Of Good Days and Bad Days

As we noted yesterday, Monday was a bad day for Lyn's symptoms.  Tuesday was a good day.  This is a common issue with Alzheimer's patients and it is not a well understood aspect of the disease.  I wish I could say the bad days were because of this process in the brain and the good days were because of that process in the brain.  I honestly haven't been able to find any study or explanation for it.  I've seen several pieces in which people commiserate and suggest charting the days to look for triggers so you can adjust.  Some theorize that the bad days are more evident when the patient has not had a run of consistent sleep.  We haven't noticed a particular pattern with Lyn yet.

We've long heard about these good days and bad days.  We've seen it in action before but not to the extend that Monday showed us.  In February, Lyn goes for a new neuropsych evaluation and we actually anticipate that she's going to be on and having some good days.  She'll feel she needs to perform and may be able to cover quite a bit because she'll be working with someone new and she'll be getting one-on-one attention.  

Several of us who are involved with her care have been asked to provide a written assessment of the changes we've seen.  I think this is a good thing because it will allow the clinician to get insight into what others who are more familiar with Lyn perceive of her behaviors and symptoms.  The Alzheimer's Association writes in an article titled "Monitoring Progress",  "...since Alzheimer's patients regularly have 'good days' and 'bad days,' a clinician's evaluation in one brief visit may not be as valuable or reliable as a caregiver's report of the patient's condition over several days or weeks."

It really won't matter if she's having a good day or a bad day when she goes for the evaluation.  It is spread over three mornings.  It is a long process and previously she's come home exhausted from it.  I suspect the same thing will happen.  She won't be able to be on show for all three days.  I anticipate that the clinician will see many of Lyn's symptoms and will be able to combine that with the write ups we provide.