Senile dementia: how to help a loved one without going crazy yourself. Worsened by incorrect treatment

“Anyone who can call for hope in Putin and see in him the author of some kind of “new course” is either an idiot or a scumbag.” - Maxim Kalashnikov

I read the newspaper “Zavtra” very rarely now. The reason for this is the newspaper “Zavtra” itself. Or rather, the journalistic team of the newspaper, which almost in its entirety went into security. Recently I accidentally came across an article by the editor-in-chief of the newspaper "Zavtra" Alexander Prokhanov, "Putin's Messiahship." After reading this nonsense, I got the strong feeling that Alexander Andreich had completely gone crazy. I fell into complete insanity, so to speak. Admire it for yourself. What are these phrases worth?

And strange, historically inexplicable, but mystically predetermined appears the appearance in Russian politics of Putin, who, like Stalin, opposes the liberal mega-machine, is waging a desperate battle for sovereign Russia, its imperial Eurasian character, its Orthodox culture, its unique civilization. He does this, like Stalin, under occupation.

What kind of habit do these guards have of clinging to Stalin, comparing the anti-Soviet Putin with Joseph Vissarionovich? And what kind of liberal machine and occupation is Putin opposing? Prokhanov did not explain something. Or just admire it.

There is a lot of secret and conspiracy in this battle. Therefore, Putin himself is still a mystery. He wears a mask, protective armor, and casts several shadows at once, some of which are more reliable than himself. He's a playboy. He is a member of closed world clubs. He is a crane and a Ussuri tiger. He is a Stalinist. He is a fan of Stolypin. He is a secret Russophile. He is the one who stands in the kippah. He is the one who flies in a fighter jet over the destroyed Grozny.

Licked like that, licked, they usually say in such cases. Isn’t Putin a Terminator or Batman? Our Alexander Andreich is very bad for spouting such nonsense. As they say, old age is not joy.

No, I'm not going to sort out this nonsense. In my opinion, Prokhanov himself did not understand what he wrote. I’d rather demonstrate what people think about this. I will cite several dozen comments from three sites on which this material was republished. Let's start with the comments on the website of the newspaper "Zavtra".

vok9491106, 13.10.2012 20:35
After Putin took Prokhanov into his team, Prokhanov completely swam. Well, well, what else will we read from him! But what a fighter he was against injustice. This is what neediness does to a person under Putin!

Nina Ni-s, 10.10.2012 07:14
Well, Putin, during the 12 years of whose rule the destruction of the army and military-industrial complex, education and science continued - According to Prokhanov, he is now already a “messiah”, for whom they “pray in monasteries” and whom “Russian patriots glorify”... I wonder why they “glorify” him so much, Prokhanov’s patriots?
And the favorite thought of those patriots is that Putin, who absolutely clearly professes liberalism in economics and anti-Sovietism in ideology, is, in spite of everything, “a friend among strangers,” but only very deeply undercover...
Oh God, what lengths can the former “nightingales of the Soviet General Staff” and “singers of the Red Empire” reach...

Margarita Lobacheva answers him, 10.10.2012 07:39
“What lengths can the former “nightingales of the Soviet General Staff” and “singers of the Red Empire” come to…”
To the point of insanity, my friend, to the point of insanity) M. Kalashnikov not in the eyebrow, but in the eye: “Anyone who can call for hope in Putin and see in him the author of some kind of “new course” is either an idiot or a scumbag.”

Ufo, 10.10.2012 07:43
Putin is the messiah. Prokhanov - John the Baptist with him. State Department - Kaifa. God, what squalor.

Fgv, 10.10.2012 08:04
Alexander Goponovich Prokhanov - "...crushing the fragile...Putin state"

Well, my dear fellow, are you insulting the Great Putin by calling some state, temporarily called Russia, after Him? You are extremely modest in expressing your true feelings for the Great Putin, because you probably wanted to say this: “.. crushing the fragile state of Russia, located on planet earth, revolving around a Star named Putin.”
It's much better and more sincere.

Larisa47, 10.10.2012 20:48
I licked it like that!!!

Fgv, 11.10.2012 09:30
The worst enemy for Russia is a rabid fool-patriot, because with his stupid thoughts, stupid actions, stupid deeds he will do so much harm, hiding behind his patriotism, that the entire Mossad with all the Jewish internal Russian kahal and beitar is unlikely to cope.

At this point I’ll stop citing comments from the website of the newspaper “Zavtra” and move on to the comments on the website Newsland.ru. There they are even funnier.

Minority report replies Owes no one to comment 10/10/2012 at 8:18 am #
Prokhan - I once respected you...

Nikolay Lachin answers Owes no one to comment 10.10.2012 at 21:32 #
It’s unlikely that Prokhanov is for sale, apparently it’s just gone crazy from old age.

Not old Grandfather comments on the material 10.10.2012 at 8:24 #
My God, how people are sinking... or maybe not people anymore...
... well, why has this old fool lost his mind?

Br.Rabbit comments on the material 10/10/2012 at 10:33 #
"Russian patriots glorify him." - a list of “patriots” praising the enemy of Russia, to the studio!!

