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Pete Wick had the sinking sense that his mother's condition was worsening when she called to ask why he hadn't shown up for her memorial service. His mother, 80-year-old Beatrice Wick of Laguna Hills, Calif., had been an RN caregiver for more than 30 years. Now, she was suffering from Alzheimer's disease and needed his care.

Beatrice, known as "Bea" to friends and family, told Pete that she'd been shot and killed outside her church. When he asked why she needed a memorial if she was talking to him, she answered, "Well, that's customary." Then she explained that she had survived.

Although delusions are common for Bea, she can accurately remember vivid details about her nursing career. Bea, her caregiver and Pete all agree that Bea's years in nursing have influenced her approach to Alzheimer's disease. It's made her a particularly inquisitive patient and eager to teach others what she learns about the disease. Her respect for the health field also prompted Bea to sign up for a research project related to Alzheimer's.

Although her clinical training has its benefits, Bea admits that the role of patient can chafe at times. "It's difficult to be the receiver of care instead of the giver," she said.

Her career as a nurse began in 1941 when she took a job as an operating room supervisor. Two years later, she transferred to an office nurse position and continued in that role for more than two decades. In 1975, she moved on to work as an industrial nurse at a carpet manufacturing facility.

She recounted a story of when a worker came to her with foot problems. She took one look at his shoes and suggested he replace them, and explained that the company would pay half of the cost of the new shoes. He was so thankful that he brought his family to the plant after buying the shoes to thank Bea.

Even after she retired, Bea was known for helping friends understand medical instructions on their prescriptions, or for helping others who needed injections at home. She also visited shut-ins regularly.

When she began missing dental appointments and leaving groceries in the car for days, Pete dismissed it as routine forgetfulness. She always had an explanation for the mistake.

More than forgetfulness
These explainable mistakes continued for two years, but an incident 1½ years ago signaled that this was more than typical memory loss.

One day, Bea drove her car 250 miles north and parked the vehicle in the middle of an intersection. It was after this incident that Bea was diagnosed with Alzheimer's disease. She had to give up her car, one of the most painful losses so far, Bea said.

She is one of 4 million Americans who have the disease. Researchers have not determined what causes Alzheimer's, and age is the only clear risk factor, said Bill Thies, vice president of medical and scientific affairs for the Alzheimer's Association. Nearly half of those older than 85 have the disease and one in 10 older than 65 have it. Sufferers live an average of seven to eight years after being diagnosed, according to the association.

At first, people with the disease will experience memory loss, such as forgetting directions to places and names of people, Thies said. Then the memory loss becomes more severe, which may result in one becoming lost in familiar surroundings. Delusions can be common as well. In the late stages of the disease, people often forget to perform daily activities, such as bathing, dressing and eating.

Finally, Alzheimer's patients lose motor control and may have trouble walking and swallowing. People sometimes die from the inability to swallow because their saliva drips down the trachea and causes conditions such as pneumonia.

But because Alzheimer's patients usually are older, in many cases people simply die from other conditions unrelated to the disease, such as cancer or heart attacks.

As Bea's condition has progressed, her delusions have become more elaborate. She has talked repeatedly about the family's new grandchild, but Pete said there is no new grandchild. One time, she called Pete's relatives and friends because she believed he had died.

One person called his home to console his wife, only to have Pete answer the phone. Pete immediately went to Bea's home to show her he was alive, but she showed no signs of relief or joy. She already had forgotten the delusion.

"Of course it's devastating because you see a family member slipping away," Pete said. "But much of what happens is so funny you can't stand it. You have to laugh or it hurts too much."

At one point, Bea started sending car ads as payment for bills. That's when Pete knew he needed to take over management of her finances. Luckily, Bea had set up a family trust before she was diagnosed, and that gave him the legal right to handle her finances. If she'd waited until after the diagnosis, she would have been deemed mentally incapacitated and a judge would have intervened to create the trust.

Nursing instincts
Although Bea struggles with delusions and daily activities, the disease hasn't robbed her of her nursing instincts. She is a member of an Alzheimer's support group and actively reads about the disease. She teaches her new findings to people, such as her caregiver, Luz Andres. Bea also is quick to pass on hygiene tips, Andres said. "She's the easiest patient I've had in eight years," she said.

Bea's clinical background also primed her to participate in an Alzheimer's study at the University of California, Irvine. The researchers are comparing the brains of Down syndrome patients with Alzheimer's patients.

Bea said she also keeps in touch with former nurse co-workers, who supply encouragement and a sense of connection.

Although her nursing background helps her to cope, it can't reverse the effects of the disease. Recently, she has been unable to understand that she needs to get up at a certain time to dress for church. As a result, her carpool stopped coming by. Her inability to understand the concept of being ready at a certain time also drove away a male friend she'd had for 13 years.

Bea's condition will continue to decline as accumulations of proteins-called plaques and tangles-multiply in her brain. These protein accumulations are toxic to nerve cells and result in the death of these cells.

But Pete is determined to help his mom live in her retirement community as long as possible before he moves her to an institution. Although she no longer has the ability to be a model nurse, she's still an example to others-this time as a patient.

"It's remarkable that even on her most difficult days she carries herself with a lot of dignity," Pete said. "I think as a nurse she felt that a positive attitude was 'good medicine' for many things, and she really lives up to that advice."