HYDERABAD: September is Alzheimer’s awareness month. I’ve heard many youngsters say’ oh I forgot my homework..must be Alzheimer’s’. or ‘I’m sure I have dementia I’m so forgetful’.
So many of us loosely use these terms without understanding how difficult it is to be aware of a loss in our most precious faculty, that is the brain. Suddenly becoming clumsy, forgetting small things, forgetting names, fumbling for words, can be an extremely scary realisation to many older people.
Many older people come to me with complaints of forgetfulness, memory lapses, unsteady gait, and crying spells. ‘Doctor do I have dementia’ they ask… I also notice the impatience and briskness displayed by the caregivers of such people who usually have a barrage of complaints about this older person, a mother, or a father, or a grandparent who suddenly seems to have changed into something annoying and difficult to manage. Forgetfulness is probably an integral part of ageing, dementia isn’t.
It includes a loss of higher mental functions such as thinking, reasoning, remembering, and learning. There might also be a loss of behavioural abilities to the extent that it interferes with one's quality of life.
People with dementia may also develop problems with language, naming objects, and paying attention. Some may even develop delusions (which are false beliefs) and hallucinations (false perceptions). Personality changes, anger sadness, confusion, and mood swings are also common. Urinary and bowel incontinence can further complicate caregiving and also the self-esteem of the previously independent and sharp-minded person.
Having said this, not every elderly person who has forgetfulness suffers from dementia. Here are some common differences between normal ageing and dementia:
Normal ageing
Forget routines
Forget tasks and sometimes words
Forget days of the week or month but remember later
Losing things from time to time
Can become moody and grumpy
Insomnia and restlessness are common
Early signs of dementia
Forgetting directions or getting lost
Confused about time people are places
Mood swings, crying spells, anger
Asking the same questions again and again
Being able to remember childhood events but for getting what one ate for breakfast half an hour ago
Repetitive talk
Poor self-care, not bathing, eating poorly, behaving unsafely, and sometimes inappropriately
Losing things often
Fumbling over words
Might soil clothing
Most of the time one may not be aware of these changes and they’re usually noticeable by family and friends. There are many metabolic and neurological changes that take place in dementia and a lot of them can be linked to high blood pressure, diabetes and other metabolic conditions if not under control. While normal ageing does involve memory loss and a loss of faculties.
Dementia and Alzheimer's have more ominous outcomes. While most neurodegenerative disorders have predictable and visible outcomes here are some tips on how one can deal with memory lapses as we age and also probably delay the inevitable loss of our most precious faculties.
How do preserve brain function?
First and foremost, maintain a healthy lifestyle and for this start young don’t wait until you retire to start exercising. Degeneration of our faculties starts quite early so be there for yourself
Exercise, eat healthily, take care of yourself
Have a daily routine
Take care of health and metabolic issues. Keep diabetes and hypertension in check
Learn a new language or skill
Play board games like chess, monopoly, solitaire et cetera
Video games are also good to maintain quick reflexes and understand strategy and logistics
Don’t stop reading, going out, listening to music, and having fun
Play with children. Teaching things to them can keep your brain awake and alive
Make to-do lists
Play word games, sudoku, crosswords and puzzles
Get 7 to 8 hours of sleep each night
Control alcohol, tobacco and other drugs
Keep your cholesterol in check
Take help for depression and other mental health issues
If you have never journaled before, this is your time to start
Keep in touch with friends and family
Practise meditation, and mindfulness, and take therapy if needed, for unresolved issues
Retired from work but never from life
Adopt or get a pet if possible
Take care of your finances, and your retirement plans and maybe it’s time to write your will.
These activities can definitely help stall the inevitable and give you a better quality of life as you get older.
Caregivers, a small note for you too. The expectation is to be patient and flexible as you care for the person who suddenly is developing a failed memory and behavioural issues. But caregiving is hard and can be extremely taxing and many caregivers are often burnt out and angry. Do take therapy to understand your feelings of hostility and anger and also to be able to understand how to take care of your elderly. Sometimes it works do establish support groups of other caregivers so you can discuss and arrive at better plans on caregiving.
And for all of us out there who are seemingly past our prime, age is just a number. Practice self-care now!
(The author is a mental health professional and psychotherapist at Dhrithi Wellness Clinic)