But among the commentators there were also those who agreed with an old idiot with the great thinker Alexander Andreevich.

mpgolovinov comments on the material 10.10.2012 at 11:03 #
I agree with Prokhanov. Putin carefully disguised all his actions and acted secretly, but the Egyptian events pushed him to take more decisive actions, and therefore his plans became clearer to the United States and the rest of the West. Now the masks have been dropped and Putin has no need to hide and disguise his actions. Forward, to Carthage. And the people will support, it’s just that all-out capitalism is in the way, we need to tweak it a little and press it a little.

But they immediately answered him

Nikolay Lachin responds to mpgolovinov's comment on 10/10/2012 at 10:03 pm #
That is, to take away from Abramovich those 13 billion dollars that Putin gave him for Sibneft? Will he really take it? Putin has corrected capitalism so that the common people can’t breathe, where else can they correct it? So that they themselves march to the cemetery in formation?

Magnusson comments on the material 10.10.2012 at 14:58 #
How symbolic this is. Under the news: “The number of mentally ill Russians has increased in recent years,” there is news: “Alexander Prokhanov: Putin’s messianism”

Bambarabia comments on the material 10.10.2012 at 19:27 #
You cannot compare Stalin's enthusiasm and Putin's oil and gas. The Stalinist state is the gravedigger of imperialism and fascism. Russia in the modern world is an observer and a performer.

Valery M. comments on the material 10/10/2012 at 20:21 #
That's it, Prokhanov was completely overcome by insanity. It's a pity. He was a good man.

Sasha Kuhelbekker comments on the material 10.10.2012 at 22:23 #
I think the old man has gone completely crazy.

Genome comments on the material 10/11/2012 at 8:07 am #
Did Prokhanov decide to switch to fantasy with isoteric elements? Strange. Maybe they are already treating with something that causes galyunics? Or maybe he is starving and praying fervently? There, too, a similar effect of changing consciousness occurs.

Grove comments on the material 10/11/2012 at 18:21 #
It looks like the old man has completely fallen into insanity.

I finish my comments here. Now let's move on to his blog in Hydepark. I wonder if people there read the same way as they do on this site?

In the very first comment there were again those who agreed with Prokhanov.

Elizaveta Bam # wrote a comment on October 10, 2012, 15:28
“The Russian state is the highest shrine. Serving this shrine is God’s work. In this matter, God help you, Vladimir Putin!”
God help!

But he was immediately answered in the next comment.

Raspberry Shchur # responded to Elizaveta Bam's comment October 10, 2012, 15:36
But don’t even hope for people’s help.

ddess BydloFob # responded to comment by ddess BydloFob

In short, bro!
Prokhanov is not a patriot.
Prokhanov is a butterfly collector. (by mind and hobby).

So, he will definitely be in heaven, along with Yeltsin, Putin and Gundyaev.

Yuri Logvinov # responded to comment by ddess BydloFob October 10, 2012, 15:56
Yes, he really went crazy, he just went crazy!

I read the newspaper “Zavtra” very rarely now. The reason for this is the newspaper “Zavtra” itself. Or rather, the journalistic team of the newspaper, which almost in its entirety went into security. Recently I accidentally came across an article by the editor-in-chief of the newspaper "Zavtra" Alexander Prokhanov, "Putin's Messiahship." Having read this nonsense, I got the strong feeling that Alexander Andreich had completely gone crazy. I fell into complete insanity, so to speak. Admire it for yourself. What are these phrases worth?

Licked like that, licked, they usually say in such cases. Isn’t Putin the Terminator or Batman? Our Alexander Andreich is very bad for spouting such nonsense. As they say, old age is not joy.

Nina Ni-s, 10.10.2012 07:14
Well, Putin, during the 12 years of whose rule the destruction of the army and military-industrial complex, education and science continued According to Prokhanov, he is now already a “messiah”, for whom they “pray in monasteries” and whom “Russian patriots glorify”... I wonder why they “glorify” him so much, Prokhanov’s patriots?
And the favorite thought of those patriots is that Putin, who absolutely clearly professes liberalism in economics and anti-Sovietism in ideology, is, in spite of everything, “a friend among strangers,” but only very deeply undercover...
Oh God, what lengths can the former “nightingales of the Soviet General Staff” and “singers of the Red Empire” reach...

Ufo, 10.10.2012 07:43
Putin is the messiah. Prokhanov - John the Baptist with him. State Department - Kaifa. God, what squalor.

Fgv, 10.10.2012 08:04
Alexander Goponovich Prokhanov - "...crushing the fragile...Putin state"

Larisa47, 10.10.2012 20:48
I licked it like that!!!

At this point I’ll stop citing comments from the website of the newspaper “Zavtra” and move on to the comments on the website Newsland.ru. There they are even funnier.

Minority report replies Owes no one to comment 10/10/2012 at 8:18 am #
Prokhan - I once respected you...

Nikolay Lachin answers Owes no one to comment 10.10.2012 at 21:32 #
It’s unlikely that Prokhanov is for sale, apparently it’s just gone crazy from old age.

Not old Grandfather comments on the material 10.10.2012 at 8:24 #
My God, how people are sinking... or maybe not people anymore...
... well, why has this old fool lost his mind?

