*16 Jan 2012* *[email protected]*
*MUMBAI* : A dementia patient in the family can be a challenge for the caregivers. Here's a personal account on how to deal with it [image: 11509473.cms] My friends give me a quizzical look when I turn down a party invite and tell them I have to babysit a four-year-old brat. How else do you describe an 85-year-old who is in the second stage of dementia? Someone who breaks the winter chill with his warm toothless grin, saying, "Mere liye kya laya?" when he sees me, and the next minute throws a tantrum over his empty brandy bottle, burnt papad and missing bank book. It would have seemed normal, but for the fact that 85-year-old Dayaram Gursahani (Daddy), my close friend Dr Roop Gursahani's father, has just finished having his hot brandy, "kadunchy papad" and has the bank book peeping out of his shirt pocket. Two years ago, when Daddy forgot his wallet or mixed up the characters of his favourite TV serial Saat Phere - Saloni ka safar and Balika Vadhu, we laughed at his absentmindedness. Over time, his interest in TV soaps dwindled. It became a matter of concern, when he started getting more confused, forgot people, names and telephone numbers, and became increasingly irritable. One morning, he asked his son, who works as a consulting neurologist at P D Hinduja Hospital, "Where do you go every day? Do you work in some office?" It took a formal cognitive test to confirm that Daddy, a retired district judge who loved reading Mills & Boons and collecting watches, was in the second stage of dementia - losing track of time, literally. So what do you do when your parent or spouse is diagnosed with dementia, and you know you're fighting a losing battle? "Accept the fact that the person is ill," says Dr Roop, who takes care of many Alzheimer patients but never thought dementia would come so close to home. *What is dementia?* Dementia is a disorder involving the gradual decline in the functioning of the brain. It affects about three per cent of people above 65 and becomes more frequent with increase in age. Alzheimer's is the commonest cause of dementia. There are three stages of dementia. In the first, patients show symptoms of memory loss and behavioural changes. In the second, they find it difficult to cope with day-to-day activities and, in the final stage, they stay bedridden until the end. Medication provides relief and retards the progression; but, it does not cure the disease. "The best solution is to take care of them in a home environment. It is only when they are bedridden that you should move them to a hospital," says Dr Gursahani. *Watch out for these symptoms* *Memory loss* The person forgets names, places and telephone numbers. The person may frequently get lost in familiar surroundings or misplace household objects. *Moodiness* The person becomes more moody and irritable as parts of the brain that control emotions become damaged. *Communication difficulties* The affected person finds it harder to communicate and relies on someone else, such as a spouse or caregiver, to make decisions or answer questions. *Help at hand * - Provide a good diet and healthy lifestyle to the patient. Daddy loves fish and he wants to eat it every day. But we make it a point to feed him lots of greens and liquids to keep him well hydrated. As time progresses, caretakers have to be vigilant about their hygiene. We take him for walks to keep him mobile. - Establish a daily routine of activities such as bathing, toileting and meals at fixed hours. They lose track of time and may, for instance, ask for a snack soon after lunch. Setting a routine helps the patient follow a list of activities throughout the day, which otherwise they tend to forget. - Minimise changes in the patient's surroundings to avoid confusion. Moving around furniture can disorient them. Socialising can sometimes be a little confusing as they not only forget places, but also people. - Allow them to complete as many things as possible on their own to keep them independent. - Label drawers and cupboards so the patient knows what they contain. - Having a strong support system makes a big difference. It helps to inform your neighbours, watchmen, relatives who live nearby in case the patient starts wandering. A reliable tactic is to tie a badge on the wrist with the name, address and contact. - "The most important thing is to accept the illness and be aware. Each patient will progress differently through the illness. Some patients and their families take anywhere between six months and two years to accept the illness but there are some who continue to live in denial," says Dr Charles Pinto, a consulting psychiatrist at Holy Family Hospital, Bandra. - Some patients could get aggressive over activities like a bath or changing clothes. You need to cajole them and find out what triggers the aggression. Don't try to force the activity or overpower them. Use of medication to mellow them should be avoided as these could lead to other complications. *For the caregiver* - Continue to socialise and lead a normal life so that you can balance your responsibilities. Hiring a caretaker helps. If you are going out of town, ask for a responsible family member to house-sit. - Don't argue or debate with or take personal offence to what the patient says. When Daddy starts with his pet peeves - bad lighting, uncomfortable furniture, lack of indoor plants and non-vegetarian food, I simply use the 'distraction technique'. I trick him into talking about his favourite fish curry, carrot pickle recipe and dry fruit box. Think of it as inverted childhood. *Get outside help* There are many organisations and support groups that provide nurses and aides. "Nobody talks about the stress and trauma the family goes through. Investing in a caregiver or leaving the patient at a day care centre provides respite to the family and the patient," says Shailesh Mishra, honorary secretary of Alzheimer's & Related Disorders Society of India, Mumbai Chapter. Most doctors say that family members and caregivers should not argue with dementia patients. Easier said than done, especially after having spent enough time with Daddy, and dancing to his tunes, right from getting the latest copy of M&B to telling him why he can't have breakfast after lunch. But that doesn't stop me from caring for him, and his asking me, "Mere liye kya laya?" http://articles.timesofindia.indiatimes.com/2012-01-16/health/30631349_1_dementia-memory-loss-final-stage -- You received this message because you are subscribed to the Google Groups "Mental Health Advocacy (News 'N Views) India" group. To post to this group, send email to [email protected] To unsubscribe from this group, send email to [email protected] For more options, visit this group at http://groups.google.com/group/MhaNewsViewsIndia?hl=en ------------- Affiliated Groups : MENTAL HEALTH ADVOCACY INDIA [email protected] Discussions on mental health law / policy / plan monitoring / human rights etc [email protected] India-specific news and views related to mental health [email protected] Information and support to carers of people with mental health issues [email protected] Mutual support and sharing of experiential knowledge, skills and social learning amongst peers
