Alzheimer’s a Dark Part of a Patient’s Life

The best and saddest part of Nelson Marlborough District Health Board psychiatrist Dr Siri Wettasinghe’s job is the people he meets, he says.

“It is very sad for all of us working with patients with dementia,” he says.

“Eventually, they will have no pain – but for those of us who remember the people they were, it is difficult.”

Alzheimer’s Disease, a degenerative disorder of the brain, is the most common kind of dementia – 60 percent of dementia sufferers have it.

Dr Wettasinghe says Alzheimer’s is more prevalent in women, and while it can occur in people in their 40s, it is more likely to strike after age 65.

“With age everybody loses memory but this is more accelerated and pronounced and comes at an earlier age,” he says.

Diagnosing Alzheimer’s disease is difficult and often done by a process of elimination, he says.

Early symptoms include forgetting names, dates, eftpos card numbers or to pay bills.

“It might be that you forget how your husband of many years has his coffee. It creeps in very slowly and insidiously.”

Registered nurse Kate Miller, who works with Eileen Appleton- Maher, says many patients and families have been living with dementia for months or years before approaching doctors.

“A lot of partners go on for a very long time without help and the stress of living with it can be huge. They want to care for their loved one but it can be devastating to deal with alone.”

She says a lot of early signs of Alzheimer’s disease can be very hurtful to family members.

“They might start misplacing items and accusing others of stealing them or hiding them. They can become very frightened and lash out at others.”

It is often families who bring a loved one to a doctor before the person will admit their failing memory, she says.

“If you’re living with someone, they will often be embarrassed and cover mistakes up or you might get used to their forgetfulness.”

She says public perception of patients with Alzheimer’s disease is of those in the latter stages.

“They may well still have eight to 10 good years and that needs to be remembered.”

Initially, sufferers have good and bad days, she says.

“It’s the recent events that go first. Those that are ingrained are last to go. The old memories are very well-rehearsed,” she says.

“The last you learn are the first to go,” Dr Wettasinghe adds.

In the late stages people cannot recognise loved ones or communicate. They cannot feed themselves and often become incontinent.

Both Dr Wettasinghe and Kate Miller agree early diagnosis is important. They say it can save unnecessary stress on families, might give patients access to drugs that can slow memory deterioration, and provide time to put legal and financial measures in place for when memory deteriorates.

The drugs are about $200 a month and give quality of life.

“They are definitely not a cure,” Dr Wettasinghe says.

“For some people the response is remarkable but the deterioration underneath continues.”

While there was no one way to prevent the onset of Alzheimer’s, it is important for people to stay fit and healthy – physically and mentally.

Dr Wettasinghe remains positive that a drug may one day be found that can arrest Alzheimer’s disease.

“I believe it is achievable.”