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Psychological characteristics of the elderly. Where do mental disorders come from in older people?

Hello dear readers! Recently, a client came to me with terrible problems with her already elderly mother. She can not in any way establish communication with her, she constantly swears, criticizes her, age makes itself felt strongly. Today I want to talk with you about what senile aggression is, what to do and how to help your elderly relative. Let's try to figure out where old people get their aggression: is it just a character trait or a manifestation of an illness?

Old age is not a joy

It's great to be young and healthy. Nothing hurts you, your mood and physical condition do not depend on the weather, you easily wake up in the morning, you can easily run a short distance. But with age, problems begin. And the problems begin not only with the physical condition, but also psychological problems.

I bring to your attention some of the symptoms that accompany normal old age, without the manifestation of any serious illness. These manifestations are typical for older people, but do not forget that in some cases they can be a signal that a person is seriously ill, but we will talk about this in more detail later.

Deterioration of short-term memory. Have you noticed how old people constantly lose glasses, forget to take their medicine on time, do not remember what they just heard? In addition, older people often have a narrower range of interests. They begin to confine themselves to a small number of dishes, the wardrobe is getting smaller, the desire to change slowly fades away. Moreover, there may be some negligence in appearance, indifference to hygiene.

With regard to physical indicators, here we are talking about the slowdown of some mental processes. For example, a delayed response to external stimuli such as a car horn or a strong and bad smell. Old people are worse at recognizing colors and sounds. It is difficult for an elderly person to teach something new.

But what is more interesting, in old age, negative character traits begin to manifest themselves strongly. For example, if a person was prudent in money matters and economical during his lifetime, then by old age he may well become like Scrooge Ebaneizer from a Christmas story.

Often, with age, relationships with loved ones begin to deteriorate due to strong resentment. Remember that in old age there are fears of death, loneliness, the feeling that you have been abandoned and no one needs you.

Where does aggression come from?

So, we have already realized that aggression can be a common manifestation of old age. When a person begins to break out all the most unpleasant traits of character.

It is difficult for an elderly person to quickly rebuild, he has his own way of life, he needs less and less, he often argues, insists on his own, does not even agree with the obvious facts, because he is used to thinking and acting in a certain way.

But besides this, aggression can be a symptom of beginning senile insanity, dementia or depression. And it is very important to notice changes in your relative's behavior in time in order to take the necessary measures. Let's analyze each disease separately and see what specific traits are present in every case.

Senile marasmus and dementia are roughly similar in their symptoms. Dementia can begin to manifest with unfounded fears, selfishness, or other behavioral deviations from the usual state. Often these diseases are accompanied by sleep disturbances, increased anxiety, and unreasonable restlessness.

But the most obvious signs of the disease are problems with memory and thinking, a lack of logic in reasoning, a person gets confused in words, spatial disorientation appears and over time the person's very personality begins to be erased. Such old people are very annoying and annoying in communication, their reaction is completely inadequate to the situation.

Senile depression manifests itself in a slightly different way. Here a person is in a depressed, depressed state, but most likely, he will not ask for help, because he does not want to change anything in his routine. Indifference to what is happening, lack of emotional reactions. But at the same time, he has a grudge against everyone and everything around him, against his family, against the state, against the younger generation.

Most often, depression is accompanied by a negative view of everything that happens. Such old people are always grumbling, expressing dissatisfaction with them it is impossible to please. As for the physical condition, the usual pains will be perceived brighter and stronger with depression. In addition, the slightest stress can cause a heart attack, severely disrupt the heart rate, or cause a hypertensive crisis.

How to proceed

In any case, regardless of the symptoms that you noticed in your relative, I strongly recommend that you contact a neurologist who will conduct a full examination, take the necessary tests and tell you exactly about the health of your elderly relative.

It will be good if everything is in order and no serious diseases are revealed. Then you just have to be patient and be as calm as possible next to the person. He needs your support and care, understanding and attention, which is most important in old age.

If it turns out that your old man has signs of a serious illness, the doctor will choose the most appropriate course of treatment and prescribe the necessary medications. Do not self-medicate in any way. Some drugs can only make things worse. For example, valocordin impairs memory and reduces intelligence with prolonged use. Be very careful.

If it is very difficult for you to cope with the constant aggression of your relative, then I recommend that you first read the articles "" and "". Both articles have nothing to do with senile aggression, but they will definitely help you understand how to behave with a person with whom it is very difficult to communicate.

Moreover, do not be lazy and read the book by A. Tolstykh and N.J. Smelzer " The psychology of old age. Reader". Perhaps it will help you better understand your elderly relative, because we have not yet been able to understand what they are really experiencing, how scared they are and why they feel unnecessary.

How does your relative's aggression manifest? What topics are especially difficult for you to talk about? Do you allow yourself to raise your voice and how does this help solve the problem? Have you seen a doctor?

Patience and peace of mind. Remember, you too will sooner or later become an old person.
All the best!

Everyone knows that an elderly person is someone who is no longer young, who begins to grow old. Then irreversible changes occur in the human body. However, graying hair, wrinkles and shortness of breath do not always indicate the onset of old age. But how do you determine the very age when a person can be classified as an elderly person?

Different times - different opinions?

It was once believed that elderly age- this is when a person has passed over 20. We remember many vivid historical examples when young people got married, barely reaching the age of 12-13. By the standards of 20 years old, she was considered an old woman. However, today is not the Middle Ages. A lot has changed.

Later, this figure changed several times and twenty-year-olds began to be considered young. It is this age that symbolizes the beginning independent life, which means prosperity, youth.

Modern views on age

V modern society again everything changes somehow. And today, most of the young people, without hesitation, will rank among the elderly those who have barely crossed the thirty-year mark. Proof of this is the fact that employers are quite wary of job seekers over 35. And what can we say about those who have stepped over 40?

But it would seem that by this age a person acquires a certain self-confidence, life experience, including professional one. At this age, he has a firm position in life, clear goals. This is the age when a person is able to realistically assess his strength and be responsible for his own actions. And suddenly, as the sentence sounds: "Elderly." At what age an individual can be considered an elderly person, we will try to figure it out.

Age milestones

Representatives of the Russian Academy of Medical Sciences say that noticeable changes have recently taken place in determining the biological age of a person. To study such and many other changes occurring to humans, there is the World Health Organization - WHO. So, the classification of a person's age according to WHO says the following:

• in the range from 25 to 44 years - the person is young;
• in the range from 44 to 60 - has average age;
• from 60 to 75 - people are considered elderly people;
• from 75 to 90 - these are already representatives of the old age.

Everyone who is fortunate enough to step over this bar is considered centenarians. Unfortunately, few people live up to 90, let alone 100. The reason for this is various diseases to which a person is susceptible, the ecological situation, as well as living conditions.

So what happens? That old age, according to the WHO classification, has become significantly younger?

What sociological studies show

Middle age crisis. What's his threshold today?

Everyone is well aware of such a concept as And who can answer the question of at what age it occurs more often? Before defining this age, let's understand the concept itself.

A crisis is understood here as a moment when a person begins to rethink values, beliefs, evaluates his life and his actions. Probably, such a period in life comes exactly when a person has past years, experience, mistakes and disappointments behind him. Therefore, this life period is often accompanied by emotional instability, even deep and prolonged depression.

The onset of such a crisis is inevitable; it can last from several months to several years. And its duration depends not only on individual characteristics a person and from his life lived, but also from the profession, the situation in the family and other factors. Many emerge victorious from this collision of life. And then middle age does not give way to aging. But it also happens that old people who have lost interest in life, who have not yet reached 50 years old, come out of this fight.

