We don’t like the idea of getting old, but nobody wants to die young. And besides, what age will we be in heaven anyway?
You mean to say, am I the only one thrown off by the photo of a dashing 35 year-old gracing the obituary of some 95 yea-old person? I’m waiting for your answer. Take your time…
You see, the average 95 year-old is likely to be suffering from dementia. This is used interchangeably with Alzheimer’s (‘Old Timers’) Disease. This is why it’s so delightful to converse with the elderly who retain full control of their faculties, the likes of Ma Pampo and others.
5% percent of those around the age of 70 suffer from full-fledged cognitive impairment. I don’t know about you, but I do get a bit nervous when my keys keep playing ‘hoop sayway’ (hide and seek) more often than I care for. We joke about such, but there are those in their 50’s and occasionally even 40’s showing warning signs.
Early in my career, I had black pair of working shoes: penny-loafers with tassels. I also had an identical pair in brown. Once, in dawn’s early light, I hastily put on my shoes and dashed off to work. Throughout the day, I traipsed up and down District of Columbia General Hospital issuing orders and saving lives. I thought nothing of it as acquaintances would look down bemused, but said nothing. It was not until later in the afternoon that someone inquired if this was preparation for Halloween costume. Only then did I look down in horror at my mismatched shoes. Boy! With friends like these…
Well, this is the kind of thing that a person with dementia may do time and again. In their day, they may have been sharp dressers, but now you have to be on the lookout that they don’t leave home with things back-to-front or inside-out.
Diagnosing Dementia
Once a source of pride, remembering the names of all the grandchildren now becomes a source of frustration. Disorientation really becomes obvious when a person begins to forget the names of their own siblings, daughters and sons. This progresses to problems recognizing the roles of different people in their lives, priest or pastor, nurse or doctor and so on. Loss of peers they can relate to add an element of depression. Attention and ability to concentrate becomes impaired. Activities-of-daily-living (ADL’s) such as setting the table or cooking also become problematic. Watch that they don’t burn the food or worse yet, the whole house.
Part of the saying, ‘you cannot teach an old dog new tricks’ refers to inflexibility in ‘executive functioning.’ They have issues problem-solving and adjusting to new realities. It is very much outside their comfort zone to appreciate changing tastes in music, fashion, liturgy or even sports celebrities. Neuroplastic pathways have become ossified. Casual conversation quickly reveals they are frozen in a time warp.
Notably, they can recall intimate details of events from their youth or when they were in their prime. However, they easily forget more recent happenings, like, let’s say what they ate for breakfast this morning. Have you ever forgotten where you parked? Thought so! One confused senior citizen got in his car in New Jersey and was declared missing after several hours. He was found over 1000 miles away in Chicago, not knowing where he was or where he was going. Yet, he still stubbornly resisted giving up his driving privileges.
Old character traits seem to magnify, the good the bad and the ugly. Folks who were frugal and tight-fisted all their lives may degenerate into paranoia about people stealing their stuff. (This is not to say that defrauding the elderly, especially returnees, is not both common and unconscionable). Frisky personalities may crystallize into dirty old men and insatiable, potty-mouthed old women. Families are sometimes simply appalled at the words that erupt from their mouths. On the other hand, there are precious souls who gracefully transform into angels of generosity, kindness and wisdom. They become more altruistic and spiritual, granting us a genuine glimpse of heaven.
Caregivers
There are those who once seemed to have all who end up lingering in neglected in lonely deprivation. Caregivers must resist the temptation that all the time and energy spent on such patients is wasted. Despite the hardships, service to our loved ones is precisely what distinguishes us as a civilized people. Even before we notice mental capacity diminishing we ought to lock in preferred place of care, last will and testament, power of attorney and advanced directives. Have you? The Dominica Bar Association has a Law Fair on May 31, 2014 offering free legal consultation on such matters among others.
The unanimous verdict is that no one would chose to be dead to world like a vegetable, having to be fed, toileted and lying there 24/7 nursing bedsores. It is hard self-sacrificing work. The nearest caregiver invariably bears the greatest burden. One of the annoying problems is relatives far from home wanting to have the biggest say in crucial decisions. Families must communicate honestly. Each must commit to shoulder their fair share of material support and taking time off to give a break to those stuck with the daily grind.
