By the Psychologist of "Thalpos Kalamata" Evie Tsikrikou
September 2016 will mark the fifth global World Alzheimer’s Month, an international campaign to raise awareness and challenge stigma. On this occasion, we may briefly "remember" some significant information about this disease.
Alzheimer’s disease is the most common form of dementia, a group of disorders that impairs mental functioning. Officially recognized, there are 74 different types of dementia, of which dementia covers the largest proportion, 64%. It is a disease uncured, degenerative and fatal, which was first described by, and later named after, German psychiatrist and pathologist Alois Alzheimer in 1906. It most often begins in people over 65 years of age, although 4% to 5% of cases are early-onset Alzheimer's which begin before this.
As of 2013, there are over 46 million people worldwide with dementia, while this figure is set to increase to more than 131 million people by 2050. Although Alzheimer’s disease usually comes out differently in each patient, there are many common symptoms. The first symptoms are often mistakenly attributed to stress or psychological disorders.
The most common early symptom is difficulty in remembering recent events (short-term memory loss). As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self-care, and behavioral issues. As a person's condition declines, they often withdraw from family and society. Gradually, bodily functions are lost, ultimately leading to death.
At present, there is no definitive evidence to support that prognosis of Alzheimer's disease can be definitely assessed, since its duration varies depending on each patient. The disease advances for an unspecified period of time, possibly for years. Although the speed of progression can vary, the average life expectancy following diagnosis is three to nine years. The cause of Alzheimer's disease is poorly understood. Moreover, in developed countries, Alzheimer’s disease is one of the most financially costly diseases.
Since it has no cure and 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.
One of the largest challenges this diseases has is the burden comes out to family and friends. Affected people increasingly rely on others for assistance, often placing a burden on the caregiver; the pressures can include social, psychological, physical, and economic elements. Alzheimer’s disease is often called a family disease, because the chronic stress of watching a loved one slowly decline affects everyone.
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 caregiver being a spouse, demanding behaviors of the cared person such as depression, behavioral disturbances, hallucinations, sleep problems or walking disruptions and social isolation (study published in International Journal of Geriatric Psychiatry, 2005).
Regarding the caregiver, it is very important to remember that the patient is experiencing his own reality, which for him is equally true with our own. Furthermore, he need to accept that his/her beloved one is not going to be cured, yet the patient can learn to manage more effectively the difficulties with which both confront on a daily basis, caregiver and patient. This will help the environment in which they live to be improved, as well as the communication between them and the cohabitation.
The erratic and aggressive behavior of the patient occurs because he feels unable to understand what is happening, is afraid of the “unknown” persons surround him and it is really difficult for him to communicate and be understood. Anxiety, agitation and disorientation experienced are the causes of the frequent escapes and wandering outside the home.
All the above, briefly described, are the reasons why the person who takes care of a patient with Alzheimer often reaches its limits, perhaps exceed them, running out of patience and losing his/her temper. Especially when the patient is a beloved one. The hardest part the caregiver is required to manage is when the person who knows and loves begins "going away" and he is now seen as a stranger, as an "enemy."
There are many times the caregiver feels unable to help his/her beloved one and also guilty because he/she gets tired or exhausted shouting. However, such human reactions are absolutely normal. Therefore, it is very important to seek psychological support and help from organizations specialized in such issues and mental health professionals.
You are not alone. Many people and organizations, both professional and voluntary, can help. Do not be afraid to ask.