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Anyone Familiar With Tam Cummings?
Posted: Monday, August 12, 2019 11:36 AM
Joined: 9/3/2016
Posts: 215

On the Tam Cummings "Dementia Behavorial Assessment Tool" under Stage 7 it says, "Loss of ability to smile -- indicates death is near." I'm not sure if that's accurate or even if it is accurate what it means. 

1) My mom is well into Stage 7 and I haven't seen her smile in a long time, but then she doesn't have much to smile about. So how do I know if that means she CAN'T smile or if it just means she doesn't want to smile? I've asked her to smile for me so I can take her picture, and she seems to think she is, but there's no smile there so maybe she can't.

2) What does "indicates death is near" mean? Are we talking a year, months, weeks? It just frustrates me when I read vague things such as this. Maybe it's just that I'm frustrated period because I feel completely in the dark and helpless to do anything even though I know there truly is nothing more that I can do. I have placed my mom on hospice.

Just wondering if anyone else has any idea what she actually means by this. I feel like a cartoon character who is oblivious to the fact that a piano is about to drop on my head. We've been traveling this road for a long time now, and even though I have learned things along the way I still feel I know so very little.

Posted: Monday, August 12, 2019 1:19 PM
Joined: 6/3/2013
Posts: 718

Hospice can best advise you about whether death is near, and what 'near' means.  It is never just one indicator.
Posted: Tuesday, August 13, 2019 4:52 PM
Joined: 10/9/2014
Posts: 786

I can relate to what you are going through, though with me, it's not my mother. I love my cousin, but, I know it must be even more difficult when the PWD is your mom. 

My LO is end stage as well. She's in a MC and on Hospice. She will go months without smiling and then it looks like she smiles, but, I'm not sure if it's just a reflex or what. And, then she doesn't speak for months and then finally says 3 words.  I'm not sure what to believe. But, she still eats pretty well and as long as she eats, I will continue to believe she will live another day or week.  I know that eventually, she won't be able to swallow and then things will not last much longer. 

  You might speak with the Hospice social worker too.  The one assigned to my LO is awesome and she's really helped me so much.  Just talking has been a great comfort. You night ask her for the booklet, Gone From My Sight. It's about end stage of life. 

Posted: Tuesday, August 13, 2019 5:16 PM
Joined: 9/3/2016
Posts: 215

Thank you! I will ask about that booklet.

Hospice stopped my mom's Aricept and Namenda over the weekend. Surprisingly, today she was much more alert, and actually tried to converse. I don't know how long that will last, but it was surely nice for today. The hospice nurse has warned me that might not last. Basically it seems that with Alzheimer's there are no hard and fast rules about anything, and very difficult to predict what even the next hours will bring much less the next days. One of the many, many cruelties of this disease.

Posted: Tuesday, August 13, 2019 5:35 PM
Joined: 6/20/2016
Posts: 2027

The smile statement isn’t accurate at all.  My mother couldn’t smile for at least 2 years prior to death.
Posted: Tuesday, August 13, 2019 6:12 PM
Joined: 9/3/2016
Posts: 215

Thank you Dayn2nite2!
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