Br.Rabbit comments on the material 10/10/2012 at 10:33 #
"Russian patriots glorify him." - a list of “patriots” praising the enemy of Russia, to the studio!!

But among the commentators there were also those who agreed with the old senile, great thinker Alexander Andreevich.

But they immediately answered him

Valery M. comments on the material 10/10/2012 at 20:21 #
That's it, Prokhanov was completely overcome by insanity. It's a pity. He was a good man.

Sasha Kuhelbekker comments on the material 10.10.2012 at 22:23 #
I think the old man has gone completely crazy.

Grove comments on the material 10/11/2012 at 18:21 #
It looks like the old man has completely fallen into insanity.

I finish my comments here. Now let's move on to his blog in Hydepark. It’s interesting, do people read there the same way as they do on this site?

In the very first comment there were again those who agreed with Prokhanov.

Elizaveta Bam # wrote a comment on October 10, 2012, 15:28
“The Russian state is the highest shrine. Serving this shrine is God’s work. In this matter, God help you, Vladimir Putin!”
God help!

But he was immediately answered in the next comment.

Raspberry Shchur # responded to Elizaveta Bam's comment October 10, 2012, 15:36
But don’t even hope for people’s help.

ddess BydloFob # responded to comment by ddess BydloFob

In short, bro!
Prokhanov is not a patriot.
Prokhanov is a butterfly collector. (by mind and hobby).

So, he will definitely be in heaven, along with Yeltsin, Putin and Gundyaev

Yuri Logvinov # responded to comment by ddess BydloFob October 10, 2012, 15:56
Yes, he really went crazy, he just went crazy!

The purpose of my speech today is to talk about the typical problems that arise in older people and show how they affect us, caregivers.

First, let's define the main concept. Dementia- This is acquired dementia. That is, when a person’s brain has already formed, and then something happened to it. We still use the word “oligophrenia”. Mental retardation- this is dementia that arose in the early stages of brain formation, and everything that a person “acquired” later is called dementia. It usually occurs after 60–70 years.

Rating of typical misconceptions. “What do you want, he’s old...”

1. There is no cure for old age.

For 14 years I worked as a local gerontopsychiatrist in Korolev in a regular dispensary. Once upon a time, he was perhaps the only person who regularly went door to door to people suffering from dementia.

Of course, we have accumulated a lot of interesting experience. Often the patient’s relatives are faced with the doctors’ position: “What do you want? He's old..." The most ingenious answer, in my opinion, was given by one relative of an elderly grandmother who said: “What do I want? I wish I had felt less guilt when she died. I want to do what I could do for her!”

The doctor always wants to be effective, he wants to cure the patient. But old age cannot be cured. And the illusion is created that there is nothing to do with old people. It is this illusion that we must fight today.

There is no diagnosis of "old age", there are diseases that need to be treated, like any disease at any age.

2. Dementia does not need to be treated as it is incurable.

In this case, any chronic diseases do not need to be treated, and meanwhile about 5% of dementias are potentially reversible. What does "potentially reversible" mean? If some types of dementia are given the right treatment at an early stage, dementia can be cured. Even with irreversible processes, at an early stage, dementia may recede for a while, and symptoms may decrease. If treated adequately.

Is 5% a little? A lot on a general scale, since according to official data in Russia there are about 20 million people suffering from dementia. In fact, I think this figure is underestimated by one and a half to two times, since dementia is usually diagnosed late.

3. “Why torture him with “chemistry”?”

Also a violation of ethics: it’s not for us to decide all this. When you yourself get sick, don’t you need to be “tormented” with medications? Why can't an older person get the same help as a younger person? Some amazing hypocrisy, relatives say: “Let’s not torture our grandfather with chemistry,” and then. When grandfather drives them crazy and drives them crazy, they can hit him and tie him up.
That is, there is no need to “torment with chemicals”, but you can beat? An elderly person cannot see a doctor himself, and we must take on this function.

4. “Doctor, just let him sleep...!”

People endure terrible behavior disorders and sleep disturbances for weeks, sometimes months, due to the dementia of their relatives, and then, staggering, they come to the psychiatrist and say: “Doctor, we don’t need anything, let him just sleep.” Of course, sleep is very important, it needs to be organized, but sleep is the tip of the iceberg, if you just improve sleep, it will not really help a person with dementia.

Insomnia is a symptom. And therefore, you can put your grandfather to sleep, but you cannot help him with dementia in this way.

For some reason, the patient’s environment - close people, nurses, nursing staff, some neurologists and therapists - think that it is very difficult to improve sleep, relieve aggression, and remove delusional ideas. In fact, this is a real challenge. We cannot cure a person, but making sure that he is comfortable for us to care for and at the same time makes him more or less well is a real task.

The result of misconceptions: Needless suffering of the patient and his environment.

Aggression, delusional ideas, behavioral and sleep disorders, and much more can be stopped, and the development of dementia can be temporarily stopped or slowed down.

3 D: depression, delirium, dementia

There are three main topics that caregivers and clinicians encounter in geriatric psychiatry:

1. Depression

Depression is a chronically low mood and inability to enjoy joy.
Often occurs in old age
At this age, it may be perceived as normal by the patient and others
Strongly affects all somatic diseases and worsens their prognosis

If a person, no matter what age, is chronically unable to experience joy, this is depression. Everyone probably has their own experience of old age. I would really like that, with my help, we would form an image of old age a la Japan, when in retirement we will save up some money and go somewhere, and not just sit on a stool.

