KOLKATA: The mental health of a celebrity’s elderly mother had declined during the pandemic so much that she now forgets everything, including the meal and medicines given to her. Recently, she has started accusing the celeb of starving her all day without understanding that she has no memory of eating everything.
This octogenarian woman is not the only one. The pandemic has given a rise to sharp “behavioural decomposition” in the mental health of patients suffering from dementia. The inability to continue doing regular chores, absence of care-givers/volunteers coming to check them and the stress within the household have had an impact on their behaviours.
Nilanjana Maulik, secretary of Alzheimer’s and Related Disorders Society of India (ARDSI) in Survey Park, Kolkata chapter, “Around 20% of the patients who used to come to our daycare centre have not reported after we reopened in June. They are no longer physically or mentally in a position to return. They can’t follow instructions and people at home are also apprehensive about sending them out.”
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Senior citizens are much more vulnerable to Covid than other age groups and are at even greater risk if they have other complications. There is an urgent need to look at elderly care a little differently because of the situation.
For logistics purposes, some senior citizens had to move in with their children. Adapting to the new environment is a stress on their brain. “The absence of proper access to doctors, care-givers, medicines and hospitals has taken a big toll on their mental health. Many dementia patients are unable to perform their Activities of Daily Living (ADL). Earlier they could do simple chores. Now, they have completely withdrawn and become crippled. Depression in this group has also increased,” said Sabyasachi Mitra, a consultant neuro-psychiatrist.
Mitra has noticed that this deterioration is irreversible. “It is a one-way traffic. We call it a step-ladder deterioration. Dementia is a progressive disease. This fast degeneration would have been slower had there been no pandemic-induced lockdown like life events,” Mitra added.
The cascading effect of isolation has been “humongous” on the mental health of the elderly, said another psychiatrist, Jairanjan Ram. Senior citizens might not have had a battery of relatives visiting them often. But they always had a support system of care givers, with whom they interacted regularly. In the absence of micro-involvement throughout the day, the decay of the cerebral reserve of patients with little external interactions will happen faster. Ram’s mother, an Alzheimer’s patient, has had people coming in and sharing stories about Varanasi, where she grew up, to make her feel good. “Even if hilsa costs Rs 1,000 a kilo, we told the fish monger to mention the price as Rs 100 in front of her. For her knowledge, the salary of the domestic help was Rs 300. She has been stuck in a time wrap and her entire support system would pander to that,” Ram pointed out.
The absence of this support system is challenging. Watching this decay is stressing out their near and dear ones. “I can’t believe that my mother — an extremely educated and erudite lady — can suddenly behave this way. Watching her fast degeneration is taking a toll on my health,” said the celebrity. For five years, a 96-year-old used to come to the day care centre without much decline. “In the six months, we notice a fast decline in him. He has lost his sense of humour and his spirit. He is taking longer to follow instructions,” said Maulik.
A dementia patient, who had the habit of going to a bank every month, became extremely insecure when she had to give up that habit. Though her son had sent over money via his friends, she refused to spend it. “She cut down on the grocery shopping and food intake. Matters reached a stage where she was on the verge of hospitalization,” Ram said.