[Alzheimer's Day] When I don't remember my name and my mother -how to care for their "dementia" time

Economic Observation Network Reporter Jiang Xin

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"Who do you think this is?"

The old man ate the food in his mouth, squinting at the screen of the mobile phone, with a puzzled face, "don't know".

"Who am I?"

The wrinkles on the old man's face slowly opened a little bit, "You are opened by the store."

"Remember me, that is, I can’t say that I can’t make a name anymore. I am my daughter in my mobile phone, your granddaughter."

Through the screen of the mobile phone, Zhang Jin's heart was tight, and tears almost flowed out, but were squeezed back.

The other end of the mobile phone is her mother. She does not know her old man, and she is the uncle over the age of 70.

On September 21, the World Alzheimer's Disease Day, Zhang Jin, who was working in Beijing, bought supplements on the Internet in advance and commissioned her mother to visit her grandmother.

Mom did not know the existence of Alzheimer's Day and did not want to "live" the day, but she still bought a lot of food for Zhang Jin's request.

Mother found that after a few days, the mother knew herself again. Although she didn't say her name, she still remembered what she was doing when she was young.

Two months ago, Zhang Jin returned to his hometown to visit his uncle. At that time, I didn't know myself or my mother.

Change clothes, cut nails, wash hair, cut hair, Zhang Jin and his mother did a series of clean work for his uncle. He was very good, and he could not see his expression deep in the wrinkles. It felt like a child who needed to take care of. For a few hours, I only said one sentence, just when she fed her melon to her mouth, she said "this melon is good".

Alzheimer's disease is called the most dignified terminal illness. Although it cannot be cured, the occasional "cognitive soberness" still makes Zhang Jin and his mother a little more comfort.

Before and after the Mid -Autumn Festival, the film "Mom" was released. The film tells the story of the old 85 -year -old mother who takes care of the 65 -year -old daughter of Alzheimer's daughter. Because her daughter suddenly suffered from Alzheimer's disease, this mother and daughter relationship returned to "the original appearance" -the daughter seemed to be a child's state, and could not travel, live, and even emotionally out of control. A mother "takes care of the daughter who has gradually declined in memory. When I saw the daughter of the film in the film, the daughter of Huajia repeatedly repeatedly repeatedly repeatedly repeatedly repeatedly duplicated "You are a good person, you are really like my mother", Zhang Jin burst into tears. She remembered that she was afraid that there would be any One day my mother did not know herself.

In 2022, the theme of "World Alzheimer's Month" is "Knowing and Preventing the Early Wisdom in the Early Wisdom -Working to the Future", paying attention to the above information and knowing this. The materials and books were sent to the mother and joked with the mother, "Aren't you always afraid that you are Alzheimer's, come, prevent it."

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Alzheimer's disease is also called "dementia" and is clinically "dementia", but in the field of care, in order to show the friendship of this group and reduce their sense of illness, people are more inclined to recognize it as recognition Knowledge.

According to the definition of the World Health Organization, cognitive diseases are a chronic or carried out syndrome caused by a variety of diseases that affect the brain. It is usually a more serious decline in cognitive function (that is, the ability to deal with thought) than normal aging. It will affect memory, thinking, directional, understanding, computing, learning, language and judgment ability. Cognitive ability damage is usually accompanied by emotional control, social behavior and motivation decline.

According to the Statistics of the World Health Organization (WHO), one person in the world is diagnosed as cognitive disease every 3 seconds. According to the "Status and Development Report" released by the China Aging Association in 2021, there are about 15.07 million patients with cognitive disorder in the age of 60 and above in my country. The rate is much higher than the global average, and cognitive symptoms have also become the focus and difficulty of the elderly care field.

From the perspective of the prevalence, the prevalence of cognitive disease among people over 60 years old is 6.04%. After the age of 55, every 5 years old, the risk of cognitive disease will double. Of course, different gender risk is also different. On the whole, the prevalence of women's cognitive disease is 1.65 times that of men.