The prognosis or outlook for dementia is that of slow, progressive decline despite availability of expensive cholinesterase inhibiters such as Donepezil (Aricept) and Mematine (Namenda). The Council on Aging, the ‘Yes We Care Program’, the Infirmary and local nursing homes do a commendable job providing dignified elder care. Yes, doctors still make house-calls. We keep alive the option of viable of end-of-life care in familiar surroundings and provide feedback to loved ones wherever they are. Healthy lifestyle and senior social stimulation helps maintain maximum mental functioning. In so doing, we prepare to transition seamlessly to that place where we regain loving relationships, no more pain, no more tears and no more dementia. Truly it has not entered it the heart of man that which is prepared for us.
What if each day in heaven, we get to choose what age we want to be? Maybe one day you just want to let out your inner child: play with your cork gun and burst a few bandits while she combs her doll’s hair. Another day you get to be a parent, or perhaps retired. Oh, never mind! That will be then, and this is now. Bottom line, if we stick around here long enough, we and our loved ones will have to deal with dementia. Because those who think they will never get that old are oftentimes the very ones who do!
As I was saying…um, what were we talking about again?
Click here to jog the memory.
Dr. Sam Christian runs the Urgent Care on 137 Bath Road. He is Medical Officer of the Dominica Cadet Corps, Medical Adviser to the Dominica Cancer Society and author of the faith and fitness nutrition book, ‘Mannafast Miracle.’ Dr. Christian can be reached anytime at 440-9133, 615-8345 or by writing to [email protected].
“Says who? If you are my friend and you know FETe, then you also know “Johnny” whom we often call “Doc” I am sure he will not agree with on that point.”
Yes, yes, anything you and that pseudo doctor Johnny boy your boyfriend say about me is quite alright. I have no intentions of defending against what you say about me; as a matter of fact, I do not care. Yo can move in with him in the desert in Arizona if you care!
And by the way when all the rattler snakes in the desert start eating you up, he is so senile he will not even recognize what’s happening to you: talking about he is doctor, finding cure for cancer; he must have worked all his life growing rubbish in a petri dish, believing he had cancer specimen in the dish, that is why he never found a cure for any disease in his life!
Him doh know what him doing oui.
Hahahahahahahahahahahahahahahahahahahah: because him ninety (90) years old he wrote something telling people how I seventy-five (75) years old him forget when him was big old man playing Windward island cricket, never scored a single run, always out for duck, naught, zero, I was a little boy walking without pants, you see; so I doh know where you and him get these things you are saying about me that I do not know about myself. As for the spelling errors, you /Elizabeth are so senile you are unable to recognize an error when you see it.
Have a happy life in the desert with your old senile pseudo doctor! I hear you planing on going home to vote for your new found friend Petter who fed you when you went home last year, but if you do, Ron Green will hear about that, and if Petter win that will be cause to consider the entire nation election null and void; I doh joking eh!
Francisco Etienne-Dods Telemaque
I am still on the subject of dementia, only that I am going to describe it in terms of confusion.
An puzzling or inappropriate behavior, or responses, confusion is the inability to think quickly, and coherently. Depending on its cause, confusion may arise suddenly, or gradually, and may be temporary, or irreversible.
Aggravated by stress, and sensory deprivation, confusion commonly occurs in hospitalized patients – especially the elderly, in whom it may be mistaken for senility. When severe confusion arises suddenly, and the patient also has hallucinations, and psychomotor hyperactivity, his/her condition is classified as delirium. Long term, progressive confusion with deterioration of all cognitive functions is classified as “dementia.”
Confusion can result from fluid, and electrolyte imbalance, or hypoxemia due to plumonary disorders. It can also have a metabolic, neurologic, cardiovascular, cerebrovascular, or nutritional origin, or can result from a severe systemic infection, or the effects of toxins, drugs, or alcohol.
Confusion may mean the worsening of an underlying, or perhaps irreversible disease. The bottom line here is that confusion may not mean dementia, although it may appear to be one of the same, that is where the skills of diagnosis comes in, if the doctor misdiagnose, then there could be a problem.
Elizabeth, I hope you are not going to use what you learn here to play doctor, cause police will hole you eh!
Hahahahahahahahahahahahahahahahahah: I know how you learn easy, yes boy you have great retention power, do not go upstairs and show off on dem Jamaican nurses and doctors trying to compete wid dem eh.
