When Mr Kumar was diagnosed with dementia, he wasn’t quite sure what it meant to him and his family. He was still able to do day to day activities and was pretty much independent. And later, when his neurologist suggested that it could be Alzheimer’s disease, he knew that his life wouldn’t be the same anymore. He started reading about dementia and Alzheimer’s and collected as much information as he could. He consulted his neurologist on a regular basis and made sure that he was on the right medicines. He prepared his life and his family to accept and accommodate the changes dementia was going to bring in their life.
Dementia is not always forgetfulness. It's an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases. A diagnosis of dementia itself doesn’t mean that you are not able to make decisions anymore but progressive dementia can lead to such situations in future. Like Mr Kumar, it is always good to be prepared to compensate for impaired decision making later in life.
Things to Do
Early diagnosis helps
Dementia is not part of normal ageing process. While forgetfulness can happen at any age, if you think that you are becoming too much forgetful recently, consult your physician as early as possible.
Dementia doesn’t always mean memory loss. Changes in behavior, abnormal behavior and fluctuating mood can indicate dementia. These are not part of normal ageing too.
Know more about dementia
Talk to your doctor about dementia. Educate yourself on the disease so that you can be prepared
Dementia is not something to be hidden or ashamed about. Dementia needs to be discussed in the family as family members needs to accept and address some of the behavioural and personality changes that can happen as dementia advances
Preparing and sorting out problems
1) Finances and Banks
It is better to have a joint account in banks. You can add your spouse or any other family member whom you entrust your finances to help you in keeping your money safe
It is better to have one bank account than multiple to keep the ease of operating easy.
Keep the checklist of all the utility bills to be paid and if possible make the payment auto-credit
Update nominee information in all your banks, mutual funds and insurance documents.
Appoint an enduring power of attorney to manage your funds and investment well ahead.
You need to keep all your disease under control. Having Dementia doesn’t mean that other diseases don’t matter any more
Consult your physician on regular basis and keep your blood work up to date
There are some medications which basically help in early stages of dementia to slow down the progression of the disease. Consult with your physician regarding these medications
Keep a well sorted file of your medical history handy. This should include all your past health records, Insurance details and medication list
Keep your brain healthy and active. Engage in social conversations, walking, learning new things and do everything that you enjoy doing. Dementia doesn’t mean that you stop doing everything.
3) Make a will or update your existing will
In case you have not prepared a will, it is highly recommended that your prepare one.
A diagnosis of dementia does not automatically mean you have lost capacity to make these decisions for yourself. However, if you are concerned about memory loss, it is important to acknowledge the issue and obtain legal advice.
4) Appoint a health Proxy
It is better to entrust your health decisions too to someone who understands you.
It is equally important to share with this person what your choices would be in future. For example, inability to eat is one of the features of late stage dementia. Whether you would like to be fed through tubes or intravenous fluids is your choice. You can explicitly state such choices in your living will.
5) Create a Living Will
Living will or advanced health care directives are health choices that are made by you much before you encounter such medical problem. Though there is not enough clarity on the legality of such a document in India, such a document can be executed based on good understanding and mutual trust between the elder, his physician and the health care proxy.
Create a list of medical treatment and procedures that you are willing to take or undergo. More than, you need to enlist treatments which you don’t want to undergo.
In case you decide to appoint a health care proxy instead of writing it down, make sure that all your wishes are clearly informed to them. Let your family know about the same. Health proxy can be your family member , a friend or a legal representative or even your primary physician.
Decide where you want to spend rest of your life. Changing your home environment at middle and late stages of dementia can worsen memory impairment.
6) Keep things organized
Organize your documents into easy removable folders. Mark the documents clearly.
Keep daily usable things in easy to find places- Always keep the keys, watch, wallet in the same place every day.
Keep the rooms where you spend most of the time well lighted and ventilated
Keep checklist of things you need to do on a daily, weekly and monthly basis. Have someone go through your checklist regularly
7) Prepare a bucket list
Prepare a list of things you had always wanted to do- a place to visit, an apology to be rendered, a food to be tasted or a road to be traveled. Discuss with your family members and friends about this and try to implement few of them
8) Use Technology to help you
Calendars, reminders and alerts are available easily in your smart phone which makes sure that you don’t miss a medication or a important day. Try to make to use of technology to make your life easy
GPS trackers are now enabled in almost all safety devices which helps to track you everywhere you go.
Medications alert apps are now available which ensure more compliance in taking medicines on time
Dr Rahul Padmanabhan is a consultant in Geriatrics and Gerontology based in Coimbatore, Tamil Nadu. He is currently the medical director for Dr Rahul’s Elder Care. He is an expert in dementia care and has designed memory care programs to help elders and their families manage elders with dementia at home. We are one of top providers of Geriatric Care in Coimbatore. Dr Rahul’s Elder Care is at No 33, Alagesan Road No 2, Sai Baba Colony, Coimbatore. For more information, visit www.drrahulseldercare.com or call +91-7871111247.