• Why do old people create problems for themselves? Senile egoism: when age leaves its mark. Two criteria will help determine the boundary

    20.06.2020

    Don't expect pleasure from communication

    If you don't expect pleasure from interacting with older relatives, you are more likely to enjoy it. You can get pleasure from yourself. For example: If I have a difficult conversation with a parent, I must stop myself from getting angry. One second it will be hard for me, and the rest of the time I will enjoy the fact that I restrained myself. This is a children's game called “weakly”: Weakly to hold on? Is it hard not to get angry?

    I have been working with older people for the past 15 years. When they start to eat me, I try to restrain myself, and then I realize that there is no one to be offended by: these are not just our parents, these are you and me in 20, 30, 40 years.

    Steer

    We are used to our parents controlling us. They strong people, and they will give advice and help. But suddenly the moment comes when you need to take the steering wheel: now you are strong and must control the situation.

    They want us to be successful. If I come to my parents and start complaining, they can no longer help me. Therefore, I separated two truths: there is a good truth and there is a truth that it is better for them never to know. Our well-being is the key to their success, we must remember this all the time.

    Don't try to change them

    When we were little, adults fed our minds with stories about the boy next door who studied better and obeyed his parents. When they become elderly, we begin to answer them in the same way: “Look, your neighbor goes for walks every day, and you sit at home all day.” We try to fix them, although we need to accept them as they are.

    There is no need to try to cram something into them, they are no longer subject to modernization. We can only accept them. If a person smoked before the age of 80, most likely he will not quit. As one of my wards jokes: “I do breathing exercises until the cigarettes run out."

    Know their “technical characteristics”

    We need to know absolutely exactly who we are dealing with. We must understand what a person is who cannot see, cannot hear, and cannot stand up. To understand what a blind person is, try to put yourself in his place: at least draw in the dark.

    Our older relatives see their opportunities diminishing every day. A super successful 80-something year old man comes to my classes - a former businessman, creator of a chain of stores in Israel. He comes up to me in tears and asks: “Will you help me?” He suffers due to the constant decrease in his strength.

    They struggle with stress. One of my students wears a device on his back, like a metal cot, with which he walks all day and which supports his spine. At night he removes this structure, but he can no longer turn around.

    Another of my wards once asked if he could sit not to the right, but to the left of his neighbor. It turned out that he didn’t like the way his neighbor sang. When I asked what difference it made which side I sat on, he replied: “I can’t hear in my right ear anymore.” We need to try to understand and take these things into account.

    Imagine for a moment that your parents are gradually switching their mode from autopilot to manual control. They start taking pills by the hour. The average life expectancy is now 80 years. 5 of them the person is sick and needs help for a couple of years. You just need to accept it and understand: okay, this is a normal story, payment for a long life.

    Don't get into conflict

    I studied this myself for a long time. There is an armor-piercing shell that pierces any skin: “I was your age, but you are not yet mine.” And indeed it is.

    Aggression in older people comes from dissatisfaction with oneself. When you accept the cause of aggression, when you smile at an elderly relative and do not respond to his attacks, aggression subsides. If he answered, he disappeared.

    Of course, you need to be able to change the topic of conversation, change the vector. Try, for example, in a calm situation in a conversation with your parents, change the subject. This exercise will help you in a conflict situation.

    Compassionate, but don't feel sorry

    Compassion is a very important thing. Moreover, it is necessary to distinguish between compassion and pity - this is heaven and earth. Pity disarms us: pitying a person, we, as a rule, cannot help him in any way. And compassion can be different, including cynical or active.

    Don't argue

    There are many moments when you really want to answer. One of my students made me buy a heavy board, and we spent two years cutting a sculpture out of it. She then complained about me to everyone: look at the hard work he gave me. I heard all this and did not answer. I can’t remind her: “You asked me for this,” she simply doesn’t remember it. When you understand who you are dealing with, everything becomes much easier. you get negative energy, you process it within yourself and give it back as positive.

    Manage impressions

    When we are young, we have a lot of impressions, but with age they become less and less. Anything that distracts seniors from their sad lifestyle is very important. They sit on benches in front of houses and discuss their neighbors precisely because they lack impressions.

    When we touch on the topic of how to protect old people from scammers, all the advice is related to strengthening the defense: install an iron door, a camera, prohibit them from approaching the door. In fact, the answer is very simple: they need to be occupied.

    You need to look closely at the person, slip him something. If you want the old man to leave early, just sit him on a chair and start blowing away the dust - he won’t sit there long. My aunt, for example, loved to retype Pushkin’s poems on an old computer. Or another friend of mine - an 80-year-old grandmother - no longer hears anything, but swims five strokes in the pool. It’s good to have communication with your grandchildren - the main thing is that it doesn’t harm your grandchildren.