In the meantime, the image of old age in our society is quite depressing. Who do we imagine when we say “old man”? Usually a bent grandfather wandering somewhere, or an angry, restless grandmother. And therefore, when an elderly person is in a bad mood, it is perceived as normal. It is even more normal when old people who have lived to be 80–90 years old say: “We are tired, we don’t want to live.” This is wrong!

While a person is alive, he should want to live, this is the norm. If a person, in any situation, does not want to live, this is depression, regardless of age. Why is depression bad? It negatively affects somatic diseases and worsens the prognosis. We know that older people usually have a whole bunch of diseases: type 2 diabetes, angina pectoris, hypertension, knee pain, back pain, and so on. Even sometimes you come to a call, ask an elderly person what hurts, he says: “Everything hurts!” And I understand what he means.

Both old people and children suffer from depression in their bodies. That is, in fact, the answer “everything hurts” can be translated into our language as follows: “First of all, my soul hurts, and from this everything else hurts.” If a person is depressed, sad, his blood pressure and blood sugar are jumping, until we remove this sadness and depression, it seems unlikely to normalize other indicators.

Bottom line: Depression is rarely diagnosed and treated. As a result, the duration and quality of life is shorter, and those around you are worse off.

2. Delirium (confusion)

1) Confusion: loss of contact with reality, disorientation, with chaotic speech and motor activity, aggression.

2) Occurs often after injuries, moves, illnesses

3) Often occurs acutely in the evening or at night, may go away and recur again

4) The person often does not remember or vaguely remembers what he did in a state of confusion

5) Aggravated by incorrect treatment

We encounter the topic of delirium in people at a young age, mainly with prolonged use of alcohol. This is “delirium tremens” - hallucinations, acute delirium, persecution, and so on. In an elderly person, delirium can occur after physical or psychological trauma, moving to another place, or physical illness.

Just the day before yesterday I was on a call with a woman who is almost a hundred years old. She always lived almost independently - with a visiting social worker, relatives bought groceries. She had dementia, but it was mild, until some point it was not critical.

And so she falls at night, breaks her hip, and on the very first night after the fracture she begins to feel confused. She doesn’t recognize anyone, shouts: “Where did you put my furniture, my things?”, she begins to panic, get angry, get up with her broken leg, and run somewhere.

A common reason for confusion to start is moving. Here is an old man living alone, serving himself in the city or in the countryside. His surroundings help him - neighbors buy groceries, grandmothers come to visit. And suddenly the relatives call and say: “Your grandfather is weird.” He gave to the pigs what he gave to the chickens, to the chickens what he gave to the pigs, he wandered somewhere at night, barely caught them, and so on, he began to speak. Relatives arrive and take grandfather away.

And here a problem arises, because grandfather, although he could not cope very well with his chickens and pigs, at least knew where the toilet was, where the matches were, where his bed was, that is, he somehow found his way in the usual place. And after moving, he has no bearings at all. And against this background, usually at night, confusion begins - grandfather is eager to “go home”.

Sometimes relatives, stunned by such insistence, actually take him home so that he can calm down about the chickens... But this leads to nothing, because in the next entrance the same grandfather is eager to “go home”, although he has lived in this apartment all his life .

People, in a moment of confusion, do not understand where they are and what is happening around them. Confusion often occurs acutely, in the evening or at night, and may resolve itself by the morning, after sleep. That is, at night they call an ambulance, the doctor gives an injection, says: call a psychiatrist, and in the morning the patient wakes up calm and does not remember anything. Because confusion is forgotten (amnesized), a person does not remember, or very vaguely remembers, what he did in a state of confusion.

Confusion is most often accompanied by psychomotor agitation: speech, motor, usually occurs at night, and, what is especially unpleasant, is aggravated by incorrect treatment.

When sleep is disturbed in elderly people, what drug is usually recommended by a therapist or neurologist? Phenazepam is a benzodiazepine tranquilizer. This drug can treat anxiety and insomnia. It lulls and calms.

But in case of confusion (due to organic brain disorders), phenazepam acts in the opposite way - it does not calm, but excites. We often hear the following stories: an ambulance came, gave phenazepam or administered Relanium intramuscularly, the grandfather forgot for an hour, and then began to “run across the ceiling.” This entire group of benzodiazepine tranquilizers often acts the other way around (paradoxically) in the elderly.

And one more thing about phenazepam: even if your grandparents use it within reasonable limits, keep in mind that, firstly, it is addictive and addictive, and secondly, it is a muscle relaxant, that is, it relaxes the muscles. Elderly people, when they increase their dose of phenazepam, getting up, for example, to go to the toilet at night, fall, break their hip, and that’s where it all ends.

Sometimes they also begin to treat insomnia or confusion in grandmothers with phenobarbital, that is, “Valocordin” or “Corvalol”, which contain it. But phenobarbital, although it is indeed a very strong sleeping pill, anti-anxiety and anticonvulsant drug, is also addictive and addictive. That is, in principle, we can equate it to narcotic drugs.

