Life with dementia can be very challenging, both for the patient and the caregivers. Let us understand why.

Dementia is primarily characterised by memory loss or amnesia, as it is known in medical terms. The patient remembers his/her younger days just fine. But when it comes to recent memory, it falters. Let me explain this further. Say you ask the patient to describe his/her wedding day. It will be an almost perfect description. But ask them what they had for breakfast this morning, and they are clueless. This gets worse with time. Often he/she finds it difficult to find the way back home when he/she has ventured out. As the disease progresses, they finding the way back to the bedroom from the kitchen becomes a tedious task. In later stages, patient forgets learned activities, like how to dress or undress. They also have difficulty identifying relatives or friends whom they are seeing after a while. Recalling people’s names becomes a challenge. What is interesting albeit pathetic is that they often forget how they themselves look. It comes as a shock for caregivers when the patient refuses to identify himself/herself in the mirror. Slowly, they lose track of day, date or time.

Added to these, a separate set of problems emerge. Their behaviour changes. That is to say, family members are surprised to note that patients are suspecting people of stealing their valuables, sleeping erratically, getting mad at caregivers over trivial issues or getting fearful for no apparent reason. Sometimes they hear voices others cannot hear or see apparitions. Despite repeated reassurances, they are convinced of the existence of these unseen and unheard entities, to the point that they can be seen muttering to themselves, when actually they are having a conversation with these apparitions.

Is there a solution? The answer is there is no permanent cure. We cannot reverse the disease process. But we can slow down its progress in many cases. There are drugs for doing just that. But the medications are not one size fits all. The psychiatrist will pick and choose the right drug depending on the patient profile and tolerability of medications. That is to say, we want maximum response with minimal adverse effects. This apart, they need support for daily activities. This is where the role of caregivers comes in. Your psychiatrist will explain how to take care of the patient and these instructions need to be followed diligently for good results.

As I always say, the psychiatrist and caregivers need to put in a team effort to give these elderly persons the life with dignity that they deserve. To sum up, life with dementia is difficult, but it is not the end of the road.

drdebasmitapsychiatrist