    Students come to me and say: I didn’t even notice how quickly time passed. 40 people come every day. When interaction begins between them, this is also an exchange of impressions. They discuss me too - this is normal. One of my wards told me: “You are like two glasses of vodka to me.”

    The impressions are different, not always good. Once my clients dragged chairs onto the balcony and watched as a man was fished out of the pool and taken away in an ambulance - this was also an impression. We can try to make sure that the impressions are only good, but we are not omnipotent.

    Don't blame yourself

    Guilt haunts everyone. No matter what happens, there remains a feeling that I didn’t do enough, didn’t give enough, behaved incorrectly with my parents. Don't blame yourself. It's time's fault. This is a closed cycle that does not depend on us.

    We must understand that a person who is approaching the border of life and death is first of all turned inward and tries to put his past in order. I have talked to many older people who remember what happened 40-50 years ago and try to sort it all out. Memory is structured like a bottle of sand. When you turn it over, the events of yesterday fly away immediately, and mom and dad remain at the bottom. People withdraw into themselves, and we are not to blame for this, we must understand this, come to terms with it and try to give them as much as possible.

    In any case, you need to take care of yourself. We must learn to rest. If you constantly live the life of an elderly person, in the end you will remain guilty: you will be blamed for the fact that everything did not work out for you. Why did not you marry? Why didn't she give birth to children?

    Forgive

    You need to learn to leave grievances in yesterday. It's like a computer - you reboot it and start working again. If today you have not forgiven your grandfather, tomorrow - it may happen - he will no longer be there.

    I improved my relationship with my mother after leaving some topics open. When I was 20, I thought: now I’ll explain a little and she’ll understand. She didn't understand. Therefore, I learned not to close topics, but simply step through them.

    But to forgive, you must have strength. There are many recovery techniques: you can meditate. Personally, I came up with the “5 minutes” technique for myself: I just leave the room, sit for five minutes and don’t think about anything. Then I return with new strength, so that I can again have the opportunity to sympathize.

    One of my main commandments is to be able to make them laugh. A cheerful old man is not dangerous.

    Sasha Galitsky's next one will take place at the end of February.

    Good afternoon girls. So I decided to share my problem, I just don’t have the strength to keep it all in myself anymore. The thing is that we used to live in another city, and in 2009 my uncle died and our grandmother was left alone. Well, how can I say she was left alone, she’s already alone, and her uncle (son) just went to visit her, she has a very tense relationship with her daughter-in-law, the fact is that the daughter-in-law is lazy to the point of losing her pulse, she didn’t want to work because she was young and that’s all for a while, she constantly complained to her husband (my uncle) that she was in pain and there was pain... she was always in pain at home and couldn’t even cook food properly. She also didn’t really take care of the children, they grew like weeds in the garden, naturally the grandmother saw all this and she didn’t like it, only sometimes she could tell her son that he couldn’t behave like his wife. The grandmother raised their son until he was 7 years old, since he almost died with such a mother. The daughter-in-law had three children in total, but only one remained. Moreover, the daughter-in-law never even remembers them (one died when he was still young, and the second crashed on a motorcycle at 23). My uncle also did not die his own death, he was driving a car and a car drove into the oncoming lane...
    As a result, my husband and I decided to move and take care of my grandmother... I left everything: good promising job, home, friends... while I was on maternity leave, I decided that it would be better for us to come than my parents, because they had to work for a year before retirement. The most annoying thing is that my grandmother now constantly harasses me. We live separately from her, we go to see her every week, because it’s simply impossible to live with her. When our daughter was very little, we lived with her, and then it started... she constantly grumbled at us that the child climbs in there, then takes it, that I won’t cook for her all the wrong things + she wants everything, but not at her expense (change the windows, make repairs). And the most annoying thing is that the grandson who comes once a week brings 2 loaves of bread and leaves and gives him money, he’s the best. And I, who constantly cleans, washes, washes and cooks food for the week, no one and constantly gets on my nerves. When we live with her she doesn’t like it, when not with her it’s not like that again (she’s bored, lonely).
    She collects her entire pension in a stocking, we buy food and medicine with our own money, we bought windows and we didn’t have enough money for the remaining 3 windows to change everything, so she didn’t give us a penny. Girls, I just don’t know how to continue to live with her???!!! The most annoying thing is that in the house where she lives, we did everything (me, my mom and dad, and now my husband), but she constantly cries and says, my son (my uncle) died and no one does anything to her, I feel so upset that I simply don’t have the strength to endure all this.
    She constantly quarrels with her neighbors and pushes us against each other, and she constantly swears at my neighbors (I just can’t find another word), she said (when she was breastfeeding her daughter) that I would lie on the sofa, take out my tit and feed the child, and my husband does all this See, this is just one example. She is now 86 years old. You know girls, my friend hears and knows all this, and when I come she tells me all this (what people tell each other about), once she couldn’t stand it and said, you know, it’s better to die at 70, so as not to be a burden to anyone. Of course she’s wrong, but before I loved my grandmother very much, and after everything I do everything just automatically, like a person from social media. services. Maybe you will judge me for this, but I’m just so mentally tired as the weekend, and I’m starting to feel depressed, that I need to go to her and what should I expect from her again???!!!