What the World Health Organization says

As we have already discussed above, old age according to the WHO classification falls in the range from 60 to 75 years. According to the results of sociological studies, representatives of this age category are young at heart and are not at all going to write themselves off as old people. By the way, according to the data of the same studies conducted ten years ago, all those who reached 50 and more years were referred to the elderly. The current classification of age according to WHO shows that these are middle-aged people. And it is quite possible that this category will only grow younger.

Few people in their youth think about what age is considered elderly. And only over the years, crossing one line after another, people understand that at any age "life is just beginning." Only having accumulated a huge life experience, people begin to think about how to prolong their youth. Sometimes it turns into a real fight with age.

Signs of aging

According to WHO, it is characterized by the fact that people experience a decrease in vital activity. What does this mean? Elderly people become sedentary, gain weight chronic diseases, their attentiveness decreases, memory deteriorates.

However, old age according to the WHO classification is not just an age range. Researchers have long come to the conclusion that the aging process occurs in two ways: physiological and psychological.

Physiological aging

With regard to physiological aging, it is most understandable and noticeable to others. Since certain irreversible changes occur with the human body, which are noticeable to him, as well as to those around him. Everything in the body changes. The skin becomes dry and flabby, which leads to the appearance of wrinkles. Bones become brittle and the likelihood of fractures increases. Hair becomes discolored, breaks and falls out frequently. Of course, for people trying to preserve their youth, many of these problems are solvable. There are various cosmetic preparations and procedures that, if used correctly and regularly, can mask visible changes. But these changes will sooner or later become noticeable.

Psychological aging

Psychological aging may not be as noticeable to others, but this is not always the case. Seniors often experience dramatic personality changes. They become inattentive, irritable, get tired quickly. And this often happens precisely because they observe the manifestation of physiological aging. They are unable to influence in the body and because of this they often experience deep emotional drama.

So what age is considered old?

Due to the fact that the body of each person has its own characteristics, similar changes occur in everyone in different ways. And physiological and psychological aging does not always occur simultaneously. Strong-willed people, optimists, are able to accept their age and maintain an active lifestyle, thereby slowing down physiological aging. Therefore, it is sometimes quite difficult to answer the question of what age is considered to be elderly. After all, the number of years lived is not always an indicator of a person's condition.

Often people who monitor their health feel the first changes in their body and try to adapt to them, to reduce their negative manifestation. If you regularly take care of your health, then it is possible to postpone the approach of old age. Therefore, those people who fall into the category of "old age" according to the WHO classification can not always feel that way. Or, on the contrary, those who pass the 65-year mark consider themselves to be ancient old people.

Therefore, it will not be superfluous to once again remember what reads folk wisdom: "A person is as old as he feels himself."

Skin and subcutaneous tissue The skin of older people becomes very thin, especially on the hands, feet, in the area of ​​large joints and in places of bony protrusions. By reducing perspiration and sebum production, loss of elasticity, the skin becomes dry, wrinkled and folded. The amount of subcutaneous fat decreases. Because of this, the skin is easily displaced, becomes flabby. It is easily injured, cracked, torn, ulcerated, and does not heal well. In a lying elderly person, even rough or heavy bedding can injure the skin and lead to the development of pressure sores. For more information on the prevention of pressure ulcers and the dangers of prolonged bed rest, see the "Bed patient" section.

