How can a person 3 years into an Alzheimer's diagnosis be deemed "healthy as a horse" by her sibling?

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How can a person 3 years into an Alzheimer's diagnosis be deemed "healthy as a horse" by her sibling?

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My sister in law was diagnosed with Alzheimer's 3 years ago. Her disease has advanced, e.g. difficulty with personal hygiene and trouble dressing, putting on footwear before anything else. She had failed to get routine tests such as mammography and colonoscopy until prompted by her sibling. Fortunately all tests were negative including blood work, which was in normal range. Her sibling uttered the words to me - "She is healthy as a horse." That to me seems to be an inaccurate statement, as her brain is broken. What say you?

Activities of Daily Living Alzheimer's & Dementia Senior Health

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Maybe she means "except for her brain"?

In terms of defense mechanisms that folks employ, denial is the one that is most protective of the individual. Seeing that a sibling has significant deficits, that she has a life-limiting, progressive disease must be devestating to a sibling.

I must say, if I had dementia, I would NOT be getting colonoscopies or mamograms. I would not want treatment for anything that ailed me.

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Those of us who are living as caregivers sometimes need to “let some things go” when we hear them.

Was there some particular reason that the statement struck you as being particularly inappropriate? Is the sibling responsible for your SIL’s care? Has SIL’s care been neglectful?

If your SIL’s sibling acknowledges the diagnosis of Alzheimer’s and observes the behaviors in day to day life, perhaps she’s comforted by the fact that there are still some positives in SIL’s life.

My Covid survivor LO has very little short term memory left, but as a survivor, she’s doing amazingly well physically. When asked by people who know her how she’s doing, I take it for granted that they realize that the dementia is still there and still about the same, but that she’s amazingly well, all things considered.

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AnnReid: Thank you for your post. Initially, I found the statement by the well SIL to be puzzling and thus my post. Inappropriate? No. The well SIL is not the fulltime caregiver. The spouse is the caregiver for his wife and it is not neglectful, though he certainly has a full plate, quite naturally.

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*Healthy as a horse*. Healthy as a horse with Alzheimer's Disease would be more accurate.

Could be denial or maybe just a throw away line - an innocent quote looking on the bright side.

My family say things like this too. She's doing really well. A bright side answer. (The reality is stroke survivor with multiple comorbidities which are life limiting).

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Beatty: Thank you for your post. Yes, I am sure that the person who uttered those words was, quite naturally, looking on the bright side. Interesting that your family says similar things.

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My mom, too, was healthy as a horse. No physical medical issues at all! No lifetime meds for heart or blood pressure or any other things that get so many as they age. My grandmother was the same and she lived to 101.

But, the brain, a different story for both. She is fortunate to not have the physical issues as that would make the caregiving even harder.

I wouldn't think this was said out of ignorance as in some ways she is as healthy as a horse. Let it go.

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gladimhere: Thank you for your post with your insight. I appreciate it.

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Barb: Thank you. Her routine procedures were VERY MUCH PAST DUE since neither she or her husband EVER got them.
The sibling who uttered those words did not include "except for her brain."

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Llama,

This comment appears to have really upset you. Many times we see people post here about their demented family member being otherwise healthy. Why are you finding this comment so jarring?

Being aware that a family member who has dementia is otherwise very healthy helps a family to understand they are in it for the long haul. It was a bit of a blessing that my step Dad died of cancer before his dementia got too bad. He was still capable of his ADL's and the cancer took him quickly.

I know my Mum has two fears, losing her mind and losing control over her body. At 86 she is in fantastic physical shape and her mind is mostly sharp.

As far as the mammogram and colonoscopy go, if a person would not take treatment, then there is no reason to have the procedure, it does not matter if they were not done in the past. Neither one is comfortable and the prep for a colonoscopy is no fun at all.

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It would kind of be funny were it not so sad. Kind of like saying "She will live FOREVER with these labs and tests." And would make you want to ask if she would really want to, with, as you say, a broken brain.
I guess she meant "physically" but of course mentally she is not healthy. You are absolutely correct; her brain is "broken". Our brains are an organ as well, and whether we label hers as failed, or injured, diseased, full of plaque, failing white matter or gray, frontal or parietal failure or vascular, it is all semantics. And it all adds up to, all equals the very loss of the one system that defines WHO WE ARE. I am certain her sister did mean, as Barb suggests, except for her brain.

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AlvaDeer: Thank you for your post. Perhaps eliminating the "unhealthy brain," somehow allows her to get through the sadness of the story that will be her sister's demise.

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Denial is not a river in Egypt. We live in a death denying culture. People can’t bear to think that someone they care about is dealing with a heart breaking terminal illness.

You might get an angry reaction if you said something like, “I have sadness when I see X person with Y symptom/behavior.” That way you’re not forcing them but disclosing yourself with the reality that you see. This may help to chip away at their denial while your not pushing them to leave their denial.

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GAMtns: Thank you for your post. Perhaps the sibling takes comfort that her sister is physically healthy, albeit with a brain that is damaged. In no way am I attempting to alter their denial, even so.

