World Alzheimer’s Day

Wednesday, September 9, 2009

 

 

 

World Alzheimer’s Day

 September 23, 2009

 World Alzheimer’s day will be observed this month (September 23, 2009). While the disease is generally known as a form of dementia which is incurable, there is a need to spread awareness about this malady because of the seriousness of the condition and the great burden it places on the caregiver. Last year we had a woman resident at Omashram with this condition and we managed her fairly well but one fine morning she just slipped out, never to be traced in spite of our own efforts to track her down and the police who also searched for her all over but without success.

 About Alzheimer’s disease
 
 Alzheimer’s disease (AD), also called Alzheimer disease, Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer’s, is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuropathologist Alois Alzheimer in 1906 and was named after him.
Alois Alzheimer’s patient Auguste D in 1902. Hers was the first described case of what became known as Alzheimer’s disease.
 
 Generally it is diagnosed in people over 65 years of age, although the less-prevalent early-onset Alzheimer’s can occur much earlier. An estimated 26.6 million people worldwide had Alzheimer’s in 2006; this number may quadruple by 2050.Although the course of Alzheimer’s disease is unique for every individual, there are many common symptoms. The earliest observable symptoms are often mistakenly thought to be ‘age-related’ concerns, or manifestations of stress. In the early stages, the most commonly recognised symptom is memory loss, such as difficulty in remembering recently learned facts. When a doctor or physician has been notified, and AD is suspected, the diagnosis is usually confirmed with behavioural assessments and cognitive tests, often followed by a brain scan if available. As the disease advances, symptoms include confusion, irritability and aggression, mood swings, language breakdown, long-term memory loss, and the general withdrawal of the sufferer as their senses decline. Gradually, bodily functions are lost, ultimately leading to death. Individual prognosis is difficult to assess, as the duration of the disease varies.
 
 AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed for years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis.The cause and progression of Alzheimer’s disease are not well understood. Research indicates that the disease is associated with plaques and tangles in the brain. Currently used treatments offer a small symptomatic benefit; no treatments to delay or halt the progression of the disease are as yet available. As of 2008, more than 500 clinical trials were investigating possible treatments for AD, but it is unknown if any of them will prove successful. Many measures have been suggested for the prevention of Alzheimer’s disease, but there is a lack of adequate support indicating that the degenerative process can be slowed. Mental stimulation, exercise, and a balanced diet are suggested, as both a possible prevention and a sensible way of managing the disease. Because AD cannot be cured and is degenerative, management of patients is essential. The role of the main caregiver is often taken by the spouse or a close relative. Alzheimer’s disease is known for placing a great burden on caregivers; the pressures can be wide-ranging, involving social, psychological, physical, and economic elements of the caregiver’s life. In developed countries, AD is one of the most economically costly diseases to society.
 
 
 
Charlton Heston and Ronald Reagan at a meeting in the White House. Both of them would later develop Alzheimer’s disease.
 
 
Caregiving
Since Alzheimer’s has no cure and it gradually renders people incapable of tending for their own needs, caregiving essentially is the treatment and must be carefully managed over the course of the disease.During the early and moderate stages, modifications to the living environment and lifestyle can increase patient safety and reduce caretaker burden. Examples of such modifications are the adherence to simplified routines, the placing of safety locks, the labelling of household items to cue the person with the disease or the use of modified daily life objects. The patient may also become incapable of feeding themselves, so they require food in smaller pieces or pureed.When swallowing difficulties arise, the use of feeding tubes may be required. In such cases, the medical efficacy and ethics of continuing feeding is an important consideration of the caregivers and family members. The use of physical restraints is rarely indicated in any stage of the disease, although there are situations when they are necessary to prevent harm to the person with AD or their caregiversAs the disease progresses, different medical issues can appear, such as oral and dental disease, pressure ulcers, malnutrition, hygiene problems, or respiratory, skin, or eye infections. Careful management can prevent them, while professional treatment is needed when they do arise. During the final stages of the disease, treatment is centred on relieving discomfort until death.
 
 Caregiver’s burden
The role of the main caregiver is often taken by the spouse or a close relative. Alzheimer’s disease is known for placing a great burden on caregivers which includes social, psychological, physical or economic aspects. Home care is usually preferred by patients and families. This option also delays or eliminates the need for more professional and costly levels of care. Dementia caregivers are subject to high rates of physical and mental disorders. Factors associated with greater psychosocial problems of the primary caregivers include having an affected person at home, the carer being a spouse, demanding behaviours of the cared person such as depression, behavioural disturbances, hallucinations, sleep problems or walking disruptions and social isolation. Regarding economic problems, family caregivers often give up time from work. Cognitive behavioural therapy and the teaching of coping strategies either individually or in group have demonstrated their efficacy in improving caregivers’ psychological health.
 
 Here’s the lighter side of it.
An Old Man’s Woes
A sad, old man sitting was sitting on a park bench when along came a police officer. The officer asked the old man why he was so upset.
The old man replied, “Every morning I wake up with a wonderful 20 year old blonde. She cooks great meals including sausage, and bacon and everything I love. Then we make passionate love in bed. Afterwards, she gives me a bath, with handdrawn hot water, cooks me lunch and followed by more passionate love. In the evening, we’ll have top the day off with a fantastic diner and yet more wonderful love.
The police officer gets a puzzled look on his face and asks, “Well, what seems to be the problem?”
The old man replied with a sad look on his face, “I can’t remember where I live!”
 
 
Mohan Pai
Omashram Trust.
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