Alzheimer's Part 1

Dementia is a group of symptoms that affects one’s ability to: think, remember, reason, plan, speak, and relate. People with dementia might also experience: confusion, problems with sleep, wandering, falling, psychosis, irritability, restlessness, disinhibition, poor coordination, poor judgement, jumbled speech, difficulty swallowing, anxiety, loneliness, depression, and aggression.

For the most part, the brain changes associated with the most common cause of dementia – Alzheimer’s. Alzheimer’s typically starts 10 to 20 years before any observable memory problems in a person.  By the time you notice lapses in memory, the brain would have been damaged, so you really cannot afford to wait before seeking medical attention, especially if you have other risk factors. Some cases of dementia can be prevented, but the disease progression can be delayed with certain medications.  Hence, early intervention is key. Most people have come to expect memory decline as part of aging, so they accept this in their older loved ones. Unbeknownst to their family members, they can help prevent or delay dementia with early intervention.

Dementia is caused by damage to the brain cells. There are many conditions that destroy the brain cells, but the most common is the Alzheimer’s disease. Because of this disease, clumps of protein called plaques and fibers of protein called tangles develop in the brain gradually. The other major cause of dementia is Vascular dementia, caused by damage to the blood cells from high-blood pressure or strokes. There are numerous other causes of dementia such as Lewy body, traumatic brain injury, Huntington’s disease, Creutzfeldt -Jakob disease, and Parkinson’s disease.

Risk factors for dementia include: age, family history, Down syndrome, poor sleep, sleep apnea, cigarette smoking, alcohol use, poorly controlled diabetes, obesity, depression, high cholesterol, hypertension, and nutritional deficiencies.

Dementia is challenging and heart-wrenching for people affected by it. Not only does the afflicted suffer but also affected family members. I recall a close friend (for purpose of privacy let us call her Mrs. B). ordeal with her mother in-law, Mrs. B Snr.  Mrs. B Snr is a retired school teacher from Lagos, Nigeria. Her son, Mr. B, is married to my close friend Mrs. B.  The first time I met Mrs. B Snr was 15 years ago while staying with her son and daughter-in-law in Atlanta, GA. Her daughter-in-law is a kind even-tempered person. For the most part, they got along well and took care of each other until 7 years ago.

 I observed Mrs. B, the coolest and calmest girlfriend one could ask for, become distraught and distant. She initially kept whatever was bothering her a “family secret”!  How could she divulge the family secret? If you are familiar with the Nigerian culture, you will get my drift! Eventually she called me crying. She said she was having problems with her husband and did not know what else to do.  He accused her of ill-treating his mother.

Mrs. B Snr had stopped eating and was not taking care of herself.  Her room that was always clean and tidy had become dirty and reeked of urine. She suggested getting adult diapers for her mother in-law, but Mrs. B’s husband felt insulted. He accused her of over reacting.  One day, Mrs. B Snr, who knew their neighborhood quite well went for a walk and didn’t return on time. When they eventually found Mrs. B Snr, she falsely accused Mrs B of stealing her money, which is the reason why she went looking for a police officer to arrest her daughter in-law. The once doting, smart mother-in-law, who helped her grandkids with their homework had become increasingly forgetful, careless, irritable, and angry with her grandkids. She became accident prone, flooding the bathroom and burning food on the stove. One minute she was happy, but the next minute was crying and no longer sleeping at night. Instead, she walked around at night occasionally leaving the doors ajar. Hence, my friend stopped sleeping well just to keep an eye on her mother in-law.

The once loving grandmother became so mean that her grandchildren avoided her. They no longer wanted to stay alone at home with Mrs. B Snr. By this time, the grandmother had involved all her other children in Nigeria. A family war ensued, and Mr. B’s siblings accused Mr. B and my friend of ill-treating their mother and all demanded their mother be returned to Nigeria immediately. I mentioned to my friend that I suspected her mother in-law had dementia. When she mentioned this to her husband, he became angry her for calling his mother “crazy”.  As educated as he was, he had the wrong notion about dementia. Eventually, he sided with his other siblings and decided to send their mother back home to Lagos.

Less than a year after Mrs. B Snr returned to Nigeria, Mr. B reached out to me. Their family secret was now “out of the bag”. Mrs. B Snr, after arriving Lagos, moved from one child’s house to the next, as she became violent and floridly psychotic.  In the span of a year, she had lived with four different children. The family initially blamed it on the wives of Mr. B’s siblings.  Finally, she went to leave with their sister. After keeping her for just two weeks, Mrs. B Snr’s daughter announced that she could not cope with caring for their mother. At the height of their mother’s sickness, her kids fought with each other, failing to realize that they were all morning the loss of their mother’s personality. The family was in turmoil, mourning, and broken hearted. How could they watch a shadow of their mother? They felt helpless that they couldn’t help and didn’t know what to do. They felt alone, as they didn’t realize that many other families go through this daily.

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To learn more about Alzheimer’s dementia, please follow the link: https://www.youtube.com/watch?time_continue=10&v=Eq_Er-tqPsA

My friend came back from work early one day and walked in on her husband weeping because this was unfamiliar territory for his family. As the first son, he felt he needed to fix it but didn’t know what to do. The siblings were no longer communicating with each other.  They eventually asked for my assistance, so I had to call each sibling in Nigeria. Eventually, they agreed to work together in the best interest of their mother. Weren’t they all suffering because of the love for their mother? After a few teleconferences and working on the family dynamics, we eventually developed a treatment plan with appropriate social support and medical intervention. By the grace of God, we were able to put the necessary things in place for the best care of their mother. Things calmed down for about two years until greed set in. Taking care of her was very expensive; one child had eyes on the money and felt they could do it cheaper. Thus, he disrupted the whole plan and took their mother to his home. Within 3 days, someone left the gate unlocked at his house and she wandered off, unfortunately. 3 years later, Mrs. B Snr is still nowhere to be found, and the family remains fragmented. I am sure you will agree with me that a little bit of education could have saved their mother. I feel sorry for this family. Will they ever heal?  Will they ever find closure as long as their mother is out there? I wonder how many other families are in this situation. . . I thank my friends for permitting me to share their story; maybe one family can be helped because of their experience.

Stay tuned for more blogs addressing various aspects of Alzheimer’s disease.

Dr Omobolaji Oyebanjo-Popoola