Last time, I discussed the troubling question of robotic caregivers for seniors (in some places developed as an alternative to the immigration of qualified human caregivers).
One of the consequences of much greater human longevity is a marked increase in the number of people who suffer cognitive deficits due to late life dementias:
According to 1996 United Nations projections, the population in the more developed countries will decline slightly from 1.19 to 1.16 billion between the years 2000 and 2050 but the number of individuals age 65 and over will increase from 169 million (14.2% of the population) to 287 million (24.7% of the population). Utilizing conservative prevalence estimates the number of individuals with dementia in developed countries will increase from 13.5 million in the year 2000 to 36.7 million in the year 2050, as an increasing number of very elderly survive.
Helping them live as rewarding a life as possible is becoming a priority medical and social challenge.
Someone I care about has late life dementia, and I offer three observations, in case readers find themselves in a similar position:
1. Much advice offered is useless. That’s because so often it is
– offered with a view to fulfilling a mandate while avoiding litigation or flak, so it avoids saying anything pertinent
– facile (for example, it assures you that you are not alone with the problem, but maybe you in fact are alone with it)
– suggests you will feel better if you talk to people (maybe, but that depends on the people, and anyway you need to do good, not just feel good)
Here is something that really happened to a friend of mine: An aged aunt lived with her family, and needed—but would not accept—residential care. A well-meaning friend sent her a fluffy seniors’ lifestyle mag, whose advice columnist offered as a typical “dilemma”:
Help! My aged mother has a boyfriend! What should I do?
My friend thought:
What should you do? How about: Mind your own business (unless, of course, you find out that he murdered his girlfriend ten years ago, and was recently let out of jail due to old age…!)
Now, in our own case, my aunt is living in our garage and won’t eat. She will die out there if we don’t do something. But what? What, exactly? What can we even legally do?
Is there anyone out there who helps with real problems, for once?
As the longevity boom progresses, my friend’s dilemma will be far more common than the magazine’s shallow, self-flattering one. (= Wow! Even my mom is still hot!) So the need for no-kidding help can only increase.
The most useful advice will come from people who have lived through loved ones’ dementia, coped, and can articulate how they coped.
2. Not all dementia is “Alzheimer.”
The term is thrown around a lot. Technically, it is an irreversible, progressive brain disorder in which brain tissues turn into “abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles),” as illustrated above. But late-life confusion can be caused by a variety of other problems including “vascular dementia” (small strokes or changes in brain blood supply) or
– medication side effects
– chronic alcoholism
– tumors or infections in the brain
– blood clots in the brain
– vitamin B12 deficiency
– some thyroid, kidney, or liver disorders
Also, and this is often overlooked: Old people also get depressed for rational reasons (which can result in confused or otherwise socially difficult behaviour): People they care about die; their driver’s licence has been lifted; they are not permitted to leave the floor; they can no longer manage a much-loved activity…
3. But now the good news. Most late-life confusion problems can be ameliorated or eased in some way, provided they can be correctly identified.
There is a growing storehouse of useful, non-feelgood advice, often available online for free. Here, for example, is a brief excerpt from an Australian source, Fight Dementia, on communicating with people with dementia:
The right environment
Try to avoid competing noises such as TV or radio
If you stay still while talking you will be easier to follow, especially if you stay in the person’s line of vision
Maintain regular routines to help minimise confusion and assist communication
It is much less confusing if everyone uses the same approach. Repeating the message in exactly the same way is important for all the family and all carers
Here is a real life example: Jane’s husband has died. Jane has short term memory problems but understands the concept that her husband has died. It is important for her well-being that everyone who cares for her agrees to tell her, when she asks, that he has died and to offer any grief support she needs. If some well-meaning persons were to tell her that he is “away” or “out of the room,” they are adding to her cognition problems by introducing an extra layer of confusion.
Denyse O’Leary is a Canadian journalist, author, and blogger.