Dementia-ville – Shades of the Past ?

As a child it was fascinating yet quite a bit disturbing to be with certain old people at times. They would ask you your name over and over again or their hands would tremble so much that it was scary to be near them. Yet the way they smiled and their love and care cannot be denied. For the young child who has yet to see and know much of disease and despair, the revelation can be disturbing, yet growing up with it can teach a lot in the name of patience and humility.

Years later after a sojourn into the sketchy roads psychology can take us along; I have a name for the various issues caused by this condition. Dementia – or the cognitive decline in daily life functioning is a term that has both the aforementioned scenarios attached to it and more.

When I was younger, I grew up in a family where it was obvious that older parents and grandparents would be taken care of by their relatives. Not doing so was unthinkable and inexplicable. Tempers flared, grievances were common on both sides of the generational divide and one learned that this is how things moved on. Age brought on various issues and life had to move on accordingly. In my clinic now, I notice a change that has hit our conservative collectivistic culture several years after it was already an established ‘western’ tradition. The younger generation has a greater tendency to have both genders working long hours. Taking care of the elderly is no longer considered a first priority in many cases as it used to be earlier. Consequently the concept of old people’s homes is talked about in hushed tones but nevertheless – talked about.

Each story can have several angles and so does this one. One may argue that better nursing care is available at old people’s homes or centres such as this – an extremely derogatory name of a proposed dementia-ville of sorts that has health care professionals divided in opinion . On the other hand there is much to be said for old fashioned home care. While round the clock health care facilities are provided at such spaces they are no replacement for the ease of living if provided in one’s own home in familiar surroundings. I have seen several instances where those with a moderate degree of dementia do very well when under the supervision of health care practitioners who may also train the caregivers to create cues for the patient. While the facility such as the one mentioned here may be an open door facility that would help in a rather advanced stage of Alzheimer’s, there are people doing extremely well in the home with nursing attendants or family members. Surely it is difficult, but not impossible. At the same time, even those suffering from dementia such as Alzheimer’s disease need a change and day long facilities may be just the right amount of change. Family members need to take care of their own health as well and providing round the clock nursing to an often irritable person can be a heavy task unless one is blessed with a rather large family with someone there to cater to various needs round the clock. Some respite may be provided by day care facilities which would go a long way towards keeping things harmonious at home. Younger children can learn from the patience and sacrifice invested in the process of home care and the family system can develop beautifully. There is after all, a lot to be said for the value system of taking care of elders in the circle of life just as they once did when we were young.


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