Page last updated at 22:57 GMT, Tuesday, 29 July 2008 23:57 UK

The Long Goodbye: Part 1

By David Willis
BBC News in Missouri

Dianne Kerley and Flossie
Dianne struggles to communicate with her mother
The first instalment in a World News America series on Alzheimer's looks at hope behind new research.

The elderly woman stared blankly, not a hint of recognition on her face.

Next to her on the bed sat two of her closest relatives - her daughter and grandson.

They hugged her, teased her, squeezed her hand: nothing.

They talked of hobbies, and pets, and adventures from her past: not a word.

Then - briefly - the haunted expression grew into a smile and both planted kisses on her pallid skin.

For Dianne Kerley and her son Mike it was the best they could hope for.

Fifteen years ago Dianne's 78-year-old mother Flossie (Mike's grandmother) was diagnosed with Alzheimer's disease.

Since then she has lost not only her memory, but the ability to look after herself, as well as the ability to walk and talk.

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Dianne and Flossie Kerley's long struggle with Alzheimer's

Traumatic deterioration

They say that Alzheimer's begins with forgetting your keys and ends with you forgetting what your keys are for, but it is a whole lot worse than that.

Flossie
Flossie no longer recognises her family

Before long Flossie's sense of balance and co-ordination will be compromised.

In the final stages of the disease so too will her ability to breathe.

Until then all Dianne and Mike can do is undertake a heartbreaking weekly pilgrimage to a nursing home in eastern Missouri and watch her fade away before their eyes.

"It was two years ago - at Thanksgiving," said Dianne, recalling the last time her mother recognised her.

"Ten or 12 seconds and then it was gone.

"She was like: 'Well hi! How are you?' and I'm like: 'Well, we sure do miss you,' and she was like: 'You do?. Then all of a sudden the fog just went over - and that was it."

It is difficult to imagine a slower, more agonising death.

Alzheimer's leaves the patient a prisoner in their own body whilst systematically eroding everything about them that makes them human.

What should be the golden years are marked by blank stares and tragically unrequited expressions of love.

My own grandmother

Flossie's situation reminded me of my grandmother.

Sprightly and independent, she was like a granny from central casting - white hair, glasses, rocking chair and slippers.

Family
It is very traumatic for Dianne and Mike

She came to live with us shortly after my parents married and she was a hoot.

She helped out at children's tea parties, always had the best biscuits in the house, and allowed me to watch shows on her black and white TV that my mother frowned on.

But as the years went by, Granny started to change.

Not only would she say the same things, she would do the same things, time and time again.

She would list the names of everyone in the family before arriving at mine, come in to tell us something and then forget what she had come to say.

All the time she was becoming befuddled by tasks which once seemed second nature.

Slowly but surely her sharp mind and sense of fun began to fade like a tropical sunset.

When she lost control of her bladder my mother decided she could not cope and we put her in a home.

The first time I visited she barely recognised me.

A few more trips and she had lost the ability to speak.

Months later a nurse rang to say granny had faded away in her sleep.

We shed a tear then breathed a huge sigh of relief.

New hope

The fact is that even though Alzheimer's was discovered more than 100 years ago it is only in the last two decades that we have really come to know anything about it.

Lab work
Trials of new treatments are in progress

Lack of funding has a lot to do with it.

The US government spends roughly eight times as much on cancer research as is does researching Alzheimer's disease, and half what it spends on substance abuse.

Finally, though, there is some hope.

This week the Irish-American company Elan and the US firm Wyeth will jointly announce they are pressing ahead with the $300m (151m) trial of a drug which could block the production of a protein called beta amyloid which many scientists believe causes Alzheimer's.

Present in all of us, too much beta amyloid can cause plaques to form in the brain, and those plaques feast on brain cells.

There is a lot at stake, not least financially. If a drug is discovered which prevents Alzheimer's half the population of the US alone could eventually end up taking it.

Need is great

Never has the need been greater: as the first baby boomers turn 60 the fear is the health care system could be overwhelmed by what some are predicting could be an epidemic of Alzheimer's disease.

It costs $50,000 a year just to keep Flossie in a nursing home.

Back in Missouri, Mike and Dianne are bidding her farewell: "There's that pretty smile, sleep tight OK?"

Flossie sits perfectly still - beyond hooded eyelids brain cells are dying.

As she reaches the hallway Dianne stifles a tear.

Hers is the heart-rending tragedy of the long goodbye.

You can watch World News America's 'The Long Goodbye' series on Alzheimer's weeknights on BBC America at 1900 and 2200 ET and on BBC World News at 0000 BST (for viewers outside the UK only).

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SEE ALSO
The Long Goodbye: Your Comments
01 Aug 08 |  Have Your Say
The Long Goodbye: Part 2
30 Jul 08 |  Americas
The Long Goodbye: Part 3
30 Jul 08 |  Health
The Long Goodbye: Part 4
31 Jul 08 |  Health
Alzheimer's disease
08 Jan 04 |  Medical notes

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