Alzheimer’s

As one progress in age, one tend to discuss health more often than any other topic. But in spite of million people afflicted by this devastating illness ''Alzheimer's'', it is rarely discussed either by seniors or by youngsters. Though Alzheimer's is not a normal part of aging, still all those who cross the age of 60; must know what the disease is.

Origin of the term Alzheimer's dates back to 1906, when Dr,Alois Alzheimer's a German physician presented a case history before a medical meeting of a women who suffered from rare brain disorder .A brain autopsy identified the plaque and tangles that today characterizes Alzheimer's disease.

It's important to acknowledge that your dear one may be afflicted with Alzheimer's and then take the person for a through checkup. If we take into account not only the victim but also the immediate family who are equally affected by this illness then we must conclude that it is the stigma attached to any mental disease, which makes the family hide it. Unless the society is educated about Alzheimer's, disease we cannot give any help to the victims, which is ever-growing in numbers.

The hope for world lies in preventing, slowing, or even reversing the disease and bolstering health-care system to meet the ever-increasing number of cases.

 Dementia means a gradual worsening in memory and other mental abilities as a result of brain damage. The most common form of Dementia is Alzheimer's.

Dementia is most unrecognized, under diagnosed. The reason being-

1. It happens to old people.

2. There is no known cure.

3. There is lack of facility to give proper care or support.

4. Lack of information about the disease.

5. Stigma attached to mental disease.

  The first reaction to the suggestion that your dear one may be suffering with Alzheimer's is denial. It's important to acknowledge that your family member has Alzheimer's disease, if one finds the symptoms related to it and then take the person for through checkup to identify it.

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   The most common form of the disease called late onset of Alzheimer's acurse at around 65 years of age. Such cases arise out of complex combination of genetic and non-genetic factors rather than single cause. Some treatable conditions such as depression, drug interaction and thyroid problems can cause symptoms that mimic Dementia. The duration of the disease averages to about eight years but can vary to twenty years. No two people experience the disease in then same way.

We can identify the disease by some of the glaring symptoms-

1.  Forgetting recently learnt information. While it is normal to forget appointments, names or numbers, those with Dementia will forget such things more often and not remember them later. But may be able remember some old event.

2. Difficulty in performing familiar tasks, finding it hard to complete everyday tasks like not knowing steps for preparing meal, using household appliance or participating in a life long hobby.

3. Trouble finding the right words and substituting unusual words making speech or writing hard to understand.

4. Dis orientations of time and space.

5. They Could  become lost on their own street; forget where they are, how they got there and how to get 6. Poor or decreased judgment: may dress without regard to the whether. They show poor judgment about money too.

6  Problem with abstract thinking, balancing a checkbook may be hard.

7. Misplacing things. Person with Alzheimer's may put things in unusual places like the phone in the freezer.

8. Rapid change in the mood for no apparent reasons.

9. Change in personality-does take place with age but people with Alzheimer's change a lot, become very confused, suspicious, fearful or dependent on a family member.

10. Loss of initiative-, become passive   like not wanting routine chores, sitting in front of T.V.

13. forgetting   and demanding meal after having it.

  Most people with Alzheimer's live at home with caregiver having the responsibility of meeting the patient's physical needs managing daily routines and making important medical and legal decisions. Many people with Alzheimer's and their family members find support groups to be helpful. Support group offer a forum to discuss their day-to-day situation and gain practical help in coping with the changes and challenges as the disease progresses.

  Alzheimer's disease progressively destroys cells in the brain and gradually destroys a person's memory and ability to learn,   reason, make judgment, communicate and carry out daily activities.

 As Alzheimer's progresses people may also experience changes in the personality of the patient and behavior. In the late stages people may need help with dressing, personal hygiene, eating and other basic activities. The plight of the care   giver is pathetic as they have to deal with their elders who behave weirdly as the disease advances, so much so that they need to be housed in a shelter where such cases are taken care of. This causes anguish to the near once. So the relatives too need counseling.

The most glaring symptoms as the disease advances -

1.      Complaining that they were never served meal and argue. No reasoning works with them.

2.      Tearing paper, books, clothes etc and collecting them.

3.      Walking off from the house.

4.      Forgetting one's relation with their children or spouse and mistaking them for some other relation and insisting on it.

Research has also shown that effective care and support can improve quality of life for individual and their caregiver over the course of the disease from diagnosis to the end of the victim's life. For Alzheimer's care-giver, the three fold impact  of physical, emotional and financial aspect of the disease often are horrendous and overwhelming. The care    giver needs support from not only the family but professional agencies to give advice about-

1. Educating the family about Alzheimer's.

2.  Giving home safety lessons.

3. Creating support group

4. Give Caregiver training.

How can we contribute to the cause of Alzheimer's?

=Learn more about the disease and progress made in research.

=Donate to the Alzheimer's association.

=Maintain a healthy brain so as to reduce the risk of the disease by keeping mentally active.

