Senile insanity, or personality degradation, is a chronic, progressive disease and is one of the most severe, irreversible mental disorders. This is the result of age mental changes personality, due to atrophy of all processes occurring in the brain. As a result, a person loses the opportunity to contact the outside world.
This severe mental disorder can be caused by various diseases, psychical deviations, pathological changes in the vessels of the brain. Very often the situation is aggravated by heredity. The disease does not appear immediately; it develops gradually over the years, and others do not immediately notice strange behavior in an elderly person. But as the disease progresses, the symptoms become quite vivid and it is no longer possible not to notice them.
How senile insanity manifests itself, the symptoms of this disease, as well as the possibility of using folk remedies - we will talk about all this today:
Symptoms of senile insanity
On initial stages, the disease is hardly noticeable. Well, maybe, old man became more absent-minded and forgetful. He develops traits of pronounced egocentrism, he becomes grumpy, gets angry more often than before, and becomes stingy. But these, we believe, are normal manifestations of old age.
But as the disease progresses characteristic symptoms grows and becomes brighter and more noticeable. Memory deteriorates more and more, false memories of non-existent events appear.
In later stages, a person loses self-care skills and develops symptoms mental disorder, behavior becomes inappropriate. In the end, he ceases to recognize his family and friends, cannot perform hygiene procedures, and requires constant supervision from others.
How and how to treat senile insanity? state
Senile insanity can be corrected by early stages development. It is impossible to completely cure the disease. But at its first manifestations, it is quite possible to stop the further process of personality disintegration. To do this, you need to show the elderly person to a doctor.
The doctor will order a full medical examination. When identifying chronic diseases that contribute to the development of this pathology, carry out adequate therapy. To stop the development, directly, of senile insanity, symptomatic treatment is carried out.
Experts strongly recommend treating a patient at home, in a familiar environment. A calm home atmosphere has a beneficial effect on the psyche and calms a person. Whereas a new, unfamiliar hospital environment can provoke an exacerbation of the disease and worsen the patient’s condition.
An elderly person should be provided with the necessary care. Reward him for even small activities during the day. Don't just lie there alone. Communicate with him more, go for walks together. Or just sit with him on a bench in the yard. If the patient is recommended bed rest, make sure there are no bedsores. Find an opportunity to take him out into the fresh air at least occasionally.
However, if the patient is so inadequate that he becomes dangerous to himself and others, he is given a referral to a hospital.
A fairly common disease among older people, senile insanity, symptoms and which we are considering today, can be stopped if vascular diseases are treated in a timely manner. For example, at the first signs of atherosclerosis, appropriate measures must be taken.
In the early stages of senile insanity, it is prescribed nootropic drugs. For chronic insomnia, a person is prescribed small doses of diazepam or nitrazepam. If necessary, if the patient has psychotic disorders or severe fussiness, the doctor can write a prescription for antipsychotic drugs.
It must be remembered that any medications for this disease are prescribed by the attending physician. It is strictly forbidden to prescribe them on your own, since such an administration can cause an unpredictable reaction from the patient.
Folk remedies
In the early stages of the disease, folk remedies can be used. For example, good effect gives the use of tincture of elecampane roots. You can buy it at the pharmacy and take 30 drops before meals. After a month of taking it, the patient's condition will improve significantly.
Experts recommend taking vitamin preparations containing vitamin B6, as well as folic acid. This will prevent the occurrence of depression, reduce the risk of developing brain dysfunction, and stop the development of senile insanity.
It is also beneficial to take ginkgo biloba extract or capsules regularly.
Include fresh garlic in your diet. It contains substances that cleanse the blood vessels of the brain, improve memory, increase mental, intellectual abilities. Be healthy!
Senile dementia is a disease that can appear in a person in old age. Dementia is popularly called. The disease develops as a consequence of atrophic processes that occur in the brain.
In old age, most people begin to experience irreversible processes and malfunctions in all organs and systems. Mental activity is also impaired; deviations in this area are divided into emotional, behavioral and cognitive. Dementia is associated with many disorders, but is closely associated with cognitive impairment. To put it simply, against this background, patients have reduced emotionality, frequent causeless depression appears, and gradually the personality begins to degrade.
