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ALZHEIMER'S DISEASE
a misery of an old age

By: Hina Ashraf Ali Mithani

A person goes through many stages in life from childhood to adulthood. As a person gets older, he not only gains experience from life but also many diseases influencing their life. One of those diseases is Alzheimer. Alzheimer’s disease is a neurological disorder which affects brain cells. It slowly destroys memory and thinking skills of a person. Over time the ability to speak, remember, control emotions, and make decisions are lost. Extrapolation Prevalence Rate of Alzheimer's disease (2004) revealed that there are 2,341,122 people with Alzheimer in Pakistan. According to World Health Organization (2001), it is estimated that there are currently about 18 million people worldwide with Alzheimer’s disease. This figure is projected to nearly double by 2025 to 34 million. Much of this increase will be in the developing countries, and will be due to the ageing population. Currently, more than 50% of people with Alzheimer’s disease live in developing countries and by 2025, this will be over 70%. These statistics briefly indicates the importance of this disease to be addressed. Therefore, in the paper, the focus would be on symptoms of Alzheimer’s disease, challenges faced by the caregivers and the strategies to deal with the patient of Alzheimer.

The symptoms are the language of the disease. It’s really important to understand symptom inorder to gain proper diagnosis. In case of Alzheimer, prognosis can be better if symptoms are timely recognized and treated. The first symptom of Alzheimer is forgetfulness. Almost all people begin to have some memory problems as they get older. Our memories are remarkable but we still forget things. We usually forget those things we don't really need to remember. But those with Alzheimer’s forget things all the time and eventually can't even remember what things are for. For a person in the early stages of Alzheimer, however, these problems are more obvious than in others of the same age. The patient has trouble remembering recent events, activities, or the names of familiar people or things. The attention span becomes shorter. Over time the memory loss gets worse. The person has problems reading, writing, and understanding. Patient may misplace or lose things. The person may get lost while driving or even at home. As the disease gets worse the person forgets things that happened recently and even things that happened in the person's own life. In general, recent memory is affected more than long-term memory. Later, in the course of Alzheimer, the person gets disoriented and confused. The person can no longer recall major facts about self or others. Things and people that were once familiar become unfamiliar. There may be mood and personality changes. The person may have false beliefs (delusions) and see or hear things that are not there (hallucinations). Patient may be anxious and restless, and wander late in the day (sun downing). (Gaugler & Haley, 2008). These symptoms are very important for the timely diagnosis and prognosis of the patient.
The caregivers are the main stem for caring of Alzheimer patients and at the same time, they have to face many challenges as the disease progresses. It is estimated that 8.9 million family caregivers provide assistance to someone aged 50 and older with Alzheimer’s disease. Alzheimer’s Association (2008). Therefore, Alzheimer also intensify the accumulated psychological, financial and social effects of family care-giving. The first challenge that caregivers face is to acknowledge the patient’s profound loss of cognitive function. Care givers should be realistic about the limitations imposed by Alzheimer’s, but be careful not to assume that they are more global than they are. They must look for what is present in addition to what is no longer a part of this person’s reality. (Gaugler & Haley, 2008). Another challenge for care givers is the daily care activities of the patient. People with Alzheimer often find it hard to complete everyday tasks. A person who has Alzheimer may not know the steps for preparing a meal or using a household appliance. A person may put things in unusual places, like an iron in the freezer. Moreover, the person may become passive, sitting in front of the television for hours, sleeping more than usual, or not wanting to do usual activities. In addition to it, word finding difficulties and becoming easily tongue tied affects their conversation. Therefore, these challenges are sometimes create frustration to the caregivers.

When problems are hustle for patient and caregivers, strategies could be incorporated inorder to face these symptoms and challenges. Firstly, it is important to understand the pathology of the disease that Alzheimer is not a normal old age. Every elderly individual does not have this disease. Thus, it is important to be aware of the signs and symptoms which could suggest this disease .Furthermore, it is also very important to understand that behavioral changes in a person are an integral part of the disease process. Under no circumstances should this be considered to be madness. The patients are unable to control their behavior and therefore, consult appropriate treatment is very important. Besides this, give appropriate time to the patient. Although the burden for many caregivers includes the physical demands, travel, and a significant contribution of time, often more than 30 hours a week (Mittleman & Haley, 2006). Alzheimer patients are generally feels isolated with problems they are suffering from. So giving them proper time is very important, so that they can share their feelings with the family members and won’t feel isolated or out of this world. Moreover, focus on the person's strengths and abilities. Set realistic goals for the patient like activities that they can still manage. It is important to acknowledge and respond to their feelings. In addition to it, the family remains the main pillar of support for the patient. The traditions of eastern culture and the lack of special care units make it clear that the patient is best cared for within the family. However, this imposes an immense burden on the family for which support should be sought. Families and others will benefit by joining self-help groups or support groups, as these are well known to provide social and psychological support to members. For this purpose, a national organization named Alzheimer’s Pakistan is working for the welfare of people suffering from dementia and their care-givers. Thus, these strategies can help the caregivers, inorder to sustain disease progression.

Hence, Alzheimer is not just a disease but it is also a misery which affects overall life of the person. The symptoms are defeating for a person and challenging for the care giver but strategies could be emphasized to maintain person’s quality of life. Therefore, it is important to do more researches inorder to gain command over Alzheimer symptom and prognosis. Moreover, support groups, home healthcare services and other helpful resources should be stressed inorder to help the caregivers and the patient. Remember that a friend is someone who knows songs of your heart and can sing it back to you, when you have forgotten the words.