=Manage weight, cholesterol, B.P and blood sugar.

=Follow healthy, low fat diet.

=Exercise regularly.

=Stay socially active, connected to society whatever once age may be.

Alzheimer's and related disorder society of India says, Dementia will be a major challenge that we in India will be faced. Unfortunately neither the Government nor the public has fully understood the repercussion of this mind crippling, devastating illness.

How can Government, societies and business houses contribute in bringing awareness among public and professionals?

=Consistent, continuous information of the disease through media.

=By raising the issue in Assembly and parliament.

=Propagating information at grass- root level by the Government.

=Make available information about the disease in regional languages.

=Producing feature film, documentaries and serials.

=By holding exhibition of photos and written material.

=To organize Alzheimer's fund by the Government.

=The medical practitioners should organize associations through rotary, lions etc in every area.

The world is moving from hopelessness to hopefulness without Alzheimer's.

It's only less than two decades since we have understood the disease. Now it can be diagnosed with 90% accuracy.

The case of an Alzheimer’s patient getting lost as they wonder off forgetting even their names is very common. There are cases where the family shuts them off and refuses to register a case of lost person.  Anyone coming across such a case must help them with the support of police or ‘Elder’s Helpline.’

Birthday

"Tomorrow is my birthday - I am thinking of skipping work", my neighbour said. 

"How do you wish to celebrate it?", I asked the forty year old man. 

"I guess I will relax by getting up late, go to a Chinese restaurant, watch a movie, and in the evening spend time with my friends followed by candle-blowing and cake-cutting", he replied.

This reply triggered some memories in my mind. I remembered the birthdays I used to have as a child. My mother would ask me what I wanted to eat, and make that dish for me. She would spend a few days bent over a sewing machine, and stitch a dress for me. In the morning she would wake me up early, draw a "rangoli", place a wooden plank on it, and make me sit on it. Then she would apply oil to my head and do "arati". After the oil bath, she would light a lamp and ask me to pray to God, and take the blessings of the elders by bowing to them. I would distribute candies to my classmates, and in the evening call all my friends in the neighbourhood and give them the special sweet prepared by my mother. 

No one knew about eating out or cutting a cake. Everything was freshly prepared with love and labour. No lazing because it was your birthday. In fact it would be a very busy day - full of activity. It being the beginning of a new year, we needed to take the blessings of the elders, pray and make a resolution for that year. The blowing off the candle somehow doesn’t go with our tradition. Light brightens everything. Candle should be lit not blown off.

 It’s amazing to see the evolution of this homely affair to a gigantic industry.

Today people are coming up with novel ideas to celebrate the day. Arranging for a clown, a puppet show, a magic show, movie, conducting orchestra, arranging swimming, boating, booking a play area etc. The elders are also in this melee. People celebrate in the plane, hot air balloon, cruise etc. 

Birthdays have become big business not just for card companies like Hallmark, but also for other businesses. People not only have kid’s birthday, there are special birthdays for turning eighteen, twenty one, forty, fifty as "Silver", sixty by Hindus as "Shastihabdapoorthi", seventy, eighty as "Sahastrachandra Darshna", ninety and of course hundred as "Golden". 

For elders computer presentation birthdays are most popular where they show the man from his infancy.  It is not uncommon to see people celebrating pet’s birthday. The dog wears designer clothes, a ribbon with a bow is tied to the dog and a cake is cut - feeding the dog first and then the guests! A unique birthday party arranged by my friend was when she took her friends and relatives to a temple in picturesque surroundings, arranged for a caterer in that remote place, and celebrated with games etc. I have  seen kids bringing loot bag after a party and dumping it if they are not happy with the contents. What a colossal waste!

The day is not far when we would be having birthday on the moon or a spacecraft! Whatever way we celebrate it, birthday is the time to pay obeisance to God and to our parents who brought us into this world. Remembering them and saying thanks by doing charity on that day should be included in the celebration.

                                East and West - Union is best

Till three decades ago we believed in Rudyard Kipling’s Poem. “Oh, East is East and West is West and never the twain can meet.” With most of our kids crossing the ocean for higher studies or jobs, this saying has become a myth. 

With modern technological progress, cell phone and internet have shrunk the world. We must keep updating ourselves as time goes by. International marriages have become common, especially with people who live abroad. So our lifestyle too has changed. We eat a variety of world cuisine like Italian, French, Chinese, Thai, Greek, Ethiopian etc. Yesterday, I had been to a Vietnamese restaurant and had a noodle dish which was like our "seviyan upma".

Today we wear dresses like pants, skirts, maxi, midi, jeans, yoga pants, salwar-kameez. Our kids wear even hot pants and spaghetti tops instead of just sarees. Our kids talk in all kinds of accents - American, Canadian, German etc.

Drinking was a taboo in our society, today it is a norm. Pub culture has invaded our cities and we see eighteen year old kids including young girls going to pubs.

