We Can’t Know for Sure

We want to know how and when. And we want to know now!

In our age of information, we have little patience for situations that aren’t easily answered with data, definitive answers, and quick fixes. We just want to take a pill or pay the bill and get on with things.

Yet, there are so many life situations that can’t easily be answered or remedied. Alzheimer’s is a great example. Just about everything about the disease is unpredictable. From the person’s behavior to its progression, things are best handled as they come, because so many factors come into play including personalities, the damage being caused to areas of the brain, other existing health conditions, past and present home and work environments, and the person’s previous lifestyle.

My husband Marshall has gone well beyond the average of 8 years since diagnosis. He’s progressed through the disease in steps. About every three months over the past 15 years there has been a noticeable decline. Meds and behavior (mine and the caregivers) would be modified and he’d ride the plateau until the next downward step.

The past six weeks the progression of Marshall’s disease has been on a continuous angle downwards. He now sleeps most of the time, eats little, has only brief periods of comprehensible language, and is mostly immobile. Muscle control and perception make feeding himself challenging. Most foods land in his lap unless he is fed. Marshall stands only with assistance and great difficulty and is limited to taking a few steps at a time.

Only God knows how long Marshall can continue in this state, or worse. He’s been accepted by hospice, an indication that the end is near, likely within six months. However, whether his remaining time on earth is days, weeks, or months is uncertain. His hospice nurse believes he may rebound for a bit. She doesn’t think he is leaving us right now, but no one really knows for sure.

From the beginning of this disease, the challenge for those around Marshall is understanding how ill he truly is. Even today, his color is good. He is otherwise healthy without illness to vital organs. Even his blood pressure is normal. Although incapacitated and not the lively, happy, charismatic man he was, he does not have the grey, sunken face we often see in one close to death. He will smile and say a few sweet words to family and caregivers from time to time.

But we can’t see what is happening in his brain. Without imaging, we can’t see the atrophy (shrinkage) or destruction. Brain cells have continuously been killed by the plaques and tangles leaving holes in the brain. Neurons no longer exist to control the body’s functions and will eventually eliminate his ability to swallow and breath. Those who die solely with Alzheimer’s typically pass from infection, aspiration pneumonia, or weight loss.

Our goal for Marshall now is to keep him comfortable and content. Our goal for ourselves is to love and enjoy him while we can.

(Here is a clear video on the progression of Alzheimer’s disease . It’s well-worth the three minutes it takes to watch.)

(Navigating Alzheimer’s available from Amazon.comACTA Publications, and my website.)



  1. Your words are an inspiration. No one knows what it is like to see the one we love go through this disease unless you are going through it yourself but you have a way of helping people understand it. I am also watching my love living with this disease and you have helped me understand so much and for that I thank you. You are suffering but you find a way to help others. That is a very special gift and I thank you. I am sure there are many others out there that are also thanking you for your openness in sharing.


    1. Thank you, Susie. No one understand better than you.


  2. Sally Thomas · · Reply

    I love you my dear friend.


  3. Thank you, Sally. I feel the love.


  4. Sonja Drobena · · Reply

    My heart and prayers are with you and Marshall. Hugs


  5. Diane Philyaw · · Reply

    Thank you for the update Mary. Know that we are continuing to pray that God gives you the strength to be by Marshall’s side during this most difficult time. We are also praying that God will keep Marshall comfortable during his time in hospice. Sending you hugs and prayers, Marshall & Diane


  6. polkajammernetwork · · Reply


    I’m very saddened to hear about Marshall. It’s had to believe that a man who gave so many hours of entertainment and miles of smiles is suffering. It doesn’t seem fair that God is letting this happen? I’ll never forget after you came to interview him for the Tribune in Roselle, he told me “I really like that reporter “
    No one could have been better for his life them you ! Please know that if we can do anything to assist you, Camille and I are here for you. Your strong faith will help you through this difficult time. All our love


    1. Thank you, Keith, for your kind words, love, prayers, and support. I truly appreciate the gift of friends Marshall gave me, you and Camille being some of those I treasure.


  7. […] out posts on my other blog, Mary K Doyle Books, including We Can’t Know for Sure, How Will Our Story End, Sacrificing for God’s […]


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