Mental Health of the Elderly
Progressive mental deterioration in old age has been recognized and described throughout history. Mental disorders among the elderly have wide-ranging impact not only on the individual but also on their families and care givers.
Dementia and Alzheimer’s Disease
Alzheimer’s disease is one of the most common causes of dementia. Dementia is just a clinical syndrome that is an indication of a serious problem with brain function. Many diseases of the brain, heart problems, diabetes, some diseases that relentlessly attack the brain such as Parkinson’s diseases, Huntington’s disease, Creutzfeldt Jakob, cancers inside the brain, diseases of the liver, kidney, liver, thyroid, etc. can all present as dementia. Generally when people get older they seem to stand a higher risk of dementia especially Alzheimer’s ‘disease dementia. However, it must be noted that dementia is a very serious disease and not part of normal ageing. Dementia and Alzheimer’s disease affects people in different ways. The impact depends on how a person was before the onset of the disease. It is a good idea to conceptualize the disease as occurring in three stages even though the symptoms of each stage are not necessarily exclusive of the particular stage.
1. In the early stage there may be difficulty remembering recent events. The person may misplace keys, personal items, and sometimes accuse co residents of having stolen those items. Difficulty with language, problems with decision-making, getting lost in rather familiar places may occur. The person may not be aware of the time of day, where the individual is or may have difficulty recognizing familiar people. As the disease progresses the problems continue to increase and become more evident.
2. At the middle stage memory problems become very serious and the person may no longer remember the names of family members and friends. Speech becomes more difficult. At some point the person can hardly cope without assistance with simple daily tasks such as cooking, washing, dressing, and going to the toilet, etc. The person may wander and not return home because he/she no longer knows their way about even in the neighborhood.
3. During the late stage the person is totally dependent on others and cannot do anything on their own. The person can no longer understand or interpret events, walk, eat, or do other normal activities. There may be a display of abnormal experiences and inappropriate behaviours.
The exact cause of Alzheimer’s disease is not known. Many complex theories have been put forward such as abnormal behaviour of some serum proteins. Early diagnosis is important to help caregivers plan ahead. Health professionals such as psychiatrists who are familiar with the disease are often able to recognize the disease and determine which type of dementia is involved. Many people simply call dementia Alzheimer’s disease. This is because many cases of dementia in old age are due to Alzheimer’s’ disease. There are drugs that are now being used to treat those who have dementia of the Alzheimer’s type. An important rich resource in dementia matters is Alzheimer’s Diseases International (www.alz.co.uk). This organization has helped to raise awareness worldwide. They have also developed useful ways to help caregivers handle the difficult behaviour problems associated with dementia. In Kenya, the Kenya Alzheimer’s Association (KAA) organizes for several groups of caregivers to meet and support each other. It is important to take an older person who is suspected of having dementia to see an expert for a proper diagnosis. It must be remembered that there are many diseases that can cause difficulty with memory. Dementia is not the same as memory impairment. Most people who have dementia will have memory problems but not all memory problems are dementia. Even when a memory problem is due to dementia, the type of dementia differs. Forgetfulness is not a normal part of the ageing process; it is always a sign of some serious disease that requires medical attention.
