[Granville-Hough] 17 Sep 2009 - 1995 - Pre-Alzheimer's Indications

[Trustees for Granville W. Hough]

     I do not recall the year in which this was written, but it seems to 
have been before 1995.  I cannot recall that Palm Terrace, a nursing 
home, paid any attention, and I do not recall any reply.  Carol 
eventually became unmanageable at Palm Terrace and had to be taken to a 
Psychiatric Hospital.  In retrospect, it appears that her first stroke 
began the progression toward Alzheimer's.   Note how minor annoyances 
can become major issues for such patients. (It appears statistically 
that people who are slightly more likely to develop Alzheimer's are 
those who have had several strokes, or who have had repeated head 
injuries (football players), those who have had car accidents or hard 
falls with head injuries, etc.)

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Regarding Carol L. Hough, Room 29A, Palm Terrace

    My wife, Carol L. Hough, did have a second stroke on Friday, 23 
July, according to the neurologists who examined her brain scan.  I was 
with her from about 10 am Friday until 10 pm (a week later); and she was 
able to tell me, over and over, what her likes and dislikes were about 
her treatment.

    She likes the food, except for the flavored or spiced soup and salty 
crackers.  She particularly likes egg custard, ice cream, cranberry 
juice, whole milk, and meat.

    She likes the physical therapy exercises which help her learn to 
walk, stand, and do things for herself.  She speaks very favorably of 
the physical therapists who help her, stating they are careful not to 
hurt her arthritic joints.

    There are some things which bother her, build up her resentment, or 
just make her plain mad.  These may not be the cause of her strokes, but 
they do not help.  A stroke seems to be a buildup of tension which 
finally explodes.  I believe the following can be accommodated within 
your policy of adapting to the individual needs of patients as much as 
you can.

    1. She habitually wakes up at daylight and has a cup of hot instant 
coffee with a small amount of food.  I believe you can arrange for that, 
and I have provided soft cookies which she likes in her food basket.  
(She was angry on Friday because no one would get her hot coffee, 
insisting that she wait an hour or two for the breakfast tray.  That 
kind of delay and annoyance to her may trigger a migrane attack.)

    2. She does not want to be restrained by a posey or by anything 
around her waist.  She withdraws her permission for restraints to be 
used.  (These restraints either press against her stomach when it is 
full or they are too warm.)

    3.  She is partially blind from her two strokes, and she likes to 
have things placed where she can feel them.  She can feed herself, and 
my observation is that she is probably using her side vision as she 
works on her food.  She does have difficulty removing lids from food 
containers and cutting up her food.

    4.  For years, we have been careful about bright lights or suddenly 
turning on bright lights.  These, and flashes of light or flickering 
light, as from a TV, can trigger a migrane attack.  She prefers a 
darkened room when the sun is bright.

    5.  She is annoyed by the use of familiar terms such as 
"sweetheart," "darling," or "sweetie."  She wants to be addressed as 
Mrs. HOUGH, which is phonetically "HUFF."  That has been her title since 
1947, and she does not want it changed.  She said she did not mind the 
term, "Yes, M'am," as she felt she was old and grayheaded enough to 
deserve it.

    6. She is annoyed by doctors and nurses stating her ice pack aids to 
controlling arthritis and headache pain are no help.  She knows that 
arthritic joints of the neck, elbow, back, and hands become inflamed, 
swollen, and hot to the touch.  The ice pack brings the swelling down 
and gives her relief.  It also works for strained and taut neck muscles 
which come with a migrane attack.  She cannot understand why doctors 
want to give her some exotic drug when she knows a simpler solution.  
This has always made sense to me.  Her ice packs are in her room and 
available to be used.  One gel pack can be used while the other is in a 
freezer.  

    I believe you can accommodate Carol's needs as listed above.  If 
doing so will help her avoid another stroke, they will be worth the trouble.



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Barbara Roesch, retired health administrator, has kindly pointed out to 
me that the medical terms for the openings for the left or right nostril 
are called the left or right naris, and that the plural is nares.  Thank 
you, Barbara.  Cathy Ballard has given me the correct spelling of the 
name of the animal with the crinkly nose which has invaded Mississippi 
from Mexico as coatimundi, or coati for short.  Thank you, Cathy.