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Could have been said I guess "besides the Dementia, she is as healthy as a horse".

Healthy as a horse means physically. Dementia is a neurological disorder. My Mom had no physical problems. A little high cholesterol and B/P but her heart was good. No signs of Cancer. And she was strong at 89.

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JoAnn29: Thank you for your post. Yes, it was no doubt an implied connotation. I am aware of what dementia entails. I am sorry about your mother.

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Actually, I say it all the time: my soon to be 94 y/o mother is as healthy as a horse. In spite of her moderate dementia which is progressing rather quickly these days. Her body is fine, her mind, not so much. But it will be quite a long time before dementia actually takes her life, in reality.............so in the meantime, she IS as healthy as a horse.

It bothers me that my mother is as healthy as she is..........b/c she's 100% miserable 100% of the time and constantly saying she 'wants to die'. Knowing that the dementia is NOT going to take her life any time soon is a point of frustration precisely BECAUSE she says she is ready to die. She has a lot of pain in her legs/feet from neuropathy, which is an ongoing thing too, but not life threatening.

Could it be that your SIL is feeling frustrated that her sibling is 'as healthy as a horse' and nowhere near the end of her life at this stage of the game?

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lealonnie1: Thank you your post and your experience with your mother. I am sorry for that. My ill sister in law is rapidly worsening.

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Did she get brain MRI? That is what will give the answer. If she had one 3 years ago, ask her neurologist to order another for comparison. Doesn’t matter what non medical non professionals think. Hugs 🤗

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CaregiverL: Yes, the M.R.I. of the brain is the gold standard to detect for Alzheimer's and yes, she did have the test. Non medical professionals can state erroneous information. Thank you for your post.

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Llama,

I think I would tell her siblings that horses don't get Alzheimer's!!

I know you understand that her brain is broken, but they need to educate themselves about the disease! As they are her siblings, they need to be aware of how the brain controls the body and that they too may be susceptible to Alzheimer's.

My heart goes out to you!
It's hard to make someone understand!!

Hang in there!!

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xrayjodib: Thank you so much for post. You're words resonated so well about the truth of Alzheimer's. When relatives may say words like I'd posted in my subject line, it does concern me. Thank you for understanding.

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My mom doesn't have any physical ailments either...she has always taken good care of herself...didn't drink, or smoke and always exercised until the mental decline. I am on year 10 with mom and her dementia and the only medication she is on are meds for dementia. So, I get it. My moms brother was telling people that my mom is fine and probably doesn't even have dementia. This is someone who sees her once a year. He has no clue that she can't dress herself most of the time and refuses to bathe, hides everything from combs to dirty underwear because she thinks someone will steal them. It angers me beyond belief. The best way I have found to deal with it is to tell myself that maybe he can't handle the fact that his sister is sick and denial is his way of dealing with it. Once I looked at it like that, I was able to let some of the anger go.

Also, I wanted to mention that I stopped getting mammograms and colonoscopies for mom because if she did have cancer, I would not put her through chemo or surgery to prolong this demented state that she is in. When mom was in her right mind, she wanted quality of life over length of life. I am following through with her wishes.

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Both of my sisters (older & younger) refused to believe me (as full-time caregiver), actually told me my 'nervous nature' was being 'hysterical', based upon each of their 3 times a year special visits (major holidays/birthdays), when mom was on her best behavior for the 'guests'--then they'd merrily go back to their lives and never call or contact until the next holiday. Mom sleeps for 3 days after such visits; they have no idea of that. D*mn, "I can't believe this is going on in MY family!"

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She is physically "healthy as a horse" as so many people with Alzheimer's dementia are. SIL probably separates Alzheimer's disease into the "mental health" category or considers dementia as a normal part of the aging process. Prior generations considered dementia as normal part of aging that affects some people and not a disease process. We now consider Alzheimer's dementia a disease.

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Taarna: Thank you for your post. I appreciate the time that you took to compose it and to give me perspective.

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Many people with Alzheimer's are free of "physical" medical problems. So, in that sense, they are "healthy as a horse."

However, many relatives are in denial because they don't understand how a person with no other health issues can possibly have Alzheimer's disease. There is also a big myth that if you "stay active" and do crossword puzzles daily to stimulate your brain, that you are protected from this awful disease.

This is one of the heartbreaking things about early-onset Alzheimer's - especially when people in their 40s and 50s get it. Many of those people are quite healthy otherwise, have full-time professional careers, etc. (A friend of mine's mother was a college professor - and got it in her early 50s.)

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dragonflower: Thank you for your post. Yes, Alzheimer's is a horrid disease and perhaps the well sister in law can provide herself with a small measure of comfort in knowing that her sibling is otherwise healthy.

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I'm sure you know what the Sibling meant.

Her body is as healthy as a horse, it's just that her brain doesn't work as well as before.

You can have alzheimers for years and years and years if you're as healthy as a horse.

If you're sickly tgen you will die from something else before the alzheimers takes away all your brain.

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bevthegreat: Thank you for your post. I appreciate you and the time you took to compose it. I was reaching out for thoughts on my thread and while I surely understand the implications made by the well sister in law, it is good to ask and receive opinions.