Due to the age-related characteristics of the skin, heat exchange is disturbed, the elderly easily give off heat and therefore they often freeze and chill, need warm clothes, heating the bed. It must be remembered that you can use electric heating pads to heat the bed only if you are sure that old man will not fall asleep next to a heating pad. Otherwise, if involuntary urination occurs during sleep, the heating pad will get wet and this will lead to electrical injury. Elderly people find it difficult to tolerate high temperatures and humidity. On the other hand, in a poorly heated room, especially in combination with low mobility, hypothermia develops even at a positive temperature, which can lead to illness or death of the patient. The optimum indoor temperature should be around 21 ° C. Diaper rash often appears on the skin of older people, especially in places of natural folds (inguinal, axillary, under the mammary glands in women, on the palms - with a prolonged stay of the brushes in a compressed state). Cancer of the skin often develops. Therefore, regular examination of the entire surface of the skin is necessary. Age-related hair changes Hair during life changes under the influence of genetic, immune, hormonal factors and exogenous influences (heat and cold, chemical agents and mechanical trauma, etc.). Atrophic and dystrophic changes occur in hair follicles and hair follicles, hair loses pigment, thinns, becomes brittle. Most often, older women are worried about hirsutism - an increase in the growth of hard facial hair during menopause. This growth is enhanced by attempts to shave, pull out hair. The growth of hair on the head, the skin of the trunk, the pubis, and in the armpits in both sexes decreases with age. The formation of bald patches on the temples, on the crown of the head, baldness (mainly in men) is more often hereditary. In addition to heredity and dermatoses leading to baldness, stress, hormonal disorders, deficiencies of vitamins and microelements, occupational hazards and intoxication are recognized as pathogenetic factors. Sometimes it is necessary to eliminate external causes (systematic negative effects of hydrogen peroxide and chemical dyes, trauma with metal combs, mechanical tension of hair when combing, systematic use of heavy hats, etc.). The experience of geriatricians shows that often elderly patients are very worried about hair loss on the head, become depressed or anxious. In such cases, it should be suggested to use a suitable wig. If you have the opportunity and desire, you can carry out a comprehensive course of treatment. Hair care of an elderly person, their frequent washing, neat combing, haircut, everyday combing create good mood, increase self-esteem, prevent depression. Musculoskeletal system Total amount bone tissue decreases with age. The articular cartilage, including the intervertebral discs, becomes thinner, which leads to the development of pain syndrome, changes in posture, and curvature of the spine. Gymnastics is of great importance for the prevention of such conditions. The elderly are often tortured severe pain in the spine, hip, knee, shoulder joints with any movement. The pain is accompanied by severe deformity and limited mobility. This leads to a decrease in the motor activity of the elderly, his isolation, depression, the desire to stay in bed all the time. Due to osteoporosis - bone loss - bones become fragile. They break easily even with minor bruises. In addition to osteoporosis, the causes of frequent bone fractures in the elderly may be loss of muscle mass as a result of weight loss, as well as joint pathology. The number of muscle tissue, which leads to a weakening of activity and ability to work. The rapid onset of fatigue does not make it possible to do the usual things, to finish the work begun to the end. Exercise not only stops the loss of muscle mass, but also contributes to an increase in strength, even in very elderly people, and an increase in their physical activity. It is known that after persistent physical education for 1-2 months, many elderly people refused canes and walkers. Therefore, physical activity in spite of the pain syndrome, physical exercises with a dosed load help to maintain mobility and physical strength any age. Isometric exercises are indicated for patients with articular pain. The gait is disturbed. She becomes slow, unstable, with a shortened step, shuffling. The period of support on both legs increases. An elderly person turns slowly, awkwardly, at different speeds in different parts of the body. Such gait disturbances often lead to falls, and falls lead to bone fractures. When walking, there must be good support in the form of a strong cane, walkers, handrails along the walls, etc. The soles of boots must be equipped with devices that prevent slipping (plaster, etc.). The floors in rooms, kitchens, corridors, bathrooms and toilets must be dry and non-slip, covered with anti-slip rubber mats. You should not rush the elderly, force them to walk fast, make them nervous about being late somewhere. It must be remembered that, according to scientists, 2/3 of falls in older people can be prevented! Respiratory system The lung tissue of the elderly loses its elasticity. Decreases the mobility of the chest and diaphragm. The lungs cannot fully expand when inhaling. Shortness of breath develops. The bronchial permeability decreases, the drainage "cleansing" function of the bronchi is impaired. Poor ventilation of the lungs contributes to the development of pneumonia. In the elderly, the cough reflex decreases. Due to a decrease in the blood filling of the lungs and hardening of the walls of the alveoli, normal gas exchange is disrupted, as a result of which air oxygen poorly penetrates through the alveoli into the blood, and carbon dioxide from the blood. Hypoxia develops - a condition accompanied by a low oxygen content in the blood, which leads to rapid fatigue, drowsiness. Hypoxia causes sleep disturbances. Therefore, the elderly need to be more often in the fresh air, to do breathing exercises, especially those who have to spend a lot of time in bed or an armchair. The head end of the bed in older adults should be raised to improve pulmonary ventilation and promote deeper breathing. In case of pulmonary diseases, it is necessary to promote in every possible way an increase in physical activity. The doctor should only prescribe bed rest when absolutely necessary. In the treatment should be used, of course, according to the doctor's prescription, expectorants in combination with agents that thin phlegm and drugs that dilate the bronchi. Elderly people with pulmonary disease need therapeutic breathing exercises and massage. If the patient is still in bed, then he should move in it as much as possible, turn, sit down. The cardiovascular system With age, the work of the heart muscle worsens. During physical exertion, the heart poorly supplies the body with blood, tissues are not provided with adequate oxygen, because of this, a person's physical capabilities are significantly reduced, and fatigue quickly sets in. You need to organize regular "breaks" when working with older people, even if they do not ask you to. Their body is poorly prepared for the upcoming physical work, it is poorly worked out and then it is poorly restored. You cannot force them right away, do something quickly, for example, go quickly right away or start dressing quickly. If you feel that you have already rested, this does not mean that an elderly person who was doing physical work with you had time to rest. In addition, as a result of a decrease in the elasticity of blood vessels during physical work, blood pressure rises sharply. Elderly people often complain of shortness of breath, irregular heartbeat when doing physical work or during a night's sleep. If an elderly person is forced to spend a lot of time sitting or standing, he develops swelling of the legs, varicose veins of the lower extremities. In this case, you can use elastic stockings or bandages, periodically (5-10 minutes every 2-3 hours) lie down and raise your legs so that they are higher than the body, while it is very good to make movements reminiscent of twisting the pedals of a bicycle. Blood pressure usually rises with age. It is important to remember that in older people, in sudden situations, such as fear, stress, blood pressure can rise sharply or, conversely, drop sharply. This happens, for example, with orthostatic collapse, when, with a rapid transition from a horizontal position to a vertical position, blood pressure drops sharply, which may be accompanied by loss of consciousness. This happens especially often in patients receiving drugs that lower blood pressure, diuretics, etc. Elderly people should not get up suddenly. It is dangerous to rise and sit up suddenly in bed after a night's sleep or after lying for a long time. This often results in falling from a bed or chair, especially if it is deep. If possible, it is best to help the patient to get up. This should be done slowly, in stages, so that the heart and blood vessels can compensate for the change in position. An elderly person's bed or chair should be comfortable for a slow rise (for more details, see the "Bed" section), since, in most cases, the patient is forced to jerk out of an uncomfortable chair or bed. Digestive system Elderly people often suffer from poor appetite. This may be due to a loss of smell, taste, and a decrease in the amount of saliva and digestive juices secreted. At the same time, nutrients are poorly absorbed. Even with their own teeth, the elderly often have impaired biting and chewing function, and the mechanical processing of food in the mouth worsens. However, older people are more likely to have chewing problems due to poor oral health. As a result, they may refuse to eat and lose weight. More details can be found in the section "Problems" - "Appetite disorders". Check for teeth in your mouth and their condition. Food prepared for the elderly should not be too hard. Little saliva is produced, and therefore the elderly often complain of dry mouth, cracks in the lips and tongue. Due to the small amount of saliva, which has a bactericidal effect, in the oral cavity, especially with poor care and the presence of dentures, under which food particles always remain, putrefactive processes develop rapidly. Elderly people need careful oral care, frequent moistening with water or juice. We must not forget that old people may simply not have money to buy food or have no opportunity to purchase it, if, for example, due to weakness or illness, they cannot leave the house or prepare food for themselves, etc. Elderly people always eat poorly alone and much better in company. It is with difficulty and often reluctance to prepare their own food and at the same time eat well if the food is prepared by someone who is nearby and who, having laid the table, can share the meal with them. Because of age-related changes the elderly often have hernias and diverticula (bulging of the wall) of the esophagus. Food passes through the esophagus "sluggishly", there is a feeling of a lump behind the breastbone, especially when the elderly eats in a horizontal position. Often there is a gastroesophageal reflex - the backflow of food from the stomach into the esophagus, which leads to symptoms