When does senile dementia begin to appear? Symptoms, as a rule, are detected in old age. The disease affects such psychological processes as memory, speech, attention, and thinking. Already at the very early stages of the onset of vascular dementia, disorders manifest themselves quite significantly, which cannot but affect the quality of life. A person begins to forget about acquired skills, and he is simply unable to master new ones. Such patients are forced to leave their professional career; they need constant care from household members.
Senile dementia begins to manifest itself gradually. Mental activity deteriorates, the patient loses his individual characteristics that were inherent to him. If the disease progresses, it takes on a total form.
Initially, others may not even notice that an elderly person suffers from senile dementia. Personality changes come gradually. Negative character traits may be perceived by loved ones as features of old age. An elderly person may show conservatism in conversation, stinginess, selfishness, and a desire to teach others. After all, this may not always indicate that senile dementia has set in. What should others and loved ones do? Carefully monitor the intellectual condition of your elderly relatives. As the disease progresses, thought processes and attention deteriorate. The patient begins to poorly generalize information, draw conclusions, and adequately analyze the situation.
Gradually, the personality becomes coarser, senile traits appear: callousness, stinginess, embitterment, interests narrow, views turn into stereotypes. It also happens that the patient becomes complacent and completely careless, he loses moral skills and does not adhere to moral standards. With features in sexual attraction some kind of sexual perversion may even arise.
As for the memory of patients, incredible things happen here. A person often forgets what happened to him yesterday, but clearly remembers pictures of the distant past. Therefore, many people suffering from senile dementia live in the past, remember themselves as young, consider themselves young, call others by names from the past, and often get ready to travel somewhere.
External forms of behavior often do not change, gestures remain the same, familiar, characteristic of this person, he uses expressions characteristic of him. Therefore, relatives do not notice that an elderly person is developing senile dementia; treatment, they believe, is not required.
Depending on the social adaptation of the individual, there are three distinct degrees of the disease.
There are two main forms of senile dementia - lacunar (partial or dysmnestic) and total.
With lacunar dementia, serious deviations in short term memory, emotional changes in this case (sensitivity, tearfulness) are not sharply expressed.
Total senile dementia, the symptoms of which are more pronounced, has a complex form. A person’s criticism sharply decreases, reactions are lost, and personality is leveled. Personal degradation occurs, emotional-volitional activity changes radically. A person loses feelings of duty, shame, and at the same time loses spiritual and life values.
Depending on the signs of senile dementia, experts divide the disease into several types:
Partial dementia. In this case, memory disorders are clearly expressed, emotional state. Increased weakness and fatigue appear. The mood is mostly low.
Epileptic dementia. This type develops gradually and does not appear immediately. A person is prone to minute details of events, to vindictiveness, becomes vindictive and pedantic. The individual’s horizons decrease, and most often their speech becomes poor. The main signs of epilepsy often appear.
Schizophrenic dementia. With this type of dementia, it is better to hospitalize the patient immediately in order to prevent a complete change in personality. Signs of the condition are complete isolation, emotional coldness, loss of connection with the outside world, decreased activity, and isolation from reality.
Why does senile dementia occur? Doctors still cannot name the causes of the disease. Many agree that the development of the disease plays an important role. hereditary predisposition. This theory is confirmed by the presence of cases of “familial dementia”. Play a big role atrophic processes brain, which can progress under the influence of certain factors. After a severe stroke, senile dementia may appear. Symptoms (treatment requires a long time) constantly accompany the disease.
It happens that dementia can develop after pathologies that lead to the death of brain cells, due to skull injuries, tumors in the brain, multiple sclerosis, as well as alcoholism.
Older people who are active, healthy image life, both mentally and physically, are much less likely to encounter this disease. Often, senile dementia manifests itself in those who are more often in a depressed mood, have weak immunity, bad living conditions for life.
For any type of dementia, the following signs are relevant:
Often, a doctor diagnoses dementia when cognitive impairment occurs after a stroke or heart attack. Decreased attention can be considered a harbinger of the development of the disease. The patient begins to complain that he cannot clearly concentrate his attention on anything or concentrate.
