An otherwise stable and generally happy family of four (a couple, their seven-year old daughter and the man’s 65 year old mother) living in the city for the past many years seemed to be in distress. Of late, on many occasions, when the man returned from the day’s hard work at night, there had been complaints from the old lady about her daughter-in-law, that she has not given her food, she hid her clothes, she has been talking ill about her to the neighbours and so on. He knew his mother well as a person who never said anything like this against his wife ever and hence maintained his calm. But when the complaints persisted, he started feeling that there could be some element of truth in the complaints. This followed domestic distress involving his wife which started eroding the peace at home. All the while, no one realised that something else was causing the situation until he reluctantly visited a mental health professional on the advice of a close friend. After that visit, his mother was put through a health assessment and was diagnosed as suffering from the onset of Alzheimer's disease.

Alzheimer's is a mental disease affecting memory (dementia),thinking and behavior, resulting from neurological degeneration in the brain.The symptoms usually develop over a period of time, at times over many years,and pass through various stages. It is usually misunderstood as memory problems or behavioural issues linked to age because it affects the old the most. Loss of short term memory (while old memories remain intact) is one of the initial symptoms that could be observed easily. Even if the old lady in the story narrated above is fed well, she could forget that she was given food by the daughter-in-law. She could keep her clothes somewhere forgetfully and blame the lady of hiding it. The condition can lead to paranoia (a type of suspicion) and she could start believing that her daughter-in-law has been talking ill about her to the neighbours. There could also be many other difficulties in areas like paying attention or organising daily activities. These can lead to their blaming others, covering up the deficiencies in the garb of something else.There could also be episodes of depression, irritability etc. in the patients

As the disease progresses, the patient’s ability to communicate effectively reduces because of the shrinking vocabulary and patchiness of memory. There could also be problems with perception, movement and normalcy of day-to-day activities. As the disease moves on, the patient’s ability to carry out even the basic activities of daily life gets impaired.Communication through speaking gets reduced because the patient starts losing many words from the vocabulary stored in mind. The ability to read and write also goes away gradually. As there is impairment in muscle movements at this stage, there comes an elevated risk of the patients falling and getting injured, many times involving the bones. They could have illusions (perceiving situations differently from what is actually present) and delusions (perceiving situations irrationally and illogically). There could also be inability to control urination and defecation.  At this stage, the patients could move out of the home and wander around which could even result in their getting lost. With a severely impaired memory and communication issues, they may, at times, never reach back home. Many mentally sick people we see along the roads and streets could be Alzheimer's patients.At such a stage, the caregivers looking after the Alzheimer's patients experience unbearable mental, physical and emotional traumas, especially if it is coupled with the ignorance of the challenges the disease can pose.

In the final stage, the Alzheimer's patient loses most abilities to do even life’s basic activities and become totally dependent on the caregivers. Their communication becomes limited to just a few, often incoherent words. Movements get too less and they get confined to bed. All these deteriorations take the patients to their finality, with their dying due to unrelated reasons like infections.

The cause of Alzheimer's is not much understood even today.It is known that it is a neurologically degenerative disease with no cure. It takes the patients through many years of tough life. The caregivers live even a tougher life. On the part of the caregiving family members, the toughest situations for most of them arise from their lack of awareness of the disease and the way it progresses. This ignorance tends to lead the family to elevated emotional problems and consequent relationship distresses among its members.

Like many mental health problems, Alzheimer's too wreck the lives of the patients as well as the family. The most anyone could do in such a scenario is to gain the best possible awareness on the disease and how to handle its fallouts. In such a situation, the caregivers have a definite need to take help from mental health professionals because in a typical Indian setting, they tend to get into grave emotional and relationship issues through the journey caring for the Alzheimer's patient.

Curing Alzheimer's is impossible today, but managing its fallout well for the patients and their family members is very much possible. And for that, awareness is the key!