There are also some risk factors that may increase the risk of recognition of recognition, such as genetic factors, low education levels, decreased hearing, hypertension, obesity, smoking, lack of exercise, lack of social, diabetes, depression, etc.

Cognitive disease can be divided into hundreds of types depending on the cause of the disease. Among them, Alzheimer's disease-type cognitive disease is the most common form, which may account for 60-70%of all cases of cognitive diseases. Therefore, people often mistake the cognitive disease and Alzheimer's disease, but in fact, there are other types of cognitive diseases, such as the other three common types, vascular cognitive diseases The damage is caused), Louis body cognitive disease (caused by abnormal protein agglomeration in neuroplastin), and the mitochia cognitive disease (caused by the lesions of the eardronal temporal lobe). Different types of cognitive diseases are not clear, and mixed types of cognitive diseases often exist at the same time.

Different types of cognitive symptoms are also different in symptoms, but with the progress of the disease, a comprehensive recession of cognitive function and living ability will occur.

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Because in a small cities in the fourth and fifth -tier tier, Zhang Jin's hometown is not rich in medical resources in this area. Although she has consulted the information many times, her family members are not very positive for treatment suggestions.

Worried about the condition of the concubine, Zhang Jin had consulted a medical classmate. She was told that the course of cognitive diseases varies from person to person, and usually ranging from 8-12 years. Because the development of cognitive disease is gradual, people with cognitive diseases will gradually experience early stages, middle stages, and advanced stages, and the performance and care points of each stage will be different. This is obvious in the body.

According to Zhang Jin's mother, as early as a few years ago, some cognitive obstacles appeared, especially forgotten, especially what happened; gradually communication became difficult, and at the same time, it was not possible to use it appropriately. Sentences to express their own meaning; they will also get lost in familiar places, confused time and date, and housework is becoming more and more difficult for messenger. But at this time, the family did not take his uncle to treat it. Zhang Jin learned that if drug treatment was received in the early stage, the development speed of the condition may slow down.

At present, not only can't remember what happened, and daily life behaviors such as dressing and bathing have become difficult. Zhang Jin's mother will buy a large bag of underwear for each time. Incontinence.

Zhang Jin does not know if I can still perceive time and place, or understand what happened around her, but it is clear that sometimes she no longer knows her children. What Zhang Jin and their juniors can do is to buy some foods and objects she likes to eat for her, and have time to help me do some personal hygiene cleaning, although it is like a white paper that has been wrinkled in the years, Zhang Jin hopes to be uncle. Can spend this special time happily.

In some medical magazines and papers, Zhang Jin understands patients with cognitive diseases, and emotional interpretation and interactive exchanges are also important, but neither Zhang Jin and his loved ones know how to do scientifically.

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In the movie "Mom", the protagonist and mother finally lived with her daughter into the pension community.

The scene of many scenes in the movie is in the elderly community of Taikang House. It is understood that the world problem of the care of patients who cannot take care of the severe cognitive diseases who cannot take care of themselves, Taikang House has set up a memory care zone in the community and is introduced. A new service model of "Ten Nursing" for patients with severe cognitive disease.

Namaste Care is a service model founded by Ms. Joyce Simard, an internationally renowned Alzheimer disease expert. Hope, helplessness, and loneliness, etc., can heal the soul through the touch of love and meaningful activities. In addition, the community also "people -centered" care concepts, creating five major special sections of friendly environment, entertainment healing, specialty catering, employee support and family members support, as well as three major non -drug therapies, multi -sensory stimulus therapy, music therapy and nostalgic therapy. , It has given up the feeling of staying in the elderly.

Gong Zengliang, the person in charge of the health care department of Taikang House Medical Care Center, said in an interview with reporters, "Care for people of cognitive diseases should be different at each stage. For the early stages, the focus of care is to retain the reservation Ability and emotional problems; for the mid -term stages, it is mainly to solve the problem of mental and behavioral symptoms; for the later stages, how to enter their world and allow their souls to interact with the outside world. For the early and middle stages of the elderly, we There are many ways; but for the old people in the late stage, how to serve their spirituality is a blank.