TO characteristic symptoms include a shaky, shuffling gait, changes in voice timbre, and articulation. Swallowing dysfunction is sometimes observed. Alarm signal Slow intellectual processes can also be a factor; a person slowly analyzes the information received and finds it difficult to organize his activities. Over time, physical signs appear: muscles weaken, pupils narrow, hands tremble, skin becomes very dry, and sometimes the functions of internal organs are disrupted. As the disease progresses, hallucinations and delusions appear.
This is how senile dementia manifests itself. How long do people live with this disease? This question interests many. The answer to this cannot be unambiguous. Dementia is not a cause of death. Sometimes any manifestations of illness (inattention, loss of orientation) can lead an elderly person to an accident.
When diagnosing dementia, the doctor conducts testing, during which the patient is given tasks that he must complete within a certain time.
When it comes to vascular dementia, it is worth noting that memory impairments do not manifest themselves as significantly. But the emotional state requires increased attention. All patients are susceptible permanent shift moods. Laughing until they cry, they can immediately sob bitterly. Very often they are visited by hallucinations, they show apathy towards everything that surrounds them. Sometimes they suffer epileptic seizures. With vascular dementia, motor activity, gestures, and facial expressions become poor. Urinary disturbances occur. Such patients are characterized by sloppiness and indifference to personal hygiene.
At therapeutic treatment there is no template for dementia, standard methods. Each case is individual and is considered by the doctor separately. This is due to a huge number of pathogenic mechanisms that preceded the disease. It is worth noting that it is impossible to completely cure dementia; disorders caused by brain damage are irreversible.
What drugs are most often used for senile dementia? Neuroprotectors are used for treatment, they provide positive influence on the brain, improving tissue metabolism. A major role in therapy is played by the direct treatment of precisely those diseases that led to dementia.
For cognitive processes, calcium antagonists are used, these include Cerebrolysin, as well as nootropic drugs. If a patient has prolonged depression, the doctor prescribes antidepressants. To avoid cerebral infarction, it is recommended to take anticoagulants and antiplatelet agents.
Particular attention should be paid to a healthy lifestyle. In old age, it is simply necessary to completely give up alcohol and smoking, too salty and fatty foods. It is recommended to spend more time on fresh air, move.
Medications are used primarily to relieve certain symptoms. Psychotropic medications are prescribed for periodic anxiety, sleep disturbances, manifestations of delirium, and hallucinations. The doctor tries to prescribe medications that do not cause side effects, including weakness.
At an early stage, nootropics and metabolic drugs help to stop the progression of the disease and slow down the pathological process. Only the attending physician can determine the treatment regimen. The funds are selected strictly individually; templates are unacceptable here.
Medical statistics state that about 35.5 million people suffer from senile dementia. At the same time, doctors give disappointing forecasts. Is it possible to prevent senile dementia? In some cases, it will help prevent the development of the disease newest drug"Brain Booster" This biological active additive fills the diet with the required amount useful substances, macro- and microelements, vitamins. Satisfies all the body's needs for necessary substances. The drug is necessary for the effective prevention of senile dementia; it also helps in the initial stages of the disease to normalize the activity of cerebral vessels.
The drug "Brain Booster" has been tested in practice by traditional medicine. To create it, we used the necessary herbal ingredients. The drug stimulates processes in the brain, improves blood circulation, and cleanses blood vessels. Allows you to cope with depressive conditions, improves memory, makes a person more efficient and focused.
No person wants to eventually acquire senile dementia, live with this illness, or create unbearable conditions for their loved ones to live together. You need to start preventing the disease when you are still of sound mind and understand the need and importance of preventive measures.
In order to stop and correct the development of senile dementia, you can use folk remedies.
It should be noted that those suffering from dementia are most often sloppy. They require constant care. If loved ones cannot cope with this, then it is better to hire a professional nurse or send the patient to a specialized institution - a boarding school, where patients with senile dementia are monitored. How long do people live with this disease? With advanced vascular dementia, according to doctors, life expectancy is about five years.
All older people are encouraged to lead an active, healthy lifestyle. Walk more, breathe fresh air. Don’t become limp, don’t fall into depression, develop your mind and intellect, and then, with a high probability, the disease will bypass you.
