Abstract
Loss of a beautiful memory, mind, … and life. This is how Alzheimer’s sucks out its victims…gradually, says Shobha Nair.
Alzheimer’s is a silent killer of brain and lives of the elderly. It is the fourth leading cause of death among the older adults in the developed world. Named after Alois Alzheimer, the German physician who identified it in 1907, it remains elusive as to its cause and is resistive to treatment. It starts as a robber of memory and slowly erodes the intellectual and functional abilities leaving the patients bed-ridden and ends in death. Its impact on the patients as well as their caregivers is huge, considering the long period of suffering (8-20 years). Late President (USA) Ronald Regan and Prime Minister (UK) Harold Wilson were two of the famous victims of this disorder that doesn’t believe in any sort of social or financial barriers. September 21 is dedicated by UN as the World Alzheimer’s Day to spread its awareness around the globe.
A man is sitting next to her. She knows his name is Vijay, but that is all she knows. She doesn't remember that when they met, she was the college beauty and he was considered the best-looking guy in town. She doesn't remember they've been married nearly 55 years and have raised two daughters. She doesn't know that her daughters and Vijay, 80, try to watch her constantly because they're terrified she will wander off. She doesn't even know her own name. She is 75 years old and she has Alzheimer's—a devastating diagnosis. "Only people who have this in their family could possibly understand what we're going through," says Vijay, an ex-banker. With other diseases, he says, "there's usually a progression, a treatment, and you're hopeful for a positive end. With Alzheimer's, there is no positive end."
That is the constant sad reality of life with Alzheimer's, the most common type of dementia. It is an emotionally wrenching journey for millions of patients and their caregivers…. The human cost is crushing, says Dr Ramesh Patel: "It's emotionally, physically and financially draining. The time between diagnosis and death can be more than a decade, with each day bringing new heartache for overwhelmed families.”
"If any one faculty of our nature may be called more wonderful than the rest, I do think it is memory. There seems something more seemingly incomprehensible in the powers, the failures, the inequalities of memory, than in any other of our intelligences," wrote Jane Austen, the English writer. This most wonderful gift, if you loose, can make your life chaotic.
We all forget a name or misplace keys occasionally. Many healthy people are less able to remember certain kinds of information as they get older. However, the symptoms of Alzheimer's are much more severe than simple memory lapses.
The difference between Alzheimer's and normal age-related memory changes
- Forgets entire experiences.
- Rarely remembers later.
- Is gradually unable to follow written/spoken directions.
- Is gradually unable to use notes as reminders.
- Is gradually unable to care for self.
- Forgets part of an experience.
- Often remembers later.
- Is usually able to follow written/spoken directions.
- Is usually able to use notes as reminders.
- Is usually able to care for self.
Following are 10 warning signs of Alzheimer's
- Memory loss. Forgetting recently learned information is one of the most common early signs of Alzheimer's. A person begins to forget more often and is unable to recall the information later.
What's normal? Forgetting names or appointments occasionally.
- Difficulty performing familiar tasks. People with Alzheimer's often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, placing a telephone call or playing a game.
What's normal? Occasionally forgetting why you came into a room or what you planned to say.
- Problems with language. Patients often forget simple words or substitute unusual words, making their speech or writing hard to understand. They may be unable to find the toothbrush, for example, and instead ask for "that thing for my mouth.”
What's normal? Sometimes having trouble finding the right word.
- Disorientation to time and place. They can become lost in their own neighbourhood, forget where they are and how they got there, and not know how to get back home.
What's normal? Forgetting the day of the week or where you were going.
- Poor or decreased judgement. They may dress inappropriately, wearing several layers on a warm day or little clothing in the cold. They may show poor judgement, like giving away large sums of money to telemarketers.
What's normal? Making a questionable or debatable decision from time to time.
- Problems with abstract thinking. They may have unusual difficulty performing complex mental tasks, like forgetting what numbers are for and how they should be used.
What's normal? Finding it challenging to balance a checkbook.
- Misplacing things. An Alzheimer’s patient may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl.
What's normal? Misplacing keys or a wallet temporarily.
- Changes in mood or behaviour. A patient may show rapid mood swings – from calm to tears to anger – for no apparent reason.
What's normal? Occasionally feeling sad or moody.
- Changes in personality. The personalities of people with Alzheimer's can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member.
What's normal? People’s personalities do change somewhat with age.
- Loss of initiative. A person with Alzheimer’s may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities.
What's normal? Sometimes feeling weary of work or social obligations.
If you recognise any warning signs in yourself or a loved one, consult a doctor. Early diagnosis of Alzheimer’s or other disorders causing dementia is an important step to getting appropriate treatment, care and support services.
How to Tackle It
Recommends Dr Patel
- Early detection by social awareness programmes.
- Counselling of retirement age group to prepare them for productive ageing.
- Increasing the facilities for elderly people to socialise by having social groups or clubs where they can meet regularly and conduct different activities.
- Persons with mild to moderate dementia can be benefitted by a multidisciplinary approach that involves social workers, psychologists, occupational therapists and psychotherapists.
"When we were kids, they cared for us," says a caregiver. "Now it's our turn." That kind of a role reversal and love is not just a memory.
Warning Signs
People with Alzheimer's show a range of responses to their own behaviour and condition
- Denial (in the early stages).
- Blames others for making them “look ridiculous”.
- Complete self-awareness (“I’m sorry, I have Alzheimer's”).
- Frustration, agitation, rage.
- Vacant despair, with no apparent recognition that they were once a different person.
As the memory lapses of early Alzheimer’s become more serious, other cognitive deficits and behaviour problems develop
- General confusion, disorientation to date, time or place.
- Apathy, irritability, depression, anxiety.
- Problems with language, numbers, abstract thinking, and judgement.
- Personality changes with strange quirks or inappropriate behaviours.
- Wandering, hiding objects, problems with eating and sleeping.
- Late in the disease, paranoia and delusions may occur.
- Towards the end, total loss of self, and inability to control bodily functions.