Expert: Paula Damgaard - 9/1/2008

Question
QUESTION: First let me say thank you for your website and the help you offer. Ii certainly is not easy to have a parent or love one with Alzheimer's.
I took my Mom to the doctor today as she caught a cold from my Dad (89 and blind)....my Mom has lost 12 pounds in the last 3 months and was dehydrated. She is now drinking more and eating a bit more....but today she I was told she is in or has congestive heart failure and we can not give her a water pill because she goes into a dehydrated state quickly.  Is there anything you can tell me about congestive heart failure and Alzheimer's?  My mom is 88, and weighs 84lbs....can hardly walk (fell last night)....sleeps most of the time...and complains she is so tired... Any help you can shed on this would be of great help.
To all those who have love ones going through this .... my heart goes out to you...
My best regards,
Linda Sullivan

ANSWER: Hi Linda, Not sure if you are asking if there is a connection between congestive heart failure (CHF) and Alzheimer's disease or if you are just asking about each?  So first I will say that there isn't really a connection between them, meaning that because you have AD doesn't mean that you will also have CHF.  But having said that, AD destroys the brain.  Your brain is what cause everything else in your body to work and do what it is supposed to do.  Usually patients with AD are very strong healthy individuals and as the disease progresses through the brain they start to lose their ability to do anything, the disease shuts down the body's mechanisms to tell it to do such things as eat and drink, go to the bathroom, get yourself dressed, pick up your feet and walk.  So it could cause someone who's heart is not exactly strong to have a back up in fluid cause the brain isn't telling the rest of the body what to do to get it to move.  

She probably is very tired.  The heart is trying to work to get her enough oxygen, but because there is a back up in fluid in her body, it has to work harder and it can't.  She isn't getting enough oxygen to the rest of her body and the extra fluid she has to carry around doesn't make it any easier.  

Or she could just be telling you that she is "tired" meaning she has had enough of this life.  Sometimes I think that AD patients know when they have had enough and tell us and that means that they don't want us trying to "fix" them.  This is a hard thing to accept but one that needs to be listened to.  If your mom could see herself as she is now, ten years ago, would she have wanted this?  I think not.  

Giving them quality of life is so much more important now than trying to make sure they have "quantity.  The end stages of this disease are not pretty and if there is anyway to avoid them I would strongly go with that.  Hope this answers your question.  Take care and know that I am with you!  This is a long crappy trail we have to travel, but making it as easy for them as possible is so much nicer in the long run.  Paula

---------- FOLLOW-UP ----------

QUESTION: Thanks so much for getting back to me on this.... I have been at my parents home for the past few days and it seems my mom is getting worse....she now can not walk at all and I noticed is having a hard time opening her mouth to speak if she speaks at all.... Is there some kind of muscle failure that happens in the end stages?  
Again, thank for doing what you do.
My best regards,
Linda

Answer
Dear Linda, As I mentioned before, the brain controls ALL aspects of our bodies, so as the disease progresses through the brain, it destroys all of the body's ability to do everything, walking, eating, thinking, breathing, heart beating, etc.  

It is a nasty disease and basically takes an adult from "adulthood" to "infantilism" over the course of it's path.  

Hope this helps.  Paula