Despite this, anyone who comes to West [here I will mention American continent specifically as I come here every year], for the first time notices the difference between the American and Indian life. To name a few -

·       The moment one lands and comes out of the airport, one notices the cars being driven on wrong side as here the driver sits on right side and so we feel that the car is going to crash into the opposite one!

·       In the airport everybody walks to their right, whereas we in India walk to our left.

·       When we cross someone on the road and look into their eyes, we smile. In America, you are supposed to wish them. In India we pass people without saying a word and nobody is poorer due to it.

·       We reach home or hotel and switch on the light in the room and are foxed as the switch looks like it is off, as their switches work opposite to ours.

·       In the night, one can hear the sounds from the adjoining room as the houses are wooden ones and the walls have only dry walls not cement ones. Any tap or flush in the house can be heard by all.

·       Total silence pervades the night so much that it gives you the creeps. Even in the remotest village in India one can hear train, highway traffic, animals, people etc.

·       The first time I came to America, I was puzzled to see the absence of crows crowing and birds chirping. I was told that the crows were annihilated in some parts of America to keep the environment clean.

·       Most houses are fully or partially carpeted and hence there is no sweeping and mopping every day. The first reaction to this is horror. What! No cleaning every day? Many Indian parents want to vacuum the carpet every day and make it thread-bare!

·       This brings us to the question of maids. Maids are a rarity and very expensive. There is no equivalent to a bai or rama. Everyone is a handyman or handywoman.

·       Neighbours keep to themselves. Sometime one doesn’t even know who lives next door after staying for more than a year. My friend was telling me that one of her neighbours doesn't like his privacy disturbed and so if your kid happens to throw the ball in their yard by mistake and they are informed, the neighbours will not throw it back. In India, one would take this opportunity to get to know the neighbour.

·       When you go for a morning walk, you see deserted streets and cars zooming by, windows raised, and you can rarely see the driver. This for a person coming from over-populated India is difficult to come to terms with. On the way you see well-laid out gardens, and in summer adorned with fantastic flowers of all sizes – a riot of colours. You go near them waiting for the fragrance to fill your nostrils; you are in for a shock as they have no fragrance. I saw a hibiscus plant having huge flowers in three colours - pink, yellow and orange! Rarely a flower is without fragrance in India except Aboli [kanakambaram].

·       Weather is so unpredictable that one checks the weather site before stepping out. It's so cold in winter that one can hardly step out. This to a person coming from India is the biggest punishment, especially if you are a senior who is used to morning walks. As the weather is extreme in winter and summer [three months], either the A.C or the heater is on. To a person coming from India, it causes immense suffering. Dryness of skin and nose is common even with the humidifier. We are used to fresh air and fan. So the weather becomes a great botheration.  We rarely think about weather conditions over there. To wear a jacket and cap or not while stepping out even to your own front yard is a big question.

·       When you tell the kids to take bath in the morning, they promptly reply - "No, we will catch cold if we bathe and go out. So, we bathe and get into the bed." In India even on Saturdays when we went to morning school  leaving home at 6.30, we would take bath. Nobody told you to, it was inborn in us.

·       Kids in the West are trained to question everything and everyone. It may be parents or grand-parents. In India, one doesn't question the grand-parents. So getting used to it is not easy. I told my grand kid,"It is not good for health to drink water just before the meal. You should drink water after the meal.'' ''Why granny, here we are told to drink water with food”, she said. Though questioning is a very good practice, it’s difficult to digest that a little kid is questioning you. Our culture is to respect and listen to grand-parents. I know of a grandparent who was visiting U.S, who scolded their grand kid for misbehaviour and the next minute the cops came to question them. The nine year old kid had called 911[cop] as they are told in the school that if the parents hit or abuse them, they should call the number 911.

·       People all the time eat frozen food whereas in India we believe in eating only freshly cooked food. Hindu scriptures say that ‘Annam is Brahman’. Food is the lord of creation. We have rules saying in whose company we should eat food, what kind, and only freshly prepared food should be eaten. In the West people eat standing, walking, working etc. We eat with hand and they use spoon, fork etc. Food habits are worlds apart.

·       Meeting a Doctor is next to impossible unless one is seriously ill. One can describe the condition to the nurse who will give you feedback. In India every nook and corner has a Doctor's clinic and one can see him or request him to come home. This non-availability of Doctor is a shocking situation for people from India.

I would conclude by saying - if the East meets West and imbibes their discipline, dedication, punctuality, non- meddling mind, work ethics and importantly not giving free advice, it will make us a great nation.

Conversely, if West absorbs - Indian hospitality, good neighbourliness, cooking fresh food, respecting elders - from our culture, with the progress in western countries, they will have less family problems and depression.

More and more westerners are showing interest in our classical dance, music, Bollywood and food. With this trend a day is not far when East will meet West and vice-a-versa.

I would be obliged if you can add to this musing.