-Balbir Singh Rawat, M.Sc., Ph.D.

Distinguished Ladies and Gentlemen,

Kindly permit me to share with you my experiences, in making beyond the normal efforts, in caregiving to the elderly, that is, to my old own wife suffering from Alzheimer’s disease.

I was 78 yr old and my wife 72 when Alzeimer’s dementia struck her. At the start she was showing signs of forgetfulness and sometimes unusual behaviour. We all in the family took it as a routine process of “Sathiyana”, ie., entering the sixties of age. Sometime later, when the disease advanced, clinical investigations revealed the disease and only then we, the family members and close relatives, became serious about her health. Being a retired person, and her spouse of fifty four plus years (in 2006) and all the children away on jobs and with their own families, it fell upon me to be her main caregiver. I braced myself up to meet the challenge.

My oldest daughter and her family, who live in the same town, have been a great support emotionally and morally , youngest daughter helped me by sending books and printed material on AD from Canada, a country where aged are taken good care of by the government as well as the society. The other two, being away, with regular contacts on phone and as many visits as possible for them. Gradually, I succeeded in convincing myself that I have to take good care of her I have to be her brain, thinking, deciding and taking suitable and helpful decisions on her behalf, and to take care of her all physical, social, emotional and spiritual needs, like a mother takes of her pet child: selfless affection, all the needed care and protection, assurance and encouragement to feel that she is loved by all, is living with her deserving dignity, free of any fear, of any shadow of negligence and ignore. AD patients are very sensitive towards self esteem, security and emotional assurance. They hate memory tests. This became a challenging task for me to prevent every single individual, who so ever he/she may be to ‘investigate’ her, sometimes sternly. Every well wisher does so invariably, though inadvertently.

Alzheimer’s is such a devastating disease that that it gradually and systematically destroys the memory in a definite pattern. The last entry is the first that is erased. This erasing of recorded memory goes back in reverse gear. So mentally the patient goes back to middle age, youth, adolescence, child hood and infancy. I saw this happening to my wife for full six and a half years. This is a challenging task to give care to an old person’s body and mind taking a backward journey and behaving according to the respective phases.  There are numerous occasions of weird behaviour, many a times annoying, so many times damaging and often hurtful to own selves. They never hurt anyone else. They may resort to tearing clothes, removing buttons and zips, trying to twist spoons and forks, eye glasses etc. It is quite common that they forget the location of their own homes, do no-destination wandering inside the house, or slip out of the house if left unattended. I have heard of cases where old parent have slipped away and got lost for all times.

This makes care-giving a very special task for the main care giver, as well as for the members of the family living with the person and  also for the hired help if any. (The hired help needs the right natural aptitude and good nature with a will to learn and be trained).The specific features of the attributes of a good care giver are:-

1. Mentally merging one’s self into the self of the patient by acquiring the skill of pre sensing the needs of the afflicted person at any given time of the day or the night.

2. Acquiring the desired skills and techniques from printed media, from doctors and from result oriented self devised methods of trials and adoptions of the best fitting ones to the personality, comfort and self esteem of the patient.

3. Being fully convinced with the fact that the patient is a living being, with feelings, emotions and sensitivity, trying to be her/his normal, but is helpless in preventing the AD induced corrupted brain signals and commands, thus totally unaware of the weirdness of his/her actions.

4. Modifying one’s own personal temperament of actions reactions to that of a two-body-one-mind ways of thinking, deciding, speaking, behaving and acting. This has to be done day and night, as they say, all the 36 (thirty six) hours of a day, all the days of the year and all the years of the life of the patient. A tremendous task it is, but not at all as difficult as it appears from the ‘side galleries’. Hundreds of thousands of caregivers are willingly doing the job successfully and gracefully all over the world. It is a self accepted duty, responsibility, compulsion, satisfaction,   social recognition. It is mixture of these all and, in addition, enrichment of humane feelings, feelings of soul elating fulfillment by helping the one who is helpless and prone to self-hurt. It is a call of conscience. You get into it with whole heart and believe me God gives you all the power and strength to be a good caregiver. (A self support group of caregivers to the elderly is a must in every locality of the country, to be each other’s source of encouragement by mutually sharing the experiences and care giving skills).

5. Taking good care of self and keeping fit and fine physically and cool and composed mentally, all the time is an essential prerequisite of a care giving capacity and quality.

