【Society 37 degrees】

  Editor's note:

  There is no flashiness, no empty talk, no "title party" here. In the age of information bombardment, we only hope to quietly record the stories around us, pay attention to the warm and cold life, and bring you to touch the body temperature of society.

  Chinanews client, Beijing, August 7th, title: Alzheimer's disease patient family: disease takes away more than memory

  Reporter Zhang Ni

  I forgot where I am, what I want to do, and I don’t have the directional ability of time and space... Recently, in the variety show "Forget the Restaurant (Second Season)", several elderly people with Alzheimer’s disease were stabbed Less "tears" from netizens.

  At present, there are about 10 million patients with Alzheimer's disease in China. Behind the huge number is the plight of individual families and the huge cost of social care.

  When our loved ones are "forgetting" the world, what we can do is not to ignore, misunderstand or even forget them.

Data map: In a specialized hospital that treats patients with Alzheimer's disease, an elderly patient is basking in the sun in a wheelchair. Photo by Cui Nan issued by China News Agency

Illness and taking away are not just memories

  Going downstairs at 6:30 in the morning, riding on an electric three-wheeler with his wife to take a lap. This is the daily routine of 80-year-old Chen Zhanqing.

  Every morning, the old couple would first go to the breakfast shop near the community to buy buns and soy milk, and then cycle around the community. During this period, Lao Chen will tirelessly chatter with his wife sitting in the back seat: This is the breakfast shop where we used to be, and the vegetable market across the road has just been remodeled... The wife sitting in the back seat is always smiling. nod.

  His wife Zhao Qiurong's manager Chen Zhanqing called "Little Chen'er" because Chen Zhanqing was two years younger than her. Another reason was that she suffered from Alzheimer's and her memory seemed to be "frozen" at a young age.

  Three years ago, Zhao Qiurong accidentally fell and caused a broken arm. After a period of hospitalization, his injury gradually improved. However, Chen Zhanqing discovered that since then, there has been a problem with his wife’s memory, always forgetting things, sometimes Even seeing acquaintances is a little overwhelming. At first, he thought it was his wife who was frightened by the fall, until she even remembered the house number incorrectly, and Chen Zhanqing felt that the problem was not that simple.

  After the hospital's diagnosis, it was confirmed that his wife had Alzheimer's disease, which is commonly known as Alzheimer's disease.

  Chen Zhanqing couldn't accept this fact for a long time, he couldn't figure out the reason. Later, after his daughter explained to him, he probably understood that his wife's illness was caused by "lesions" in his brain.

  Alzheimer's disease is the most common type of cognitive impairment in the elderly. The "lesions" referred to by Chen Zhanqing can be described in a more professional way as a degenerative disease of the central nervous system. With the development of the disease, the patient's brain nerves The metabolites are continuously damaged, leading to the decline and decline of cognitive functions including thinking, learning, and memory, until they enter dementia.

  In addition to "stealing" people's memories, it will also gradually reduce the patient's ability to take care of themselves in life. Serious patients will also have abnormal behaviors and require 24-hour care by a dedicated person.

  As of now, there is no cure for Alzheimer's disease. The number of elderly people like Zhao Qiurong in China is huge. Statistics show that China has about 10 million people suffering from dementia, including Alzheimer’s disease. It is the country with the largest number of patients in the world, and more than 300,000 new people are affected every year. The number of cases is increasing rapidly.

  "She can't remember which building she lives in anymore. When people ask her who she is looking for, she will only tell them to look for'Little Chen'er." Chen Zhanqing said that in the past two years, Zhao Qiurong's memory decline has become more obvious, and now it is difficult. Go out alone.

Data map: An old man walks with his wife suffering from Alzheimer's, and examines the writing on her wall. Photo by China News Agency reporter Yang Kejia

Caring for "baggage", the most realistic dilemma

  For many families of patients with Alzheimer's disease, they are not only suffering from a mental shock, but also facing a more realistic burden of care.

  At the beginning of this year, the first domestic "Survey Report on Family Living Conditions of Alzheimer's Disease Patients" was released. The survey shows that over 80% of caregivers have to keep caring for patients, and over 60% of caregivers have great psychological pressure. Insufficient care capacity, lack of care resources, and single treatment services have become the three major dilemmas faced by patients' families.

  "Not all nursing homes can accept such elderly people, and not all families have the ability to send them to such institutions." Li Meng, who also has dementia patients at home, expressed his frustration in an interview with reporters.

  Li Meng's grandfather is a 90-year-old man who has been sick for many years. In recent years, the focus of their family's lives has revolved around how to take good care of this old man who has gradually forgotten them and behaved abnormally.

  Can the elderly be sent to nursing homes? The family had discussed this issue, but the high cost and the acceptance threshold of the nursing home made them give up this idea.

  “Good nursing care institutions charge almost twice as much for elderly people with dementia as ordinary elderly people. Even nursing homes in remote areas are several thousand larger, and the other party has to assess the elderly before they can determine whether they will charge them.”

