But the majority of these cases, as with Bajracharya\u2019s grandmother, remain undiagnosed. According to Alzheimer\u2019s Disease International, 75 percent of people with dementia have not received a diagnosis, and therefore \u201cdo not have access to treatment, care and organised support that getting a formal diagnosis can provide.\u201d<\/p>\n\n\n\n
The percentage is believed to be much higher in Nepal, where a majority of the general population still does not understand the disease, and only a handful of hospitals is equipped to make a clinical diagnosis.<\/p>\n\n\n\n
\u201cPeople dismiss symptoms of Alzheimer\u2019s as part of the normal aging process,\u201d said Dr Nidesh Sapkota, head of the psychiatry department at the Dharan-based BP Koirala Health Institute of Sciences. \u201cThere\u2019s still a lack of awareness about the disease in the country, both among the public and government officials.\u201d<\/p>\n\n\n\n
Because Alzheimer\u2019s patients often suffer from behavioural abnormalities, which may include being physically and verbally aggressive, hoarding stuff, loss of bowel control, engaging in improper sexual behaviour, and wandering around without any sense of the place they\u2019re in, they\u2019re often confused to have a mental illness. This has led to the stigma surrounding the disease.<\/p>\n\n\n\n
\u201cAs soon as an elderly person starts acting abnormally, society is quick to label them crazy,\u201d Caregivers struggle to put clothes on Vidhya Laxmi Shrestha, 64, who has been living at a residential care home for the past year. Tsering D Gurung\/TKP<\/em><\/p>\n\n\n\n As the number of Alzheimer\u2019s patients increases, there is also a growing need for trained caregivers who can provide adequate care and respond to a patient\u2019s needs accordingly.<\/p>\n\n\n\n \u201cIf you have no orientation of the disease and do not understand why the person is acting in a particular way, you tend to take things very personally,\u201d said Bajracharya. \u201cAnd often that may result in lashing out at the patient.\u201d<\/p>\n\n\n\n According to Bajracharya, all caregivers\u2014whether they are family members or hired help\u2014must undergo training.<\/p>\n\n\n\n \u201cYou have to use different tactics, some elderly patients need attention, some need to be distracted, some just need company,\u201d she said.<\/p>\n\n\n\n Bajracharya said she has trained over 120 caregivers so far, many of who are domestic workers.<\/p>\n\n\n\n \u201cMy priority is to ensure the elderly stay at their home and have a trained caregiver there who can help when the children are unavailable,\u201d said Bajracharya.<\/p>\n\n\n\n While there is no known cure for Alzheimer\u2019s, early diagnosis, supplemented with proper care and treatment, can help delay the progression of the disease, according to medical professionals. On average, people with Alzheimer\u2019s live between four to eight years after first showing signs of the disease, according to the Alzheimer’s Society<\/a>, a UK-based charity that funds research on dementia. But some patients have lived for up to 20 years.<\/p>\n\n\n\n Early signs of dementia include forgetfulness, losing track of time, and becoming lost in familiar places, according to the World Health Organisation. As the disease advances, patients become increasingly dependent on others, facing difficulty with communication, needing help with personal care, and experiencing behavioural changes including wandering, repeated questioning and becoming conspiratorial. In the final stage of dementia, a person becomes totally dependent, unable to even move and feed themselves.<\/p>\n\n\n\n For years, Gaya Prasad Pradhan and his family had no idea what was wrong with his sister, Vidhya Laxmi Shrestha, a former Post Office employee from Tansen who had begun behaving irrationally, often shouting into the night, throwing things around, and urinating everywhere.<\/p>\n\n\n\n It was only after a visit to a geriatrician in Kathmandu that they finally found out she had Alzheimer\u2019s. After her condition began to deteriorate, they decided to put her in a residential care home.<\/p>\n\n\n\n \u201cIt became impossible for us to care for her,\u201d Pradhan told the Post. \u201cShe had to be watched 24 hours and there was no one in the family who could do that.\u201d<\/p>\n\n\n\n Unlike other diseases, the impact of Alzheimer\u2019s is often felt more by the caregivers\u2014who are most often family members, who have to watch a loved one\u2019s condition deteriorate over time\u2014 than by the patients themselves, say health professionals.<\/p>\n\n\n\n \u201cIt can be physically, emotionally and financially exhausting,\u201d said Bajracharya.<\/p>\n\n\n\n The most difficult part is knowing they will never be the same, said Rupa Joshi, whose mother was diagnosed with Alzheimer\u2019s at 60.