It is a tremendous task to take care of an old person who cannot even lift his/her hand or leg, and needs to be physically lifted and carried for performing daily chores. There is an acute scarcity of Care Centers, of trained nurses, trained helping personnel, as well as of a well trained good family caregiver. It is the urgent need of the day that:

– Alzheimer’s patients are officially recognized as BRAIN INVALIDS, so that they become entitled to all those facilities that invalids of other reasons get.

– An intensive survey should be conducted all over the country to correctly know the density of AD patients in every district.

– Districts with large densities should be given an Alzheimer’s Care-cum-training Center at their hospitals, fully equipped with diagnostic and treatment & caring facilities.

– AD Societies, on lines with AIDS and Cancer Societies, should be organized in each State.

– AD families should be encouraged by the government to organize their own support groups and to celebrate World Alzheimer’s Day, conduct, runs, parades and marches to spread awareness and to collect funds for the help of the poor patients by way of treatment, care and moral support.


Mrs. Sundara Devi Rawat (1935-2012)

Mrs. Sundara Devi Rawat
Dehradun, India
Mom passed away on July 1st in dad’s arms when sister, Usha was feeding her. The most wonderful and proud mother to four children, four children-in-laws and grandmother to six grandchildren, dear sister to eight siblings, and luckiest wife of our father; mom’s legacy of wisdom and strength and her loving and caring heart has always left warmness in people’s hearts. She was everything that one could imagine to be; an amazing and committed person, daughter, sister, wife, mother, friend, auntie and neighbour.  She was affectionate, encouraging, always smiling, funny, sensitive to others, organized and wise.  She was in fortunate care of dad while she was struggling with Alzheimer’s for past 6 years. Now, mom is in good company of her parents and siblings where she is peacefully watching upon her loved ones.
“We know we can’t see you anymore mom, but we know you are always there guarding our lives as our guardian angel.”
Rupa Rawat
July, 02, 2012



The oral administration of virgin coconut oil is continuing. She is showing steady but very slow progress.
Area wise it is as follows:
  1. She is more cooperative and understands what is desired of her,
  2. She is now aware about her hygiene, and has developed her on signals for assistance to go to the loo,
  3. She enjoys bathing, and tries to wash her hair and limbs,
  4. She prefers to eat with her own hands and holds spoons, cups but coordination to take them to lips is yet to improve,
  5. She wants only me and the maid, to whom she is every moment of the day, help her change her clothes, does not like  even her daughters and son to be present during the process,
  6. Her digestion is normal and has gained her lost weight,
  7. Many a times she clearly asks short questions like, Who is she/he?, What is happening?, Where are you going?,and enquires What is this?, This is mine, and the like.
Such improvements are encouraging and suggest that VCO therapy, along with regular AD and psych. medication, should continue.
Report given by main caregiver (her husband)
Dr. Balbir Singh Rawat, M.Sc., PhD.

Setting up care centre for Alzheimer’s Disease patients at Dehradun

Dear Readers,

Alzheimer’s disease is a brain damaging dementia of the elderly. It creeps in very slowly and progressively makes the person so disabled that an all time care giver is needed who can guess correctly what the sick needs when and give care with full affection.

It is much misunderstood disease, families think the affected person has become lunatic – PAGAL – and keep it a secret lest the sick person be an obstruction in setting up relationships. Many families do not have enough people having time for the sick, all being busy in jobs schools/colleges etc. So the sick are locked in side, no medical help for the disease is sought.

It is seen to be believed how helpless and fully dependent the disease makes a person. In this respect it is more devastating than Cancer and Aids. While the Governments and Social organisations are doing much for the patients of the two diseases – one very fatal and painful and the other a self-acquired but glamorous disease – very little is being done for the sufferers of Alzheimer’s disease (AD) which destroys the memory as well as self-esteem of a person when she/she reach old age. It is a rough estimate that there are more than 500 active AD patients in the city of Dehradun alone.

It is requested to kindly come forward for the help of these unfortunate senior citizens by establishing a care centre where such patients could be looked after by trained doctors and nurses. Local help by way of volunteers and finances could also be mobilised. Kindly add this project in your immediate future activities.

Since I am an 83yrs.old, full time care giver to my 76 yrs old wife, now in II stage of the disease, for last five years( I do not personally need any financial help), I know how hard it is for those families who are short of man power, of awareness, of skills and of enough money. I am sure your Foundation will definitely come forward to their help.