"Mom's condition is getting more and more serious. She closed herself in her world. The two of us could not communicate at all, and we couldn't find the intimate feeling of the past ..."

In the Taikang House · Shuyuan Memory Care District, there is an elder who is called "You Mother -in -law". The mother -in -law is 83 years old and has been troubled by cognitive disease for 10 years. According to Ms. Chen, the mother -in -law's daughter, before staying at Taikang's house, the mother -in -law could not communicate with people normally, and completely forgotten the loved ones around them, and could not remember their appearance and name; she couldn't walk autonomously; Close your eyes tightly, hold your hands tightly into a fist, immerse in your own imagination world ...

After contacting Taikang House Memory Care Service, the mother -in -law will come to the care room to accept the ten care every day. Clean, combing massage, hand cleaning, essential oil touch, nail care, taste delicious meals and drinks, touch simulation dolls, feel comfortable rocking chairs, listen to soothing music, etc. Relax. After receiving several nursing nursing, Ms. Chen found that her mother -in -law's hands stretched from tightly to stretching, and her eyes closed from micro to her eyes, and she also gave different feedback on the environment in which she was located. She said, "This method of nursing allows us not only to have physical contact but also emotional communication, so that moms start to let go of the alert, start to feel the outside world, and be willing to vent their feelings."

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But not all patients with cognitive disease are as lucky as the protagonist and mother -in -law in "Mom".

Like Zhang Jinyu, in China, 90%of patients with cognitive disease are actually taken care of by relatives at home. The dilemma of "one person is disabled, the family's imbalance" is appearing in countless families.

The symptoms of cognitive disease can be roughly divided into two categories. One is the core symptoms. Due to the decline in cognitive capabilities caused by the changes in the pathogenesis of the central nervous system, such as memory disorders, directional disorders, calculation disorders, aphasia, etc. The second is the surrounding symptoms, which is caused by the superimposed social environmental factors, which mainly refer to various types of spiritual and behavioral abnormalities, such as: hallucinations, delusions, depression, walking, collection, excitement, violence. Therefore, the treatment of cognitive diseases has two types: drug treatment and non -drug therapy.

Drug therapy is mainly carried out in memory clinics and neurology of professional medical institutions. Related drugs are mainly aimed at the pathogenesis such as Alzheimer's disease and Louis lesions to intervene to try to completely solve its core symptoms.

The treatment of non -drug therapy has effectiveness in alleviating cognitive symptoms and peripheral symptoms, especially peripheral symptoms.

For example, through non -drug therapy and activity, good communication, and environmental support, psychological and emotional support and support of people of cognitive diseases can be given to enhance their sense of security, self -esteem and self -confidence, and reducing the symptoms of mental behavior.

However, in the family, in the face of family chores, it is difficult for the caregivers to do professional care. Therefore, outside of high -end pension communities, how to make more people enjoy the guidance or service of care.

The "Notice of the State Council on Printing and Distributing the Development and Pension Service System Plan for the Development and Pension Service System of the" 14th Five -Year Plan "of the" 14th Five -Year Plan "earlier this year mentioned many measures to pay attention to disability and dementia.

For example, the notification requires the improvement of the service level of public elderly care institutions. Increase the transformation of existing public old -age elderly institutions, improve the ability of disabled elderly care, add the care zone of dementia elderly people, and give priority to the proceeding elderly people to stay on the basis of meeting the needs of policy guarantee objects.

Another example is to promote medical services to the home community. The supporting medical and health institutions with conditions are disabled, chronic diseases, age, disability and other disabled, or the elderly who are inconvenient or difficult to provide home medical services such as family beds and on -site visits. Public medical institutions provide on -site medical services for the elderly, and use "medical service price+on -site service fee" to charge.

At the same time, the notice proposes to support the elderly, disabled, disabled, and disabled elderly families in the regions with conditional regions. Explore the establishment of a child care leave system for the establishment of the only child. Explore the "gasping service" of the elderly caregivers of disabled elderly. Encourage conditions to implement barrier -free and aging renovation of families such as disability, disability, and elderly people such as disabled, disability, and senior people.