such as chest pain, heartburn. To prevent this complication, it is necessary to eat in an upright position in small portions, more often; after eating, stay upright for at least 1 hour. Food should be homogeneous, mushy, not too liquid. The last meal should be taken no later than 3-4 hours before bedtime. The gastric mucosa of the elderly is very easily injured. The risk of developing stomach ulcers is high. Special care must be taken when taking anti-inflammatory drugs that are often prescribed to patients for joint pain, such as aspirin or ibuprofen. Constipation is a big problem. They are explained by a slowdown in intestinal motility, a decrease in the tone of the colon and a violation of the movement of feces along it, a weakening of the muscles of the anterior abdominal wall and pelvis, a sedentary lifestyle, unhealthy diet, concomitant diseases, such as hemorrhoids. For the prevention of constipation, you can advise to lead an active lifestyle, take daily walks, do gymnastics, massage the anterior abdominal wall of the abdomen, consume a sufficient amount of liquid, vegetables and fruits. The pancreas undergoes degenerative changes with age. Diabetes mellitus often develops. To prevent the disease, you should limit the consumption of flour products, sweet and fatty foods, and alcohol. In old age, the liver takes more time for the decomposition of toxic substances and drugs, the production of proteins - albumin decreases, which causes poor wound healing. Urinary system With age, the number of nephrons, the working cells of the kidneys, decreases. Diuresis, i.e. the daily amount of urine decreases (in an 80-90-year-old person, it is only half of the urine output of a young person). Urine is excreted in small amounts, in high concentration. Drugs are poorly excreted from the body, so drug overdose can easily occur. The bladder wall thickens and the elasticity and capacity decrease. The frequency of the urge to urinate increases. Violation of the closure function of the sphincters of the bladder causes urine leakage, i.e., its non-continuation when the bladder is full. Due to the decrease in the functions of the higher nerve centers that control the urinary reflex, older people do not tolerate well when the bladder is full of urine. When the urge to urinate occurs, they feel the need to urinate immediately. With this in mind, when caring for the elderly, it is necessary to reduce the interval between urination, to compel patients to go to the toilet more often, or to use a boat or duck. Vision In the elderly, refractive error occurs, cataracts often develop, which leads to a decrease in visual acuity, especially peripheral. Elderly people poorly fix their gaze on objects, often or do not see at all what is to the side of them. Therefore, when communicating with them, entering a room or approaching from the side, you should somehow attract their attention so as not to frighten. Do not approach a visually impaired person against the light. Knock on the door in advance or let me know that you are nearby, for example, say hello so loudly that he hears you and answers you or gives a sign that he has noticed you. However, do not start a conversation loudly or abruptly when near an elderly person. If the patient wears glasses, then it is necessary to ensure that the lenses of the glasses are clean, not scratched (plastic lenses are especially easy to deteriorate if glasses are often placed on hard surfaces with the lenses down). The glasses must be correctly fitted. It is important to periodically consult an ophthalmologist for older people, as vision loss can occur quite quickly. Glasses should always be close to the patient. The room must be provided good lighting ... It is dangerous to be in the twilight. During the day, you need to open the curtains on the window, in the evening, turn on the lamps on time. Do not unnecessarily rearrange objects in the room without notifying the elderly person about it, otherwise he, not seeing them very well in a new place, will follow his usual route out of habit and stumble or hit. By changing the usual place of the glass with spoons on the dining table, you doom the patient to a fruitless search for a spoon during tea drinking, which will be very unpleasant for him, especially if he understands that everyone is looking at him. When new people or objects appear in the room, they must be described to the patient so that he has the opportunity to imagine them. For example, "Today is a sunny day, I opened the door to the balcony." "I brought you red carnations. They are on the coffee table in your favorite vase." Comment on your next steps: "We need to take medicine. I will now bring a glass of water." "Time for lunch. First we have mushroom soup. We have sour cream with it." It is convenient to explain the arrangement of objects on the table using a comparison with an hour dial: a sugar bowl stands at 12 o'clock, a breadbox with white bread at 3 o'clock, a glass of tea in front of you, at 6 o'clock. When moving together, hold your companion by the hand, preferably the forearm. Tell him what you will meet on the way: "Now we will get off the sidewalk" or "Now we will start climbing the stairs to the second floor." When eating, an elderly person should not have many objects. It is useful to use light contrasts so that you can better see objects, for example, place a dark non-slip support on a light table, a dark plate and a spoon on it. In this color combination, your patient will see everything well. In an elderly person, the eyes adapt poorly and slowly to conditions of insufficient or excessive illumination, especially with a rapid transition from light to darkness and vice versa. Therefore, your ward may not see anything under his feet if he has just looked from the window to the room where he is. When entering from the street into an entrance or into a vehicle, an elderly person becomes extremely vulnerable. He does not clearly distinguish insufficiently consecrated objects, for example, the steps of a staircase, on which a shadow falls. It is advisable that additional lamps be installed in such dangerous places as stairs, corridors, front doors. Stair steps or their edges, thresholds (if it is not possible to remove them completely! ) should be painted in contrasting (light) tones. There are twice as many switches in such places than usual in order to be able to turn on the light at the beginning of its path and turn it off at the end. Hearing If your client wears a hearing aid, make sure that he / she is using it correctly according to the included technical manual; periodically check how the device works, whether it is broken, whether the batteries are dead, or whether earwax has clogged up in the headphones. When talking, make sure that the device is working and turned on. Your interlocutor will be able to understand you better if he focuses on facial expressions, lip movements. Therefore, when talking, it is better to sit so that your faces are on the same level. It is impossible for the interlocutor to look at you against the light. It is necessary to speak not loudly (!), But also not quietly, clearly, distinctly, somewhat slowly, but without exaggerating or emphasizing individual syllables (not chanting!), Accompanying speech with lively facial expressions and a small number of expressive gestures. When talking, try not to turn your face away, look at the floor, or cover your mouth or face with your hands. Firstly, you thereby impair the clarity of sounds, and secondly, people with poor hearing often read lips well. Speak in short phrases, small blocks of meaning; finishing each of them, make sure that the other person heard you correctly. In especially important cases, ask to repeat the meaning of the words you said. If the ward does not understand you, repeat using other words, but in no case raise your voices, do not shout, do not get irritated and do not rush. Elderly people with hearing impairment are better at low tones and worse at high tones; high female and squeaky children's voices are hard to hear. People with hearing impairments are very disturbed by background noise, such as when several people are talking at the same time or when you are talking to them in a room where the TV is on. In this case, a hard-of-hearing person may think that other people speaking with him are whispering, saying something about him that he himself should not know. If they laugh at the same time, then he thinks that they are laughing at him. If a person has difficulty hearing in one ear, then it is necessary to speak from the side of the other ear. If the situation does not allow creating such conditions for your interlocutor to hear you well, write him the necessary information on paper. Be kind to him, make an effort to establish good contact, otherwise, feeling your irritation, he will withdraw into himself. Hearing impairment can be associated with the appearance of earwax plugs, therefore, if you notice that the patient's hearing has deteriorated, it is imperative to conduct a medical examination of the ear canal. If there is a sulfur plug, it is usually washed out with a syringe and a warm furacilin solution. For the best effect of the procedure, it is necessary to instill 1 drop of warm petroleum jelly into the ear for 3 days before that. Instillation of oil can also be used as a means of preventing sulfur plugs, combining it with cleaning the ear with a cotton turunda or special ear sticks. This procedure must be done dexterously, since sulfur can clog into the depths ear canal, to the eardrum, and carefully, because the surface of the ear canal wall is easily injured. In case of hearing impairment, it is necessary to check whether wax has clogged in the opening of the hearing aid, and if so, then it must also be cleaned. Taste In older people, the ability to taste food is significantly impaired due to the age-related decrease in the number of taste buds - the cells that perceive the taste of food. By the age of 70, less than half of such cells remain. Elderly people have a bad taste of sweet, sour, bitter, often oversweetened food. Dentures additionally impair the perception of taste. The taste can not only deteriorate, but also perverted. Often the elderly complain of a bad taste in the mouth, discomfort or a complete lack of any taste at all: "The food is completely tasteless!", "The food is so tasteless and completely bland!" and others. This often leads to refusal to eat, complaints of poor appetite. Therefore, when cooking, it is advisable to use spices, tasty and strong-smelling herbs, etc. It is important to monitor the condition of the oral cavity, be sure to clean dentures, rinse your mouth before and after eating, and clean the surface of the tongue from plaque. Smell The sense of smell also deteriorates with age. Elderly people have difficulty smelling and distinguishing between smells. Due to the lack of smell, food seems tasteless, which leads to a loss of appetite. Another serious problem caused by impaired smell is the risk of poisoning from spoiled food, gas escaping from an open burner in the kitchen. Not feeling the smell of smoke during a fire, an elderly person may not notice the fire in time. Tactile (tactile) sensitivity In older people, the ability to sense objects is impaired. Because of this, they take objects awkwardly, they