That’s why in Russia we have such a specific phenomenon as corval carol grandmothers. These are grandmothers who buy a huge number of bottles of Valocordin or Corvalol at the pharmacy and drink several of them a day. Essentially, they are drug addicts, and if they don’t drink it, they a) won’t sleep; b) they will begin to develop behavioral disorders reminiscent of delirium tremens in an alcoholic. They often have slurred speech like “porridge in the mouth” and an unsteady gait. If you see that your loved one regularly takes these over-the-counter drugs, please pay attention to this. They need to be replaced with other medications without such side effects.

Bottom line: if confusion occurs, they do not treat it in the early stages, do not look for the reasons, treat it incorrectly, and as a result, the suffering of the patient and the entire family, the flight of caregivers.

3. Dementia

Dementia is an acquired dementia: disorders of memory, attention, orientation, recognition, planning, criticism. Violation and loss of professional and everyday skills.

Relatives and sometimes doctors “notice” dementia only in advanced stages
Mild and sometimes moderate disorders are considered normal in old age
Dementia may begin with character disorders
Wrong treatment is often used

What do you think, if you bring an average elderly person of about 70 years of age with impaired memory and orientation to an appointment with a neurologist, what diagnosis will he most likely receive? He will receive a diagnosis of “dyscirculatory encephalopathy” (DEP), which translated into Russian means “a disorder of brain function due to impaired blood circulation in its vessels.” Most often, the diagnosis is incorrect and the treatment is incorrect. A non-stroke, but severe form of cerebrovascular disease (CED), this is a severe and relatively rare disease. Such patients do not walk, their speech is impaired, although there may be no asymmetry in tone (differences in the work of the muscles of the left and right half of the body).

In Russia there is a traditional problem - overdiagnosis of vascular problems of the brain and underdiagnosis of so-called atrophic problems, which include Alzheimer's disease, Parkinson's disease and many others. For some reason, neurologists see problems with blood vessels everywhere. But if the disease develops smoothly, gradually, slowly, most likely it is not associated with blood vessels.

But if the disease develops sharply or spasmodically, it is vascular dementia. Quite often these two conditions are combined. That is, on the one hand, there is a smooth process of death of brain cells, as in Alzheimer’s disease, and on the other hand, against this background, vascular “disasters” also occur. These two processes mutually “feed” each other, so that just yesterday a safe old man can “go into a tailspin.”

Relatives and doctors do not always notice dementia, or only notice it in advanced stages. There is a stereotype that dementia is when a person lies in a diaper and “blows bubbles,” and when he, for example, loses some household skill, this is still normal. In fact, dementia, if it develops very smoothly, most often begins with memory disorders.

The classic variant is dementia of the Alzheimer's type. What does this mean? A person remembers events from his life well, but does not remember what just happened. For example, at a reception I ask an elderly man, he recognizes everyone, knows everything, remembers the address, and then I say: “Did you have breakfast today?” - “Yes,” “What did you have for breakfast?” - silence, he doesn’t remember.

There is also a stereotype that dementia is something about memory, attention, orientation. In fact, there are types of dementia that begin with character and behavior disorders. For example, frontotemporal dementia, or as it used to be called Pick's disease, can begin with a character disorder. A person in the first stages of dementia becomes either complacently relieved - “knee-deep sea”, or, on the contrary, very withdrawn, self-absorbed, apathetic and sloppy.

You probably want to ask me: where, in fact, is that conventional border between what is still normal and the onset of dementia? There are different criteria for this limit. The ICD (International Classification of Diseases) indicates that dementia is a disorder of higher cortical functions with impairment of everyday and professional skills. The definition is correct, but it is too vague. That is, we can use it both at advanced and early stages. Why is it so important to define the boundary? This is not only a medical moment. Very often legal issues arise: problems of inheritance, legal capacity, and so on.

Two criteria will help determine the boundary:

1) Dementia is characterized by a disorder of criticism. That is, a person no longer criticizes his problems - memory disorders, mainly. Doesn't notice them, or downplays the scale of his problems.

2) Loss of self-service. As long as a person takes care of himself, we can assume by default that there is no dementia.

But there is also a subtle point here - what does “serves oneself” mean? If a person already exists in your care, but is functioning in the apartment, this does not mean that dementia does not exist. It may very well be that it is already developing gently, but a person simply does not detect it in his usual environment. But, for example, he can’t go and pay the receipt himself: he gets confused, doesn’t understand what and where to pay for, is unable to count the change, etc.

This is where the mistake comes from: mild and slow disorders are considered the norm in old age. This is very bad, because it is the mild and slow disorders that can be effectively treated. If you bring your relative in the early stages of dementia, it can be stopped with the help of drugs that do not cure dementia, but are great at keeping it at bay. Sometimes - for many, many years.

Bottom line: Dementia is diagnosed late and treated incorrectly. As a result, loved ones live less, worse, suffer themselves and cause suffering to those around them.

Where should you start if a loved one has dementia? A very unusual answer: from caring for the caregiver!

