How to accept a diagnosis of “dementia” “Where have the former skills, abilities and opportunities gone? I myself want to return them back. You can’t imagine how offensive it is... I had a higher education, and now I’m in the deepest fall..." “I fell out of life..." “I used to really like life. I would like to return everything back. Work, friends, life..." "Absolutely empty in my head. It’s interesting to listen to myself now...” “I don’t know the past. I feel like I'm from another planet. There is no past. I don't remember anything. Like the first day of life...” “I now seem to be living in a magical space here and there.” These are the words of a seventy-year-old woman, an extraordinary personality, a talented artist, a wonderful person. Alzheimer's disease crept up on her unnoticed over the years. It was aggravated by loneliness. We found a new job, which became the possible meaning of the impossible - to fight for ourselves. It involves challenging the diagnosis and preserving cognitive functions as much as possible. In small grains, we extract information from the bottom of the memory and brain. In the initial stage of the disease, while criticality towards one’s condition is preserved, this gives the most positive and productive result. “As early as possible, get as much out of memory as possible” is my motto. It will become more difficult over time. The connection with the outside world will be lost, the knowledge of oneself will be erased. It will be impossible further. She is already confused between dreams and reality, and cannot always distinguish one from the other. But he remembers, he tells me with delight or sadness. Yesterday she “walked” along Red Square, saw the eternal flame and wanted to visit grandfather Lenin. If she were now left alone, without support and therapy, the process of personality degradation would, softly and smoothly, cover her brain with delirium like a lilac fog. Yes, the disease will still win, sooner or later. But there is still time! Time and communication are the only cure for fading memory! Our attention right now is able to answer all unanswered questions. The more attention a person gets, the better. In this interaction, any but living, human one, the broken connections with the external world are strengthened, on the other hand, new knots are tied that help the psyche somehow be responsible for its behavior. When we hear that by 2050 there will be 152 million people with cognitive impairment, this seems to be a very distant event that has nothing to do with us. However, every second the number of people with dementia is growing non-stop and increasing, and, worst of all, the disease is becoming much younger. Previously, at lectures, I voiced the earliest case of the disease, 42 years old; today it is a 37-year-old patient. Senile dementia progresses and begins to take precedence with its severity, material cost, and psychological consequences. There is still no clear understanding of the causes of the disease, high-quality diagnosis, and drug treatment. There are even fewer professional practitioners in interacting with people suffering from neurodegenerative diseases. Our hands are tied by the lack of full awareness, the lack of accessible specialized institutions, and the lack of information about doctors specializing in this disease. World statistics are conjectural in calculations. Much closer and more real, and therefore even more shocking, is the statistics of requests from relatives of elderly people to only one specialist. Over the course of 4 months, 61 clients came to me as a clinical psychologist to diagnose their mental status. These were children concerned about the state of the cognitive functions of their elderly parents. Thirteen men and forty-eight women ranging in age from 60 to 100 years. Follow the thought, men do not live to old age. The study used diagnostic tools that looked at cognitive status, the presence of depression (to avoid pseudodementia), and techniques for 24-hour caregivers in situations where a person cannot tell anything about themselves. Personally, I was disheartened by the numbers.cognitive impairment in 7, pre-dementia impairment in 2, mild cognitive impairment in 5, moderate in 18, severe cognitive impairment, diagnosis of Alzheimer's disease in 29 people. Conclusion - out of 61 people, only 9, if nothing is changed in their way of life, can live and work independently. While they can still...Interesting results of marital status. Only 9 out of 61 people live in a partnership, 52 are single people. And loneliness, we talked a lot about this, provokes, aggravates and accelerates the development of dementia. We can easily miss, not notice the onset of the disease, the severity of the parents’ condition if they live with their family. One complements the other, life follows a well-established, familiar pattern, “automatically,” although both may have been demented for a long time. And suddenly, left without a partner, we observe a sharp regression and dementia becomes obvious to others. Why am I sharing these numbers? For our competence! When the doctor at the appointment is surprised by your persistence: “What do you want? How old are you? These are age-related changes!”, do not agree with this formulation of the question and be sure to make an appointment with a doctor who specializes in the diagnosis and treatment of neurodegenerative diseases (here, the “Find a Doctor” section on the website will help you). Remember that there is no such