“Why are you cheating on me? Why don’t you love me anymore?” These painful accusations cut through John like a knife every single day.
John’s beloved wife of more than five decades, Sarah, had been lost in the grip of Dementia. Their once vibrant home had now transformed into a battlefield of suspicion, paranoia and unrelenting pain.
As Sarah’s nights grew increasingly restless, John faced the relentless onslaught of her frustrations. Emotional outbursts were met with punches and pinches daily. On some nights, John endured more than a hundred pinches, leaving bruises all over his limbs. The toll on him was profound, and his emotional exhaustion ran deep.
Adding another layer to their anguish was Sarah’s longstanding struggle with alcohol. A misguided belief in the health benefits of drinking tonic had led her to consume a full bottle daily by her fifties.
Despite their children offering respite, John chose to remain by Sarah’s side, honouring her desire to stay in the familiar surroundings of their home.
The breaking point came when Sarah’s behavioural issues posed a serious risk to John’s well-being. At their wits end, John and his children reached out to the SLH Community Intervention Team (COMIT) for help.
An allied health-led, multi-disciplinary team that aims to provide holistic services for clients with mental health issues, including dementia, and their caregivers at home, the COMIT team recommended Sarah’s admission to St Luke’s Hospital’s dedicated dementia ward for behavioral management.
“Dementia reduces the brain’s ability to interpret and understand information. As a result, it can lead to suspicion, paranoia and false ideas,” said Dr Cleo Chiong, Registrar, St Luke’s Hospital. “Employing behavioural techniques can be instrumental in helping to manage these challenging symptoms.”
When Sarah was first admitted, she repeatedly pleaded with John to bring her home.
The multi-disciplinary team in the dementia ward introduced strategies for activity engagement, medication titration and behavioural techniques to manage the behavioural and psychological symptoms of Dementia (BPSD).
Beyond patient care, caregiver training was also an integral part of the process. John and their caregiver were also equipped with necessary skills to manage her behavioural symptoms. The team emphasised the importance of self-care and shared options to seek help should Sarah’s behavioural symptoms worsen over time.
Post-discharge, Sarah was enrolled in a Dementia day care programme, providing social interaction and stimulating physical and cognitive functions to enhance her quality of life. This granted John much-needed respite for socialising and personal activities.
The team also put in place structured and tight schedules for post day care hours to reduce opportunities to develop delusions, suspicions and accusations.
To help her with the alcohol addiction, the team tapered her alcohol intake over time, and she successfully weaned off alcohol after using 0% beer as a replacement.
With a new caregiver in place, Sarah’s nights became more restful. The acceptance of change marked a positive shift in her behavior. With fewer episodes of delusions and reduced agitation, both Sarah and John experienced an improved quality of life.
After her discharge, John noticed a flicker of recognition in Sarah’s eyes as she smiled gently. Even in the shadows of dementia, hope can bloom, nurtured by compassion, understanding and unwavering love.
“I will continue to remember our love even when she can no longer do so,” said John.
