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An Anchorage couple’s Alzheimer’s journey
Living with Alzheimer’s
An Anchorage couple’s shared path takes them to a new land
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By Aliza Sherman
That’s how Michael Strahan describes what it is like when a loved one has Alzheimer’s disease.
In 2016, Michael’s wife of more than 40 years, Linda, began exhibiting unusual symptoms. Michael recalls one night in their Anchorage home when he heard a noise in the living room. He found Linda carrying a thermos of hot water. When he asked what she was doing, she said she was waiting for the kids to arrive for the day care she managed in their home.
“A.M. or P.M.?” Linda asked. She didn’t seem to know the answer.
Michael led his wife to a clock and asked her what time it was. She didn’t know.
That incident got his attention.
The couple met in Oregon and were married in 1977.
Before the diagnosis
Michael is quick to marvel at his wife’s energy. She was a woman who had always been extremely active – easily walking 10 to 15 miles in a day – and highly engaged with her church and her community. The two of them met at a church leadership training program in Oregon where Linda had grown up and Michael had moved after high school.
The couple fell in love, got married in 1977, and lived in Eugene, Oregon, for a while until they moved to Hawaii to work with some friends who were taking over a church. In 1985, they moved to Alaska, and Michael was hired right away by Alaska Airlines, where he worked for the next 33 years.
In addition to working for the airline, he was also a registered hunting guide, and in 1996, he purchased the Alaska Outdoors Supersite commercial website from its previous owner after working as a writer for the site. He and Linda ran the online business together while she also ran a day care in their home. The couple relished outdoor adventures in Alaska, and spent the years hunting, fishing, river rafting, and flying all over the state.
Receiving the diagnosis
Fast forward to 2016 when Michael, and even Linda’s friends and Michael’s sister, expressed concern about Linda’s state of mind. They were starting to observe Linda experiencing moments of extreme confusion or speaking aloud but not making sense.
Linda went to Alaska Neurology for her first test – a MiniMental State Exam – to test her cognitive function and screen for cognitive loss. The test didn’t go well, and a number of possible diagnoses were discussed, including Creutzfeldt-Jakob Disease, an aggressive form of
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After Linda Strahan began to behave erratically, she took a cognitive test at Alaska Neurology. Later, she traveled to the Mayo Clinic in Arizona for more tests. She was diagnosed with early onset Alzheimer’s.
dementia.
The couple traveled to the Mayo Clinic in Arizona for additional tests, including an EEG, a CT scan and brain MRIs. Her official diagnosis was Young Onset Alzheimer’s, also referred to as early onset Alzheimer’s, an uncommon form of dementia that affects people under 65 years of age. Linda was in her mid-50s at the time.
The news was devastating. Linda was instructed not to drive, which took away a major part of her work life – transporting the kids at her home-based day care to parks and other recreational spaces around Anchorage. In one diagnosis, her entire career of taking care of children in her home and at their church nursery came to a halt.
The diagnosis dealt a major blow to Linda and Michael’s finances.
“We had some money in savings, and we were floating on that,” Michael recalls, realizing that the savings would not last more than a year. Without Linda working, their income was cut in half.
Michael ran all the numbers, and they kept coming up short. They were homeowners, they owned two vehicles, and all he could see is they would start losing things – the vehicles, his job if he couldn’t get to work, then their house.
“I could see the dominoes falling in front of us,” he says, and at the time he thought they weren’t going to make it.
According to Michael, these were the financial considerations for Linda’s care: • In-home care – In the United States, they were looking at $200 to $250 per day for nonmedical, in-home assistance that included cooking, cleaning and companionship while he worked. • A care facility – As Linda’s condition progressed into the later stages of Alzheimer’s, the couple would be looking at about $8,000 per month.
Moving forward from diagnosis
As Michael looked at their finances, Linda began her treatment, which included a combination of medications that could only do so much to stave off her deteriorating condition. She began taking donepezil and memantine, two standard Alzheimer’s medications. She also was prescribed escitalopram, an antidepressant, as depression can be a common offshoot as Alzheimer’s progresses.
