‘It’s not a budhapa thing’

On September 5 Dr Vinayak Kolvankar a retired scientist went below his home at Bandra Eastrsquos MIG Colony to buy fresh flowers for puja as on any other day He was found on September 11 in Andheri West Struck by dementia five years ago the former BARC Bhabha Atomic Research Centre employee had wandered for six days Kolvankarrsquos story is one that some of us may have witnessed firsthand with a family memberDementia is a broad term for diseases of cognitive decay that affect a personrsquos ability to think remember and perform daily activities and social abilities There are six kinds of dementia with Alzheimerrsquos disease and vascular dementia being the most common Itrsquos not a normal part of aging though age is the biggest known risk factor In India dementia is often brushed away as agerelated forgetfulnessA 2019 report Dementia in IndiamdashA Call for Action found that about 41 million persons aged over 60 years had dementia in India in 2015 This number was estimated to rise to 635 million by 2025 and to 1333 million by 2050 This has nudged players in the senior citizen care segment to focus on dementia when conceiving and building their servicesActor Robin Williamsrsquo Parkinsons led to memory loss among other effects PicGetty ImagesPrasad Bhide who established the elder care service called Aaji Care 10 years ago says that their dementia care centres in Pune Thane and Versova are testament to the growing need for specialised care ldquoMost people donrsquot like to accept that their loved ones need specialised care as the years go byrdquo says the entrepreneur ldquoDementia is a neurodegenerative disease and care for these patients goes beyond just locking them inside the house They need 24x7 monitoringrdquoRecalling an incident of a dementia patient wandering away from a centre Bhide says ldquoThe retired banker went to his former office because it was the only place he knew when he didnrsquot remember anythingrdquo Kolvankar informs his psychologist Saakshi Patel was trying to get to Bandra West where he had lived most of his adult lifeAmboli Naka where he was found used to be his brotherrsquos residenceActor Ranbir Kapoor recently revealed about his uncle actor Randhir dealing with dementia PicGetty ImagesIn the absence of cure and preventive measures for dementia the degeneration can only be monitored and controlled via medication ldquoOther than residing in centres such as ours a community has to be created around individuals like Kolvankarrdquo says Bhide ldquoThe watchman shopkeepers outside the society and other vendors in the area need to be informed and told to keep an eye out for the persons which many people may avoid doing because of the stigma attached to dementiardquo He also advises the use of technology to track and monitor loved onesldquoYou can make them wear watches with GPS trackers place cameras inside homes to track them going in and out of the houserdquo he says ldquobut the most vital thing is to consult a neurologist They will be able to narrow down what kind of dementia the person has and prescribe medication accordinglyrdquoDr Annu Aggarwal is a consultant neurologist and specialist in cognitive and behavioural neurology attached to Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute The hospital has one of the largest research centres for Parkinsonrsquos disease in the private health sector Though the disease starts out with physical symptoms problems with cognitive function come in later and four out of five Parkinsonrsquos patients develop dementiaPrasad Bhide from Aaji Care talks about how dementia centres like his are growing in number due to specific needs of patients PicAditi HaralkarDr Aggarwal observes that often when a senior with dementia loses his or her way it has more to do with spatial and visual recognition than memory impairment ldquoOne of the earliest signs is noticed when seniors move residences between two or three childrenrdquo she says ldquoWhen they live with a child whom they do not visit often they tend to lose their way One of the first things doctors must do is warn the family how lack of spatial recognition will lead to them losing their way Intermittent memory loss like forgetting an incident or name can be managedHowever when the ability to recognise a space is hindered children and relatives have to start preparing the environment for the samerdquoWhile most of us know about Alzheimerrsquos Vascular dementia and itrsquos symptoms are not as familiar and spoken about ldquoThere are two types of Vascular dementiardquo says Dr Aggarwal ldquoIn one type the patient suffers brain strokes could lose mobility and begin to show signs of dementia as well In the second type the patient