Judie Boltz went to the mall a few months ago with her daughter, Wendy Savkranz, and granddaughters, Kym Hendricks and Nikole Kirby.
Kirby, then with her mother’s surname, was getting married in late July; the women were shopping for an outfit Boltz could wear to the wedding.
They picked out a white skirt. A pair of wedge shoes was bought somewhere else, and a lace top matching the skirt was ordered online.
That was May.
Anticipation for the wedding grew each week. Each time anyone talked about it, Boltz, 76, wondered aloud — sometimes with a laugh, other times frantic — “What am I going to wear?”
Boltz has middle stage Alzheimer’s disease. She started showing symptoms about a decade ago, and they’ve worsened.
Each time her mother asked about an outfit, Savkranz showed Boltz a cellphone picture of her trying the clothes on.
They went to the wedding. Boltz felt confident — even cut a rug with the groom — and talked to nieces and nephews she hadn’t seen in years.
Family, including a new great-grandchild, has given Boltz consistency and support during often erratic days. Her short-term memory probably will not return; those around her instead prioritize her moment-to-moment happiness.
“I still see joy in life,” Boltz said. “It’s the only way to look at it.”
Dementia creeps in
Boltz grew up on a farm near Menan with nine siblings. She was in the middle. They were always up to something.
The kids set firecrackers where they shouldn’t have, and built tree forts by the river where they fished.
When they were old enough to drive, the siblings took their father’s Buick for errands in Rexburg and Idaho Falls. Afterward, at times, they’d use the farm’s big stock of gasoline for recreation.
“Sometimes we’d take the car and we’d back in — you couldn’t touch the brake or anything because the lights would go off —fill up the car and sneak back out. They never knew the difference,” Boltz said. “There were so many of us, and we had so much fun. Our poor parents; I don’t know how they did it.”
Boltz stayed in the area and got married. Later on, around 2001 as a widow, she moved to Washington state, where a boyfriend lived.
The relationship soured, and Boltz became lonely. Her health took a turn; she battled colon cancer and ulcerative colitis. To make things worse, the dementia was creeping in, as it did for Boltz’s grandmother years before.
“I spent so long in the hospital, off and on, and that’s when I realized I couldn’t remember anything,” Boltz said.
Eventually, about 10 years ago, Savkranz orchestrated her mother’s move back to eastern Idaho, where Boltz’s family still peppers the region. They bought a condominium in Idaho Falls; Boltz lives alone with frequent visitors.
“I thought, by moving her back here, things would change and she’d get a little better. She has several siblings who live here. My kids were still little, and she had a support system,” Savkranz said.
Time with family
Boltz did, and still does, spend time with her four siblings in the area, and her grandkids. Which is nothing new.
Boltz helped her granddaughters cope with a car accident that left their father quadriplegic in 1996. After Boltz moved to Washington, she still talked to her granddaughters for hours on the phone.
“And she’d always come back for two or three weeks at a time. We’d call her Nana; we’d always want to sleep in the same bed as Nana,” Hendricks said. “She always has been a big part of our lives.”
Six years ago, when Kirby was 14, she slept over at her grandma’s house with a few friends from the basketball team. Boltz perks up at the memory.
“They giggled the whole time, didn’t sleep,” she said. “Nikole used to bring her friends here all the time, and I miss that. They grow up; I just hate it. Kym’s here where I can see her. Nikole’s… where is Nikole?”
Kirby recently moved to South Carolina for school; she receives a call from her grandma almost every day.
Boltz’s health has continued to decline since the move back to Idaho.
About four years ago, Boltz stopped taking her medication regularly. She also stopped making payments on the condo, and it became obvious other finances were being ignored.
“Her justification was that they were charging her too much money,” Savkranz said. “I realized that I had to step in. At that point I went and had my name put on her accounts with her. She was upset, but it was so short-lived. She’s upset for five minutes and then doesn’t remember.”
As the years passed, schedules became more hectic. Kirby had high school classes and several basketball games per week. Hendricks visited Boltz regularly, but was preparing to have a baby.
The role of family caregiver began to drain Savkranz. No one told her how to tend to someone with Alzheimer’s.
“You have one person who will say ‘She’s living by herself; does she eat?’ Then you have someone on the opposite side that’ll say ‘Don’t you dare put her in a home,’” Savkranz said. “And you don’t know what the right thing to do is.”
Caring for her mother also has made Savkranz, 55, more cognizant of her own mental health.
“Getting dementia is one of my biggest fears. I’m always looking for it, and ways to keep my mind sharp,” she said. “For people my age, it’s really on our minds.”
‘A lot of stress and trial and error’
There are about 85,000 unpaid family caregivers taking care of about 23,000 dementia patients in the Gem State, said MacKenzie Rodgers, executive director of the Alzheimer’s Association’s greater Idaho chapter.
