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“My name is Natasha. I am 62 years old and live with my family. Throughout my life I have achieved success in whatever I have endeavoured. Loved by family and friends, I have never felt that anything could go wrong. I would always pull through.
Particularly fond of making memories, I loved birthdays and anniversaries, be it my own or someone else's. Never one to forget an important date, I give it my all to make sure everyone has a good time.About this, I never thought it to be peculiar when I forgot my sister's birthday. I am human, and I can forget. But then I began to forget other important dates. I even forgot to visit a dear friend in the hospital who met with an accident. I started getting more worried when I began to misplace my things. My son had to remind me to wear my spectacles, and even look for them, as one morning I tried to read newspaper extremely squint eyed, complaining about how it was all out of focus. Later my husband pointed out to me, much to my annoyance and irritation, that I was messing up my grammar. Who messes up their grammar when they've been complimented for their fluency all their life?
These things, random at first, became frequent and persistent. They became a part of me, and that's when my family and I realised that this is not a case of occasional blues. This was something more sinister, and I knew I needed help.”
Ageing is not lost youth, but a new stage of opportunity and growth. However, for many like Natasha here, it is not an easy transition.
According to one study nearly 4.1 million people in our country have dementia. Dementia in itself is not an isolated disease but rather a collection of ailments that affect a person’s overall functioning. Everyday activities tend to get affected and quality of life becomes severely compromised.
It is common to confuse forgetfulness due to normal ageing with memory impairment due to dementia. An estimated 40% of all elderly over the age of 65 suffer from memory loss. However, cases of dementia tend to be more severe. In addition to memory problems, trouble with language, judgement, abstract thinking, understanding information and attention difficulties also surface. Tasks that were earlier easy to initiate and perform become more difficult. Significant changes are observed in the individual’s mood and behaviour, all of which affect their personality.
Early signs of dementia tend to be more subtle and vague. Men and women would find themselves with frequent loss of memory and confusion, and everyday tasks would become more difficult to perform. Changes in personality such as lack of interest in earlier pleasurable activities tend to reduce causing social isolation.
Dementia stages are divided into 3 main categories: early/mild, middle/moderate and later/severe. With ageing, symptoms tend to get progressively more severe, making the person more disabled.
Till now there has been no conclusive cure found for dementia. However, different medications and various forms of psychotherapy have shown to have a positive impact on enhancing a patient’s cognitive, social and communication skills. Some of these therapeutic techniques include:
A) Reminiscence training - This form of therapy involves encouraging clients with memory loss to remember their past through different memory triggers. These triggers stimulate various senses like old photographs (visual), music and sounds (auditory), which tend to prompt discussion of remote memories. These strategies therefore try to use the life history of the individual to increase their sense of well-being.
B) Occupational Therapy- Occupational therapists help by enhancing function, promoting relationships and encouraging social participation. They work as consultants, assisting in daily life activities and even by providing suitable assistive technology. For example, external memory aids such as Personal Digital Assistants (PDAs), clocks and message boards are provided for helping individuals with memory issues in daily activities.
C) Validation Therapy- Essentially used only with clients with dementia, this form of therapy helps the client to resolve challenging behaviours by working through the emotions behind them. These behaviours are viewed essentially as a way to communicate those emotions, especially in people with memory loss, confusion and disorientation. The client is provided a safe environment in which communication is encouraged, beliefs and values are validated so that the client shares his/her feelings.
D) Cognitive Stimulation Therapy- This approach is conducted to revive some degree of cognitive processing in the client by keeping their mind active. This is often conducted in groups through structured discussions and enjoyable activities on different themes like childhood, current affairs, food etc. For example, audio recordings of the voices of one’s loved ones can be played while discussing the theme of family.
E) Cognitive Rehabilitation and Psycho-education- Individually tailored interventions are provided to individuals with dementia and their caregivers through cognitive rehabilitation. It is conducted in their homes to help them live independent lives, retain skills and cope better. Potential targets could include tasks of everyday functioning, self-care, language and communication, social interaction etc. This process is accompanied by psycho-education which helps clients to understand their cognitive strengths and difficulties.
Although a particular cause of dementia is difficult to determine, several factors such as high BP, lack of exercise and smoking, especially during the middle stages of one’s life are linked to diseases that cause dementia. A healthy lifestyle consisting of regular physical and mental exercise, no smoking and moderate drinking, along with a balanced diet have shown to reduce the risk of it.
Suspecting whether you or someone you love who might have dementia can be anxiety provoking. But understanding the condition and its impact can improve coping and lead to a better life.
-Tanya Bakshi
Counselling Psychologist
Chetana Counselling Centre
Pune, Maharashtra
References
(2020). Retrieved 18 May 2020, from https://www.dementia.org.au/files/helpsheets/Helpsheet-AboutDementia01-WhatIsDementia_english.pdf
(UK), N. (2020). PREVENTION, EARLY IDENTIFICATION, ASSESSMENT AND DIAGNOSIS OF DEMENTIA. Retrieved 18 May 2020, from https://www.ncbi.nlm.nih.gov/books/NBK55453/?report=reader
Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer's or vascular type: a review. Alzheimers Res Ther. 2013;5(4):35. Published 2013 Aug 7. doi:10.1186/alzrt189
Pathak KP. (2018). An Overview of Dementia. MedDocs Publications
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