could get multiple mini brain strokes but the only outward sign could be that the person admits to sleeping very little The biggest sign is that the person will not be able to recollect details or get confused about the way homerdquoKaryn Pearl and Vinayak KalvankarMost dementia patients observes Aggarwal have lifestylerelated comorbidities such as obesity hypertension and diabetes ldquoPeople who have an overall good lifestylerdquo says the doctor ldquoie fairly regular exercise and wholesome food are unlikely to get dementia Even if they do get it their condition does not slide at the pace of a patient who is a smoker diabetic or obeserdquo Different research across countries and demographics has found that those with Type 2 diabetes where the body either doesnrsquot produce enough insulin or resists insulin have between 16 to 22 per cent likelihood of developing some form of dementiaKaryn pearl 38 lost her father back in 2017 to tragic circumstancesmdashRolland Pearl slipped on the staircase outside his apartment in Panvel and sustained fatal injuries He had been diagnosed with Parkinsonrsquos diseaseThe diagnosis itself did not come immediately ldquoIn 2010 my dad had an incident where he collapsed while I was handing him a cup of tea We rushed to a doctor and they said that he has a clot in his brainrdquo says Pearl Things kept getting worse when Rolland went all the way to Rasayani by mistake and called Pearl asking for the name of their apartment complex ldquoIt was then that we took him to Hinduja and that is when we got the diagnosis of Parkinsonrsquos This was three years after the tea incident They gave him physiotherapy and his blood thinners were already on but it was then that the doctors explained to us what the disease was Until then we were kind of in the darkrdquo adds PearlRolland was known in the family for his ability to do hard labour and the loss of that ability did lead to frustration We ask if any doctor recommended therapy of the nature Kolvankar and Patel were engaged in ldquoNohellip no one in Panvel or even Hinduja told us this Mind you this is almost 11 years agordquo says Pearl The family looked for senior centres at the time to keep Rolland in a fulltime care home ldquoThe centres were not specifically for dementia but for senior citizens In some we didnrsquot like the quality of care for someone like my dad who had specific needs due to his forgetfulnessAlso most good centres were an hour away All we thought was that if something were to happen it would take us an hour to reach him I felt that was unacceptablerdquo she addsRolland was lost for two days a few years before he passed onHe had gone out to walk their pet dog During the search operation it was Rollandrsquos canine companion that helped his son Jonathan trace and identify him on the PanvelSion highwayKolvankar says Patel is strong as an ox ldquoHe has a solid lifestyle regimen implemented by his wiferdquo she says ldquoEverything runs like clockwork in the house But dementia makes seniors a bit sneaky They try to slip out of the house when they canrdquoKolvankar was taken to BARC Hospital after he was found in Andheri He had grown weak due to undernourishment and had been vomiting His limbs were bitten by insects and CCTV footage showed him refusing food offered by good Samaritans ldquoOur view of dementia is very archaicrdquo says Patel ldquoItrsquos not just budhapa thing itrsquos a disease and we need to start treating it like one If you see a lost confused senior citizen on the road or railway station take them to the station masterrsquos office or a nearby beat chowki You never know whose parents you are returning homerdquoWhat do you recommendDr Annu AggarwalInstead of wristwatches and phones that have GPS stitch labels with the name and addresses of the patient on the inside hem of their clothing Hire a dedicated daycare helper to monitor them at least Create a community Inform neighbours and security personnel that the senior has dementia and that they should watch them in public placesPrasad BhideIf the disease is getting out of control consider a dementia centre The needs of a patient with dementia are far more specific than those with comorbidities such as diabetes for exampleSaakshi PatelGet the elder to write their name and address in a book every day this helps create a visual recall of the address The importance of solving brain teasers cannot be understated Sudoku chess and crossword puzzles are known to keep the brain sharpThe key with getting the elderly to do these things or attending social rituals is to make it seem like going out for a movie or to a restaurant was their idea Especially with seniors who were highly functional members of society like Kolvankar