thing as a “normal old age”! We are told that with dementia, memory, speech and the ability to cope with simple everyday and financial issues are the first to suffer. I would recommend paying attention to these factors right now: “Brain fog” - “brain fog”. Feeling of brain fog, fogginess, emptiness. This is one of the first warning signs, along with the appearance of forgetfulness. The presence of “bad” and “good” days. The growth of this division. Staying in a state of laziness. Increasing level of demands, claims, grievances, whims. Criticism of everything and everyone. Playing to the public, demonstrative behavior, attracting attention. Devaluation of everyone and everything. Even loved ones. “Know-it-all.” Frequent changes in mood. Distance from reality, retreat into a painful world of fantasy. Absence, decreased joyful perception. Decreased sense of humor. Violation of the associative series. Forgetting new information. Difficulty in using simple household appliances. Tying knots. Storage expired products, excessive quantities of them, forgetting about them. Frequent changes in the location of items. The appearance of “stashes”. Shuffling gait. If suddenly, in yourself or in your family, you begin to notice such manifestations, you should immediately consult a doctor. However, remember! Even experts cannot come to an understanding of the exact number of types of dementia. Three years ago I voiced 70, today there are 120 of its types. One thing is certain: the changes that occur in the brain during the aging process are varied, as is the structure of the brain itself. The age at which signs of impairment appear, as well as the set and degree of physical changes that affect intelligence, vary. Most of them are found between 50-60 years. Some become noticeable only after 70 years, but the greatest changes are noted after 80 years. If a doctor mentions the word dementia, it is necessary to find out its causes! The most common is Alzheimer's disease, which affects 60-80% of patients with symptoms of dementia, followed by stroke, dementia with Lewy bodies, Parkinson's disease, brain injury. Most often, a person has several causes of dementia. It is extremely important to know about the potentially reversible causes of dementia and only by eliminating them can we talk about Alzheimer's disease or dementia. We must exclude delirium, dehydration, exhaustion, trauma, tumors, brain infections, vitamin B deficiency ", drug overdose, metabolic disorders, chronic alcoholism, normotensive hydrocephalus. Before drawing conclusions and assuming the worst, it is necessary to find an explanation for the changes that have appeared in a person's behavior: anxiety, screaming, attacks of pain, temperature, poor health, fear. Particularly emphasize onemotional background, categorically exclude depression. If it is present, the cognitive status decreases, and a person’s behavior may be inappropriate. The sooner an examination is carried out, a diagnosis is made, and the causes are identified, the more time and opportunities will remain for both the sick person and his family. This is the time for rational use in resolving legal issues, no matter how immodest and cruel it may sound. We do not betray, we ensure the future. Both the sick person and we, his loved ones, have it. Regardless of age, diagnosis and condition. In my professional practice, I never voice diagnostic results over the phone. This is a categorical prohibition. Otherwise, it is emotional and psychological rape of the client! The results of a neuropsychological study are bad news, which must be reported humanely, carefully, but truthfully! Even when guessing about problems, realizing that something is “going wrong,” hearing a presumptive diagnosis is painful. Conditions for the meeting must be created, the atmosphere and emphasis enough time. It doesn’t matter whether the client himself suffers from cognitive impairment or whether his relatives came. We must take care of the person, because news of illness in most cases is perceived as real grief and recognition of this will take the form of the grieving process. It `s naturally. The work of grief will be equally strong during a divorce, and during the loss of a job, and during retirement, and when a diagnosis of dementia is made. Knowing the stages of grief will help to understand everything that is happening and will help relatives accept the disease. For us, loved ones, or the sick person himself, if he is aware of the presence of problems, everything that happens may seem abnormal. In order not to drive yourself into a corner of unresolvedness, it is important to get acquainted with the stages of grief and their characteristic features. This information is vital for people who are personally faced with a diagnosis. To be honest, in my practice there was only one case when the person himself asked for help “on time.” In ordinary stories, due to ignorance of the first symptoms, people perceive them as something insignificant. Especially in our country, it is customary to blame everything on old age. And as a result, do not visit a doctor when the first signs appear. However, the sooner you find out the diagnosis and begin taking therapy, the higher the chances of maintaining your usual lifestyle for many years. So, what to do if you are diagnosed with dementia... There are several stages of grief. The first stage is shock. We experience horror, stupor, we want to distance ourselves from what is happening or, on the contrary, we