Your loved one who, not so long ago was managing home and work affairs effectively, begins to struggle to remember where he placed the keys or remember regular mealtimes. Such changes are confusing to the affected one and his dear ones. Also sometimes, dementing disorders do not present as memory decline, there may be marked changes in behaviour including irritable mood or uninhibited behaviours. It is unwise to sideline such changes as age-related. There are reversible causes of dementia like anaemia, depression (pseudo dementia), thyroid disorder, build-up of cerebrospinal fluid in the brain etc which can be managed medically. In the irreversible causes of dementia, there are scientifically supported ways through which your loved one may find more comfort.
The elderly population face many losses in day-to-day life – loss of health, loss of a steady income, loss of a loved one, and so on. Such losses may trigger late-onset depression. The patient complains of fatigue, nonspecific aches, and pains, decreased appetite, sleep problems, and feelings of worthlessness. Such a depressive episode needs to be tackled effectively. If left unbreached, this may cause rapid worsening of physical and mental health, suicidal thoughts, and even loss of life. There is also a chance of worsening of depressive symptoms in individuals with pre-existing mood disorders. Depressive symptoms may at times be a forerunner of dementia, so needs detailed evaluation.
Psychosis is a type of psychiatric disorder in which a person may lose touch with reality, he may become preoccupied with certain unreal experiences like hallucinations, or false irrational beliefs. The age of onset of psychosis, schizophrenia, and delusional disorder is usually considered to be below 50 years. But in vulnerable people, certain triggers like the death of a spouse, loss of job, medical illness, and visual and hearing impairment, may precipitate such symptoms in the elderly. Psychosis in the elderly can result in rapid worsening of physical health as well. Sometimes the patient is paranoid that poison is being mixed in food, resulting in refusal of food and medications, thus endangering his life. Psychosis may also be a forerunner of dementia.
As age advances sleep structure changes. Thus old age in itself is a cause of insomnia. However, long-standing insomnia can worsen your cardiac status, blood sugar levels, etc. Certain basic sleep hygiene measures like avoiding daytime naps, and daily exercise can improve the quality of sleep. But even so, if sleep is not better, it would be wise to contact your mental health professional. There are various reasons for insomnia in the elderly like decreasing melatonin and reduced response to certain neurotransmitter systems, certain medications, and systemic conditions of the respiratory system like sleep apnoea, depression /anxiety, etc. Your practitioner can help identify your cause for insomnia and thereby suggest measures to help improve sleep.