can easily drop them from their hands and, as a result, get burned and scalded; cause fire and fire. Items that are often used by the elderly, such as dishes, should have large enough handles that are comfortable to grip. The objects must be heavy enough to feel good in the hand. This is especially true for walking sticks. Violation of plantar sensitivity leads to the fact that the elderly person does not feel well the nature of the surface on which his foot steps. This creates an additional fall potential. Boots must be matched exactly to the leg (worn-out shoes are very dangerous!). Age-related deterioration in tactile sensitivity does not mean at all that you do not need to touch the elderly. Vice versa! It turned out that older people really need touch, no less than small children. Touching, stroking, simple shaking hands - all this is very important for inspiration, spiritual support of your ward. Tactile contact can help restore self-confidence, a sense of their own relevance, lack of abandonment in this world. Do not take your hand off when, going up to the bed of an elderly person, you will see how he suddenly, without waiting for your help, he himself grabbed your hand, literally clung to it! Pain sensitivity Older people have a slower response to temperature. This can lead to the fact that, touching a hot saucepan, frying pan or open fire, the elderly person does not immediately withdraw his hand, but only after a while, sufficient for the development of a serious burn. When washing in the bathroom, by touching the temperature of the water, he is not always able to correctly determine it and, immersed in a very hot water may get burned. Therefore, it is important to measure the temperature of the water in the bathroom not by touch, but with a water thermometer. Memory Senile memory also has its own characteristics. In addition to a general decrease in the ability to memorize, there is a characteristic impairment of memory for recent events, as well as intentions and actions associated with the current life. Seniors have difficulty remembering dates, names, phone numbers, appointments. They quickly forget what they saw on TV or read, they cannot remember where they put this or that thing. In such cases, you need to teach them to take notes, put all things in the same places, in no case change the established order or location of objects! This also applies to those caring for the elderly. When cleaning the room, laying out things on the table or in the closet, putting things in order in the kitchen, we must not forget that everything that you have done can be perceived by the elderly as a disaster. Elderly people find it difficult to navigate in a new environment, remember poorly the location of rooms in a new apartment, hospital, orphanage, many times they master new ways of getting around. Therefore, it must be remembered that placing an elderly person in a new environment is always a strong stress for him, which can dramatically worsen his health. It is possible to help such a patient to single out the most important, meaningful for him in the new information for him, and not to overload his memory with unimportant information. Bearing in mind that older people often logically structure material for better memorization, it is necessary to convey information to them in a pre-structured form. It is necessary to ensure that after receiving the instruction, your patient must repeat, as he understood the task. It's good if he repeats the task again in 5-7 minutes. The telephone set, in a conspicuous place, should have a list of the main phone numbers of relatives, neighbors, medical and social organizations that provide this person help, with the obligatory indication of surnames, names, patronymics, positions held by them. On the table, you need to have a list of necessary tasks, for example, for today or for the near future. It is helpful for the patient to have a plan in front of him for the sequence of actions to be taken. For example, in order to take a shower, you need to: 1) prepare fresh linen and a towel; 2) put a rubber mat in the bath; 3) prepare a bathrobe; 4) arrange conveniently soap and a washcloth, etc. It is necessary, especially at first, to monitor the implementation of medical appointments and instructions of a social worker. It must be remembered that in some cases the elderly person really cannot remember something, although he wants to, and in others he simply does not want to remember, because, for example, he is lazy or apathetic, or is depressed. He can also consider - "at the suggestion" of relatives, doctors or at his own discretion - that his memory impairment is associated with age-related characteristics, develops fatally and cannot be corrected. Therefore, it is important to know if the older person has incentives to remember. Against the background of loss of memory for current events, the old people retain and even "revive" the memory of "the deeds of bygone days." It is believed that "going into the past" and memories associated with a period of social activity and significance, increase the self-esteem of an elderly person, allow him to escape from the realization of a sad reality with which he does not want to agree and which he does not want to comprehend. It is possible that an elderly person is often not ready to address such global issues of being as the meaning of a life lived and the realization of what awaits him after death. Dream Older people take longer to fall asleep and reach the deep sleep stage, which is rewarding. The period of superficial sleep, which does not give rest, increases. With such a structure of sleep, there may be complaints such as: "I did not close my eyes all night." If such people are accidentally woken up, they may then not fall asleep for a long time. The frequency of accidental awakenings increases with age, and the total duration of sleep does not change. This often leads to fatigue and apathy. However, we must bear in mind that sleepiness, fatigue and apathy can be associated not only with sleep disturbances, but also with mental disorders (for more details, see the section "Caring for patients with mental illness"). Other factors contribute to sleep disturbance: stress, worries, depression, violation of the daily routine, prolonged bed rest, dehydration, environmental factors. By following simple rules, you can improve your sleep. To do this, you must: always go to bed at the set time (do not fall asleep or doze during the daytime); stay in bed only during sleep (if the patient is in bed, it is necessary to be in a sitting position as much as possible, it is better in a chair, and not in bed); after accidentally waking up, do not leave the bed for more than 20 minutes; limit or completely abandon exciting drinks, especially in the afternoon (tea, coffee, alcohol). It is necessary to know which food products cause excitement in the patient; reduce fluid intake at night; increase daytime activity (exercise, walks, games, classes); organize rest during night sleep, especially in the morning and evening (telephone, alarm clock, voices, etc.); exclude uncontrolled intake of sleeping pills; drink a warm drink at night in a small amount; provide a comfortable mattress (firm and elastic); before going to bed, ventilate the room well, maintain the temperature at 20-21 ° C; take a warm bath or shower. Communication The mental activity of the elderly is declining. They get tired quickly. You need to carefully monitor how your patient behaves and, having discovered the first signs of fatigue, give him the opportunity to rest, "take a breath". The attention of old people is easily distracted by external reasons, and then they lose the thread of the conversation, often forget what was just being discussed. Therefore, it is important to create such conditions when communicating so that nothing distracts them from the conversation. Fast speech with short intervals between words is poorly perceived. You need to speak slowly enough, with breaks between words. You cannot "swallow" the endings of words and say "avidly". The facial expression should be friendly and welcoming. Elderly people have difficulty participating in a group conversation, if several people are talking at the same time, they do not understand the meaning of the ongoing conversations, they do not immediately join the conversation, respond to the question asked ... Therefore, when doctors or social workers tell and advise them something, they cannot immediately remember these recommendations and appointments and from this they begin to worry, get annoyed and, as a result, understand and remember even worse. Attempts to avoid situations requiring intense thinking are characteristic, to replace intellectual efforts with various motor techniques - shaking the head, scratching the back of the head, stretching speech. If an elderly person speaks to you with irritation, in no case do not respond in kind. In a tough conversation, don't think the gross truth is good. Answer gently and try to divert the conversation away from a topic that irritates the older person or makes him feel uncomfortable. Elderly people are very upset if they get sick. Worried, anxious, panicked, depressed. They are afraid that they will not have enough money for treatment, that they will be helpless, dependent on others. Fear increases when admitted to a hospital in which everything is unfamiliar, incomprehensible and appears to be hostile and aggressive. Fear and stress, in turn, impair memory and cognitive (cognitive) functions. The elderly do not adapt well to changes in external conditions, they are not able to remember the daily routine, the location of the premises, the orders of doctors and nurses, and their names. From this they become isolated, withdraw into themselves. In the hospital, it is important to psychologically support the elderly person, not to leave him alone, to remind him more often that he will not be left in a helpless position, to show and explain where the toilet, the cafeteria, etc. are located in the department. Elderly people need encouragement for their actions. It is advisable to more often confirm the correctness of their actions and reward success. "Today you move more confidently with a cane!", "How well you sat on the bed today!" etc. Asking older people about their past is very beneficial for them. Ask the older person to tell about his relatives, childhood, places where he lived in his youth, about his past work, interests. It is very good to consider together old photographs of the places where he was born, lived, worked, especially those in which he is depicted in power, performing socially significant work. It always helps to improve the self-esteem of the older person. However, older people should feel your real interest in the events being told, your desire to experience what he once experienced and felt. If he does not believe your interest, then, most likely, he will withdraw into himself, and you will lose his trust for a long time. Elderly people willingly play games, including simple ones, which we all played in childhood: mosaics, bingo, dominoes, puzzles. If they organize workplace, they willingly sew, weave, knit, cut, paint, etc. They love to play together, with each other, communicate with animals, collect flowers, weave wreaths.