In speaking with friends, Michael knew he and Linda would have to make some major changes in their lives to accommodate her diagnosis and their finances. Some people suggested that he consider retiring early and moving to another state, or even country, where their money could go further. A major factor in picking a new place to live was that it had to have a quality health care system so Linda could get the ongoing treatment she would need.
“We went online and thought, ‘Maybe we need to do something radical,’” says Michael, and the couple began looking at Costa Rica.
Michael learned that Costa Rica had a good quality medical system with affordable prices set up by the Costa Rican government. In-home care in Costa Rica ran about $30 to $40 per day. A care facility would cost about $1,900 per month.
The couple traveled to Costa Rica in
During the decades they lived in Alaska, the Strahans spent as much time as they could exploring the state and getting outdoors as much as possible. Despite Linda’s diagnosis, Michael says the couple continues to explore, this time in Costa Rica. They are focusing on the positive and living in the moment. Michael credits their faith with helping them persevere.
2018 as tourists, then settled in for 90 days, returning to Alaska to visit family and friends, then going back again to accumulate enough time in the country to gain residency status.
Their days start with Michael helping Linda get dressed and fed, then they jump in their truck and go on drives.
Some people have asked why he keeps taking her on adventures if she doesn’t remember any of it, but he says some people just don’t get it.
“She doesn’t have to remember it. She wants to live in the moment,” he says.
The long goodbye
While he is already feeling an overwhelming sense of loss, Michael says that in some ways there are blessings that come with an Alzheimer’s diagnosis. If someone dies suddenly, he says, it can be really hard because there could be unfinished business that can’t be fixed after someone’s passing. With Alzheimer’s, there is some time to connect, reconnect, say what needs to be said.
Michael and Linda spent much of the first two years after her diagnosis making the rounds to friends and family — “the long goodbye,” as Michael says he’s heard others call it.
When they arrived in Costa Rica, Linda was solidly in Stage 5 of Alzheimer’s, according to the Global Deterioration Scale, developed by Dr. Barry Reisberg, director of the Fisher Alzheimer’s Disease Education and Research program at New York University Langone Health. Stage 5 is “moderate Alzheimer’s disease,” marked by early deficits in “basic activities of daily life” and an inability to recall major life and current events.
By mid-2020, Linda was a little past the middle of Stage 6. At “moderately severe Alzheimer’s disease,” a person may find it challenging to dress or bathe or to carry out other basic activities of life, with heightened confusion and difficulty speaking.
Michael points out that not everyone experiences all of the symptoms described in the literature about Alzheimer’s, and they don’t necessarily experience them all in the same order or the same periods of time. A person with Alzheimer’s can plateau in a stage for an unpredictable amount of time, then
RESOURCES 7 Stages of Alzheimer’s https://www.alzinfo.org/understand-alzheimers/ clinical-stages-of-alzheimers/
Teepa Snow/Positive Approach to Care – Support for caregivers https://teepasnow.com/ https://www.youtube.com/user/teepasnow
Information on Alzheimer’s drugs https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/ in-depth/alzheimers/art-20048103
undergo sudden rapid and significant deterioration.
Through the challenges, Michael says his and Linda’s faith in God has been instrumental in helping them persevere through the last few years. After her diagnosis, Linda asked God for more time and was able to spend those first few years enjoying quality time with loved ones.
“For a person of faith, there is an unshakable hope that this is not really an end in any sense that matters. It’s a beginning. Your entire life on Earth is but a grain of sand on the white shores of eternity,” Michael writes on his blog, Grey Havens, named after the Elvish port city in “The Lord of the Rings” that was portrayed as a sanctuary. On his blog, he documents his and Linda’s experiences with Alzheimer’s.
“You feel yourself completely surrounded by the love of God in ways you never experienced before, and somehow you know, between the waves of emotion, that it really is going to be okay.”
Aliza Sherman is a freelance writer in Anchorage. Comments about this story? Email editor@AlaskaPulse. com
