“Yes, Grandpa/Grandma is a little bit scattered today.” With this kind of brief statement, many relatives are content to believe that their loved one suffers from temporary memory loss. But what is hiding behind the confusion of the elderly? What does modern science have to say about this? Although we are young and thus quite far from old age, we wanted to spend some time investigating these questions.
In order to get some professional input, we attended a lecture of Professor Berhard Igelseder at the University of Salzburg. In addition, we invited Dr. Wolfgang Staffen to give us a presentation at our school. Finally, we learned about the psychosocial aspects of dementia in a comprehensive workshop held by Dr. Helga Schloffer.
“Dementia” is a basic term for a “deficit in cognitive, emotional and social abilities, which leads to a deterioration of social and occupational skills and is mostly associated with a diagnosed disorder of the brain” (Bib. 2). In Austria alone, there are currently about 100,000 people suffering from dementia (Bib. 3).
According to the International Statistical Classification of Diseases and Related Health Problems of the WHO, dementia is classified into three categories (Bib. 2):
This term is used when the illness is connected to a reduction in brain cells. Alzheimer’s disease falls under this category (Bib. 1).
Vascular dementia occurs as a concomitant symptom of vascular diseases in the brain and related circulatory problems. As symptoms vary significantly, diagnoses are usually made using magnetic resonance imaging (Bib. 5).
Dementia can also be a symptom of other illnesses, for example, Cholera Huntington disease, Parkinson’s disease and HIV. Dementia can also occur in connection with epilepsy, an excess of calcium or a vitamin B12 deficiency.
Fifty to sixty percent of patients with dementia are diagnosed with Alzheimer’s.
Alzheimer’s disease was first described by the German psychiatrist and neuropathologist Alois Alzheimer, while treating his 50-year-old patient, Auguste Deter. After her admission to the Frankfurt Psychiatric Clinic in 1901, Alzheimer continued to treat her until her death in 1906 (Bib. 4).
With the exception of the case of Dr. Alzheimer’s 50-year-old patient, Alzheimer’s disease primarily affects the elderly. The risk increases dramatically for people over 65; twenty percent of people between the ages of 80 and 85 have been diagnosed. Worldwide, approximately 29 million people suffer from Alzheimer’s disease. While this number of cases can be managed by the health care system, the UNO predicts it to grow to 106 million cases by 2050 (Bib. 4), as more and more “Baby Boomers” reach the age with the highest risk for Alzheimer’s. Whether our western health care system can compensate for the increase remains to be seen, but the current state of things leaves room for doubt.
It used to be that all of the generations of a single family lived together in one house and there were enough people in the community to care for the sick. To some extent, the care was, in a way, “rotated” among family members so as not to be too burdensome on any one person. Today, on the other hand, many families live in separate households and it is not uncommon for all adult family members to be employed. This new family structure led to the alternative “nursing home”, an alternative which like the pension system, will not be financially possible much longer if the number ofpeople supported by the social system continues to outpace the number of workers who finance it.
Currently, a room in a nursing home in Austria costs about €1500 to 3500 per month (2012)! If the monetary allowance for nursing care from the State is not sufficient, then either relatives will be asked to pay or the patient’s room will be signed over to the State (Bib. 7). If the relatives are not overburdened, care at home can be a good alternative. In comparison, one year in a nursing home costs about €35,000; home care costs “only” about €12,000 (Bib. 1). The Austrian health care system would be greatly relieved by an increase in at-home care. Nevertheless, many people choose nursing homes – because they cannot handle the fact that their mother or father is sick, or cannot provide home care for other reasons.
1) Univ.-Prof. Dr. Bernhard Iglseder: Vortrag „Demenz – Die ‚vergessene‘ Zukunft“
Doz. OA Dr. Wolfgang Staffen: Vortrag „Demenzielle Syndrome“
Dr. Helga Schloffer: Workshop: „Demenz – Der Mensch ist weit mehr als sein Verstand“
2) http://de.wikipedia.org/ wiki /Demenz
3) http://www.alzheimer- selbsthilfe .at/
4) http://de.wikipedia.org/ wiki /Alzheimer- Krankheit
5) http://de.wikipedia.org/ wiki /Subkortikale_a rteriosklerotische _Enzephalopathie
6) http://de.wikipedia.org/ wiki /Altenpflege
7) http://www.seniorenheim.at/ pflegeheime /start7 /info/ kosten.htm