Dementia, Alzheimer’s and Parkinson’s Disease: What You Need to Know & How You Can Help

It can be normal to notice your older relatives begin to behave strangely. Misplaced keys, losing track of conversations, forgetting names of close family members and forgetfulness is usually waved off as harmless signs of old age. In reality, they could also indicate the early stages of some of the most common diseases to affect senior citizens: dementia, Alzheimer’s disease and Parkinson’s disease. All three diseases affect brain function, and there are currently no available cures. 

In Malaysia, it is estimated that around 50,000 people suffer from Alzheimer’s disease, while patients with Parkinson’s disease are believed to number around 15,000 to 20,000 people. As of 2005, it was reported that 0.063% of the population suffered from some form of dementia. This number is expected to reach 0.454% by 2050 due to our ageing population. However, the statistics may be skewed because many people still go undiagnosed. This may be due to a lack of awareness among Malaysians regarding mental health issues. Many also believe that dementia or Parkinson’s are simply a natural part of growing old, and opt to deal with it on their own rather than seek help with managing it.

You may think of dementia as a specific illness, but it’s a range of diseases that impair memory and thought processes due to nerve damage in the brain. Symptoms are different depending on which parts of the brain are affected. Some common signs to look out for are:

- loss of memory and disorientation
- difficulty communicating
- loss of physical coordination
- becoming depressed, paranoid or anxious
- hallucinations

Those at risk for dementia are usually individuals over 60 years old with existing conditions that could potentially develop into dementia, such as diabetes or late-onset depression.

Parkinson’s disease develops when certain nerve cells in the brain die and fail to produce the chemical dopamine. This results in irregular brain functions which affects the individual physically. You are most at risk for Parkinson’s if you are male, over 60 and have a family history of the ailment.

Symptoms of Parkinson’s include:-
- tremors or shaking limbs, usually beginning in the hands at one point
- stiff muscles
- poor balance and posture
- speech problems (slurring, speaking too slowly or too rapidly)
- bradykinesia, or the slowing down of physical movement
- trouble with simple movements like blinking or smiling

Parkinson’s disease can be accompanied by depression, sleep disorders, pain and fatigue. Over time, patients can also develop a form of dementia called Parkinson’s disease dementia.

Alzheimer’s is, in fact, the most common cause of dementia. It involves the destruction of brain cells which lead to loss of memory and other related functions.

Symptoms include:-
- forgetting names of relatives and common objects
- difficulty with language and conversations
- taking a longer time to complete basic tasks
- poor judgment and decision-making
- becoming depressed, moody and aggressive
- delusions

The causes of Alzheimer’s disease are still unclear, but women over the age of 65 are believed to be at most risk.

It is currently not possible to cure or reverse the growth of these diseases. As a result, most treatments focus on drugs which help to stabilise symptoms related to memory loss, reasoning and learning.

Medication to manage depression, insomnia and mood regulation may also be prescribed. Parkinson’s patients will be given other drugs to control tremors and impaired physical movement. For late stage of Parkinson’s disease, a surgical procedure called deep brain stimulation (DBS) is available to help control tremors and stop involuntary movements.

Occupational therapy helps teach patients coping skills and how to minimise the risks of accidentally harming themselves. For dementia patients, art and music therapy are wonderful options for mental stimulation and self-expression.

Aside from medical treatment and therapy, patients will likely spend most of their time at home or in care centres. Over time, these illnesses will rob the patient of the ability to do many things on their own.  Remember to always treat those afflicted with the disease with dignity and patience. Try to allow them to be as independent as possible while supporting their needs.

Food and Eating Habits
Many patients may refuse to eat or start to dislike their favorite foods. Some may develop a taste for peculiar combinations of food. It’s important to accommodate their desires while still providing healthy and nutritious meals. Parkinson’s patients with impaired motor skills may also require you to feed them.

Hygiene and Personal Care
Someone with dementia, for example, may not be able to go to the bathroom on their own and will need your help to direct them there or to recognize body language that indicates their need to use the toilet. The use of adult diapers is also an option. You may need to remind your patient to shower, change their clothes or brush their teeth regularly. Middle or late stage patients could require daily assistance with those tasks.

Safety
Alzheimer’s disease and dementia patients will eventually lose the ability to complete simple functions safely. To secure the home, you can install safety knobs on gas stoves, list down emergency phone numbers in a visible location, childproof electrical outlets and keep sharp objects and dangerous substances out of the way.

Home Environment
Try to minimise clutter around the house and limit visitors so that the patient doesn’t feel overwhelmed. With all three diseases, the caregiver should be prepared to accommodate changes in mood, personality and communication ability. You may also incorporate light exercise, games or the patient’s hobbies and interests into the daily routine.

Day Care Centres
This is a good option for caregivers who have to work during the day. Hospis Malaysia and various NGOs run care centers for patients, although there is a dire lack of services in rural areas. It is also a challenge to find suitable doctors and therapists, since many Malaysian patients may find it difficult or uncomfortable to talk about their worries and feelings in a different language. As a caregiver, try and raise more awareness in your community about these illnesses. The negative perception and lack of knowledge regarding diseases like dementia are often what prevents people from seeking the help they or their family member truly needs. In the BFM Health and Living Event that took place recently, themed as Urban Happiness, doctors advised on practicing certain lifestyle methods to help patients who are diagnosed with these three diagnoses, such as:

• Participating in exercises like yoga or swimming
• Being in nature
• Sitting in open green spaces
• Going to a park to meet new people through different interactions
• Owning a dog or a cat as pet therapy allows them to have a purpose in life as an animal is depending on them for shelter and food to live
  

- Take initiative
If you are a relative or friend to a caregiver, take steps to be a helpful presence before being asked. Offer to prepare meals and run errands. Reach out to spend time with caregivers, who can often feel lonely and isolated. Remind the caregiver that you are thankful for their sacrifices through words and simple gestures, such as a hug or a thank you card.