DO offers a behavioral strategy to match the needs of older people with your capabilities.

Five years ago, 40-year-old Vera was afraid of her mother - she was always very strict and sharp on the tongue. However, Vera knew for sure that mom can solve any problem, give an assessment to any person and any situation, always keeping calm and a sound view of things. Mom dressed smartly, regularly visited the beautician and scolded Vera for her "laxity and softness." Now everything is different. Vera is forced to control every mother's step: whether she ate, put on a skirt, turned off the gas, took pills, and hid a cup of tea in the nightstand. In just a few years, an overbearing and intelligent woman has turned into an awkward and ridiculous old woman who can put on a nightgown, beads, a hat and go outside in this form, and she can wander there until midnight. In the end, after another complaint from her neighbors, Vera had to move her mother to her place, because she was afraid to leave her at home alone.

“The most terrible thing,” Vera admits, “was the realization that my mother, whom I had known all my life, was gradually disappearing. She still remembers that I am her daughter, but she is already confused in the events of her and my life ... And I struggle with irritation and shame, which I often feel for her in front of my friends. And I feel terribly guilty for these emotions. " It was especially hard for Vera when her second child was born. She decided to hire a nurse for her mother, but this turned out to be overwhelming for the family budget.

Faith is not alone in facing such problems. Aging parents demand more and more attention, and their children, who already have their own families, are torn between the needs of old and young. According to sociologists, there are now about 30 million elderly people in Russia, and 4.5% of them are over 75 years old. About a third of all elderly people admit that it is often difficult for them to take care of themselves, and 31-40% of those over 80 suffer from dementia (dementia).

Not everyone can afford the services of a permanent nurse today. In Moscow, for example, it will cost 1200-1500 rubles. per day plus travel expenses. The permanent presence of a nurse (work with accommodation) today is at least 17 thousand rubles. per month. Moreover, this market has not yet become civilized, and there is always a danger of fraud on the part of those in whose care the elderly person remains. Another option is a well-maintained nursing home that will provide care. There are still very few of them, but they appear and in terms of comfort are close to Western counterparts. One of the most famous is the Nikolsky Park boarding house, which has been operating in Zelenograd near Moscow for three years already. Beautiful lakeside building, specially equipped rooms, good food and constant medical supervision - all this will cost at least 1900 rubles. per day (when staying in a standard room).

Recently it was reported that the Senior Hotel Group intends to attract investors and build about 25 elite nursing homes in Russia, with the expectation that many will agree to pay 150 euros per day. In many countries Western Europe moving from home in such a boarding house it happens quite often. Elderly people, fearing loneliness and helplessness, sell their homes and move to a place where they will not be lonely and scared. However, even in prosperous England, where nursing homes are quite comfortable, doctors admit that about 8% of old people die in the very first year of their stay in a nursing home - chronic diseases are exacerbated from stress and a sharp change in the situation.

But you can help your parents live a happy old age and without major costs. Many problems of the elderly arise not so much from age, but from the lack of understanding of the surrounding human needs, from inappropriate living conditions, from neglect of his capabilities.

Health and wellness

When arranging the life of an elderly person, first of all, one must bear in mind the characteristics of the organism.

Decreased visual acuity, especially peripheral. Therefore, an elderly person does not fix his gaze well on objects, does not see well what is from the side. Vision can deteriorate quite quickly, so it is very important to consult an optometrist every six months. Twilight is the most unfavorable lighting, so during the day you need to open the curtains on the windows, and when dusk comes, immediately turn on the lamps. Try not to rearrange or move objects unnecessarily in the room where the elderly person lives, otherwise it will be difficult for him to navigate.

Hearing deteriorates, and this greatly affects the overall well-being. The person begins to feel helpless, easily irritated. If necessary, buy a hearing aid and check it periodically to see if it works. During a conversation, do not turn away, do not cover your face with your hands. Hearing impaired people often get used to lip reading. It is better to speak in short phrases, lowering your voice if possible (low tones are perceived more easily than high tones), and in no case shout or rush.

The sense of smell becomes dulled with age, which makes food seem tasteless and insipid to an elderly person. In order to avoid this, you can add spices, deliciously smelling herbs to food. A weakening sense of smell is sometimes dangerous: an elderly person may not notice the smell of gas, not feel smoke, or eat spoiled food. Therefore, it is necessary to install smoke detectors in the apartment, a stove with a blocking system that blocks the flow of gas into the burner when the fire goes out.

Tactile sensations also change, people have a deteriorating ability to small movements - they awkwardly pick up objects, they can drop them, injuring themselves. Try to pick up utensils with comfortable large handles, a comfortable walking stick, and stable shoes for an elderly person. However, older people really need touch - hugs, stroking, shaking hands. Doctors say that tactile contact maintains self-confidence, gives a feeling of need and demand.

A slow reaction to temperature changes, which is typical for old people, is dangerous - a person does not immediately feel a hot frying pan, too hot water in the bathroom, can stand barefoot on an ice floor for a while, etc. Just take care of this in advance, for example, setting mixer with temperature limitation, putting carpet on the floor, purchasing pots with non-heating handles, etc.

As you know, elderly people often get cold because of age-related heat transfer disorders, so they should have warm home clothes and a good blanket. But you need to be extremely careful with electric heating pads and blankets - it is best not to use them in your sleep. The fact is that older people have problems with bladder(by the way, this is why the room where the elder family member lives should be close to the toilet) and in the event of an unexpected "trouble", a short circuit may occur. Insulate the windows, install thermoregulated batteries (the optimum temperature is + 21 ° C), and you will see how a comfortable "climate" means a lot to old people, they become less irritable and grumpy.

Hair loss is very painful for older people, especially women, which often makes them depressed. You can try to improve the situation by changing the hair dye to a more gentle one, and the metal comb to a wooden one. If all else fails, buy an older woman a matching wig. But in any case, frequent washing, brushing, and haircuts increase self-esteem and improve mood.

Mood and mental health

The main fear of an elderly person is denoted by one word - "uselessness." Even with ideal care, people who do not feel involved in society, family, and loved ones fade away very quickly. Hence the conclusion: it is necessary to involve a person as actively as possible in everyday family affairs, to keep him performing simple duties as long as possible. This is important both for maintaining mobility and for mental balance. At the same time, the elderly quickly get tired, easily lose the thread of the conversation, forget what was discussed. Therefore, if you turn off the TV or stereo during a conversation with them, mutual understanding will improve. The older a person is, the more difficult it is for him to be in a large society: he gets lost, the sounds merge into a uniform hum, against the background of which it is difficult for him to grasp the meaning of the conversation. Therefore, the arrival of several people at once can be a disaster for the elderly. Talk face to face - you can help the old person feel much calmer.

Forgetfulness in the elderly is becoming a real problem. Very often it becomes the first symptom of dementia (dementia). You can slow down this process if you understand the mechanism of short-term memory lapses: a person perfectly remembers his wedding day, describes in detail the birth of his first child or the end of the war, but cannot give a confident answer whether he had breakfast today. Experts say that memory is like a fenced-off section of a field in which there is a gate. The information that passed through the gate remains in place, but the gate closes - and nothing else can get inside. Therefore, do not scold the elderly person. Say, “You already had breakfast today,” but don't add, “Don't you remember?” By doing this, you can upset him all day.

When the disease gets worse, explanatory signs attached to objects, appliances and room doors will help. If a person begins to confuse the days of the week, months and dates, a tear-off calendar, photographs of relatives and friends with large signatures, hung on the walls, will help. Try not to change the habitual stop - even changing the bedspread on the bed can confuse the old person, he will not know where to sleep.

Irritability and moodiness can have many reasons, from uncomfortable clothing to feeling addicted. Try to give the older person more independence, independence, if at the same time he does not harm himself. The less he decides and does for himself, the faster dementia will progress. Encourage intellectual activity - crosswords, board games, reading newspapers and books, helping grandchildren with lessons.

Security

If an elderly person is left alone for a long time

Hang a sheet on the wall with the necessary phone numbers - relatives, neighbors, the clinic's registry, local social organization (with the names of social workers, if they are helping).

Take the time to meet in person with social workers - it is better to know them by sight.

If you know that an elderly person is hiding important papers and money in "hiding places", talk to him, ask him to show you these places and explain that in an emergency every minute spent looking for documents is precious.

Have copies of your pension certificate, savings book, certificate of ownership of housing, etc.

“To help an elderly person. Allowance for the elderly, as well as for those who care for them "K. G. Efremova, S. A. Anufriev and others.