In addition, the notice also encourages the establishment of a long -term nursing insurance system, focusing on solving the demand for basic nursing protection for severe disabled personnel. However, in the current pilot, few projects include dementia into the scope.

With the acceleration of the aging process and the decline of the birth rate, the care problems of cognitive diseases and the contradiction between supply and demand will become more obvious. Fortunately, from the national level, this problem is being paid more and more attention and solve.

Shortly after Zhang Jin's visit to his grandmother last time, because his aunt was not at home, he accidentally injured when he was thinking about going out. Fortunately, it was not a big deal.

Nevertheless, Zhang Jin hopes that such stories will not be performed on other cognitive elderly.

(At the request of the interviewee, Zhang Jin is a pseudonym)

Tip

1. What early signals are prompted to have cognitive disease?

Common symptoms of cognitive diseases are the decline in memory, computing ability, learning ability, understanding ability, judgment, language ability, behavior ability, etc. The ten early early alerts announced by the Alzheimer Association of the United States can help us identify the occurrence of cognitive diseases.

1) Memory decline affects daily life. What happened to it immediately forgot to be one of the most common symptoms of Alzheimer's disease, especially in the early days. Other symptoms are also manifested as forgetting important dates or events; repeatedly asking the same information and so on.

2) There are difficulties in planning or solving problems. For example, it is difficult to cook according to a familiar recipe, or it is difficult to deal with monthly bills. It is difficult to concentrate, and spend longer than before to do what familiarity.

3) It is difficult to complete familiar jobs at home, work and leisure. Sometimes, driving to a familiar place, management work plan, or remembering the rules of the favorite game will be difficult.

4) Puzzling time and place. May confuse time, date and season. Sometimes you may forget where you are or how you go to this place.

5) It is difficult to understand the relationship between visual images and space. It is difficult to read and judge the distance and distinguish between color. I can't even recognize myself in the mirror.

6) New difficulties in speaking and writing. I may not know how to continue dialogue, or repeat what I said. Can't find the name of the right word or the wrong thing (for example: the watch is called "the bell on the hand").

7) Put the wrong place and lose the ability to recover. Sometimes it may be accused of stealing. Over time, this phenomenon may occur more frequently.

8) Weaken or poor judgment, for example: difficulties may occur when paying. There may also be problems with personal image and neatness, and it becomes unparalleled.

9) Exit work and social activities and start to give up your hobbies. 10) The changes in emotion and personality become very confused, suspicious, depressed, fear, or anxiety. When working, when you are with friends or strange environments outside the "comfort zone", you will feel disturbing.

2. Can cognitive disease be prevented? How can I prevent cognitive disease?

According to a review article published in the "New England" magazine magazine published in 2020 in Shanghai Huashan Hospital. Essence Therefore, cognitive disease can be prevented to a certain extent.

In terms of scientific lifestyle: through a reasonable diet and proper physical exercise, the BMI (physical quality index) can be reached and maintained within 18.5-24.9kg/㎡, it should not be too fat or too thin; Do brain exercise, such as reading and playing chess; do not smoke; ensure sufficient and good sleep.

In terms of controlling common diseases: Try to avoid and manage high -risk diseases for cognitive diseases, such as diabetes, cerebrovascular diseases, head trauma, weakness, hypertension, depression, atrial fibrillation, anxiety, etc.

Other aspects: In the early years, education should be accepted as much as possible to increase the cognitive reserves of the brain. In fact, learning and education at any stage of life is helpful; in addition, vitamin C can be added; Patients with vitamin B and/or folic acid are used for patients with blood disease.

However, for postmenopausal women, it is not recommended to use estrogen instead of therapy to prevent Alzheimer's disease, and for patients with mild cognitive disorders who have not been diagnosed with cognitive diseases, it is not recommended to use acetylcholine inhibitors to prevent Alzheimer. sick.

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