It is around ten in the morning and old Mr. K, brushes his teeth for a second time and sits down for his second breakfast. Mr. K has forgotten that he had been through these chores a little while ago. His family believes that it is old age leading to senility. His loss of recent memory has become a source of entertainment for his grandchildren but a nuisance to their parents. In reality, Mr. K is the victim of a progressive degenerative disease, that affects the brain, called the Alzheimer’s disease.

“The disease manifests in impaired memory (recent memory to start with, and later on remote memory), impaired cognition and behavior, which means that, apparently simple forgetfulness interferes with the day to day life of the patient. Activities in self care like dressing and hygiene becomes difficult and the person has to depend on others for these tasks. The disease involves the death of those brain cells which control memory, thought and language”. Says Dr. Ichaporia, a neurologist. Describing Alzheimer’s as the most common cause of dementia, Dr. Ichaporia explains, “Since the onset of the disease is unnoticeable, and it progresses very gradually, family members mostly fail to identify it. Acquired skills like language and interpretation are lost. So are his social graces and sometimes even common decency. There is disorientation in time and direction. For instance, these patients can forget the recent time and date and they tend to lose their way even in familiar places. This is why a caregiver is required round the clock”.

September 21st is commemorated as the World Alzheimer’s Day and a month starting from September 21, as the Alzheimer’s Caregiver’s month. The role of the caregivers is invaluable. In spite of having 3,00,000 Alzheimer’s patients in India, we still do not have either a special home for them or even trained caregivers. The caregiver, be it a relative, a friend or even a hired person, needs to be trained specially for the job since they are the people who have the most intimate contact with the patient. They should be firm, yet loving and highly disciplined people themselves in order to set a much required routine for the patient. An efficient caregiver would try to make his or her wards as independent as possible, making their homes as safe and ‘Alzheimer–friendly’ (much akin to child–friendly homes) as possible. A good sense of humor will go a long way in making the daily chores seem simpler.

“Though there is no cure for this disease, there are drugs to control it and keep it in check, but the costs are prohibitive”. opines Dr. Ichaporia. He elaborates, “An Alzheimer’s patient should be kept physically and mentally fit. Physical exercises in accordance with their age and mental stimulation in the form of puzzles will help in bringing a semblance of activity and regularity into their lives”.

The two main factors which are in acute short supply are commitment and funding. A lack of understanding of the gravity of the situation coupled with indifference has resulted in the fact that there are no institutions in India catering to the needs of the Alzheimer’s patients or their caregivers. The patients, most of whom have entered the final phase of their lives certainly deserve a dignified end.