"Make Your Home Comfortable When Age Fails" D. Caston

"If your loved one suffers from mental illness" R. Woolis

"Practical Psychology of Old Age" M. Ermolaev

What you need to know about benefits, discounts and compensation

In addition to official benefits for pensioners and disabled people (this information can always be found on the website of the Ministry of Social and Health Development: www.minzdravsoc.ru), many commercial organizations enable older people to receive services cheaper.

For example, in the capital's baths, one day a week, pensioners are given a 50% discount.

Almost all modern cinemas have introduced into their practice to sell tickets for daytime and morning screenings on weekdays, cheap tickets for pensioners (from 50 to 100 rubles).

Few people know: from July 1, 2008, those who take care of the elderly who need care on the basis of a doctor's opinion, a disabled person of group I, or who have reached 80 years of age, are entitled to compensation in the amount of 1200 rubles.

Useful things

	SPYTEL security system with several functions: "Panic button" (call for help), "Bebiphone" (you can hear everything that happens in the room in real time) and an alarm that monitors the apartment using sensors in the absence of the owners. Price - from 13,000 rubles.
	The HiTech Medical Box electronic medicine box will remind you that it is time to take a pill. The required tablets are put into each compartment, and a timer program is set. The device will signal that it is time to take the medicine. Price - from 300 rubles.
	The HotStop water temperature limiter in the shower or tap mixer will prevent accidental scalding. Most manufacturers have the limiter set to the most comfortable temperature of + 38 ° C, but there are also models with individual settings. Price - from 1000 rubles.
	The bath mat is attached to the bottom of the bath with suction cups, so it does not slip. Many notches are applied to its surface, thanks to which a person feels more stable. Price - from 200 rubles.

In touch

The Internet is a real boon for an elderly person. On the one hand, mastering and working with a computer supports thinking and trains the brain. On the other hand, the Internet allows you to receive information on any topic and, thirdly, makes up for the lack of communication. In the Netherlands, people over 50 make up a quarter of all Internet users, and in Israel, 45%. A sufficient number of resources have already been created on the Russian-language Web, specially designed for users of "50+".

Here is some of them:

www.pensioner.vollar.ru Virtual school for inexperienced Internet users. Helps you navigate the Web and pick up information on hobbies: books, gardening, travel, etc.

www.seniorinfo.ru Collection of useful links, documents, coordinates of social organizations.

www.seniorschool.spb.ru "School of the Third Age" - a virtual part of the St. Petersburg club of the same name.

www.sta-net.ru - site under the motto "The Best Half of Life". Articles, advice, useful documents and links.

www.3vozrast.ru - acquaintances, articles, search for joint hobbies.

www.eons.com is one of the world's largest sites for older people. Suitable for those who know English, German, French.

Alzheimer's disease: how to live with it

This insidious and so far incurable disease affects mainly the elderly - after 65 years, the likelihood of contracting it doubles. The disease is based on the gradual destruction of the cells and tissues of the brain, especially those parts of it that are responsible for memory and thinking. The disease, as a rule, lasts 5-10 years: gradually a person loses memory, abstract thinking, mathematical abilities, there is a disintegration of the personality as a whole, ceases to move and speak clearly, does not recognize loved ones and cannot serve oneself. Today, Alzheimer's disease is well learned to identify and with the help of drugs to mitigate its manifestations, to alleviate the condition of both the patient and his family. But it is very important to recognize the first symptoms in time, distinguishing them from simple senile forgetfulness, and take the person to a doctor.

Symptoms:

Difficulty finding words in a conversation;

Deterioration of short-term memory;

Serious difficulties in making independent decisions;

A person is easily lost, especially in an unusual setting;

Time disorientation;

Initiative and motivation to act, indifference and isolation are lost;

Difficulty doing complex household chores (such as cooking)

Interest in their hobbies and other previously favorite activities disappears. Gradually, as the disease progresses, forgetfulness increases sharply, a person becomes helpless, cannot serve himself on his own and ceases to understand that he is sick. There are tendencies to vagrancy (he constantly rushes out of the house), sometimes - visual hallucinations. At a later stage, the patient ceases to recognize loved ones, cannot move, speak and understand speech.

How to arrange life if there is a sick person next to you?

1. Establish a daily routine in which there are usual activities, thereby saving the patient from making decisions.

2. Give the opportunity to do what you love: work in the country, carpentry, knitting, etc. Any physical activity can slow down the manifestations of the disease.

3. Not to draw the attention of the patient to his failures - this leads to stress for himself and, as a result, to even greater problems.

4. Ensure safety in the house: remove stabbing and cutting objects, household poisons and medicines, turn off the gas, install locks on the windows, etc.

5. Do not change the usual arrangement of things in the house where the patient lives: do not rearrange furniture, leave free passages, do not move things that he uses.

6. Maintain communication with the patient, try to speak clearly, slowly, looking into the eyes. Listen to him, even if the stories seem ridiculous. Treat with respect, maintain self-esteem in the patient.

7. Avoid clothing with complex fasteners, small buttons, preferring elastic bands, Velcro, zippers. Do not rush the patient when dressing, give the opportunity to dress yourself.

8. Try to cut food into small pieces, as in the later stages of the disease it can be difficult for a person to chew and swallow normally.

9. If the patient often loses things or accuses others of stealing, look for places where he can hide things. Keep on hand duplicate keys, glasses. Hide the originals of documents: passports, pension certificates, property documents. Check trash bins before throwing out trash.

10. If a person leaves home, he may get lost and even go to another city. Make sure that there is always a note in your clothing pockets with the address and phone number of your relatives. Have a recent photograph of the sick person with you to make it easier to find them. Try to attach unbreakable mirrors to all doors; your own reflection in the mirror can distract you from the intention to open the door.

11. Try to remain calm, not to respond with aggression to the aggressive behavior of the patient. Try to trace what triggers his outbursts of anger, switch your attention to other, calmer things.

12. Do not reject the help of family members, do not shoulder the entire burden of leaving. Leave time for yourself and get rid of guilt if you go to the movies, to a restaurant, or to your friends. Don't beat yourself up - Alzheimer's disease affects people regardless of social status, education, or skin color.

By the way, in many hairdressing salons there are discounts for the elderly - ask about this in the salons closest to your home. In the capital, a decree of the Moscow Government provides for social assistance to the elderly living alone - in addition to cleaning the apartment, changing the linen and nursing services, there are shampooing, cutting and hair styling. If the pensioner's income is less than 150% of the official living wage, these services are provided free of charge, you just need to write an application to social services.

“Eh, there’s no memory at all ... Where did I put the damn glasses - they were just at hand… I’ve been looking for an hour!” - the upset old woman laments.

“Is it her memory problem ?! Yes, she can tell for hours and in all details how she went to the first grade - and that was, mind you, at the end of the 30s, ”her grandchildren are perplexed.

Yes, these are the seemingly mutually exclusive initial symptoms of dementia in the elderly: short-term memory weakens day by day, but memories from childhood and adolescence are striking in their accuracy and detail. Over time, disorders of memory, intelligence and personality become deeper, until the person fades away completely.

However, after age 70, the likelihood of the onset of dementia increases significantly: psychiatrists and neurologists say that signs of dementia are found in about five percent of aging people of this age. Among those who are fortunate enough to live up to 90 years and more, dementy old people are a third.

Alzheimer's or atherosclerosis: why the brain suffers

Why do some people live to a ripe old age in a clear mind and firm memory, while in others, by the time they are seventy, signs of mental destruction are clearly traced? Doctors point out the two most common causes of mental deterioration up to complete dementia - Alzheimer's disease and the real scourge of our time - cerebral atherosclerosis.

What happens to people with these diseases? There are usually two scenarios - rapid and steady progression, ending in death in 5-8 years, or a slowly current process that stretches over many years.