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It’s just a figure of speech, and I’m sure no harm is intended or that there’s a lack of awareness about the neurological issues for your mom. I think she meant that your mother’s lab values and general physical presentation are good, and within normal limits for her age. I use it to describe how my mom’s doing to our family. They understand that it means physically she’s doing well.

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That would be my GUESS, as well. My own mom is 'healthy as a horse'--for a 91 y/o, and she is definitely pretty well into dementia.

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don't be to upset with your sister-in-law. she means well. she's just stating other than her having Alzheimer's she is healthy. For example, high blood pressure, diabetes that's what she's meaning. Otherwise, it could also, be that she's in denial and that's her way of not helping or seeing the truth for what it is. She is healthy besides the Alzheimer. what's more important is that she is getting assistances.

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Candyapple: Thank you for your post. In no way am I upset with the sister in law's statement. I was only researching out for perspectives, which I received.

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Her body and lab work deems her healthy as a horse - no issues. Her brain is totally separate. Think about a young person with severe mental issues - the brain is not functioning normal, but overall they ARE healthy as a horse.

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my2cents: Thank you for your post and time that you spent posting it. I appreciate you.

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Llamalover47, ((Hugs)), I understand how you feel. When I try to explain what is going on with my hubby and they will say, "Oh, everyone our age (insert condition) all the time. It makes me want to either hit them or tear my hair out. I have just given up trying to explain what is going on in our lives.

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MaryKathleen: Thank you for your post and hugs. It is frustrating, isn't it? Hugs and prayers for your husband.

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First I do agree that a person can be as "healthy as a horse" and still have dementia of any type. Yes the brain is broken but the rest of the person is healthy.
Second, anyone with dementia I would not push to have a mammogram, colonoscopy or other testing along those lines. I say this for several reasons.
1. to put someone with dementia through some tests is difficult and in some cases they would have to be sedated. Dementia and sedation do not do well together.
2. IF they were subjected to the tests and IF one came back indicating there was a concern would you actually opt to put someone with dementia through surgery and possibly chemo and or radiation? (I would hope not)
I have to say my Husband was healthy in all respects EXCEPT the Alzheimer's (and maybe Vascular dementia) and I opted not to have him have a colonoscopy. I went through 1 bout of Norovirus with him and after cleaning diarrhea for a solid weekend and doing 40 loads of wash I can not imagine having had him prep for such a test! Toss of the coin what would have killed him faster the Dementia or colon cancer.

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Grandma1954: Thank you for your post. I do understand what you're stating; however, this person NEVER had mammography or colonoscopy, is about to turn 69 with Alzheimer's, as previously stated.

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She is, physically, in a way....but not from a mental health standpoint.

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gdaughter: Thank you for your post. Yes, her brain is broken.

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I can testify that SOMETIMES dragging a person with mental deficits from doctor to doctor and lab to lab for PROPHYLACTIC care is needlessly cruel. They don't understand why and their distress can be more harmful than detecting a fatal illness. For me, if I fall into this situation later, leave me ALONE AND IN PEACE.

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JustDaughter: Thank you for your post. In this case, it did aide the ill Individual since they had never received these aforementioned tests.

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Llama, I always love knowing where a certain phase comes about. I found this.... The phrase "healthy as a horse" is believed to come from America and the UK in the 1860s. Horses were believed to be very powerful and energetic, meaning that it would be good to be as healthy and energetic as a horse.

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freqflyer: Thank you for your post. Wow; thank you for the background on the statement, "healthy as a horse." I appreciate that.

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A wise geriatrician once told me "If you aren't going to consent to treatment, then you don't do the test".

This was at a time when my mother's cognitive impairment was fairly mild and some abnormal cells were found in a pleural effusion. The hospital oncologist wanted to do a spinal tap.

Would this person be a candidate for treatment of breast or colon cancer?

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That's not so much a wise doctor. That's a doctor who see's the glass as half empty. In very many procedural tests, problems are found and remedied all in one gig. C'mon, a scope up my bum, while I'm loopy buzzed, to check it out and remove what could kill me later? It's a no brainer for me...and did I mention the loopy buzz.
Please post the doctors name so I can avoid that one.

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At 82 my mom had....mammo, chest Xray, ultrasound on a small neck mass and bone density.....all in one day, at one facility....she's a good patient....she's a retired nurse. When we did the follow up visit for the results, they were clear and normal. Just as your your sister in law. The results of my mom's bone density was sooo good it prompted the doctor to exclaim "she can pull a truck!".
In that same follow up visit with the simple cognitive test performed, my mom failed.
In summary, my mom can use a shovel to dig a hole to plant a landscape shrub. It's just that she quickly forgets why she's digging and soon after forgets that she ever did.
Your sister in laws sibling just might mean 'as strong as an ox'. You're correct that the statement "as healthy as a horse" may be inaccurate but isn't that just semantics?

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bolers1: Thank you for your post. I appreciate hearing the story of your mother and your analogies.

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How can a person 3 years into an Alzheimer's diagnosis be deemed "healthy as a horse" by her sibling?

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