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Living with loss
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Right intervention can make a difference to those suffering from Alzheimer’s Disease
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SENSITISATION As a person grows older, he is at greater risk of developing Alzheimer’s
Lakshmikutty Amma laughs a lot. She cries a lot too. She asks for her parents repeatedly, and thinks Rajeshwari A. is her chechi (sister). She needs constant care, is confused, and remembers little. She has no idea that her parents are long dead and her chechi is, in fact, her daughter. Lakshmikutty is 72 and has Alzheimer’s Disease (AD).
When Krishnaswamy wouldn’t respond when his family addressed him or stared blankly, they thought it was because he was going deaf. But, gradually they noticed changes they couldn’t ignore. Spells of lucidity were followed by complete withdrawal when he would recognise no one, respond to nothing or talk non-stop for hours on end. Krishnaswamy was 70 when AD affected him.
AD does not discriminate between rich and poor, engineer and doctor, teacher and head of State. Says K. Jacob Roy, National Chairman, Alzheimer’s and Related Disorders Society of India (ARDSI): “The only known risk factor is age. As a person grows older, he is at greater risk of developing Alzheimer’s. After 60, the risk is one in 20, but after 80 it is one in five.” No one knows why it happens, but it occurs when cells in the brain start dying. It is degenerative and leads to progressive mental deterioration.
How does one know if a family member is afflicted? There are warning signs.
* Difficulty in doing familiar tasks: inability to perform simple, tasks such as unlocking a door or making tea.
* Slipping job performance: forgetting appointments or meetings.
* Language difficulties: difficulty with words and in naming objects such as pen or spectacles.
* Confusion of place and time: difficulty in remembering the time of day, or even recognising their neighbourhood.
* Lack of judgment: touching a hot object, being insensible to traffic while crossing the road and wearing clothes inside out.
* Lack of initiative: becoming passive and needing constant prompting.
Often, these are dismissed as normal signs of aging. “But, when these start interfering with day-to-day functioning, and familiar activities become increasingly difficult for the person, it is time to seek help,” says K. Selvaraj, Professor of Psychiatry and Consultant Psychiatrist, Vazhikaati Mental Health Centre and Research Institute. And, the best person to approach is a neurologist or psychiatrist, or a geriatrician who has a special interest in dementia.
Dr. Roy says judicious use of medicines, a stimulating environment and a caring support group can make a huge difference. “Drugs can reduce the suffering, even if they don’t completely cure a patient. They can modify behaviour and enhance cognition,” adds Dr. Selvaraj.
In a report, Mathew Varghese MD, Professor of Psychiatry, NIMHANS, says mental disorders in the elderly in India are a major public health issue for these major reasons: poor public awareness of these disorders; rapidly changing traditional family and social support systems; and few health services that are geared to cater to the special needs of the elders.
(World Alzheimer’s Day is observed on September 21.)
PANKAJA SRINIVASAN
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