  Chen Zhanqing is 80 years old. In the past two years, he has become more and more strenuous to take care of his wife. A year ago, he had looked for a babysitter, but the babysitter did not persist for a few months and left because he could not stand Zhao Qiurong's weird behavior. He had to take on all the work of caring for his wife once again.

  "Sometimes she would suddenly get up at night to toss at home, and always feel that there is a stranger in the house, and the temper is bad, and outsiders can't bear it." Chen Zhanqing is too old, often feels physically weak, sometimes even unable to support his wife boarding. But even so, he still has to grit his teeth and insist. He doesn't want, can't bear, and doesn't want to throw the "baggage" of caring for his wife to his children. Because he understands that this burden is too heavy.

  In 2018, Jia Jianping, director of the Department of Neurology of Beijing Xuanwu Hospital, and his team published a paper "Reassessment of the burden of Alzheimer’s disease in China and worldwide". The article pointed out that the annual per capita cost of Alzheimer’s disease in China in 2015 It is RMB 130,000.

  Projecting the annual expenditure of more than 100,000 to tens of millions of sick families, Alzheimer's disease is not only a complex health problem, but also a difficult social problem.

Photo by Yang Kejia

Decline in cognitive function is just "old silly"?

  Early diagnosis, early intervention, and early treatment are the unanimous recommendations of the medical community for Alzheimer's disease. The reality is that in Chinese society, Alzheimer's disease is facing the embarrassment of the "three lows": low awareness and treatment rate Low, the proportion of receiving treatment is even lower.

  "Some people think that'old confusion' is a natural phenomenon. This is a misunderstanding." said Sun Yongan, chief physician of the Department of Neurology, Peking University First Hospital.

  As experts say, in the eyes of ordinary people, "old muddled" is a natural phenomenon, and it is this kind of misunderstanding that often delays patients' medical treatment and treatment.

  In August 2019, Jia Jianping’s team published a review in The Lancet Neurology, which focused on Alzheimer’s disease, and discussed the current status of diagnosis and treatment of dementia in China. Data showed that nearly 70%-80% of dementias in China The patient did not receive treatment.

  Li Meng said that she could not recall when her grandpa started showing symptoms. By the time she went to the hospital, her condition had progressed very quickly, and until now, the elders in the family did not think it was necessary to take grandpa to the hospital, as long as she was at home. Look good on him."

  "Looking back now, maybe when my grandma passed away more than ten years ago, some changes occurred in him, but at that time no one would have thought that'forgetting things' would go to the hospital for an examination." Li Meng said.

  There is a set of worrying figures in the "Survey Report on Family Living Conditions of Alzheimer's Disease Patients": 41.91% of family members believe that memory decline is a natural aging process of the elderly, and treatment is not necessary, 12.31% believe that there is no effective treatment, and 15.39% of patients’ families do not know where to go for help.

Data map: In a charity event, the staff distributed anti-lost bracelets for the elderly. Photo by Chen Chao

How to retain the sense of life that is being lost?

  In 2019, the International Alzheimer's Association estimates that more than 50 million people worldwide suffer from dementia, and this number will increase to 152 million by 2050. Every 3 seconds, a person develops dementia.

  To prevent this set of worryingly fast numbers, people's awareness, medical intervention, and social cooperation are all urgent problems to be solved.

  In the opinion of many experts, at present, early identification and early intervention of cognitive decline is the most effective way to delay Alzheimer's disease.

  In September 2019, the National Health Commission released the "Alzheimer's Disease Prevention and Intervention Core Information", which clearly stated that patients and their families should be aware of the early signs of the disease and actively prevent and intervene. The signs mentioned here include: often forgetting what has just happened; it becomes difficult to complete previously familiar tasks; it becomes confused about the time and place of the place; it becomes difficult to speak, talk, write and read; the original extrovert personality becomes unsocial, Lost interest in things you liked in the past; changes in personality or behavior, etc.

  In terms of treatment, the treatment of Alzheimer's disease includes drug therapy and non-drug therapy. "At present, drugs cannot cure Alzheimer's disease, but taking drugs can effectively help delay the progress of the disease and greatly improve the quality of life of patients. The earlier diagnosis and treatment, the better the effect." Sun Yongan said.

  Basic medications and non-drug treatments for dementia are included in the scope of medical insurance reimbursement, long-term care insurance systems have been tested in many places, and China’s first innovative Alzheimer’s drug has been launched...In recent years, more and more positive signs have emerged. For families like Chen Zhanqing and Li Meng, the hopes gathered together still support them.

  Since her wife became ill, Chen Zhanqing has always liked to take her to walk the places where she had been together. The doctor said this can help delay the development of the disease. He still walked on the road holding her hand as he did when he was young.

  "We are all this age, and we don't think about how long this kind of life will last. We just hope to make my wife happy right now." Chen Zhanqing said. (At the request of the interviewee, Li Meng, Zhao Qiurong, and Chen Zhanqing are aliases in the text) (End)