Dementia – A Social Priority

Be patient with me – I am a victim of brain disease
Talk to me – though I cannot answer you
Be kind – each day is a struggle for me
Consider my feelings – I am still very much alive within
Remember my past – I was vibrant
Remember my present – I am still living
Remember my future – it is bleak

Alzheimer’s dementia is the most common of all dementias. The brain cells are destroyed in particular region of the brain and there is disruption in transmitters which carry messages particularly those responsible for memory storage and retrieving new information thus affecting the ability to remember, speak, think and make decisions.

WHAT ARE THE SYMPTOMS?

*Begins with lapses of memory, difficulty in finding right words for everyday objects or substitute unusual words.

Progresses

* Decrease in short-term memory, forget recent events, names, faces and difficulty in understanding what is said.

* Confuses handling money, difficulty in performing familiar task

* Personality changes – no longer care about those around them, dull or suspicious

* Mood swings – unusually emotional or show less emotion than before

* Agitation

Progresses

* Unsettling behaviour like wandering off and getting lost

* Disinhibitory behaviour – undress in public places, inappropriate sexual advances

* Misplace things or put things in unusual places

IS EARLY DETECTION BENEFICIAL?

Enables the caregiver to be better equipped

Helps people with dementia to make decisions (financial and legal)

Better chance to benefit from treatment

WHAT ARE THE PREVENTIVE STRATEGIES?

* Physical exercise improves cognition

* Social engagement

* Identify risk factors and treat (thyroid, vitamin deficiency, hypertension, diabetes, depression, hearing impairment, and smoking)

* Encourage cognitive games – scrabble, Sudoku, learning new skill or language

* Good nutrition

ROLE OF A CAREGIVER

Caring for your loved ones with dementia poses challenges.

* Speak in a respectful and pleasant way, use simple words slowly and distinctly and repeat message if needed.

* Listen and be patient

* Breakdown activities to small steps

* Remember their good old days

It is a long and winding road and we as physicians understand why Alzheimer’s caregivers can be so thoroughly unsettled day after day as we do not know how long and what is coming next.