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.
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, a lot has accumulated 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.
In this case, any chronic diseases does 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.
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.
People suffer for weeks, sometimes months, with terrible behavior disorders and sleep disturbances 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 surroundings are close people, nurses, middle medical staff, some neurologists and therapists think that it is very difficult to improve sleep, relieve aggression, and remove delusional ideas. In fact, this is 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.
There are three main topics that caregivers and clinicians encounter in geriatric psychiatry:
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 sit exactly 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 Bad mood, this 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.” It is not right!
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.
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 among people in at a young age, mainly when long-term use alcohol. This is “delirium tremens” - hallucinations, acute delirium, persecution, and so on. In an older person, delirium may occur after physical or psychological trauma, moving to another place, 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 did not cope very well with his chickens and pigs, but, according to at least, knew where the toilet was, where the matches were, where his bed was, that is, he somehow orientated himself in a familiar 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 the consequence is the suffering of the patient and the entire family, the flight of caregivers.
Dementia is an acquired dementia: disorders of memory, attention, orientation, recognition, planning, criticism. Violation and loss of professional and everyday skills.
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 pronounced form of the course of cerebrovascular diseases (CED), this is 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 vascular problems 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, this 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 border. 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 you have loved one 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 you do when proper treatment and caring 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 preserve our health and work.
– 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 citizens’ rights during 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?
– What could it be related to? complete failure from food and water in late stages of dementia?
– First of all, we need to look for and treat depression.
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.
Senile dementia is an age-related disease that most often occurs between 65 and 85 years of age. Pathology disrupts the functioning of brain cells and leads to irreversible processes in mental activity. If senile insanity is detected early, it is possible to correct it by taking appropriate medications, and then the inevitable disintegration of personality will be delayed by long years and the patient will be able to take care of himself and will not get serious problems to your loved ones.
Irreversible changes during the onset of marasmus occur at the cellular level. Neurons responsible for mental and mental activity, gradually die and the person can no longer fully control his daily actions, loses the ability to learn and memory. The most unpleasant manifestation of senile dementia is considered to be a sharp change in personality, and in all patients this happens in a negative direction.
The disease can be either primary or secondary, that is, arising under the influence of other neurological problems or as a result of alcoholism, drug addiction, or metabolic disorders. Dementia is detected almost twice as often in women. According to medical research The number of patients with dementia is increasing year by year. Often the disease begins in people who are still of working age.
Researchers have suggested that marasmus occurs when immunoregulatory mechanisms are disrupted. As a result, special autoimmune complexes are produced that negatively affect brain tissue. Senile dementia is often detected in blood relatives, that is, the tendency to the disease can be inherited. The causes of dementia are divided into primary and secondary. At primary lesion independent destruction of the cerebral cortex is observed; such damage is typical for the following diseases:
Secondary damage occurs under the influence of the main, previous disease:
In a small number of patients, the first signs of marasmus are recorded after:
In some cases, senile dementia develops under the influence of several factors provoking the disease.
The onset of senile dementia is always mild, characteristic features often attributed to age-related personality changes. However early detection changes that occur serve as a guarantee of pushing back severe stages diseases, so the patient’s relatives need to focus on the first signs of pathology.
Senile dementia leads to the development of greed and stinginess; often people suffering from this disease create a whole warehouse of unnecessary things in their home. At the initial stage, excessive appetite and hypersexuality are noted. As the disease progresses, all self-care skills are lost, decades of years disappear from the patient’s memory, and he imagines himself as a young man without children or grandchildren. Periods of aggressiveness, anger, tearfulness or depression often occur.
IN late period diseases, patients with senile dementia need constant monitoring, since they cannot take care of themselves and can become the culprits of fire, flood and similar situations that are not safe for themselves and others.
During the course of the disease, there are three stages (degrees):
In the last stages, symptoms of cachexia are observed, the person often lies in the fetal position. Any somatic disease can lead to fatal outcome, since all metabolic processes are disrupted.
