By Julie Gregory, Chief Health Liaison for Apollo Health

As the seasons of nature unfold, we can glean wisdom from observing its changes. Spring represents growth and new beginnings, summer is about discovery and building strength, fall signifies the shedding of unnecessary baggage to focus on preserving strength, and winter is a quiet time of well-deserved rest, leading me to ponder the end stages of life. We are all here for a finite time, and it’s important to discuss when it makes sense to surrender.

This is a very personal decision for anyone with Alzheimer’s and their loved ones. While we are blessed to have a path to treat Alzheimer’s finally it is far from a passive journey. We all know the tremendous effort that it takes to continually identify and address the various contributors to Alzheimer’s, not to mention the energy needed to follow the diet and apply all of the necessary lifestyle strategies to support brain health optimally. Many of us are doing our best with great results, while others may be struggling for various reasons.

For instance, I sometimes see care partners who are fighting tirelessly for their loved ones who simply have no self-motivation to try to heal. Pushing someone to follow the protocol almost never works, but often, leading by example can be helpful. We sometimes see reluctant participants become converts after trying a few strategies and thriving with their newfound energy and health. Small successes can lead to a bigger commitment and a desire to move forward. For tips on how to encourage your loved one to use the protocol, see It’s About Pulling Not Pushing.  

We also have participants come to the program in very late stages. While we have peer-reviewed evidence that the protocol can be very successful if applied early enough, we have less evidence about its efficacy in the later stages. That said, we do have dozens of examples of those who began the program in advanced stages and experienced remarkable improvements. I was blessed to witness one woman who came to the protocol with a MoCA score of zero, unable to make eye contact or perform any self-care, who later healed enough to not only bathe and dress herself but even take up bike riding again. These late-stage participants may not fully recover, but they consistently report an improved quality of life, which may be motivation enough for some people to persevere.

However, sometimes, in the later stages, trying to follow the protocol becomes too burdensome for the participant and care partner. Often, when mobility is diminished, when swallowing is affected, and when your loved one is sleeping more than they are awake, it may make sense to focus on quality of life rather than fighting the inevitable. This is a very personal decision. Rather than feeling a sense of failure, I encourage you to reframe this sacred time as one of celebration. Consider working with a hospice program, which can offer a tremendous amount of support and better enable you to surround them with love.

While your loved one may appear to be quiet and reserved during this period, he or she may still be experiencing a rich inner life. Make them comfortable: tempt them with their favorite foods, play music that was once the soundtrack of their life, and try to elicit meaningful conversation. When they are no longer able to speak it’s likely that they can hear you. Consider inviting various family memories to sit by their bedside, chatting quietly, and sharing their favorite memories. Finally, as your loved one loses their senses, touch becomes very important. Let them know you are there by holding their hand, performing gentle massage, or even rubbing lotion on their skin.

As they become weaker, more vulnerable, and innocent, everything comes full circle. What often surfaces during the wintertime of a life fully lived is the distillation of their true essence, an honor to behold and remember.   


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