boil over. Everything that happens seems unreal. The head refuses to accept and believe. The perception of reality becomes dulled, and events may be lost from memory. Suicidal thoughts come. Allow yourself to experience any emotions, tears and bitterness. If possible, do not be left alone. The second stage is denial. Even when we begin to get acquainted with the topic of dementia, we will not believe that therapy can only stop the progression of the disease. Our love for ourselves (if we are sick) and for our loved ones, our efforts to save them, will give and fuel the illusion that the world can change the way we want. After all, we love so much! After all, we are trying so hard! This period is accompanied by “waves” of emotional pain, while gradually opening up internal forces for struggle. The third stage is aggression. Many adult children of adult parents blame themselves for their illness, cannot forgive their faith in their words: “Everything is fine with me, don’t bother me.” , I’m not going to the hospital!” Now the feeling of guilt develops into pain, indignation, aggression towards others and towards the sick themselves. The search begins for the culprits and the desire to punish them, to take revenge for lost time. We begin to fight the injustice of this world, trying to prove our affection and gratitude to our parents. During this period, the body joins the emotions. Attacks of panic and fear, sleep disturbances, mood swings begin, energy potential decreases, general weakness andfatigue. Salvation can be found in breathing practices of self-regulation, relaxation, and visualization. Massage, swimming and regular walks in the fresh air will help to switch attention, prevent the brain from starving and us from suffocating. The fourth stage is depression. The most difficult period of immersion in one’s experiences, the desire to “hide in a house”, not to let anyone in and not to go out. But mental anguish, over time, will lead us to some rethinking, evaluation of ourselves and our lives. We will remember happy moments next to sick loved ones and begin to “see” only the good in their past. Observing your loved one with a diagnosis of dementia will expose your fear for yourself, make you think about your own life, and look at it from the perspective of eternity. Take a diary in your hands and write your memories of childhood, first love and all the best moments of your life. Write letters of gratitude to your sick loved ones or letters of love to them if you yourself are sick. The fifth stage is acceptance. I must admit, not everyone comes to this stage. Children are left with an inveterate sense of guilt; we will not go into their psychological characteristics now, which will resist diagnosis until death and after it. They will never be able to accept themselves and their loved ones as sick people. In a “normal”, healthy process of grief, this stage allows you to accept everything as it is, build a life within the illness, slowly rush to live and solve issues as they arise. The sixth stage is a possible repetition of all stages. Having grieved, our psyche can bring us back into the past, but with less mental suffering. If you are near someone who has just learned about the diagnosis of Alzheimer's disease, help him. Stay close. Accept. Give him the opportunity to talk as much as he needs. Talk, regret, cry, hysteria. Listen without giving advice. Don't say you understand him! His grief is not the same as yours! It’s bigger, it’s scarier, it’s more painful... Perhaps he will remain silent. Be silent with him. Touch him. Give your warmth. Just be there. On an unconscious level, the person now wants to shout to us: Let me just talk...Ask me about myself...Support me and let me...Don't scare me...Don't leave me...He needs to be heard. It is necessary to share his clash with hopelessness, dependence, lack of hope, but at the same time, find new meanings! Of course, you need to immediately consult a doctor, undergo examinations, clarify the diagnosis, and receive medication prescription. Immediately start looking for a psychologist who will support and train mental functions, through cognitive training, restructure impaired brain functions and create compensatory means. Get ready for long-term, permanent work. You need to go study right away! Get to know the disease and its prospects. You will have to start living from scratch! Protect yourself from negative habits without shortening your allotted time. Fight depression. Allow yourself healthy selfishness! Avoid stressful situations at all costs. Change your attitude towards them. Take responsibility for yourself. Get outside help. Think about where and who can provide it. Accept this help! You and I agreed to keep a diary. The paper will absorb the spilled out experiences, no matter what they are. It will help you gain understanding, balance forces, and reveal meaning. Come to meetings with a psychologist. Allow yourself to find support in another while we can be together. I repeat, we still have time! While Alzheimer does not know our address and is not friends with us, please love yourself! There is time for change, you can believe me. Please watch the feature film “After Life”, Japanese director Hirokazu Kore-eda, released in 1998. Look in silence. After watching, don't talk to anyone for at least a couple of hours. In your diary, write down the answers to the questions. What and who would I like to always remember? Who and for what am I grateful? What is my happiest!