The diagnosis is made on the basis of a general examination and conversation with the patient himself, as well as with his close relatives. The doctor pays attention to the presence of the following criteria:
Senile dementia is similar to manifestations of severe depression, lack of folic acid, vitamin B12 and thiamine. Pseudo-dementia can also occur after severe nervous shock. Therefore, when making a diagnosis, it is necessary to conduct special studies for the presence of such changes.
Therapy for senile dementia must be comprehensive. It is important to involve relatives in treatment; they must create a certain psychological comfort and constantly guide the patient to do feasible work. In the early stages of the disease, the progression of marasmus can be stopped by taking nootropics. Psychotropic drugs used to improve sleep quality, reduce aggression and depression. Treatment is carried out by a psychiatrist; when choosing medications, they are constantly required to be adjusted.
Severe forms of dementia occur with early development diseases. The prognosis of the course of the disease also depends on the constant use of medications, support for physical activity, and timely treatment of somatic diseases.
It is not yet possible to completely eliminate senile dementia with the help of drugs, but it is possible to make the life of patients comfortable by taking care of their well-being.
No person is immune from dementia, but its development can be prevented if you constantly follow these recommendations:
The video shows an excerpt from a discussion about the impact of vitamin D deficiency in nutrition on the development of dementia:
The cognitive abilities of the human brain go through several stages throughout life. These periods are reflected in the behavior of the individual and his life as a whole:
The period of stagnation (sustainability) is quite long - the loss of acquired knowledge most often begins only in the 7th or 8th decade. At this time, signs of dementia appear, called senile dementia.
All thinking and physical processes controlled by the brain. Its successful activity depends on sufficient blood supply, the absence toxic effects, foci of inflammation, injuries and their consequences.
Throughout life, changes occur in the human body that negatively affect the functioning of the brain and lead to a decrease in cognitive functions:
Whatever the reasons for the decline brain activity, they happen to everyone in old age and old age. But not everyone suffers from full-blown dementia. For some, the process of involution occurs very slowly, and is considered an inevitable manifestation of old age.
Important! In approximately 10% of the population aged 70 years and 50% after 80 years, senile dementia is severe. Its demonstrative manifestations are growing dynamically and inevitably attract attention.
Mental degradation occurs gradually. Unfortunately, the first signs are not always perceived by the elderly person himself and his immediate environment as a symptom of trouble. Most often, the disease becomes obvious to relatives and strangers in advanced cases. Among the striking manifestations of the disease, doctors name the following changes:
Memory impairment manifests itself in many ways. The first “bells” appear in fully capable people who are still far from old age: who is not familiar with the phenomenon when you forget why you came to some room in the house or cannot remember where you saw a person! Such moments cause bewilderment, annoyance, laughter - anything but concern about your health, and rarely prompt you to visit a doctor.
Difficulties with memories are as follows:
These manifestations brain disorders Once they appear, they constantly increase and gradually lead to complete self-isolation of the patient from others. It's just a matter of time - with a slow progression, the disease reaches its peak after 15-20 years, and with the use of memory enhancing drugs, even later. But often the rapid development of the disease, which makes a completely disabled person completely disabled.
Important! All other manifestations of dementia are in one way or another associated with memory impairment.
Loss of mental functions also occurs gradually. Its manifestations are no less diverse and revealing:
A decrease in the depth of thought processes initially discourages the patient himself. In this case, he tries to veil his incompetence and turns the conversation to a topic that is still familiar. Such communication gives the impression of a certain absent-mindedness, but does not suggest an organic pathology of the brain, and does not become a reason for consulting a doctor.
The first signs of mental aging do not escape the attention of the bearer of these signs. At first, emotional changes are not associated with organics, but rather with the awareness of the inevitability of pathological phenomena. Therefore, a change in the psyche is often preceded by a decadent mood.
Important! Even before a deep organic change in the emotional state, depression can develop - the result of awareness of the inevitability of the disease.
As the disease progresses, depression goes away, emotions become not as complex as before, and they are caused by superficial phenomena. At this time the following appear:
Important! Emotionally, a person gradually ceases to be a member of the team, does not notice the affection and love of loved ones, which makes communication with him difficult.
Senile dementia often changes opportunities motor activity person. With the onset of brain changes, movements become not as coordinated as before, endurance decreases, the person becomes weaker (in in rare cases attacks of increased strength are possible).