Francisco Etienne-Dods Telemaque
interestingly the comments here always seem to detract from the article itself. There seems to be some contention going on here. Seems like people are fighting over the dear doctor. heheheheh
Maybe you should learn to read. Mostly everyone here commented on the article. You seems to have a problem. Is it dementia?
Another very timely article Dr. Sam.
I think you touched on most of the essential points except the role of bush tea and things like Ginsing in stimulating memory.
It is certainly worth saying again that we have to take care of our own. That is what family is all about. We cannot always leave it to government and charitable organizations. We have to show some gratitude to those who changed our diapers and worked hard to put bread on the table that make us get big so.
Dementia in any form is not funny. It’s bewildering to the person who has it, and frightening to the person who is watching this happen to a loved one. The person who has dementia will also tell you the same thing over and over again. You become frustrated but you also have to remember this is the first time to them they have told you. They are NOT going mad/crazy etc. parts of their brain are slowly dying. And it will just get slowly worse. it is one of the most scariest things to watch happen to a loved one. All I can ask is that if you know of someone who suffers from this, PLEASE take time and give all the patience you can find in yourself. There is no point in becoming angry with the person, because they have no idea why you are angry. I hope one day someone will find a cure for this awful thing.
And besides, what age will we be in heaven anyway?–Dr. Christian
Hahahahahahaha! Doc in the first place if we plan to be in heaven–I prefer to call it Paradise–, we should also plan to encounter the “new birth” the birth of Life in Love, and Love is Spirit, the nature of God Almighty. And the apostle John tells us that “if we are able to love this means we are born of God and knows Him” 1st John 4:: 7
But Love is not always the good things which we do, because we can do a lot of good things without Love–our good works must be motivated by Love–otherwise this work is still empty
Also, do not forget that Jesus cautioned us, “that unless we are born again we cannot enter His Kingdom”. John 3: 1-17
We begin to grow in the Spirit after we have encountered the “birth of Love in the Spirit”, but that growth also demands that we feed on the food of the Spirit–that food is the message of Life in the Holy Bible. Otherwise we continue to be the “natural man” with a “carnal condition” of the mind–both are enmity against God.
The length of time which we spend in the body–growing through Life in the Spirit– will be the age that we will enter into Paradise; and when we are there we will not grow older–even if we will continue with faith and hope, thriving in Love forevermore.
For example I was born of the Spirit in early September 1998–this will make me 16 years old Spiritually. I would like to continue in the body until Jesus returns–but if that does not happen for me, my age in the Spirit will be the age that I remained in the body until I go to my grave to wait for the day Jesus will call me back to Life in Spirit and in Truth.
Havind said all of this, let us go to Dementia!
First of all in that last line above, the word is supposed to spell “having” not “havind”
What can I say about “dementia”? Not very much–except that I have this “annoying” habit of putting things away and can’t remember where I put them until I am searching for something else–and there is that thing which I have been searching for, like since 2 months ago.
Right now I need my favorite screw driver but the last time I used it I must have left it in that same place–the problem is that I cannot remember what I used it to do–and so I have no idea where I should look, but the others cannot do the job for me.
One day last year, I got dressed and went to Church: I was supposed to be the preacher on that day–and so I put my Sunday best–white and black skirt; white top, and black vest to match completely, and I set out to do what God had called me to do.
Well I went up front when it was time for me to speak my sermon–everything went fine; and I went back to take my sit with the congregation. Worship came to an end with the normal “go in peace” from our Pastor, and we began to get cakes and coffee for fellowship.
Well what do you know! Our Pastor’s wife looked at my vest and there it was! My vest was inside out, I didn’t know about it–even if I am sure that I looked at my self in the mirror 5 or 6 times before I left the house–I preached just like that; but lucky for me it was only visible through the linings on the sides and the shoulder, which was not very much.
Anyway I give thanks to God, that He has my mind in its process of renewal–this mind of ours must be in that process long before we reach that number known as the senior age–and yes, mine got into the process long before that age.
I am not worried because I know that I am in the process of winning both–the battle and the war– conquering the omens of the flesh and every kind of mental disturbance that should come against me—that includes “dementia–but to God be the glory.