Having normalized the caregiver’s state of mind, we:

– Improving the quality of care;

– We carry out the prevention of “burnout syndrome” among loved ones and caregivers. To put it simply, those around you go through stages of aggression, depression and somatization;

– We preserve good caregivers and the health of our loved ones who bear the burden of care;

– If the caregiver works, we improve his ability to work, and sometimes even keep him employed.

Does anyone have any ideas about why you should start with yourself when caring for a loved one with dementia? Let's remember 3D, where depression comes first. The caregiver is, in fact, much more vulnerable than the dementia patient.

A dementia patient may no longer understand anything and consider you a granddaughter, a neighbor, or a nurse instead of a daughter. And you still need to provide for the patient – socially, legally, medically. If you put the patient, or rather his illness, at the center, over time you will lie next to the patient. Only by normalizing the condition of the caregiver can we improve the quality of care and help the patient himself.

Burnout syndrome has three conditional stages: aggression, depression, somatization. Aggression – often as irritability, the classic version is asthenia (weakness, fatigue).

Depression occurs after aggression if the caregiver does not have the opportunity to rest. This is the phase of apathy, when a person no longer needs anything at all, he walks like a “zombie”, is silent, tearful, automatically takes care of him and is no longer with us. This is a more severe stage of burnout.

If at this stage we do not take care of ourselves, somatization sets in. Simply put, a person can simply die. The caregiver develops his own illnesses and becomes disabled himself.

It is impossible to deceive reality. If you care without taking care of yourself, then after some time you yourself will die .

What can be done with proper treatment and care for a mentally retarded relative?

– Identify and treat “potentially reversible dementias” and depressive pseudodementias;

– Extend the life and quality of life of a loved one if dementia is incurable;

– Eliminate the suffering of the elderly, behavioral disorders, psychotic disorders;

In 5% of cases, dementia can be cured. There are dementias with hypothyroidism, with hyperthyroidism, with a lack of vitamin B-12, folic acid, normal pressure hydrocephalus, and so on.

If we cannot cure dementia, we must understand that on average it takes four to seven years from the time of diagnosis to the death of our loved one. Why should we turn these years into hell? Let's eliminate the suffering of the elderly, and save our health and work.

Questions:

– What if I notice some behavioral abnormalities in a relative, but she doesn’t admit it and doesn’t want to be treated?

– In medical law there is the Federal Law “On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision.” I believe that all people who care for dementia patients, due to the complex social and medical-legal situation, need to read and know this law. Especially about observation by a psychiatrist: how can a psychiatrist be invited, in what cases can a psychiatrist involuntarily refer a patient to a hospital, and when to refuse, etc.

But in practice, if we see dementia, we try to treat it as soon as possible. Since obtaining court permission for an examination takes a very long time, and the disease progresses, relatives are going crazy. It should be remembered here that psychotropic drugs cannot be left in the hands of dementia patients. We need strict control. They forget to take them or forget that they took them and take more. Or they don’t take it on purpose. Why?

Damage ideas, which are formed against the background of memory impairment. That is, an elderly man, already gripped by paranoid anxiety, takes his documents, money and hides them, and then cannot remember where he put them. Who stole it? Either relatives or neighbors.
Poisoning ideas. This problem can be solved if you start treatment with medications in solution. Then, when a person loses this idea, he agrees to take memory drugs voluntarily
Inappropriate sexual desires. I tried to talk a little about this at the Conference. A very complex topic. We are accustomed to the fact that guardians can be sexually violent towards helpless guardians. But it also happens the other way around: the ward, deprived of criticism and “inhibitions,” commits indecent acts towards minors, etc. This happens much more often than many people realize.

– What may be associated with a complete refusal of food and water in the later stages of dementia?

– First of all, we need to look for and treat depression.

Depression (no appetite);
Ideas of poisoning (changes in taste, poison added);
Concomitant somatic diseases with intoxication.

If you have a replacement, the best thing to do when you are tired is to leave the post for a while. A replacement can be found if you set such a goal.
If you can’t leave and relax, we treat “burnout syndrome” with medications.

We must keep in mind that caring for an elderly person is hard physical and mental work, which, for us, relatives, is not paid. Why else is burnout syndrome so relevant? If you were paid money for leaving, you wouldn't burn out so quickly. Adequately paid care is the prevention of burnout syndrome.

But it’s even harder to rebuild yourself inside, admit that your loved one is sick, take control of the situation into your own hands, and, despite the fatigue and troubles, try to enjoy this life. Because there won't be another one.

Old age can be different: some old people are cheerful and productive until their last breath, others change beyond recognition. Marasmus is a common pathology in the modern world, bringing a lot of suffering to a fading person and, most of all, to his close people.

What is insanity?

Marasmus is a pathological process of complete degradation of psychophysical processes, extinction of cognitive functions. Accompanied by brain atrophy, irreversible changes in human tissues and organs. Among doctors, the disease has a common name “tabes”, reflecting the ongoing process of exhaustion and withering. The disorder begins gradually, the risk group is people over 60 years of age. There are several types of insanity:

presenile (premature, presenile);
senile (senile);
nutritional (in children and adults, due to insufficient protein intake in the body)

What is senile insanity?

