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Dementia: Understanding and learning to cope with a most dreaded affliction

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A prologue to a weary “wanderer’s” dreams

From the “outside looking in” one can only imagine that experiencing the degenerative side-effects of dementia is somewhat comparable to walking alone through a very large, dimly lit home of a close relative / friend as light from winter’s late-afternoon-sky rapidly retreats beneath the horizon and the darkness of night begins to stream in through dusty windows.

Throughout this colossal home “where shadows play tag”, there’s a strong aroma of oatmeal cookies being baked. Befuddled and irritated the home’s “wanderer” cannot quite remember if it was uncle Roy’s house or grandma Octavia’s kitchen that always smelled so warm and inviting.

From the parlor, mama playing “Rock of Ages” on papa’s old piano can be distinctly heard. Weary, the wanderer can’t recall if it’s been either 25 or 30 years since mama and papa both passed away holding hands. As images of yesterday / yesteryear flashes before him / her, the wanderer thinks aloud, “Why aren’t the kids calling from college anymore?”

Behind every slightly ajar door within the home there are sounds of happy and familiar voices. Siren-like, the voices behind the door call the wanderer’s name.

Initially the wanderer is ecstatically giddy at the prospect of being able to soon see and talk to one of their adult children, a seldom seen grandchild or even perhaps an old friend; all he / she has to do is push open the door and enter the room and like magic everything will be alright again. The wanderer is determined to do just that, to open that damn door.

The problem is that once the room is entered [just like so many doors that were entered prior to this one] the light inside mysteriously becomes dimmer and the familiar voices once heard so clearly, have now been cruelly replaced by distorted, nonsensical babble that’s coming from people you (the wanderer) cannot recognize.

Convinced that you will find whatever it is you’re looking for behind the next “ajar door”, the wanderer (you) continue to push open doors that are left open.

Irritated and befuddled, it become increasingly more difficult to recognize the people who politely smile and talk to you, so the wanderer (you) decide that it’s best to leave the room.

You (the wanderer) find an empty room with a nice warm bed that’s lit by a single candle and the weary wanderer (you) lies down. It has become much easier to sleep and dream all day than it is to walk through a home full of people you just can’t remember.

The wanderer closes their eyes (you) and hopes that their (your) dreams will taste sweet like the cotton candy papa bought you (the wanderer) at the state fair in 1940 and smells as sweet as mama’s rose garden did that same year. It was the year the Cicadas came during the summer and sang us all a lullaby every evening. Yes if I (the wanderer) can dream such sweet dreams then why wake up?

Dementia, Senility and Alzheimer’s … the debilitating common thread

Dementia which is also known throughout the world as “senility” is a chronic disorder of the mental processes that is triggered by brain disease or injury. Nearly 36 million senior citizens worldwide suffer from dementia and an estimated 8 million more will be diagnosed with this mentally / physically crippling disease in 2015 and every year thereafter until a cure is found.

Throughout the world dementia is one of the major causes of disability and dependency among senior citizens. It is not only an incredibly terrible burden on the people who suffer from it, but also for their families and the designated caregiver(s).

In a nutshell, dementia causes memory losses / malfunctions, impaired reasoning and personality disorders. In the end the disease causes the afflicted person to succumb to the body’s malfunctions and then the afflicted person dies.

Medical research reveals that there are many forms of dementia. Alzheimer's is probably the most common form of this dreaded brain disease. People who suffer from Alzheimer's gradually begin losing their brain’s functionality. For some it’s a fast [debilitating] process and for others it’s a slow [debilitating] torture that takes years before the brain completely shuts itself down.

The pain of watching a loved one suffer from dementia / Alzheimer’s is akin to watching them die in slow motion.

How does Alzheimer’s kill?

Too often there is a lack of understanding of how dementia / Alzheimer disease kills a loved one.

Because the disease causes the brain to stop working, patients with Alzheimer's often die from suffocation as they forget how to swallow; however, it should be noted that suffocation can be just one of many causes of death.

