Mangaluru, Sep 23, 2022: "World Alzheimer’s Day 2022" was observed in the city after a lull of two years. A full fledged forenoon programme was held at ’Town Hall’ on Friday, September 23, 2022, with a large number of elderly persons’ presence. Awareness programs are on-going in other cities in the country and also reported from all parts of the world.
This programme was spearheaded by ’PAGE - People’s Association for Geriatric Empowerment’. This is a conglomerate of many divergent organisations to make a ’difference to the lives of elders’. To enrich the natural ageing process a wide cross section of elders and youth, together as one body and mind and a tremendous effort and force emerges in society. PAGE is people joining together to make ’Namma Mangaluru’ Dementia free and elder friendly. The key persons in this effort currently Mr.Jerardin D’Souza, Dr.Prabha Adhikari, Mr.Mohan Raj, there have been many generous, kind and active institutions, groups and people in this effort consistently and all of them are to be remembered and admired now and in the future. At this juncture it is apt to recall the late Ms. Olinda Periera who has been the backbone of the yeoman efforts to uplift the elders and sick in the city.
At this celebration of the aged several knowledgeable professionals shared their expertise on "Dementia & Alzheimer’s" that the large gathering at ’Town Hall’ in the heart of Mangaluru generated. Among those present on the dais at a virtual symposium apart from the three trustees of PAGE named above were dignitaries Sri. Sashi Kumar IPS, Fr. Richard Coelho, director Fr.Muller’s, Dr.Vijaya Kumar Vice Chancellor Yenepoya deemed uni., Dr.B Unnikrishnan Dean KMC, Dr. Kishore Kumar District health Officer and several other extempore invitees who shared their experiences and made suggestions. After the lighting of the ceremonial lamp there was a very well chalked out programme by various groups of ’Caregivers’, ’Senior Citizens’, Students’ and ’Institutions. This was indeed an exercise which brought out a lot of useful information and a roadmap for the immediate future of this traumatising age related illness.
September is a month dedicated to awareness about one of the devastating forms of Dementia, caused by Alzheimer’s disease (AD). Named after Dr Alois Alzheimer, to document it. AD is progressive and irreversible, because symptoms worsen over time and correction is not known. Alzheimer’s Disease (AD) is a neuro-degenerative condition which gradually damages brain cells causing problems in memory and thinking. It has been estimated that more than 50 million people are diagnosed with AD worldwide and it is the most common cause of Dementia accounting for 60-70% of all dementia cases. The gist of the disease and discussions can be summarized in the following information:
Personality and Behaviour :
Memory Chaos: in memory are the early symptoms of AD with difficulty registering/recalling new information, forgetting recent events and conversations. Short-term and immediate memory are the first to be affected. This memory loss often results in arguments with family as the person may accuse the loved ones of not feeding them, stealing their valuables and so on. The disease progresses, and severe memory impairment with problems to carry out simple daily tasks or recognize loved ones results commonly. People with AD may move aimlessly, get lost in familiar surroundings, or forget where common things are. They may wander away from home and not be able to find the way back. The family/caregivers have to be alert all the time as the risks are great.
Due to alterations of the brain zones which are directly responsible for thought processing, people with AD have difficulty finding words to identify things, and converse. They have difficulty with numbers and find it challenging to handle money, pay bills. Everyday tasks like turning off the stove, dressing, bathing or grooming may not be handled. Because of their inability to communicate with clarity, family/caregivers’ efforts to understand what they want- whether they are hungry, thirsty, want to use the washroom or if they are in pain and respond accordingly is a challenge.
Behavioral and personality issues develop in AD (Alzhimer’s Disease) patients. Temporal lobe involvement leads to emotional reactions like anxiety, sadness, and apathy, lack of trust, anger and aggression. “Sun down Syndrome” is seen, they are more agitated and irritable after the sun goes down, i.e., in the late evening hours. Their sleep patterns drastically alter; they want to sleep during the day and keep awake at night, confusing the circadian clock. Psychotic symptoms like delusions are sometimes seen in people during the later stages of AD. They may accuse loved-ones/care-givers of poisoning their food, stealing their valuables, plotting to harm them and so on. The persecutory content of their thought processes may mislead others into believing the accusations if they are unfamiliar with the symptoms. Hoarding paper cuttings, fruit peels, match sticks or other junk and treating them as items of immense value is seen in some. When family caregivers take them away, they become very agitated or aggressive. On rare occasions they may become violent if others do not go with their thinking and argue otherwise. Sometimes it is best to leave them alone and not monitor every move of theirs as long as they do not harm themselves or others. Losing their inhibitions, undressing in public, urinating or defecating in the living room are noticed in the advanced stages of AD.