    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.

    Rating of typical misconceptions. “What do you want, he’s old...”

    1. There is no cure for old age.

    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.

    Grigory Gorshunin

    Of course, we have accumulated a lot of 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.

    2. Dementia does not need to be treated as it is incurable.

    In this case, any chronic diseases do not need to be treated, and meanwhile about 5% of dementias are potentially reversible. What does "potentially reversible" mean? If on early stage If some types of dementia are given the right treatment, then the 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.

    3. “Why torture him with “chemistry”?”

    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 old man can't get the same help as a young 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, those around the patient—close people, caregivers, nursing staff, some neurologists and therapists—think that it is very difficult to improve sleep, relieve aggression, and remove delusional ideas. In fact, this is a 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.

    3 D: depression, delirium, dementia

    There are three main topics that caregivers and clinicians encounter in geriatric psychiatry:

    1. Depression

    • Depression is a chronically low mood and inability to enjoy joy.
    • Often occurs in old age
    • At this age, it may be perceived as normal by the patient and others
    • Strongly affects all somatic diseases and worsens their prognosis

    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 just sit 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 is in a bad mood, it 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 it is common in older people a whole bouquet diseases: diabetes the second type, angina pectoris, hypertension, knees hurt, back hurts, 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.

    2. Delirium (confusion)

    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 return again
    4. The person often does not remember or vaguely remembers what he did in a state of confusion
    5. Worsened 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 elderly person, delirium can occur after physical or psychological trauma, moving to another place, or 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 could not cope very well with his chickens and pigs, at least knew where the toilet was, where the matches were, where his bed was, that is, he somehow found his way in the usual 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 as a result, the suffering of the patient and the entire family, the flight of caregivers.

    3. Dementia

    Dementia is an acquired dementia: disorders of memory, attention, orientation, recognition, planning, criticism. Violation and loss of professional and everyday skills.

    • Relatives and sometimes doctors “notice” dementia only in advanced stages
    • Mild and sometimes moderate disorders are considered normal in the elderly and old age
    • Dementia may begin with character disorders
    • Wrong treatment is often used

    What do you think, if you bring the average elderly person, about 70 years old, with memory and orientation problems 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 severe form of cerebrovascular disease (CED), this is a 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 of vascular problems of the 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, it 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 was once 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? Eat different criteria 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.

    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, classic version– asthenia (weakness, fatigue).

    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.

    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 be done with proper treatment and care 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;
    • Preserve the health, strength, and work of caregivers and relatives.

    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.

    Questions:

    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 the rights of citizens 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, the relatives are going crazy. Here it should be remembered 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?

    1. Damage ideas, which are formed against the background of memory impairment. That is, an elderly man, already gripped by paranoid anxiety, takes his documents, money and hides them, and then cannot remember where he put them. Who stole it? Either relatives or neighbors.
    2. Poisoning ideas. This problem can be solved if you start treatment with medications in solution. Then, when a person loses this idea, he agrees to take memory drugs voluntarily
    3. Inappropriate sexual desires. I tried to talk a little about this at the Conference. Very complex topic. We are accustomed to the fact that guardians can be sexually violent towards helpless guardians. But it also happens the other way around: the ward, deprived of criticism and “inhibitions,” commits indecent acts towards minors, etc. This happens much more often than many people realize.

    What may be associated with a complete refusal of food and water in the later stages of dementia?

    – First of all, we need to look for and treat depression.

    1. Depression (no appetite);
    2. Ideas of poisoning (changes in taste, poison added);
    3. Concomitant somatic diseases with intoxication.
    1. If you have a replacement, most The best way when you are tired, leave the fast for a while. A replacement can be found if you set such a goal.
    2. If you can’t go away and relax, we treat “burnout syndrome” with medications.