Alzheimer's disease: fast and hopeless

More than half of cases of senile dementia are a consequence of this particular disease. With it, the frontal and parietal lobes of the cerebral cortex atrophy, pronounced changes occur in the ganglia of the subcortex.

The frontal lobes are responsible for a person's ability to act independently and critically assess actions, behavior, emotions. The parietals control praxis - a lot of useful skills that we usually use when writing, reading, counting, performing the usual everyday and professional activities. Also, the parietal lobes are responsible for visual perception and processing of visual information, orientation in space.

With age, the cerebral cortex gradually thinns physiologically, but Alzheimer's disease accelerates this process. That is why people with dementia with such a diagnosis lose their memory much faster and become completely helpless in everyday life than, for example, those who suffer from cerebral atherosclerosis in a non-stroke form.

Cerebral atherosclerosis: how the card will fall

Vascular diseases also have an effect on the development of dementia. The first violin here is cerebral atherosclerosis - the formation of dense fatty plaques on the walls of the arteries of the brain. Blood circulates worse through narrowed vessels - the brain is starving, which is why older people often complain of headaches, drowsiness, become depressed, lethargic, and capricious.

An elderly person with normal blood pressure is incredibly lucky: most of his peers have long been diagnosed with hypertension. At some point, worn-out vessels cannot withstand the pressure of blood and burst - a stroke develops. If it does not kill immediately, then in the future it becomes the cause of the onset of irreversible and progressive changes in the psyche - vascular dementia.

Those who still manage to avoid vascular accidents suffer from dementia much less. Atrophic processes in the cerebral cortex go very slowly - and so much so that these people often do not even have time to live to the stage of gross changes in the psyche. They die of age or some kind of somatic illness, remaining in the memory of their relatives as vigorous, adequate grandmothers or strong grandfathers completely in their minds.

Dement hell: in the first circle

Taking pity on us, their adult children and grandchildren, elderly parents try to hide their bad health, save on medicines. However, it is enough to observe their behavior, daily routine, changes in habits to sense something amiss.

Should alert:

• Short-term memory problems: old people who develop dementia often lose things, forget where they were put, but remember many events from childhood, adolescence and youth for sure
• Nighttime sleeplessness and daytime sleepiness
• Not quite firm gait
• Loss of interest in old hobbies, when yesterday's lover of needlework no longer even touches the knitting needles and hoops, and the fishing rods of an inveterate fisherman gather dust in the pantry all season
• Character changes in the worst side: nervousness, grumpiness, obsession with endless teachings, suspiciousness

At the very beginning, dementy old people do not yet need constant monitoring. They cope with household chores, take care of themselves, are able to make purchases, although their mental counting skills are already noticeably affected.

They are also aware of what is happening to them. Their main complaint is forgetfulness, otherwise they feel quite tolerable and continue to lead an active lifestyle enough for their age.

In the second circle: getting worse and worse

Symptoms for Alzheimer's disease and cerebral sclerosis differ in a certain way.

Progressive Alzheimer's disease is characterized by a whole complex of mental disorders with a relatively intact somatic state:

• Gross memory impairment
• A sharp decline in intellectual abilities
• Pathological increase in drives
• Obvious violations in speech and writing, mathematical actions
• Episodes of delirium and confabulations - fictional memories
• Increasing household helplessness
• Passivity, drowsiness during the day and increased activity in the evening with the collection of knots "on the way home"

Alzheimer's disease in progress: a portrait of a typical patient

From the outside, dementia patients with Alzheimer's disease look something like this: elderly woman does not remember her name, how old she is, and when trying to remember she calls her maiden name and age, which is much lower than the actual one, sometimes even for children. By the way, a gradual fall into childhood is an almost indispensable attribute of the height of the disease.

The old memory continues to play evil jokes on the poor woman: she does not remember whether she has children, considering sons and daughters to be sisters and brothers, or even completely strangers. Further - more: quite real memories from childhood are replaced by confabulations - fictional memories that are perceived by the old woman as real facts from her past life... Even delirium is possible - constant statements that someone wants to kill her, rob her.

The patient's speech becomes slurred: she often repeats the same syllables in words, has difficulty understanding the statements addressed to her, has difficulty writing simple words and suggestions. In monologues and dialogues, attention is drawn to the viscosity, excessive detail, because of which the woman quickly loses the thread of the conversation. The ability to count is completely lost.

The old woman suddenly becomes unusually gluttonous - she simply forgets that she has just eaten. Sometimes people caring for dementia patients observe a form of embarrassment: their wards suddenly wake up with a strong sexual desire, which they strive to realize at all costs, plunging into confusion and shame those at whom it is directed.

Towards nightfall, the dozing grandmother begins to show activity all day: she moves furniture, wanders around the rooms, collecting things and tying them into knots. When asked why she is doing this, she usually answers: "It's time to go home, I'm staying with you!" And she leaves if you accidentally leave her unattended: notice boards near the police and reports in the media about the disappearance of old people are evidence of this.

She is becoming more and more like a helpless child - it is simply dangerous to leave her alone: ​​the grandmother does not remember how to handle the gas stove and electricity. It is necessary not only to prepare food for her, but also to make sure that she eats, and then wash the dishes.

Often it is almost necessary to force a once very clean woman to wash, change clothes and comb her hair: the skills of self-care have also been lost. It is difficult for her to dress - she does not remember the sequence of actions, cannot assess the weather outside in order to choose the right clothes.

Portrait of a demential patient with cerebral sclerosis

The course of vascular dementia in atherosclerosis, not complicated by hypertensive crises and vascular catastrophes, at the stage of progress is characterized by a gradual increase in the symptoms of the initial stage.

Observing dementia "sclerosis", it can be noted:

• More memory loss
• Excessive sentimentality - violent reactions with tears to what he saw and heard
• Militant conservatism is a complete and aggressive rejection of anything new. Try to persuade your grandparents to make repairs or change furniture in their apartment!
• Obsessive caring or, conversely, selfishness
• Attacks of hypochondria - searching for new diseases in oneself
• A tendency to get bogged down in narrative details

This may be a little annoying for those who took on the responsibility of caring for a sick old man, but on the whole the situation is quite bearable, although it also makes them watch the ward more closely and take on a significant part of household chores.

The situation is much worse with those who suffer from hypertension and have already suffered a stroke. To the above symptoms, they add delusional psychoses and true hallucinations - auditory, visual and tactile, epileptic seizures. The course of the disease is aggravated by neurological and cardiological symptoms - headaches, dizziness, heart rhythm interruptions, pressure surges - on their background psychotic reactions most often occur.

In the third circle: the tragedy of the apotheosis

Immersion in a semi-vegetative state - this is how you can briefly describe the last stage of senile dementia in Alzheimer's disease and vascular dementia caused by atherosclerosis.

At the end of life, elderly people with dementia do not at all realize who they are, where they are, lose the ability to communicate, express their thoughts and even complaints, and stop moving independently.

The sight of a deeply feeble-minded old man is terrible and pathetic:

• A state of stupor - a person can lie for days, looking at the ceiling and not reacting to anything
• Complete loss of control of physiological needs
• Great emaciation with extraordinary gluttony.
• Extreme physical and mental exhaustion

Grabbing and swallowing what is possible is the main thing that remains of the habits of feeble-minded old people: if you give such a sick person food or some thing, he literally grabs it with a death grip. If you put food in his mouth, he will chew it and swallow it, although before that he was completely indifferent. It seems that food is the only thing that deeply dementy old people do not refuse to the last.

The final stage of senile dementia lasts for a relatively short time - from several months to a year. The only thing that can be done for the unfortunate is to provide them with special care and maintenance in warmth, cleanliness and satiety, and to prepare for the inevitable.