<\/p>\n\n\n\n Sharada Sharma, 89, who is suffering from Parkinson’s and dementia, is immobile and lives with other patients at the same care facility. Tsering D Gurung\/TKP<\/em><\/p>\n\n\n\n \u201cIt\u2019s like you\u2019re watching them slowly die,\u201d she said. \u201cOn days when the person is lucid, you grow hopeful that they\u2019re back and better, but that moment is short-lived.\u201d<\/p>\n\n\n\n After she started showing behavioural problems, the family stopped taking her to social functions as they thought it would be embarrassing.<\/p>\n\n\n\n \u201cIn hindsight, we should not have done that,\u201d said Joshi.<\/p>\n\n\n\n Since the job of a caregiver can be mentally and physically taxing, Joshi said, the responsibility should not be left upon one person.<\/p>\n\n\n\n \u201cEven if you have a nurse or a caregiver, family members and relatives of those who are suffering from Alzheimer\u2019s should make it a point to visit them, spend some time with time, act like nothing\u2019s changed,\u201d said Joshi.<\/p>\n\n\n\n In 2013, Sapkota, who has been running a memory clinic at the Dharan-based hospital, conducted a year-long study with his colleagues, monitoring the number of people visiting the hospital\u2019s psychiatric clinic, and found that over 11 percent of them had dementia.<\/p>\n\n\n\n \u201cIt\u2019s is a growing health epidemic,\u201d said Sapkota.<\/p>\n\n\n\n As in other countries, Nepal\u2019s ageing population has been growing with the increase in life expectancy. Between 2001 and 2011, the total population aged 60 and above grew from 1.7 million to 2.2 million. As such, it won\u2019t be long before dementia will soon be a major health crisis, affecting hundreds of thousands of families, health professionals say.<\/p>\n\n\n\n \u201cThe situation is dire but the government doesn\u2019t seem to care,\u201d said Pradhan of Alzheimer’s Related Dementia Society Nepal. \u201cThe state has no plans or policies to tackle Alzheimer\u2019s which will continue to affect a growing number of Nepalis.\u201d<\/p>\n\n\n\n In 2013, the government introduced the only significant provision that it has put in place to support Alzheimer\u2019s patients so far\u2014it will cover treatment up to Rs 100,000. But because the process is so cumbersome, not many have benefited from it.<\/p>\n\n\n\n To take advantage of the program, a person needs to first obtain a recommendation letter from their respective ward office and then get a clinical diagnosis from one of the 13 hospitals recommended by the Ministry of Health. Since these hospitals are exclusively in the cities, with nearly half of them based in Kathmandu, only a few people have taken advantage of governmental support.<\/p>\n\n\n\n Less than ten people utilised the service during the first three years of its provision. But in the last fiscal year, 69 people have taken advantage of the service.<\/p>\n\n\n\n \u201cThink about those people who have to travel from remote areas to Kathmandu to first receive a diagnosis, and the amount they have to spend on transportation and lodging,\u201d said Pradhan. \u201cIt\u2019s just not convenient or feasible.\u201d<\/p>\n\n\n\n And because the amount isn\u2019t paid in a lump sum, they have to keep making repeated trips.<\/p>\n\n\n\n There\u2019s also no state-run nursing home to take care of Alzheimer\u2019s patients. Families have to rely on residential facilities run by private companies, which are expensive, ranging anywhere from Rs 30,000 to Rs 150,000 per month.<\/p>\n\n\n\n \u201cThe state needs to invest in the care of its senior citizens,\u201d said Bajracharya. \u201cThere are many elderly people with the disease who are forced to live on the streets because they\u2019ve been shunned by families. These people need a home.\u201d<\/p>\n\n\n\n Pramila Bajracharya remembers when her grandmother started hallucinating. She would forget her way back home,…<\/p>\n","protected":false},"author":7,"featured_media":444,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,17,7],"tags":[],"class_list":["post-443","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-nepal","category-stories"],"yoast_head":"\n
said Prabhat Kiran Pradhan of Alzheimer’s Related Dementia Society Nepal<\/a>, one of the first organisations to actively work to generate awareness about the disease and lobby the government for policies to address it. \u201cMost families often resort to isolating a patient in a locked room because they don\u2019t know how to care for the patient.\u201d<\/p>\n\n\n\n![\"\"](\"https:\/\/assets-cdn.kathmandupost.com\/uploads\/source\/news\/2019\/health\/Alzheimers_0005.jpg\")
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<\/a><\/figure><\/div>\n\n\n\nTsering D Gurun<\/a>g<\/h5>\n","protected":false},"excerpt":{"rendered":"