Senile insanity is the final and irreversible stage of senile dementia or senile dementia. The diagnosis is made only after 60 years of age, the incidence of the disease is high from 10 to 35% in all cases of mental disorders. The irreversibility of mental functions in dementia complicates the course of the disease and complicates treatment. Features of female insanity:

occurs 2 times more often than in men;
symptoms are more pronounced;
delusional disorders.

Male insanity:

less susceptibility due to shorter life expectancy compared to women;
disorders progress slowly;
hypersexuality and increased excitability.

Causes of senile insanity

Insanity in old people manifests itself more clearly when there have been demographic holes in different countries for several years. The predominance of the elderly part of the population clearly demonstrates the fact that dementia is a common phenomenon, requiring the development of social and health programs that would help people, when the first alarm bells appear, begin to take measures to reduce destructive processes.

Causes of senile insanity:

Marasmus and - the close relationship between the neurogenerative disease identified by A. Alzheimer and the occurrence of marasmus was confirmed back in 1910.
Genetic predisposition.
Somatic diseases (pathologies of the cardiovascular system: atherosclerosis, hypertension).
Oncology.
Prion proteins are foreign proteins of animal origin that come with food that can penetrate the human nervous system and destroy it and the immune system.
Use of psychotropic drugs.
Pick's disease.

Senile insanity - symptoms and treatment

Senile marasmus is a severe multi-organ pathology, which is the final stage. For several years, the body has been subjected to destructive pathological changes, and marasmus is a deeply serious condition with pronounced symptoms. Treatment of advanced dementia does not bring results and is aimed at alleviating the patient’s condition, so it is important to consult a doctor at the first signs of the disease.

Senile insanity - symptoms

Most people in society know who senile people are, due to the high frequency of the disorder. The disease manifests itself in all its glory after 60 years. Early manifestation worsens the prognosis and all symptoms develop at lightning speed; late occurrence suggests slowly progressive changes extended over time. Signs of insanity:

worsening negative character traits (a greedy person becomes a stingy miser, sloppiness turns into a complete lack of self-care);
increased egocentrism - the need to control everything and everyone increases;
women experience delusional disorders (complain that their relatives want to poison them or rob them);
indifference and callousness towards others;
there is a desire to walk through garbage dumps and store the trash you bring at home;
uncontrolled appetite;
memory disorders (dates, events, recognition are erased from memory);
disorientation in space;
cachexia – severe exhaustion.

How to treat senile insanity?

Senile is a person in need of maximum care, care and treatment. An important condition is to ensure the following regime:

a cozy, familiar and familiar environment for the patient (it is not recommended to transport a person to unfamiliar, even better living conditions);
encouraging physical activity (participation in cleaning, cooking, simple household chores);
daytime nap;
walking in the park together with the patient;
eating foods rich in proteins, microelements and vitamins (fish, vegetables, herbs, fruits).

Drug therapy is mainly symptomatic and aimed at treating the underlying disease:

Neuroprotectors – nootropil, mexidol, cinnaresin.
Calcium antagonists – verapamil, Cerebrolysin, Dilgart.
Antidepressants - azaphene, tryptophan, preparations based on St. John's wort.
Antipsychotics - clozapine, haloperidol, dicarbine.

How to determine the risk of developing marasmus in old age? Can anything be done to avoid this? This is what we will talk about today.

For some it is earlier, for others it is later, but the aging process in the body inevitably affects all tissues and organs, including the nerve cells of the brain. They atrophy, energy and metabolic processes in them slow down, and the quality of work deteriorates. Alzheimer's disease or senile dementia develops, which, as it grows, turns into senile insanity - the highest manifestation of such age-related changes as memory deterioration, character deterioration beyond recognition (an altruist becomes an egoist; a cheerful, open person can become vindictive and suspicious, etc.).And it happens that some traits become aggravated to such an extent that it reaches the point of absurdity. For example, thrift and frugality turn into greed and stinginess. A caring, loving parent becomes a despot for his children. Any previously existing fears and anxieties turn into panic fears, phobias, etc.

For a person who has fallen into insanity, there is nothing and no one except himself and his needs. All his interests come down to their satisfaction. As a result, the patient, who is increasingly immersed in this state, has no other needs other than physiological ones.

Such changes in memory and personality progress at different rates and are currently irreversible. But it is still possible to “extend the youth” of brain neurons or even stop age-related changes that have already begun.

What contributes to the development of insanity

In addition to the natural processes of aging, which gradually destroy nerve cells in the brain, there are factors that increase the risk of developing this disease. First of all, this is atherosclerosis of the blood vessels of the brain. In this case, the blood supply to the brain deteriorates, that is, the nerve cells receive less and less oxygen and other substances necessary for life and work. As a result, they cannot fully function.

In addition, recent studies have shown that the risk of developing senile marasmus increases 4 times in smokers. This happens because smoking contributes to the most pronounced deterioration of cerebral circulation.

Lack of physical, as well as mental, stress is a contributing factor to the earlier development of the disease. By the way, educated people, people of intellectual work, fall into insanity much later (we are talking about a difference of 20, 30 or more years). Scientists suggest that they retain a bright head much longer, due to the peculiar “training” of their brain cells. “Trained” cells later begin to undergo aging processes. In addition, even age-related changes in brain cells that have already begun do not manifest themselves externally for a long time. Therefore, until old age they retain clear memory and sobriety of thinking.

