By Nishi Pulugurtha
In 2010, Amma was diagnosed with Alzheimer’s Disease. Named after the German psychiatrist and pathologist Alois Alzheimer, who discovered it, Alzheimer’s disease (AD), or Alzheimer’s is a neurological degenerative disease that usually begins slowly and gets worse with the passage of time. About 60% to 70% of people affected with dementia have Alzheimer’s disease. Dementia is a broader term that is used to refer to brain disorders that affect memory, thinking, and behaviour. Early symptoms of dementia are memory loss, difficultly in doing ordinary, familiar tasks, problems communicating, and marked changes in personality. Alzheimer’s Disease is the most common type of dementia. There is no cure for dementia and certainly none for Alzheimer’s.
One of the most common early symptoms of the disease is difficulty in remembering recent events, what is referred to as short term memory loss. As the disease progresses, symptoms include problems with language, with expressing oneself, with remembering words, disorientation, wandering off, easily getting lost even in familiar surroundings, mood swings, depression, loss of interest in things, not being able to take care of one’s daily needs, and behavioural issues. A person with Alzheimer’s will slowly withdraw from family and society. Bodily functions are lost over a period of time, including the fact that they forget to eat and swallow. The rate of progression of the disease and the degeneration vary from person to person.
Alzheimer’s Disease is not a normal part of aging. It is not a disease of old age, though the majority of people with Alzheimer’s are 65 years and older. Incidence of the disease is also seen in people in the age group of 40 to 50, what is referred to as early onset Alzheimer’s. There is no cure for the disease; medicines taken just slow the degeneration. People with the Alzheimer’s disease need constant care, supervision, and assistance as they become slowly and completely dependent on the caregiver. This results in a great social, psychological, physical, emotional, and economic pressure on the caregiver.
Signs of dementia are not obvious to the one who has it. They are usually more obvious to family members and friends. It is imperative that a person with signs of the disease should consult a doctor as early as possible. Early diagnosis and medication work in helping to address the management of the disease so that the quality of life could be maintained. Once Amma’s diagnosis came in, medicines prescribed were begun. Initially Amma had to take medicines twice a day – once in the morning, after breakfast and once after dinner. The initial dosage of the medicines prescribed was gradually increased to the optimal level over a period of time. I used to keep medicines in a cupboard in the kitchen. Each day, I used to give her the medicines which she took.
One day, about three or four months after Amma’s diagnosis as I went to take medicines from the box to give to her, I noticed that there was a medicine less. There were two medicines that Amma used to have those days – Admenta 10 and Aricep 10. The maid did not touch the medicine box as she did not know which one to give Amma. I was able to find out that one medicine Aricep 10 was missing simply because that day in the morning I had put in a full strip. I asked the ayah who said she never touched it. Amma must have taken it out since having medicines every day had by now become a routine with her. There was no point asking her; she might have said ‘yes’ or might have said ‘no’. Her memory had started playing tricks with her. This was the first time something like this had happened, or maybe this was the first time I noticed this as it was from a new strip that a tablet had gone missing. I asked my psychiatrist friend who then advised me to keep the medicines away from reach. From that day, I kept medicines locked up in an almirah.
I knew I had to keep important documents, keys, and other such stuff in places where Amma could not access as she might keep them ‘safely’ and not be able to recall where she had kept them. After this episode, I had to be careful with medicine, too. Amma did not usually move things here and there. However, one could never be sure when dealing with a loved one who had Alzheimer’s or dementia.
Amma did not have to be coaxed to take the medicines she was given. There was just one incident where she refused to take the medicines and when I persuaded her, she whacked me. I was in a hurry to leave for work and Amma must have been in a bad mood that day. After a while, she did take the medicines. In January 2013, we moved house. In our new residence too, I kept the medicines out of her reach. I did not have to lock them up. Since, this place was not her familiar place, Amma was still to get used to the new home. I kept the medicine box stashed high up. A few months after this move, I noticed a change in Amma. She did not the swallow the medicines given. She started to bite and chew them. I tried asking her to swallow, but it did not work. As she advanced, complications increased and the frequency of medication increased as did the number of medicines, too. The ayah at home had to be given instructions about the medicines and when they were to be administered. These days, they give Amma the medicines. So, after breakfast, after lunch, before and after dinner, Amma has medicines. Amma bites and chews them; the only reaction one gets is a grimace as she chews them.
Dr. Nishi Pulugurtha is Associate Professor, Department of English, Brahmananda Keshab Chandra College, Kolkata. She is an academic with varied interests and writes on travel, too. Twitter: @nishipulu
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