Because of the unique and time-consuming challenges involved with caring for someone with dementia, caregivers often have health problems themselves, including anxiety, depression, lower levels of physical health and self-care, along with, ultimately, higher levels of mortality, according to the Family Caregiver Alliance.
The number of dementia patients is expected to triple to 135 million people by 2050 as life expectancies increase with advancements in medicine. The burden placed on family members could grow as well amid a wide professional caregiver shortage.
“Family caregivers can have more health issues than the patients themselves because it’s hard to get to doctor appointments and have preventative health care,” Rodgers said. “There’s a lot of stress and trial and error.”
Mercurial behavior can worsen things. Dementia patients can become angry or violent.
Boltz’s behavior never reached those levels, but she had phases. What is now the “treasure hunt” ritual of finding the TV remote and phone each day was previously Boltz’s justification to believe everyone was stealing from her.
Yogurt would go ignored, then spoil in the fridge. Stacks of paper and calendars would appear all over the condo one day — full of notes from months past — then disappear.
It became hard for Savkranz not to correct Boltz when she repeated something or forgot she had seen someone close to her.
“The worst thing you can do is correct them, and it’s so hard not to,” Savkranz said. “Being a caregiver can be the worst job in the world. It’s just so sad. So sad. You want to do as much as you can but she doesn’t remember it most of the time.”
Coping with her condition
The family wanted Boltz to live generally independent as long as possible, so about six months ago they hired a professional caregiver: Sandy Raffetto from Visiting Angels Home Care. Raffetto isn’t a medical aid, but a companion.
“She’s someone to come in and talk to mom and help her,” Savkranz said. “It is a relief. I can’t tell you how much of a relief that is.”
Raffetto specializes in dementia care, and can approach the situation from an emotional distance.
“The family has been around their whole lives, so it’s hard to see the decline in her. With us, we’re not family. We can step back from things,” Raffetto said.
Raffetto has had patients who were depressed and upset at their situations and the diminishment of their faculties. Boltz copes with her condition well, she said.
Savkranz has noticed that lately.
“It may just be this phase of the disease, but I feel very fortunate because mom is so happy. She hasn’t shown any signs of getting mean, which I hope doesn’t happen. She’s almost childlike. She laughs; she’s really fun,” she said.
Sticking to a consistent schedule is an important way to reduce confusion, Raffetto said.
Raffetto visits Boltz twice a week, and arrives around 9 a.m. each day. Boltz usually asks why she hasn’t seen her caregiver in a while, even though it’s only been a few days, then they eat, and walk around the block.
They watch TV news, and Boltz reminisces about her childhood and life. She and Raffetto connect over upbringings spent on farms.
Sometimes they look at old family photos. Many of the pictures have disappeared lately, but some are still around.
Family members visit regularly. Boltz gets her hair done with her sister. It’s an excuse to talk. Savkranz visits her mom during her day off, and they drive somewhere for a hamburger and a soda.
‘Spending time with them. That keeps me happy’
Savkranz is reluctantly accepting her mom’s reality.
“It’s hard to recognize that things aren’t going to get better — that, in fact, they’re going to get worse,” Savkranz. “The best thing I can do for her is to include her with things to make her happy. It’s hard to do, because she doesn’t remember. It would be easy to say ‘Why bother?’ but we have to continue to do the best we can and include her in everything we can, especially anything that involves my grandson, because that’s all she cares about.”
Boltz’s great-grandson — Hendricks’ son — is 7 months old. He’s Boltz’s first, and long-anticipated, great-grandchild. Hendricks, 24, has been married for five years, and her grandma had been begging her to have a baby “from the get-go.”
“It’s a big deal to her,” Hendricks said. “I think she’s the last of her siblings to have a great-grandkid, and maybe she didn’t think she would’ve made it to this point.”
Boltz sees the baby at least once a week. She spends time with the infant at the salon where Hendricks works. Or she’ll see him at dinner or a birthday party.
Sometimes Boltz thinks it’s been months between each visit, and the child is a few years old. But he always pacifies her.
“She can be in a really crappy mood and the minute he smiles at her it’s all over with,” said Hendricks, who also is a CNA. “Any dementia patient I’ve worked with, whenever someone brings their grandkid around, it always lightens the patient’s mood. It always changes them.”
Hendricks brings the baby to Boltz’s condo. He’s getting a little big for his grandma to hold him, but Boltz can still sit with him, and feed him.
Sometimes Hendricks puts the baby down for a nap, and Boltz won’t stop coddling him. She gets too excited to let him sleep.
Other times, when the baby is playing with his toys on the floor, Boltz will get down there with him. She isn’t too old for that.
“Seeing my grandkids, and spending time with them. That keeps me happy,” Boltz said. “I love to be around the kids. They grow up though — the little farts.”
Reporter Kevin Trevellyan can be reached at 208-542-6762.