We have a lady in my Church–she is well over 70 years–in-fact she normally behave quite strangely, very often–I am now wondering if she is suffering from “dementia”.
Last week she told us, that as she was setting out for Church, she decided to put on her glasses; but she could not find it anywhere. She said she looked and looked, until she started to feel worried that she might have lost it–and so she sat on her bed wondering.
She told us that she was looking into the mirror for quite a while, before she realized that she was wearing the glasses, which she was looking for all over the place.
That was a funny one–but could this also be a sign of dementia? She really does behave strangely too often.
Liz! hahahahaha you never put a pencil behind ur ears and keep looking 4 it? Liz how far from or close to 70 are you. You call ur former friend FET old man but he seems not to have any signs of the topic in question.
lol I find it rather interesting that you only comment on Dr. Christian’s articles. lol what’s up with that??? and those lonnggg comments… is it that you have a personal message to tell the dear Dr?
“What can I say about “dementia”? Not very much–except that I have this “annoying” habit of putting things away and can’t remember where I put them until I am searching for something else”(Elizabeth).
You see the reason is because you are totally, and completely senile oui!
Pick the beam out of your very own eyes before to try to pick the mote out of my eye. You and your boyfriend in Arizona, keep adding up my age, and after you are through tallying, from the product you attained you convinces yourselves that I am senile; the fact is both of you are in worst shape than I am; I hear your boyfriend is in the desert in Arizona is living among snakes, unable to find his way, he is so senile, he does not even remember breath.
I doh calling him name eh, cause, cause him cannot even recognize him own eh!
Hahahahahahahahahahahahahahahahahahahahahah!
Since I found out that you are senile, the only rope you can try to hang around my neck is to call me a liar as you and that boy in the desert has done so many times. Check out my submission, perhaps you will learn something from it you will find out that we all are vulnerably to the same thing, even at an early age, so whether I am 50, 25, or an hundred and twenty-five senility would not be a crime.
More to come.
Francisco Etienne-Dods Telemaque
@Liz’s friend May 19, 2014 “You call ur former friend FET old man but he seems not to have any signs of the topic in question”
Says who? If you are my friend and you know FETe, then you also know “Johnny” whom we often call “Doc” I am sure he will not agree with on that point.
Perhaps you have never paid attention to how he responds to something that is written to him–I once copied and paste his own idea and spoke to him about it–he quickly responded with a criticizing his own idea; what do you call that?
Read his comment below, and you decide again.
Anyway I am not anywhere near 70 years and I am sure that I will never suffer from dementia–did you not read where I said that my mind is in its process of renewal since 16 years ago?
@amused May 19, 2014 “I find it rather interesting that you only comment on Dr. Christian’s articles”.
Dr. Christians writes about health and people, I believe that what have something is common which is about “God, the Lord. I have chosen to comment on his articles because I like what he writes.
Among the comments here there is no childish stupidity of red and blue, laborites and uwpites; this, that, and the other foolishness about politics–and I glad to be among those comments here.
Do you have a problem with that?
Some disoriented drive from NJ to Chicago. Others skip the town of Tifany completely to Goodwill. Is this a sign of the disease too or playing ‘hoop sayway’ (hide and seek) ?
And your point is what curious george? I think he is well oriented. Since Dominica is his country and the house at Goodwill is his house . Now you go get a life and stop acting like the little problematic monkey you call yourself. Stop being jealous of the good doctor.
Doc your are doing a good job in your homeland. Keep it up!
An interesting write up on dementia. I love your style of writing informative, amusing and yet with a little bit of seriousness. I have a family member who has dementia and I can certainly relate to this article. Nice work!
Great info doc. thanks
Its a terrible disease, some persons will call their parents or grandparents “wicked” because of what they are going through….caregivers have a task on their hands, but patience and love will overcome…also making sure the patient gets the right medication…
Doc that was brilliant.
“Have you ever forgotten where you parked?”
Very intriguing question; not only have I forgotten where I parked my car, but have found myself looking for my keys, for more than an hour, until my girlfriend asks me, have you looked into my pocket? My reaction to her question was; ” do you think am stupid?” in any event after I exhausted my search I decide to check out my pocket and found my keys, in my very own pocket. I remember one week end I checked into a hotel in Las Vegas, where I remained for three days, eating sleeping and gambling never venturing out side.
