Watching Alzheimer’s steal away a loved one is always painful, but there are additional challenges when you’re living on a farm.
Trent, a grain farmer from east-central Alberta, knows this all too well. He farmed with his father, now in his late 70s, until five years ago.
“I knew Dad was getting older and getting a bit more forgetful,” said Trent, who requested that neither his last name or his father’s name be published.
“The first clue to me was that he wanted a GPS. He had a cellphone that he struggled with and he wasn’t a technology guy. He just never embraced it.”
His father said he wanted to use the GPS when he was in the city, which seemed reasonable. But in reality, he was driving into the town where he was born and raised, but couldn’t remember how to get home. He often ended up in the next town, although he kept such incidences from his family.
“Looking back, I could see it coming on, but I didn’t realize it — I just thought it was old age and forgetfulness,” Trent said. “We worried a lot about his safety and the safety of others. Driving around not knowing where you are can’t be safe.”
There are higher risks associated with dementia in rural areas, said Arlene Huhn, client and program manager with the Alzheimer Society of Alberta and Northwest Territories.
“Take all the same things that urban people have to worry about, but put these worries in a rural environment and there’s just more to worry about,” she said.
People with dementia will often forget a step in a series of steps, and may stop doing one activity because they don’t know what the next step is.
“Since safety on farms is so important, if you miss one safety step, it could mean a difference of life or death,” said Huhn.
Operating equipment is an obvious risk, but there are others. Huhn knows of one case where the father would sit awake at night with a gun — convinced that there were things out on his land that threatened his family.
Trent’s father had some vision problems so wasn’t running large equipment. As his Alzheimer’s progressed, his driver’s licence was restricted, only allowing him to drive the four miles into town. That was something Trent didn’t agree with.
“It’s really hard on them when they take it away, so they don’t,” he said. “He had to cross a busy highway. There was a lot of traffic on the road.
“That was my biggest concern — him driving. With farm equipment, if you’re in your field or in your yard, you’re putting yourself in peril. On the road, it’s everybody who’s at risk.”
People with dementia will often wander off. This is hazardous in urban areas, but can become even more dangerous in a rural setting.
“If you wander when you’re out on an acreage or a farm, you’ve got a lot more land to cover,” said Huhn. “The people who tend to wander and not get found — or who get found upon death — tend to be more rural.”
While Trent lived on the home quarter, his father lived on an acreage with sloughs and bushes, in the type of terrain where it would have been difficult to find him.
“The constant worry was always there,” he said.
About five years ago, Trent’s father was helping with harvest and had a small accident which resulted in a mild concussion. He was never the same after that.
“It seemed to accelerate it. He got a lot more reclusive.”
About two years ago, after treatment for an unrelated health problem, his doctor told Trent that his father should be moved into town. Along with the risk of wandering, spotty cell service in the country and blocked roads in winter could turn a crisis into a tragedy.
“The doctor said, ‘This is hard, but it’s going to get harder.’”
His father now lives in an extended-care home in a nearby town.
Short-term memory loss and forgetting details are common warning signs. Appointments are made, but not kept. Something as simple as making coffee or turning on the oven become a major challenge. Things such as forgetting to feed animals or closing gates are other clear signals, but there are also little incidents that everyone experiences once in a while that become commonplace.
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“It’s very common to see bills double paid or not paid at all,” said Huhn. “When a bill comes in, they can’t make sense of what it is saying. They can’t process it or make sense of what the bill is trying to tell them, even though they can read the words.”
Although it’s human nature to cover up such things, those close to someone with Alzheimer’s often sense “there’s something off,” she said.
“People really need to listen to that voice that tells them that something is wrong.”
The stigma surrounding the disease often seems to be stronger in farming communities. People suffering from Alzheimer’s may be more reluctant to ask for help or fearful about losing the respect of their neighbours.
There is a lot of stigma about mental illness in rural areas, said Trent, and in some ways, Alzheimer’s provokes a similar reaction.
“This isn’t a mental illness, but it’s such a taboo thing and people think they’re going to catch it,” he said.
The stigma is one of the reasons why Trent said he had to share his father’s story. He also wants to urge people to see a doctor sooner rather than later, if someone in their family shows signs of the disease.
A family doctor can provide a diagnosis, but if the doctor has known the patient for a long time, he or she may be fooled. Often those with Alzheimer’s are adept at steering conversations to old times, and it may not seem like they have memory problems, said Huhn. There are specialists available, and staff at any Alzheimer Society of Alberta location are available to help or answer questions before or after diagnosis, she said.
“We’ll help get families through the initial process,” said Huhn. “We want families to be able to call us and we’ll follow them along their journey. We help families put things into perspective, so they can change as the disease grows.”
The Alzheimer Society of Alberta has offices in Edmonton, Grande Prairie, Fort McMurray and Red Deer. For more information, visit www.alzheimer.ab.ca.