In May 1996, Mom gave us a scare when she failed to return from a dental appointment. She did not call home for a pick-up as instructed and it was now evening. Finally, a good samaritan brought her home. Mom had been wandering around Kaimuki for hours trying to get home. Dad began scolding her and couldn't stop yelling at her, as if somehow it would make everything right again. This was the wake up call. Although Mom's behavior had been changing, I attributed it to her aging process and was not very concerned.

After seeing several specialists and having many tests done, an MRI revealed multi infarct dementia in September 1996. "Thank God it's not Alzheimer's disease," I thought, not knowing at that time the progression would be the same. Her initial gradual progression went unnoticed; there was no obvious decline in her homemaking skills as I had been doing the cooking and cleaning since 1970 as a 9 th grader. Being the only daughter, the tasks fell to me. My Dad and brother were typical old style Japanese - the men did not do household chores.

In August, a few months after the initial diagnosis, I was awakened at 4:00 AM by a neighbor who had found Mom wandering around in her yard. Mom needed to have activities to tire her out and to keep her days and nights coordinated, so I decided to place her in an adult day care ("ADC") program. With the assistance of a grant from Project Dana, Mom attended Franciscan ADC twice a week. Initially, she was one of the higher functioning participants and enjoyed the program.

I also began attending monthly Alzheimer's caregiver support meetings at Project Dana where I received enormous emotional support that I was not able to get from my family. I was a "one man act" doing all the work and making all decisions alone.

Mom's condition progressed, and by 1999 she was unable to manage personal self-care, and became incontinent and less ambulatory. This increased the time and energy needed to care for her. I continued to work full-time, which became my respite from caregiving, but added to my stress. Dad became increasingly impatient with her and drowned himself in alcohol (12 beers daily), which made him undependable. However, he managed to transport Mom to day care twice weekly. When I got home from work, he would be passed out on the couch in front of the TV and Mom would be wandering around the house getting into everything, which I then had to clean up. I was caring for and managing financial and legal matters for both parents now.

My brother came home once every 2 years for about a month, and then returned to California with no communication or no indication of concern or support. Like Dad, he would not face the reality of the situation and had built a wall of stoicism and denial, which I could not penetrate.

In early 2000 I realized that Mom needed closer supervision so she attended SECOH ADC daily. She was happy there and received lots of personal attention. Dad continued to transport her, which was unsafe due to his drinking. His behavior toward Mom was bordering on abuse and neglect. SECOH staff observed this behavior and contacted Adult Protective Services. I placed mother into a private care home which could provide 24-hour supervision, as I was totally exhausted with "caregiver burnout." I was afraid that I would also begin to become abusive due to sheer frustration and fatigue. In August, with a lot of anxiety, I took Mom to a highly recommended care home in Waipahu. I felt a tremendous sense of relief, but I also felt bad and guilty leaving her there. These feelings decreased knowing that she was in good hands, and that the caregiver was competent, kind, and patient. Mom adapted very well, was happy there, and did not want to come home.

In early 2001, I stopped Dad's driving and could then control his beer consumption. He was allowed 5 beers a day, which was gradually decreased. I was weary and downhearted, partially due to Mom's condition, but also because I knew that I needed to continue caring for Dad for the next few years. I had no life of my own, and I was depressed and physically exhausted.

Mom's condition rapidly declined: her speech became minimal, she required a wheelchair as her legs no longer worked properly, and she would not eat or open her mouth, even to drink. It took an hour just to get her to drink a can of Ensure. What a contrast to those earlier days when I hid things or when she would eat everything in sight! The doctor suggested that a feeding tube be implanted in her stomach. After discussion with Mom, Dad, and other family members, I decided not to do the procedure. It was not what Mom wanted, would only prolong her suffering, and not improve her quality of life. There would be no hospitalization, no heroic measures, no resuscitation, but we would use hospice for comfort only.

Mom died in January 2002 due to "terminal Alzheimer's disease." I am at peace with my decision, knowing that her journey ended the way that she wanted - on her own time. In March 2002, I got married and moved to a new home. I struggled with leaving Dad alone, felt guilty and worried, and continued to do so, but decided that I needed to live my life. I deserved some happiness and peace. My husband is considerate and nurturing. He is involved with Dad's care and provides constant support and humor. He was a caregiver to his mother until she died, so understands my situation.