Wendel Abel
ALZHEIMER'S DISEASE is a form of dementia. Persons affected by this disorder experience progressive deterioration in memory. The disease wipes out memories of date, time, one's current address, telephone numbers and the names of close family members and friends. There may be personality changes, decline in judgement, loss of social skills and difficulty performing simple tasks such as bathing, brushing one's teeth and getting dressed. Other features include agitation, wandering away from home, aggressive behaviour, difficulty sleeping at nights and the inability to adjust to new surroundings and routine. Some individuals may experience hallucinations.
ABOUT MY GRANDMOTHER
My grandmother was a victim of this disease. She would forget where she placed keys and money and would accuse others of stealing them. As the condition worsened she would wake up at nights, wander around the house, switch on lights and leave doors open. This was very dangerous! She would often leave the stove on. One day the house almost caught afire. It was difficult controlling her. Then she started to wander away from home. She could no longer recognise me. That was painful.
Grandma lived for six years, which is the average period of survival from diagnosis to death. It was painful watching her go down the drain. Some individuals survive for as long as 25 years. When grandma died it was a painful relief. We missed her but her suffering had ended. Our pain had ended.
THE CAUSE OF ALZHEIMER'S DISEASE
The exact cause is not clear. It may be hereditary and the probability of developing the condition is increased if one has family members with the condition. Viral infections and the possible accumulation of metals such as aluminium in the brain are possible causes.
MAKING THE DIAGNOSIS
It is sometimes difficult to distinguish Alzheimer's from other forms of dementia. The diagnosis of Alzheimer's can only be made by examining brain tissue under a microscope and this can only be done after death. Doctors however are able to do detailed examinations and investigations to rule out other causes and then make a diagnosis.
HOW IS THE BRAIN AFFECTED?
Certain nerve tissues known as nuerofibrillary tangles and plaques become knotted in the brain like braids. Like weed in a garden, the tangles and plaques grow and choke the brain and affect its function.
As we watched our grandmother wither away, we were all affected. The condition placed physical and psychological burden on family members, friends and caregivers. Everyone was affected; we were emotionally drained and burnt out. I could no longer relate to my grandmother, I could no longer maintain a basic conversation as she no longer made sense. It was painful.
Family members who are left behind to take care of a parent may feel resentful toward other siblings. Burn out and frustration on the part of caregivers may lead to abuse and neglect of the person with the disease. We had to take turn in taking care of grandma to avoid this.
TIPS FOR DEALING WITH ALZHEIMER'S DISEASE
1. These individuals need a caring, stimulating, nurturing and stable environment. Avoid moving them from place to place as this may worsen their confusion.
2. Discuss the use of medication with your doctor. Drugs available in Jamaica include Donezepil (Aricept), Rivostigmine (Exelon) and Galantamine (Reminyl). Vitamins and herbal products such as gingko biloba are of limited use.
3. Taking care of someone with Alzheimer's may be very stressful. Family members should work together.
4. Additional caregivers such as a helper or a nurse may help to reduce the burden of caring. This disease does take a toll on caregivers.
5. Placement of the affected individual in a nursing home may be necessary when it is no longer possible or practical to care for the individual at home.
More specialised facilities to provide quality care for persons with Alzheimer's disease are needed in Jamaica. If you are interested in participating in the establishment of such a facility call 922-3216.
Dr. Wendel Abel is a consultant psychiatrist and senior lecturer, University of the West Indies; phone: 922-3216; email: yourhealth@gleanerjm.com.