Improving the quality of life, with Dancing, singing, playing an instrument, handicrafts, reminiscing (telling stories) are some of the skills which are preserved for a longer time and by keeping the person with AD engaged and cognitively occupied, it is possible to slow down cognitive decline to a great extent. Research evidence suggests that the above-mentioned skills are controlled by parts of the brain which are not affected by Alzheimer’s Disease for a longer time.
What can family/ caregivers do? Caring for a person with AD is a challenge indeed, can be quite foxing. Each day poses new challenges as the disease progresses. Each person is unique and the families have to learn to deal with new options every day. Few general guiding points to be kept in mind are : • Place personal belongings visible so they can easily be found. • Keep emergency contact numbers on them so someone can contact you if they wander away. Identity cards, Bracelets with phone numbers etched on them also help. • Keep medications out of their reach to prevent overdosing by mistake. • Calendars, clocks must be on hand so by themselves they can find out what time/day/month it is. If they think it is Monday, and you know it is not, don’t insist they are wrong. Don’t force yourself to prove you’re right and they are wrong. • Most people with AD have problems with balance. Comfortable footwear with good traction will help in mobility. • Remove excess furniture, clutter from the rooms, too much furniture can be confusing. Rearranging furniture could be very confusing so try to avoid it. • Handrails are useful in corridors and bathrooms. Bath time is sometimes a challenge and it is important to schedule a bath according to convenience not yours. Do it when they are in a better frame of mind. • Remove mirrors from the rooms as the images are sometimes frightening to them. • Finally, do not ask them repeatedly if they know who you are and what your relationship with the person is. They have dementia, you don’t have to prove.
Some vital points to note: The causes of mental confusion in the elderly, are not usually "Tumors in the head" nor early signs of Alzhimer’s. The three most common causes: uncontrolled diabetes, urinary infection, dehydration. When no one is around to remind the aged to drink fluids, they quickly dehydrate. Dehydration is serious and affects the entire body. It may cause abrupt mental confusion, a drop in blood pressure, increased heart palpitations, angina (chest pain), coma and even death. This habit of forgetting to drink fluids, begins at age 60, when we have just over 50% of the water we should have in our bodies. People over 60 have a lower water reserve. This is part of the natural aging process. But there are more complications. Although they are dehydrated, they don’t feel like drinking water, because their internal balance mechanisms don’t work very well. People over 60 years old dehydrate easily, not only because they have a smaller water supply; but also because they do not feel the lack of water in the body. Although people over 60 may look healthy, the performance of reactions and chemical functions can damage their entire body.
Finally, note that even in the case of Queen Elizabeth t II, who passed away just weeks ago; experts say loneliness and heartache may have contributed to the Queen’s declining health. GP Dr Deb Cohen-Jones explained, it’s more about “losing your will than it is about your health, in some ways”. “From a physiological point of view, the loss of Prince Philip would have caused her severe stress, peaking her cortisol levels, and leaving her body to deal with that.” Meanwhile, heart surgeon Nikki Stamp said the death of a spouse can trigger a stress-related “chain reaction” that can lead to declining health. Royal commentator Angela Levin posed a question to Twitter. “What we know is that for some people the stress of losing a loved one, or any kind of stressful event in your life, does precipitate a whole bunch of reactions in the physical body as well as in your mind that can cause disease and sometimes cause someone to pass away, It’s certainly something that we’re discovering more and more lately.” So, with rising population of the aged and higher life expectancy the people have to take mental well being grasped in both hands and rise to make life a better routine from day to day in the future without undue tensions and frustrations for happiness and joy of life’s sun to set in peace.