I decided to go to another Casino, and decided to drive rather than walking. So, I decided to go to my car, after walking around and could not find the care, I decided to go back in the Hotel, and report to security that my car was stolen. One of the security guards told me don’t be too hasty in calling the police, he will drive me around to see if we find it. The parking lot is more than twenty archers large, there are thousands of park cars it like as they say finding a needle in a hay stack, it took us about two hours, driving around looking, until he stopped, and said this the time we should call the police. The next thing I discovered, was my car right at the exact spot where we stopped ; Strange I thought, very strange.
Now in regards to the subject at hand, I will comment on it in two variables, someone may claim I am repeating Dr. Christian, but if you read carefully you may get a much easier understanding to the way the doctor approached the subject. Dementia is an organic mental syndrome characterized by a general loss of intellectual abilities involving impairment of memory, judgment, and abstract thinking as well as changes in personality. It does not include a loss of intellectual functioning caused by clouding of consciousness, as occurs in delirium, nor that caused by depression, or some other functional mental disorder: (pseudodementia).
Dementia may be caused by a large number of conditions, some reversible, and some progressive, that cause widespread cerebral damage or dysfunction. The most common cause is Alzheimer’s disease; others are cerebrovascular disease “multi-infract dementia,” central nervous system infections, brain trauma, or tumors, pernicious anemia, folic acid deficiency; Wernicke-Korsakoff syndrome, normal-pressure hydrocephalus, and neurological diseases such as Huntington’s chorea, multiple sclerosis, and Parkinson’s disease.
There is also Binswanger’s disease which is progressive dementia of presenile onset due to demyelination of the subcortical white matter of the brain, with sclerotic changes in the blood vessels supplying it. We can also mention epilepitic d., which is an progressive mental, and intellectual deterioration that occurs in a small fraction of cases of epilepsy; it is thought by some to be caused by degeneration of neurons resulting from circulatory disturbances during seizures. Multi-infract dementia, a patchy deterioration of intellectual function resulting from damage by a significant cerebrovascular disorder. There is also paralytic dementia; or dementia paralyt’icia, general paresis. We can also get into dementia prae’cox, in the United States, a former name for schizophrenia; commonly used in Europe to denote process schizophrenia.
Primary degenerative d., dementia of insidious onset, and gradually progressive course, occurring in almost all cases after the age of 50; is classified as presenile onset, or senile onset depending on whether onset is before, or after the age of 65 years old. In most cases there is the characteristic histopathology of Alzheimer’s disease; and in rare cased that of pick’s disease.
I might be back to focus on the disease in terms of confusion!
To two certain lady’s if you have difficulties understanding it, do not only say Francisco lie, and do not know what he is talking about; feel free to E-mail me, and get the answer before you assassinate me.
Not Edited:
Francisco Etienne-Dods Telemaque
Francisco Telemaque May 18, 2014 “I decided to go to another Casino, and decided to drive rather than walking. So, I decided to go to my car, after walking around and could not find the “care”
First of all, it is so funny that you never spell anything wrong but you simply write one word for another–like here the word is ‘car” not “care”. Hehehehehehehehehehe!
Now pertaining to the line above, I just wanted to say, you were lucky that it was your car which you could not find in the parking lot–that is not strange.
My employer, from years and years ago, once told us that he got lost in the parking lot–this means that he could not find his way out of it–has this ever happened to you?
” So, I decided to go to my car, after walking around and could not find the “care”
Yes mama Liz, you are elated that you have found one drop of spilt to build a case on against me. That will not fade me anyway. To error is human, you never error , because you are a god!
Happy desert living oui!
Hahahahahahahahahahahahahahahahahahaha!
I gone to sleep.
FET.
Thanks again Doc. I had to read every word. I’m truly thankful for the elderly, we are where we are today as a society because of those who came before us. The circle o life continues. Let’s live well and put God first. One does not know the day nor the hour when they will depart this world. Doc you are too funny, I am a little like you…..What did the doctor say again?
Thanks Doc, I had to read every word. God bless the elderly, because they gave us life and contributed to society for us to be where we are today. Like they say, life happens and there is the circle of life. One never knows, let’s eat right, live right However, I believe that my steps are ordered by the Lord. and I believe in living a spiritual and Christ -filled life. You are too funny, Doc, I’m a little like you, ….what did the Doctor say?