More Than Memory : A Psychiatrist's Reflections on Alzheimer's Care

The dimly lit consulting room, redolent with the scent of old books and worn leather, seemed to shrink around Rohini as she struggled to contain her emotions. Her mother-in-law, Geeta, sat beside her, the once-sharp lines of her face now softened by the relentless creep of Alzheimer's. In Geeta's fading memories, Rohini saw the echoes of a thousand tender moments, a lifetime of love and laughter slowly unraveling like the threads of a treasured tapestry. (Names changed to hide identities)

As a psychiatrist working with elderly patients, I've witnessed countless family members like Rohini navigate the complex emotional landscape of Alzheimer's disease. In India, where family ties are strong, caregiving often falls on relatives, who sacrifice their own well-being to support loved ones. Alzheimer's prevalence is rising, with over 5.3 million Indians affected (ARDSI, 2020). The disease's progression ravages not only the patient's mind but also the caregiver's mental health.

Clinically, Alzheimer's poses significant challenges. Patients' cognitive decline necessitates constant supervision, medication management, and behavioral interventions. Caregivers struggle to cope with agitation, aggression, and sleep disturbances. In my practice, I've seen caregivers experience anxiety, depression, and burnout. Social isolation exacerbates these issues, as caregivers sacrifice social engagements and personal interests.

Women, particularly in India's patriarchal society, bear the caregiving burden disproportionately. Female caregivers often sacrifice careers, financial stability, and personal aspirations. This phenomenon is echoed in ARDSI's findings, where 70% of caregivers are women (2020). As a psychiatrist, I've witnessed the resilience and love of these caregivers, but also their desperation for support.

To effectively address Alzheimer's care, India requires a multifaceted approach:

• Enhance diagnostic facilities and early intervention programs.

• Provide training and resources for caregivers, including home care services and respite care.

• Offer financial support, such as subsidies for medications and caregiver allowances.

• Launch community awareness campaigns to reduce stigma and promote understanding.

In my experience, empowering caregivers through education, support groups, and therapy can significantly alleviate their burden. Collaboration between healthcare professionals, caregivers, and community organizations is crucial. By acknowledging the challenges and rewards of caregiving, we can work towards a more comprehensive and compassionate Alzheimer's care ecosystem in India.

To address the gender bias in caregiving, we must promote shared responsibility within families and communities. This can be achieved through:

• Encouraging male family members to take on caregiving roles

• Providing accessible, affordable childcare options for working caregivers

• Implementing policies like paid family leave and caregiver support programs

• Challenging societal norms that perpetuate gender-based caregiving expectations

• Empowering women through education, economic independence, and social support

By recognizing the value of caregiving and redistributing responsibilities, we can mitigate the disproportionate impact on women and foster a more inclusive, supportive environment for all caregivers.

References:

1. Alzheimer's and Related Disorders Society of India (ARDSI). (2020). Dementia in India.

2. World Health Organization (WHO). (2019). Dementia.

3. National Institute on Aging (NIA). (2020). Alzheimer's Disease Fact Sheet.

Statistics:

• 5.3 million Indians suffer from dementia (ARDSI, 2020)

• 70% of caregivers are women (ARDSI, 2020)

• Alzheimer's prevalence expected to triple by 2050 (WHO, 2019)