returned to another hospital. By then, he was in the final stage of this cruel disease. He still recognized my mother, but had difficulty communicating, was very noisy and had to be restrained. He remained in this condition for four months until his death.
More than just “a victim of Alzheimer’s Disease”
Born in 1903, my father, Caperton Braxton Horsley, was the third of eight children. His father was a well-known physician in Richmond, Virginia, and the family led a very comfortable life. By age 7, my dad was writing cursive, learning German, and excelling in all subjects.
He went on to make his career as an entrepreneur. He held more than 40 patents on inventions he had designed. His expertise was first in X-ray development and then in the field of sound. His failure was in finances. His mother-in-law referred to him as “a mechanical genius and a fiscal idiot." Financial difficulties plagued him throughout his life. He was always “this close” to coming into a million dollars.
My Father's Inventions
One of his inventions was a particle collection device for industrial smoke stacks. He was passionate about the problem of air-pollution and had written about the dangers of “acid rain” and air pollution as early as 1933. General Motors was interested in his dust collecting device in the early 1960’s. GM had foundries in which cast iron engine blocks are poured. The hot metal is produced in cupola melting furnaces. The cupola, in the form of a vertical stack, is efficient. It is continuously charged from on top and periodically tapped from the bottom. But it produces large amounts of metal, coke, and metal oxide dusts which are discharged into the atmosphere after passing through mechanical dust collecting devices. The particulate above a certain size was trapped. But the fine dusts would escape and their amount was intolerable.
General Motors was interested in the design that employed sound energy to separate the fine dust from the clean air in which it was entrained. You might liken it to a home washing machine with its reciprocating agitator to separate the soil from the clean clothes. My father called his device an Alternating Velocity Precipitator, or an AVP. General Motors was interested enough to move the AVP to the GM foundry in Buffalo for testing. There, piping was installed to divert suitable flow of dirty cupola exhaust from the large dust particles that had already been removed. This ran to the AVP for precipitation and then discharge. The inlet and outlet streams were instrumental to measure dust discharge. Instruments are cruel and on this day, they showed insufficient dust reduction. The foundry manager thought that further improvements were called for. The AVP did not make it. There was never quite enough funding to get his inventions to market, even though there was significant interest in his concepts and designs. The GM Senior Engineer of Manufacturing Development in Warren, Michigan, Dr. Isadore Hodes, wrote “I always felt some part of the aura which he [Caperton] exuberantly radiated. I admired his manner and views from the first day we met in the GM building. All that came after only strengthened my opinion of him. I remember well the wintry day on the steel platform at the Tonawanda foundry. How fair a trial did the AVP get? I am troubled by this and other similar questions about several different projects that I had part in.” Life, indeed is not always fair.
My dad was a devoted husband and father to his five children. Somehow, he managed to navigate through a remarkable life, full of adversities and achievements. Sadly, very near the end of his life he looked into my mother’s eyes and asked, “Did I ever do anything important?” I would find it difficult to know where to begin to list the “important” things this brilliant man accomplished in his 84 years of life.
Poem for a Red-Haired Wife
By Caperton Horsley
There is no new
There is no old
There is only what there is.
It is for the magic eye to see
I have not been there, but I remember.
Faces are the things behind windows that look out,
Like the girl with the red hair and flowers