Day Five!

Today is a special day for me as the fifth of December as it is St. Nikolas Day tomorrow. Spending a large part of my childhood in Germany, we celebrated this child celebration. (St. Nikolaus explained). Placing our shoes outside the door at night on the 5th, and in the morning, if "good" a toy and goodies would fill the shoes. If not "good", coal.

The holidays, birthdays, graduations, bring loved ones together in celebration. Often, after an Alzheimer's diagnosis, we may think their is limited comprehension (and yes, with moderate to severe there can be) and celebrations are not needed. In celebration of this small holiday of St. Nikolaus, I would like to tell a story.

My Patient

I had a patient, in her 80s, with severe Alzheimer's diagnosis. Toward the end of life she had muscular atrophy, was not communicative for four months, and unable to take care of her own daily needs. Her diet was adjusted for aspirating and she adored, I mean adored! chocolate milkshakes, with a whole heaping topping of whipped cream. I would like to add that she was a devout Catholic and I asked caregivers to play Catholic chants daily and for the priest to come often praying the rosary. She was as devout as ever even with advanced Alzheimer's.

Toward the end of life, given her signs, we knew her time was near. We were able to sit her in a wheelchair and she loved to stare at photographs from her life. On this particular afternoon the priest came to perform what I knew as the Last Rites. She was in a wheelchair and her family was on an iPad face-timing to witness the priest performing this Catholic ritual. The the priest began blessing her with oils and saying prayers and then he asked her if she would like to say the Lord's prayer. Now, remember, she had not spoken for months and only communicated with her eyes. She was also leaning back in the wheelchair fairly quiet observing... then something completely unexpected and wonderful, perhaps a miracle, occurred.

When we began reciting the lord's prayer, my sweet patient, sat straight in her wheelchair upright and began clearly, confidently, conveying the Lord's prayer with all the emotion and power behind those words. There was not a dry eye in the room, including myself. During that entire ritual and prayer I had been holding her hand, and I would like to say, I felt her vibrance and energy and life moving through me and swirling around me, and I knew I was in the presence of beauty.

This event is not singular to my patient. Often, at end stage, there is clarity and lucidity. All my patients toward the end of their life wanted to convey to me the only thing in life that mattered, was love. There were no other words of wisdom other than love.

Love.

After the Catholic ritual, my patient passed away on Christmas Day morning. I had a feeling that I should stay home instead of visiting my family and was called at 7:00 AM to come be by her side. I thought it such a blessing for her that she would pass away on one of the favorite days of the year for her the Lord's passing.

My point of sharing this story is to remind you to fully engage and listen, quietly with no cell phone or computer or television or music distractions but really engage with your loved one that has Alzheimer's. Long term memory of their passions, their hobbies, their career, often stay with them and if you can bring forward the joys they held so closely in their heart, I think you too will find this beautiful connection.

If you celebrate Saint Nicholas day then I wish you a wonderful morning to tomorrow on December 6th and don't forget to put your shoes out.

So, for all of you caregivers out there, 50 million of you, I would like you to know that even without your shoes placed outside the door to night, I am sending you all the gifts of love and joy and peace for all you do.

Happy St. Nikolaus Tag!

Dr. Holzner

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