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In this journey that we call life, there is but one question that each of us has to answer. It is the question that many of us wrote papers on in high school and many more did their thesis on in college. Some of us even had drill sergeants in the military that answered it for us. It is: “Who am I?”

During a lifetime of searching, we will have a variety of answers. At each bump and snag in our life's journey, we will have a different response to that question.

We take in all that we do, all of what we have seen, all of what we have said and all the people we have encountered. Each person either gives or takes something from our fabric of life and touches what we think of ourselves. All of the people we have loved and all that have loved us will leave us with a piece of them and they will have something of us. Add the fact that how we treat each person along our journey will probably affect us the most. When we get to that age where all we have left are our memories, how will we feel about our journey? Did we do well or did we fall down a lot? Whatever the answer to that last question, we will all become the sum total of what we have experienced.

At some point, our self-esteem and our feelings of self worth will equal the sum total of our memories. Thus, we become what we REMEMBER of our lives!

Imagine how it might feel if you could not remember? Could not recall certain experiences. Had only fragmented memories of your life. Think of the frustration and anger that would grow with only bits and pieces of your past. The anxiety would only terrify us. Why? Because our identity, our self, is lost without those memories.

Loss of memory, whole memories of just segments, is called dementia.

Dementia can be temporary or permanent. It can be caused by accidents, disease or aging.

Medical professionals call dementia a syndrome. A collection of symptoms characterized by the decline in the person's ability to think, socialize and the very competence that we have in doing everyday activities.

There are several different types of dementia that are written about in nearly all neurological (pertaining to the brain and nervous system) textbooks. A very common form is called: Multi-infarct dementia.

Usually this type follows an abrupt change in mental state. The effected individual will exhibit weakness and slow or no movement of one side of their body; be prone to sudden mood changes as well as changes in thinking and understanding. Being unable to understand a simple request or remember what just happened leads to frustration and often depression. One or all of the changes can be transitory, meaning that the person can regain some of what has been lost. However, not everything is regained. Loss, no matter how minimal, will remain and the individual prone to have more episodes unless the underlying causes are controlled.

Multi-infarct dementia is usually caused by small, often called, “mini”, strokes. We have all heard that term. Technically, a small stroke is called a TIA (trans-ischemic accident). These TIAs are a result of small blood vessels in the brain bursting due to increased pressure or fragility of the blood vessel. Once the vessel bursts, brain damage occurs. Diseases like high blood pressure, diabetes, alcoholism and congenital abnormalities of the blood vessel (aneurysms) are the basic culprits.

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The important issue about multi-infarct dementia is that if the causative factor is controlled, the TIAs are controlled, or minimal in occurrence and effect. The doctor must be seen regularly and any changes noted and told to the physician. There are medications and treatments available to decrease the effects of the TIA and control the different diseases. If the doctor does not know all the changes, he cannot treat and the TIAs will continue and brain cell loss will increase.

Brain cell loss occurs with substance abuse. Each episode of drug and or alcohol use will and does kill off areas of the brain. The more use, the more loss. The more brain cells that are destroyed, the more dementia. The name of this dementia is: senile dementia.

The causes of senile dementia are not only related to substance abuse. Other causes include: misuse of medications and poor nutrition. This term is also used in cases of brain aging (known as atrophy), where the individual has a lack of mental stimulation and exercise. We all need stimulation of our thinking processes (memories) and good blood flow to prevent brain cell death by aging. Brain atrophy is when the brain actually shrinks. It can be seen clearly on a CAT scan or MRI. This is slowed by increase in activity and socialization with friends and family. Senile dementia can be slowed or even stopped by remembering our lives and experiences.

Many confuse senile dementia with Alzheimer's Disease. But they are different. Alzheimer's Disease is progressive. It cannot be slowed or stopped. It will progress to death. Unless there is continuing loss with increase in forgetfulness and loss of functioning of the activities of daily living (bathroom, eating, walking, talking) there is not Alzheimer's Disease.

Other diseases can also cause dementia. However, usually the symptoms are unique to that disease, having their own separate behaviors associated with progressive nerve and or muscle death. Parkinson's Disease, cerebral palsy, multiple sclerosis, amyotropic lateral sclerosis (Lou Gehrig's Disease), Huntington's Chorea and a rare inherited disease known as Fredreich's ataxia are some of the diseases that will demonstrate memory loss. All these effect different body systems, giving different symptoms. Dementia can be and usually is seen at some point, normally as an end result of the disease. Making this type of memory loss a senile dementia.

Another dementia is caused by injury to the head and neck. Auto accidents, falls, being struck or thrown and whatever else effects brain circulation or damage will all result in dementia. Again, this type of brain cell loss is a senile dementia. The loss is stopped after the effects of the injury have subsided.

Alzheimer's Disease (AD) is not like, nor caused by the same factors as senile dementia. As was mentioned earlier, AD is progressive, it does not stop. It can be slowed by medication and constant interaction with people and activities like exercising, talking and memory stimulation, but it does not stop growing. By growing. Alzheimer's can only be diagnosed conclusively by autopsy. The nerves stimulating the brain and the blood vessels feeding the brain are changed and tangled and contorted. Some newer MRI testing have been used to diagnose, but are not always accurate.

Can there be a misdiagnosis? Oh, yes. Sometimes it can take years of treatment before the right diagnosis is given and the right treatment provided. For this reason, getting a second opinion, maybe even a third, is advisable.

Parkinson's Disease and Alzheimer's are often misdiagnosed. The best advice would be to watch closely if the medications are working or not. If after three months with any medication, if you do not see a difference, go back to the doctor. There are new medications that will show some result if the diagnosis is correct.

This article is a result of very personal experience with Alzheimer's Disease, Parkinson's Disease and alcohol abuse seen in loved family members.

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The last fifteen years of this writer's life has been involved with the care and treatment of parents, brothers and one aunt. Through this time, mistakes were made with diagnosis, treatment, supposedly a sage doctor's advice and medications. The guilt of not watching closer and not being there more still haunts this writer. And, it is because of that guilt that it is hoped others will learn what NOT to do.

One thing is quite clear; the loss of function and memory is not done by choice. The person did not choose the dementia. Those we love are victims!

Because dementia affects the family and friends as well as the victim, coping requires the REMEMBERING of the good times, before the changes occurred. We must remind those affected of their experiences and of their lives when their own memories have failed. We must spend time with our loved ones, talking, laughing and remembering. Let our loved ones feel good about themselves. Through reminiscing, pictures and just being with them, we give them back their self-esteem, even if it is for just a few hours. You will be glad you did!


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