Dorothy Jordan sat fascinated, playing with some wooden blocks and some brightly colored plastic stacking doughnuts. She rubbed the blocks together, then popped a plastic doughnut into her mouth.
Dorothy Jordan is 86 years old. She is incontinent. She no longer speaks, only to humming or muttering an occasional word. She has begun to suck her thumb.
Dorothy Jordan has Alzheimer's disease.
"Her whole life is wrapped up in the Playskool toys," said Dorothy's daughter-in-law, Pat Jordan of Finksburg, who with her husband, Lee, Dorothy's son, cares for Dorothy around the clock.
"Thank goodness for Playskool."
Pat Jordan is 68 years old, and Lee Jordan is 66. They are among a growing army of senior citizens who are caring for their aging parents or spouses with Alzheimer's.
Alzheimer's is a progressive, degenerative illness that afflicts about 4 million Americans, according to the Alzheimer's Association. It attacks the brain and affects memory, thinking and behavior. Nationally, it kills 100,000 people a year, and is the fourth leading cause of death among adults.
Alzheimer's affects about 10 percent of people over age 65. According to Carroll County planning figures, there were 12,557 people over age 65 living in Carroll County in July. That means there could be more than 1,200 affected with Alzheimer's in the county.
Pat and Lee Jordan have cared for Dorothy for seven years, 24 hTC hours a day. They never go out together, even to church, except once a year on their anniversary.
They have had to child-proof their house, removing sharp objects and putting locks on medicine cabinets.
Before Dorothy was confined to a wheelchair, they had to watch her because she wandered. Once, she got out of the house, crossed Route 140, and hitchhiked to her old bank in Westminster.
Sharon Baker, who works for the county Bureau of Aging and is facilitator of the Alzheimer's Support Group of Carroll County, said the strain of looking after such a person can weigh heavily on older care-givers, who face particular physical, emotional and financial problems.
"A 60-year-old can be taking care of their parents, their children and their grandchildren," she said.
Ms. Baker said she knew of one case in the county where an 80-year-old was caring for her 50-year-old child, who had Alzheimer's disease.
And in one extreme local case, Ms. Baker said, a 92-year-old woman was caring for a daughter with Alzheimer's disease. Another daughter who had suffered from the illness had already died. And a third daughter, who was well, stayed away from the home because she was terrified by her sisters' fate.
Physically, older care-givers may themselves be frail. And if a small woman is caring for a larger, stronger patient, she may be unable physically to control the person.
Pat Jordan said that for about six months, her mother-in-law went through a period of violent behavior. She threw shoes and, once, she threw a trash can. She hit her son, her grandson, even the dog.
Now, Pat Jordan said, Dorothy is peaceful. But these days, she said, "I can't lift her any more. . . . She's probably 60 pounds, and feels 250."
Pat Jordan is fortunate in that her husband helps bathe his mother and lift her in and out of her wheelchair. But many older care-givers are widowed and have nobody to share the load.
Emotional exhaustion can be a problem for care-givers, Ms. Baker said. She said that "many, many times," the care-giver becomes ill because of stress.
Ironically, she said, the patient is sometimes in better physical shape than the care-giver, because the care-giver is subject to stress-related illnesses, such as headaches, digestive problems, high blood pressure and stroke.
Often, Ms. Baker said, the care-giver is isolated because friends and relatives don't understand the situation or are afraid of it, and pull away.
Money is also a common problem. The Alzheimer's Association estimated that the cost to a family caring for a patient at home can be $18,000 a year. They said 70 percent of care for Alzheimer's patients is provided by their families.
If a person must enter a nursing home, Pat Jordan said, the cost in Carroll County can be $35,000 a year or more.
However, help is available.
"Tell them to join a support group, because it's fantastic," said Pat Jordan. Without it, she said, "I don't know what I would have done."
She said the group taught her simple tricks that make caring for Dorothy easier. For example, they showed Lee and Pat how to put a hook-and-eye latch outside the screen door, to keep her mother from wandering away when she was in the garage or outdoors.
Pat Jordan also recommended a book, "The 36-Hour Day," by Nancy L. Mace and Peter V. Rabins, M.D. "That's what we call the bible."
Ms. Baker said people caring for Alzheimer's patients should contact the Bureau of Aging for helpful information.
For example, she said, respite care is available to allow the care-giver time off. Longer spells of temporary care are also available for the care-giver who needs a longer break. Ms. Baker said some of these programs offer financial aid.
"Call and discuss all the alternatives," Ms. Baker said. "Don't restrict yourself in what you consider."
Pat and Lee Jordan also recommend that the care-giver try to preserve a sense of humor.
"If you don't," Pat Jordan said, "you're in big trouble."
To reach the Carroll County Bureau of Aging, call 848-4049, 875-3342 or 876-3363. To reach the Alzheimer's Support Group of Carroll County, call 857-0993. To reach the Baltimore/Central Maryland chapter of the Alzheimer's Association, call 435-4933.