The physical side suffers especially in Parkinson's disease, a frequent companion of senile dementia. In this case, the following symptoms appear:
Behavior also changes communicative features, as well as worldview in elderly people affected by dementia.
The surrounding world gradually ceases to exist - the patient himself becomes the center of the universe. Everything that happens outside of his senses is not perceived at all.
Therefore, communication skills are gradually, and sometimes very quickly, reduced to nothing. If the patient is active and says something, this does not mean that he is trying to communicate something - he expresses himself this way, regardless of the interest of others. The object of his communication is fictional characters or himself.
Important! The instincts of self-preservation disappear quite early - a person becomes dangerous to himself.
Unfortunately, it is impossible to influence a clearly developed disease - this is one of the signs of a person’s inevitable decline, an option for leaving this world.
It is possible to somewhat delay the onset of the disease if you start monitoring with a neurologist in time. At the first signs of memory deterioration, medications are prescribed to improve blood supply to the brain and enhance brain activity. Strengthening blood vessels, preventive measures, detoxification (if necessary, for example, alcoholism or drug addiction, renal failure) and treatment of chronic diseases, of which old age accumulates enough, can extend the light period of life.
Treatment of dementia. Rice. 1 
Treatment of dementia. Rice. 2 
Treatment of dementia. Rice. 3
Relatives are responsible for organizing care for the patient at all stages.
The stages of the disease are presented in the table.
| Stage | Signs | Communication opportunities |
|---|---|---|
| Lightweight | Self-service is preserved, coordination of movements is quite good, orientation in time and space is good. Noticeable apathy, decreased interest in events, depressive symptoms | There is contact, but at times there is isolation, taciturnity, and a desire to be alone |
| Average | Significant impairments in memory and thinking, unconscious-automatic actions, high risk of causing harm to oneself and one’s home | Contacts are gradually broken off, constant supervision and control is required, as well as daily assistance |
| Heavy | Active actions and their awareness are absent | There is no communication, assistance consists of sanitary and hygienic care |
In the first, mild stage of dementia, when communication is possible, it is necessary to surround the family member with love and demonstrate your willingness to help. However, one should not emphasize the patient’s failure in certain matters or make a diagnosis publicly. Delicacy and tact are what is needed to ensure that an elderly family member avoids depression.
Recommendations for caring for patients with dementia. Rice. 1 
Recommendations for caring for patients with dementia. Rice. 2 
Recommendations for caring for patients with dementia. Rice. 3
At this time, it is necessary to create situations where the patient is included in the life of the family, entrust him with feasible tasks, emphasize their importance - let the person feel needed.
Cognitive activities are very useful - organizing reading and discussing what you read, watching a film with an exchange of opinions, solving crosswords.
Active participation in family life can stop the progression of the disease no worse than symptomatic treatment.
Recommendations for caring for patients with dementia. Rice. 4 
Recommendations for caring for patients with dementia. Rice. 5 
Recommendations for caring for patients with dementia. Rice. 6
Important! At this stage, old people develop good contact with children - to mutual pleasure. This should be welcomed and used.
The following stages require constant supervision. Even with reduced communication, an elderly person still feels the presence of relatives for a long time. And no matter how he behaves, it is necessary to eliminate all dangers that could cause harm.
Bathing and hygiene of the patient 
Keeping people with dementia safe 
Communication with a person with dementia
In the later stages of the disease, it becomes most important hygiene care. Timely change diapers, underwear and bed linen are necessary but not sufficient measures to maintain physical health. It is necessary to regularly change the position of a bedridden patient in bed, ventilate the room, and organize proper and sufficient nutrition.
How to behave with an aggressive patient 
Dressing the patient 
Nutrition of the patient
All this requires effort and time. Therefore, most families resort to the help of professional nurses or people with experience caring for bedridden patients.
Important! When the question arises about relocating a patient to a specialized institution, it is necessary to take into account the fact that a change of place of residence will most likely lead to a worsening of the condition - this is a proven fact.
Going to the toilet for people with dementia 
What to do if the patient often loses things
Senile dementia is a disease from which no one is immune. Meaning:
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