Dementia: Do not take it personal

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IN last week’s column, we talked about the importance of geriatric-care services and nursing homes in various forms for our elderly. A big contributor to the rising demand of this services is dementia. In this week’s column, I will give an overview about dementia, its history and the frustration it can cause.

Dementia is a topic very close to my heart, as my own “Lola” back in Germany was diagnosed with vascular dementia after a stroke back in June 2015.

The World Health Organization (WHO) describes dementia as “a syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform everyday activities”. It is important to note that dementia is not a disease, but the symptom that  is accompanying the disease. For example, cough is the symptom that a flu causes; cough is not the disease.

Dementia is not associated with one common disease, but is the umbrella term for a number of neurological conditions, with the major symptom of a decline in brain function. Simply put, people with dementia symptoms become forgetful because the disease is stealing their memories.

There are more than 100 diseases that may cause dementia. The most common causes of dementia include Alzheimer’s disease, vascular dementia and dementia with Lewy bodies. Alzheimer’s disease is the most common cause of dementia and contributes to an estimated number of 60 percent to 80 percent of all dementia cases worldwide.

Why does it seem that dementia is on a rapid rise and, yet, we only know very little about it? To understand this, we need to look into history and statistics. On a global perspective, dementia was very rare before the 20th century. Only a few people lived until old age. From the 15th century onward till around the year 1800, life expectancy was between 30 years and 40 years of age. It is only since the 18th century that life expectancy increased, actually doubling until today. Nowadays, global life expectancy is at around 70 years. Therefore, it was not until the mid-1970s when dementia began to be described as we know it today. About 40 years later, we have an estimated 51 million people with dementia worldwide. The number is expected to increase to an estimated 76 million by 2030, and 136 million by 2050.

While historic data before 1960 on the life expectancy in the Philippines is difficult to find, the recent numbers draw a clear picture.  From the 1960s to today, life expectancy in the Philippines has been 10 years less than in the US and 15 years less compared to Japan. Today, if you are born in Japan, you can expect to live around 83 years. If you are born in the Philippines, your average life expectancy is 68 years.

As dementia occurs only in older people, it explains why until several decades ago, we almost never heard about dementia in the Philippines. Today, we have an estimated number of 300,000 dementia cases forecasted to reach 315,000 by 2020 and 1.2 million by 2050. The rapid rise will continue to put pressure on families, health-care systems and health-care providers.

Our nurses, caregivers and myself are dealing with persons with dementia symptoms every day here at RainTree Care. It can be frustrating and heartbreaking for our team at times as we develop an emotional attachment over time. But imagine the painful emotions families are facing, seeing their loved ones slowly slipping away. Persons with dementia forget places they have been to, forget the rooms in their house, forget how to get home and, unfortunately, also forget who their family members are.

While it is difficult for those who are close to the patient, it is most difficult for the dementia sufferer. Often, they do not understand what is happening to them and around them. Everything becomes blurred and fuzzy.

“As our mom’s dementia progressed, so did the mood swings. She could be totally happy one moment, and the next, she would be yelling and getting violent. It remained a mystery to us as to what prompted her outbursts,” is what the children of one of our residents shared with me.

The mood swings and losing control over the situations is what brings many families to the edge. The difficulties in communication and not understanding each other anymore can be one of the most frustrating aspects of caring for someone with dementia—and it is depressing for those with the disease and their loved ones.

Very often, it is hard to understand why people with dementia act the way they do, but the explanation is the changes the disease causes in the brain. It is important to remember your loved one is not behaving like this on purpose. The aggression is usually triggered by something, such as physical discomfort, being in an unfamiliar situation or place and poor communication.

The most important advice I have received when dealing with a person with dementia is: “Do not take it personal and let it go.”

There are many guides you can find online on how to deal with persons with dementia.

Remember your childhood. How many times did your parents not take it personal when you misbehaved and just let it go? Now, it is your time to return the favor.