Doctors Urge Systemic Support for Alzheimer's Care

 Hyderabad: On most mornings, 92-year-old Shankarappa insists on going to work. He asks his son to ready his files, leaning heavily on his walker. He believes his long-lost friends are still waiting for him. At times, he is absorbed in phone conversations, even though no one is on the other end. On other days, he asks to return to the old family home he built with his own hands—sold years ago.

For his son Mallesh, a medical professional, these moments are both painful and strangely beautiful. “Living with my father has been deeply emotional and enlightening,” he said. “Though he struggles with the present, he recalls the past with astonishing clarity—land measurements from decades ago, the names of old associates, stories from his farming years. It feels as though the past is alive for him, while the present slips away.”

This sharp divide between vivid long-term memory and fragile short-term recall is one of the hallmarks of Alzheimer’s disease, the most common neurodegenerative disorder in the elderly—what Shankarappa is now living with.

“Alzheimer’s usually begins after 60, but often goes unnoticed because families assume memory loss is a normal part of ageing,” explained Dr M. Jayasree, consultant neurologist. The disease, linked to amyloid deposits in the brain, can also have genetic roots.

Early signs are subtle: misplacing belongings or forgetting the way back home. Over time, the decline accelerates. Patients may become aggressive, anxious or lose sense of night and day. “Families often misinterpret these behaviours as mere attention-seeking,” Dr Jayasree said.

Not all memory loss signals Alzheimer’s, she added. Vitamin deficiencies, thyroid imbalance or low sodium can also impair memory. Doctors rely on blood tests and MRI scans to rule these out before confirming the diagnosis.

Dr Dharshitha Varigonda, consultant geriatrician, described Alzheimer’s as a journey that gradually reshapes a life. “In the early stage, patients manage daily routines but need help with planning or remembering appointments. As the disease advances, confusion deepens. People may no longer recognise their own homes, forget loved ones’ names, or withdraw into silence. In the final stage, they become fully dependent—for eating, bathing, even moving.”

Medicines can only slow the decline. What sustains families most, doctors say, is compassionate caregiving—structured routines, patience, and emotional support. But caregiving itself extracts a heavy price. In India, daughters, daughters-in-law and spouses often shoulder this burden, quietly giving up careers, sleep and sometimes even their own health. “If caregivers collapse, the entire system falters,” Dr Varigonda noted.

She stressed the need for systemic support—respite care beds in government hospitals, monthly support groups and mandatory caregiver counselling in private facilities. She also urged workplaces to recognise caregiver burnout with flexible leave policies.

For Mallesh and his family, each day with Shankarappa is a test of endurance and empathy. They show him old photographs, play familiar songs, and retell stories from his youth. “Though his short-term memory fades, his long-term memory shines like a lamp,” Mallesh said. “It reminds us of the man he was, and still is, beneath the fog.”