Expert: Mary Gordon - 7/9/2006

Question
Dear Mary,

My mother is in the late stage of Alzheimers:  she can't walk or feed herself and talks less and less.  She's been in a nursing home since early this year, but she still seems to recognize me.  Recently, she has stopped opening her eyes.  When I ask her to look at me, she'll open them a crack and say she can't see me.  She has had glaucoma for many years, but it's been controlled by eye drops which she still takes.  I've requested an opthomalogical exam for her, but do you think it's possible that her mind no longer "understands" what she sees?

Thanks for your opinion.

Answer
First off Susan, I owe you a huge apology. I get a lot of junk mail and my husband recently changed the settings on our e-mail to screen out more, and the software decided all my allexperts questions were junk! I didn't realize that until today, so I am so, so sorry I didn't get back to you promptly.

It is possible she is losing the ability to recognize both people and objects - that is indeed part of the disease. And you are very wise to be asking the doctor about her vision, although...would you attempt to treat anything serious (i.e. requiring surgery?). You will have to wait for the results of the eye exam, but as you know, things like detached retinas can happen suddenly so something may well have happened. My grandmother had one detach while in Florida on holiday - it didn't hurt - she described it as a sudden black curtain coming down.

Another possibility has to do with the actual opening of her eyes - two things occur to me - perhaps she has just stopped understanding she has to open her eyes to see? Another is some loss of muscular control, along the same lines as the way they lose their ability to chew and swallow.

I'm actually surprised she can still answer questions and speak intelligibly at the stage she's at. My MIL lost her ability to make sense verbally about two years before she died - all you got was garble, and asking her questions (even yes or no questions) was dicey.

This is such a horrible disease. My mother in law used to look at us without a flicker of recognition towards the end - not sure which is worse - your mother knowing you but not opening her eyes, or opening her eyes and not knowing you.

I really feel for you - some of the worst of this stage is wanting to do something and feeling so helpless. You also have to live with such terrible uncertainty since you can't get definitive answers from anyone, and you fear the person is suffering unnecessarily.

She's lucky to have concerned loving family by her side looking out for her.

I apologise again for the lateness of this response.

Mary G.