June Caregivers Meeting: 9 June 2012 on
Common Geriatric problems in Persons with Dementia
- The meeting commenced by a brief recap by Bala and Rukhsana about the importance of aspects of hygiene and safety for a person with dementia and how minor lapses in safety can turn into life threatening situations.
- Caregivers were asked to share their experiences about the safety issues they faced while tending to their loved ones and how they coped with difficult situations.
- Dr.Rama Rao, a care giver, told about a situation where he and his wife went on for their usual morning walk where upon they came across a ditch of 2 feet wide and deep. There at that moment his wife simply wouldn't listen to him and wanted to jump over the ditch. At that moment he simply held her and pulled away from there. By sharing this incident he emphasised that if he was not quick enough and pulled her away from there probably there was a fair chance of accident and how worst the situation could turn into.
- He further went on to say how important it is to employ a home attendant to help look after their loved ones so that the caregivers don't slip into a burnout situation. It is important that the total stress of taking care of the patient should be shared.
- A few other care givers went on to share their experiences regarding safety and emphasised on points like flooring should be always kept dry. Lights in the bathroom should always be on - especially at night.
- Stress was laid upon how good, nourishing food is essential for a patient's wellbeing.
- Bala introduced Dr. Konappa who took the meeting forward by discussing the Digestive track problems caused in aged.
- He discussed about the most common problems like indigestion and constipation and reasons behind it.
- Other problems caused due to co – morbidity like Heart burn, Peptic ulcers, diarrhoea etc. were discussed.
- Dr. Konappa further went on to talk about gastro paresis which is a disorder in which food takes a long time to clear the stomach resulting in many unpleasant symptoms.
- Intestinal Ischemia – more systemic problems that are more common with age are really the reason behind severe abdominal pain and urgent need to have a bowel movement or frequent, forceful bowel movements.
- Dr. Konappa further went on to discuss Alzheimer's and dementia related disorders and eating challenges.
- He said that one of the reasons for poor nutrition can be ill fitting dentures.
- He said that poor nutrition can cause progression of disease and aggravate confusion, lead to physical weakness and increase the risk of infection.
- Chronic conditions that affect appetite are diabetes, heart disease digestive problems, depression and constipation.
- Dr. Konappa said that fortunately the digestive tract doesn't have to become a victim of age like the rest of the body. He went on to give few suggestions
- It can be often protected with a healthy lifestyle.
- Stay hydrated by drinking a lot of water
- Limit fats in the diet.
- Load the diet with fibre
- Avoid over eating
- And do regular exercise.
- Dr. Konappa re-iterated the importance of Vitamin B12 supplements, especially for vegetarian diets. There are several options in the market including easily absorbable chewable tablets. He also said that when we take acid suppressors they have the side-effect of reducing gut bacteria which produces B12.
- He said that a simple fact that solves constipation is bulk. And the bulk is formed by fluid or water or by fibre from vegetables, fruits, whole-grain cereals.
- He said that it is better to use a stool softener to solve constipation before it becomes chronic.
- Fibre suggestions included leafy vegetables raagi, "korral (local jowar), oats etc. Fresh mint, curry leaves and tulsi have nutritional benefits and help boost immunity.
- He said that it is better to have frequent small meals throughout the day.
- To prevent aspiration in patients he said to make sure that the head is not bent backwards while having food.
- Caregivers asked several questions related to nutrition, appropriate quantities, feeding times, swallowing problems, and Dr. Konappa provided practical solutions for common problems.
- Caregivers need to watch out for pocketing of food and adequate amount of time needs to be given for meals. Typically 30 minutes- hours. Patients shouldn't be rushed through meals.
- Caregivers need to plan for the possibility of tube feeding when swallowing problems becomes severe and recurrent – seen as frequent choking, coughs during meals or when taking liquids.