But if senile dementia does develop, then it manifests itself more clearly and the disorders progress faster than in uneducated people. A possible explanation for this is this: after a long, unremarkable period of “quiet” aging and destruction of nerve cells, a moment comes when there are so few cells capable of maintaining the intellectual functions of the brain at the proper level that all manifestations of senile insanity develop with amazing speed.

Another interesting discovery was made by American scientists after numerous studies. It turns out that people with thin waists and wide hips are more likely to fall into insanity in old age than people with narrow hips and a not very defined waist.

Is it possible to prevent the development of senile dementia?

There is no method or remedy that would help with a 100% guarantee to avoid senile insanity. But we have the power to extend the period of normal, full-fledged mental activity.

One of the means to slow down the aging process and, at a minimum, delay the onset of the disease is an active lifestyle. During physical activity, not necessarily complex or severe, metabolic processes and the activity of nerve cells in the brain are stimulated. The same thing happens during mental stress.

It has not been proven that any specific type of activity will relieve senile insanity, but regular physical and intellectual activity, and most importantly, alternation and change of different activities will prolong the life of brain neurons for a long time. For example, today clean the house or work in the garden, and then read something. Tomorrow, go knitting or take a walk in the fresh air, and then try to solve a couple of crossword puzzles. And the day after tomorrow, swim and chat with friends, talk about the news, etc. Brain cells will age and deteriorate five times slower.

Don't forget that atherosclerosis and smoking are the main enemies of your brain. Therefore, quit smoking and watch your diet and body weight. Limit your consumption of sugar and sweets in general, and animal fats.

You can also increase the amount of foods containing vitamins B6 and E in your diet, since they largely protect the nerve cells of the brain from destruction, greatly slow down the aging process and, thereby, contribute to longer-term normal activity of these cells, even in conditions of not very good blood supply to the brain. So eat porridge from whole grains, bread made from wholemeal flour or with bran, fish, liver, bananas, beans, yeast (contain vitamin B6), vegetable oils (olive, sunflower, corn, flaxseed), cereal grains, lettuce , eggs (do not overuse, the yolk contains a large amount of cholesterol).

Marasmus can be treated

You should not reassure an elderly person by saying that memory deterioration is a natural process. Because this process, although completely natural, will progress and complicate life not only for the patient, but also for his loved ones, including you.

Therefore, in old age, when the first signs of memory deterioration appear, especially against the background of hypertension, diabetes and other chronic diseases, consult a doctor immediately. The arsenal of medications that slow down the aging process of brain cells and improve their function today is enormous.

First of all, these are drugs from the group of so-called nootropic drugs (from the Greek words “noos” - thinking, mind and “tropos” - means. They improve memory, facilitate thinking and increase the brain’s resistance to stress. These drugs have gained well-deserved popularity all over the world and are used not only by older people, but also by young people whose work involves intense mental stress, and even by children to improve academic performance. Most of these medications, if followed by a doctor, are quite harmless to the body.

In addition to nootropic drugs, your doctor may prescribe you medications to improve blood supply and nutrition to the brain, vitamins and adaptogenic agents.

Comprehensive treatment, begun in the early stages of the disease, will stop destructive processes in the brain and help maintain mental clarity for a long time.

Traditional medicine recipes

And finally, here are a few traditional medicine recipes that will help you maintain good spirits and a clear mind longer in old age.

An ancient remedy is tincture of elecampane with vodka.

You need to let 30 g of dry elecampane root brew in 0.5 liters of vodka for 40 days. Take 25 drops of tincture before meals.

May nettle tincture

Pour 200 g of nettle into 0.5 liters of vodka or 50 - 60% alcohol. Cover the neck of the bottle with gauze or a cloth. Keep it on the window for 24 hours, then 8 days in a dark place. Strain, squeeze. Take 1 teaspoon 2 times a day: in the morning on an empty stomach half an hour before meals and at night before bed.

Rowan bark decoction

Pour 200 g of bark into 0.5 liters of boiling water and cook for 2 hours over low heat. Take 25 drops before meals. The broth should be thick.

Heather decoction

Pour a tablespoon of chopped heather into 0.5 liters of boiling water, boil for 10 minutes, leave for 3 hours (wrapped), strain. Drink like tea at any time of the day. Pairs with any food or drink. During the first week, take 1/2 cup, then a glass.

Rose hip decoction

Pour 2 tablespoons of crushed dry rose hips into 0.5 liters of water, boil for 15 minutes over low heat, leave overnight, strain. Drink as tea (preferably with honey) and instead of water.

Onion juice with honey

Grate the onion on a fine grater and squeeze. Mix onion juice with honey in a 1:1 ratio (a glass of juice per glass of honey). Stir well. Take 1 tablespoon 3 times a day either 1 hour before meals or 2 to 3 hours after meals.

Garlic tincture with vodka

Fill 1/3 of the bottle with chopped garlic, fill the remaining 2/3 with vodka or 50 - 60% alcohol, leave for 2 weeks in a dark place, shaking daily. Take 5 drops 3 times a day before meals, diluted with one teaspoon of cold water.

loss of initiative;

changes in mood and behavior.