Amongst the different types of Dementia, Alzheimer’s disease is the most common one, accounting for 50% to 75%¹ of all cases. In Hong Kong, there is 1 Dementia patient in every 10 men aged over 70, and goes up to 1 in every 3 men aged over 85. As the speed of population aging is picking up, Dementia cases would only increase accordingly.
The World Alzheimer Report in 2015² indicated 2 out of 3 people know very little or nothing about Dementia. Instead of hoping for Lady Luck to save our parents, we should act early to understand the disease. So in this Part 1, we will be looking at the importance of timely diagnosis and treatment, whereas Part 2 will go in depth on different treatment methods.
Bad memory ≠ Dementia Seek professional diagnosis as precaution
Our cognitive function includes memory, attention, language and visual and spatial processing and Alzheimer’s disease particularly affects our short-term memory. If the diagnosis of the patient’s self-care ability is sub-optimal, the case will be classified as Mild Cognitive Impairment. But if the patient starts having trouble taking medication properly or handling money, the condition could have entered the intermediate stage.
People frequently asked about the difference between age-associated memory impairment and Dementia. In reality, it’s common for elderly people to forget things from time to time. This doesn’t really affect how they go about their daily lives, and tools such as sticky notes could help them out. But writing things down doesn’t work for Dementia patients. Having said that, it may not be accurate enough by just looking at these symptoms. If an elderly displays abnormal cognitive function, it’s advised that he or she should take a cognitive assessment, such as a mini-mental state examination or Montreal Cognitive Assessment. It is both a fast and accurate way to evaluate whether the subject has developed Dementia and if so, at what stage.
A timely treatment eases the family’s burden
If treatment could be given as early as possible, it helps the patients slow down the deterioration which in turn eases the burden put upon their families’ shoulder. This is because patients would need to be taken care of in everyday life at the intermediate to later stages, from using the toilet, putting on clothes to bathing. Unaccustomed to the over-reliance on family members, the patients would develop emotional and behavioural problems. All these would constitute a heavy burden and pressure on their caretakers, ie. family members.
Meanwhile, caretakers should get well-prepared in advance, including having a positive attitude to listen to and communicate with the patients so as to minimize the patients’ chances of developing behavioural problems at a later stage. Frictions or even quarrels, on the contrary, would only intensify such problems. But things wouldn’t improve with just one talk or act of kindness. Caretakers should realize and learn from the very beginning and try to stabilize the patients’ condition at the early stages as long as possible where the patients could exhibit basic self-care abilities to lighten the burden on their families.
Case for sharing
There once was a case where the patient had serious behavioural problems, such as threatening to kill himself. On one occasion, he even held a knife at his maid just because he wanted to cook for himself. His caretaker then learnt the DementiAbility Methods: The Montessori Way™ (DMMW) and started to communicate with him in a systematic manner that gradually brought his emotions to a controllable level. For instance, his radical acts were replaced by having a walk in the neighbourhood. This also helped unload pressure from his family.
Apart from the DMMW intervention approach, there are other medical and non-medical ways to defer Dementia and we’ll go through them in Part 2.
Dr.Chuang Lai, Specialist in Geriatric Medicine
Danny Y. W. Chan, Occupational Therapist