    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.

    Those families who are forced to live with their parents have experienced all the difficulties that inevitably arise when three generations of people with their own views, principles and characters gather in a limited number of square meters.

    Yes, very often conflicts between parents, children, grandchildren take such a turn that about normal family relationships It’s already difficult to talk. And very often there is simply no way out - you cannot leave old people losing their health to live alone in front of their eyes, because even if they live nearby, sooner or later they will still have to take full control of their lives and provide constant assistance and care.

    But why does this happen? Why loving friend friend's children and parents constantly quarrel, poisoning life with petty insults and nagging? What is the reason for this: have the old people become too touchy and picky, or has the younger generation lacked patience and understanding?

    Most likely, the reason is both. It is difficult for parents who, as it seems to them, until recently enjoyed unconditional authority, could teach, instruct and control their children. Now we have to realize that they live as if on the sidelines of life, and the life of their grown children is a foreign life for them, into which they are either not allowed at all or are doing so extremely reluctantly.

    And parents try to at least somehow somehow regain their former rights, and their attempts cause persistent resistance and reluctance to devote their children to all aspects of their family life. And, if, moreover, the relationship between mother-in-law and daughter-in-law or mother-in-law and son-in-law does not develop smoothly, then there is almost always a tense atmosphere in such a house.

    How can you improve normal life in such a situation, and is it even possible to do this? Of course, it is possible if you have patience and understanding. First of all, think about the fact that your elderly parents, for the most part, are no longer very healthy people who have come to understand that Life is going towards sunset.

    Their strengths are no longer what they were before; their range of interests and opportunities has already narrowed. And, most importantly, there is a fear of becoming helpless, sick, and becoming a burden for your children. This is especially difficult for those parents who led a busy and energetic life and had many interests and hobbies. For them, the coming old age is a serious stress, and they resist as best they can.

    It is these parents who begin to strengthen their authority in every way and try to control the family of grown children in order to return to the old time when their opinions and advice were unconditionally listened to. But, if you look at it, they need very little - participation in the life of the whole family, the opportunity to live with common interests, concerns and problems. And the younger generation should simply understand and acknowledge this, without separating their parents from the rest of the household.

    This is not difficult to do. When you come home from work, tell your parents about your business and ask what they did in your absence. Come up with simple family activities for them so that the parents see that they need them. If it is possible to follow parental advice, be sure to do so and emphasize the reasonableness and appropriateness of such advice, thank you for it. Discuss family plans together with parents, without separating them and without keeping secrets from them.

    Respect the elderly. If guests come to you, be sure to invite them to the common table, give them the opportunity to make a toast and chat with your friends. Try to take time to communicate with your parents, even just sit next to them and listen to their simple news and stories. Celebrate their holidays and birthdays, invite guests and friends of your parents to your home. Don’t forget to congratulate and give gifts - any sign of attention is very important for old people - it speaks of your love and care.

    The older members of the family must have their own corner, in which everything should be the way they like it: furniture, things, old books and albums with photographs - everything that is dear to them and preserves the memory of their life. Elderly people live largely on memories, and therefore you should take care of this.

    If your parents live separately, do not forget to call them. Do this every day - even a short conversation and questions about well-being and life will be important and pleasant for older people. And, of course, visit them regularly, and not only to bring food or medicine - it is very important to be with them, communicate, talk at least for a short time, but informally, but with interest and attention.

    If you do not have the opportunity to often visit your parents living in another city, write them letters. Even a few lines in a letter, beautiful card A well-timed congratulation will brighten their lives and instill confidence in your love and care.

    Do not try to wean your parents from their usual life and things. Don’t overwhelm yourself with complex household appliances with demands to use them. Yes, of course, such devices can really make life easier, but it is difficult for older people to get used to and master new things, and if you throw away what they are used to, you will offend them.

    Share the concerns and problems of the elderly, do not brush them aside if they seem insignificant or frivolous to you. This is important to them, and therefore requires attention from you. Even patiently listening to a story about a conflict with a neighbor or about a new TV series will be more important and necessary for old people than mountains of food and money left on the run.

    Do not limit communication between elderly parents and your children. Grandparents should communicate with their grandchildren; such communication will benefit both parties. Even if the old people are sick and helpless, the grandchildren should see and understand that in life there is grief, old age, infirmity and illness. Otherwise, they will grow up to be soulless egoists, and a difficult old age will await you.

    Life flies by very quickly, and you only begin to feel it after living most of it. And someday you will become old and helpless. And only on how you treat your parents, on how you raise your own children by personal example, will depend on how your children will treat you when you need their care and help.

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