The thief called Dementia

It started with the little things

She would forget where she kept her keys or her shoes. She would take her bath multiple times forgetting that she had just scrubbed herself clean. Later, it would progress to her suddenly forgetting where she was momentarily and then having to sit down temporarily until her memory returned. When these episodes started happening frequently, she stopped going out alone pretending, instead, that she preferred company. It worried her, this sudden loss of orientation and filled her with panic, but she kept it all to herself and focused instead on intensifying her prayers.

When she began to forget people’s names and faces, she simply smiled in greeting and people imagined that she was engrossed in prayer as she pressed her tasbeeh (prayer beads) hurriedly and moved her lips silently. Her children worried about her new found silence and religiosity but attributed it to old age.

When her eldest son came visiting from Abuja, he found her enjoying a nap, as she was sometimes prone to, during hot afternoons. She had found a cool spot under the shade of the Moringa tree, in her backyard and was asleep on her mat. He tapped her gently and when she woke up, stared at him strangely. She asked who he was. He was shocked.

She stopped recognizing her children and the carefully built façade she put on crumbled away as she became increasingly paranoid and agitated. She accused her children of cheating her of her husband’s inheritance. She insisted on visiting her parents in the village who she claimed were still alive. When she started throwing her precious ceramic, hand painted dishes at people, her relatives decided enough was enough. The best solution they could come up with was to lock her up in her room. A hole was carved in the wooden door and used as a channel through which food was served. The windows were closed and a relative went in once a week to clean her room and bathroom. When neighbours became curious as to her whereabouts, they claimed she had travelled to the city, to visit her children.

I got to hear of her from a colleague with whom I work. She worked as a cleaner in the hospital and felt guilty about the condition of her aunt. It was she, who, when she went in to clean her room found her dishevelled and lying in a pool of urine. The old woman had forgotten her name and who she was. She no longer knew how to use the toilet or how to bathe herself. The cleaner confided in me about the family’s decision to keep her a secret so as to avoid the shame and pity associated  with people whose relatives had a mental illness.

I was at a loss.

The old woman, who was simply referred to as Inna* had been found by dementia, the thief that robs the minds of more than 50 million people worldwide. The disease, so common and yet so cruel comes gradually leaving those tending to the patient, devastated. The relatives refused to bring the patient to the hospital and so together with the cleaner, we hatched a plan.

The cleaner, a middle-aged woman would leave the door slightly ajar when next it was her turn to clean Inna’s room. She would then wait for Inna to come out, agitated, where her step-son (the cleaner’s) and his friends would be waiting, sitting idly in the compound ‘majalisa’ chatting innocently. They were to restrain her and bring her to the hospital claiming that they did not know who she was. She had been locked up for 2 years.

Sometimes, in this profession, one has to be cunning.

The plan worked and she was brought to the hospital and evaluated. In addition to suffering from what was most likely Alzheimer’s disease, she was malnourished and had a urinary tract infection. She was admitted and treatment commenced. The cleaner, together with assistance from the hospital social welfare for indigent patients, helped to cover her bills. Her children were summoned.

They gave a highly fabricated story about Inna’s illness and how they had been to several hospitals yet she had not gotten better. I kept mute as I could not divulge what I knew about the patient and listened to them half-heartedly. My role there was to serve as a health counsellor. I educated them about the dementia, the symptoms and prognosis. I encouraged them to give her the much-needed support and to try and understand her illness and they promised to do better.

When Inna’s condition improved, she was discharged and was seen regularly in the psychiatry clinic. She continued to live in her house with relatives prior to her death. Her door was never locked again. Occasionally, she would wander down the street, lost, but was always returned home by someone familiar. She became fondly known as ‘Inna mai yawo’ until her demise in 2018.