The brain controls all of the body’s vital organs, so it’s not unusual for a patient who suffers from Alzheimer’s to die from complications incurred by strokes and organ failure. Without the brain transmitting proper instruction to the body, the afflicted will soon wither and die.

Because senior citizens are sometimes misdiagnosed, proper medical attention and therapy can be delayed.

The negative impact of dementia on “family-turned” caregivers is a tremendous physical, psychological and social challenge that requires total dedication to improving the quality of life of the afflicted person.

Warning signs and symptoms

Depending upon the progression of the disease, dementia affects each individual differently. The signs and symptoms linked to dementia can be understood in three stages.

Early stage: The early symptoms of dementia are often overlooked by nonprofessionals because the maladies of the disease gradually impact the ill. Common symptoms include:

  • Forgetfulness
  • Losing track of the time
  • Becoming lost in familiar places.

Middle stage: As dementia progresses to the middle stage, the signs and symptoms become clearer and more controlling. They include:

  • Becoming forgetful of recent events and people's names
  • Becoming disorientated at home
  • Having difficulties with communication
  • Needing help with personal care and hygiene
  • Experiencing behavior changes that include wandering and repeated questioning.

The final stage: The final stage of dementia reveals a very ill individual who is completely dependent on their caregiver. Their inactivity worsens and for the most part they remain bedridden. There will be clear signs of physical deterioration and almost all memory is lost. Symptoms include but are not limited to:

  • No longer being aware of time and surroundings
  • Having difficulty recognizing close relatives / friends
  • Having difficulty walking
  • Becoming aggressively disorientated
  • Death

Can Alzheimer’s be cured?

Currently there is no known cure for Alzheimer’s; however worldwide, a variety of new treatments are being conducted and reviewed in clinical studies that give researchers and doctors a better understanding of how to improve the patient’s quality of life as they (the patient) transition through the various stages of the disease.

The U.S. Food and Drug Administration (FDA) has approved two types of medications, cholinesterase inhibitors (Aricept, Exelon, Razadyne, Cognex) and memantine (Namenda) to treat the cognitive symptoms (confusion, loss of memory and loss of reasoning) of Alzheimer's disease.

As the Alzheimer’s disease progresses, brain cells die and millions of pulse connections that empower the cells to “communicate” with each other are forever lost, causing cognitive symptoms in the patient to worsen. Although the aforementioned medications cannot stop the damage Alzheimer’s causes to brain cells, they may help decrease or alleviate symptoms for a limited time by affecting certain chemicals that are involved in transmitting (communicating) messages between the brain's nerve cells.

Motivated by a sincere desire to improve the quality of life of their patients, it’s not uncommon for some physicians to prescribe both cholinesterase inhibitors and memantine together. Additionally, some physicians will also prescribe high doses of vitamin E to counter the negative cognitive effects of the disease.

The most promising / innovative research involves a team of biochemist researchers in San Francisco who are attempting to restructure the apolipoprotein E4 gene (aopE4). Apolipoprotein E4 appears to be the single most common “risk-gene” that’s linked to nearly eight out of ten Alzheimer’s patients. The researchers hope to develop within the next three years a “structure-correcting” drug that will positively alter the destructive properties of apolipoprotein E4, mimicking its non-harmful variant, apolipoprotein E3.

Studies over the last two decades indicate that routinely eating a healthy-heart diet, participating in rigorous exercise two to three days a week and engaging in challenging intellectual stimulation are important factors in preventing dementia.

In closing, on December 22, 2013 I lost a loving aunt to dementia. The love and affection my Aunt Juanita showered on her family and friends throughout her life will not be forgotten and this article is written in her memory. We miss you Aunt Juanita. The legacy of love you left behind for all of us to bask in will live on long after a cure for dementia is found. Sleep well; your days of wandering alone in an “unfamiliar home” are forever over.

For further information on the effects of dementia and treatment of the disease please visit www.alz.org

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