With great hopes and expectations
Yours Sincerely,

B S Rawat, Dehradun, Mob. no. 9458911505

Notes of a AD Caregiver on Alzheimer’s disease (a merciless enemy)

In developing countries, with old civilizations, dementia is taken as an avoidable stage of the health of old people. In India they say “so and so is now sixteed  – sathiya gaye hain”. People take this so lightly, very few go to a specialist for checkup and advice. The medical profession too has been non-serious about the disease because no agency, ranging from the government to the drug agencies, has taken any initiative to spread awareness of the deadly realities of Alzheimer’s Disease (AD) and medicos have no time for this, social workers do not want to understand the implications, politicians pass on the proposals of rehabilitation to the bureaucracy, which, uncommitted as it is to anything for the masses, just files the papers and forgets about it. Perhaps when some big bureaucrat gets into AD net, the file may then be taken out from oblivion.

AD victim first shows some forgetfulness and does not bother. So often family members do not observe the changes because they are so very gradual to be noticed, the victim himself does not feel the difference. Others in the family are busy with their own owes. When the disease manifests noticeably, it has already done irreversible damage to the brain of the victim by killing considerable number of neuron cells from different areas of the brain. The memory starts vanishing with the system of LIFO, i.e., what was remembered last vanishes first (Last In First Out).( This ‘reverse’ gear takes the person, mentally, back towards youth, then childhood, then infant stage when only mother, feeds and survival techniques if infants are remembered and one behaves like an infant).

This is the last phase of the first stage of AD. There is noticeable change in behaviour, mood and decision making. Only then the family thinks of consulting a doctor. Relatives and acquaintances give advices, ranging from soothing the bad stars to appeasing the ‘bhut prets‘( ghosts) and curses casted by jealous  ones from the wider circle of relatives. Families visit astrologers, sorcerers and every one claiming to have supernatural powers to heal, to reveal real (?) causes and to appease the powers that be. Precious time is lost and the second stage starts to set in.

This total lack of the awareness of AD also is mistaken by the uninformed family members and the society at large, to be a lunatic attack (where behaviour is violent and with tendency of retaliation). On the contrary, an AD victim fails to understand and express, is frustrated, is confused and behaves like a person lost in dense woods laden with heavy morning fog, trying to find right direction with no success. This frustration is the worst thing that can happen to an active, vibrant, creative and socially respected person. The disease torments the victim. This, happening in old age when one deserves to bask in the warmth of the love of family and recognition of society, destroys the will to live, and, also the respect one deserves along with the self esteem one had earned through the life lived. Depending totally on someone else for everything at every moment of the day and the night is not at all a pleasure, all the humor is sapped off from the life left. Entertainment, music, laughter, jokes, all recreating factors become meaningless for the victim of AD. Life becomes drab, tasteless and robbed of a smile. The affected person cannot say what is happening when suffers from colds, cough, fever, stomach upset, headache, tooth ache, sprains, cuts, body pain, weakening eye sight, hearing loss and other sicknesses. All these ailments have to be noticed and got treated by the caregivers. Thus the caregiver has to be a very devoted and keen observer of the changes in day to day health of the AD victim.
To aggravate the tragedy, during last one hundred and odd years of the discovery of the AD, there is no effective medicine found so far. The few ones prescribed, only slow down the progress of the disease. Theses being imported, are costly and beyond the reach of a vast majority of sufferers. There is no medicine that could help growth of new neuron cells to replace the dead ones

Here the plight of AD victims can be categorized as: 1. Those who are taken good care of by any one of the family members, or those who are provided with proper care at AD Centers, 2. Those who are left in care of maids etc during day time when family members are away on their jobs, studies etc. and receive some sort of treatment, 3.Those who due to lack of resource and understanding are just tolerated and kept in confinement away from the sight of any one other then the family. These unfortunate ones also go without any treatment and affection, 4. These are the ones whom the family members themselves consider to be dangerous, the disease to be hereditary and a shame. They have a fear of social bycot, particularly in relation to marital relationships of children. Some chose to leave them in trains going far away, at bus stations, religious places etc., at the mercy of the society.  Sometimes it is also heard that, the father or mother of so and so has run away from home never to be found again. AD, in late first stage and early second stage, does impel the victim to run away to destination nowhere, to tear clothes and to inflict other such self punishments. They also resist any restraint.

The only effective treatment is to provide compassion, love and comfort to the victim of AD. It is possible only when the caregiver has the quality of merging him/her own self with the self of the sufferer. In other words, the caregiver has to be himself and at the same time the self of the AD sufferer. The former quality is important to be a good caregiver, and the latter, the caregiver is in good health and required mental disposition so that the sufferer develops full confidence in the caregiver and is able to survive with dignity as long as destiny has desired.

In those Western countries where AD care is legally a social responsibility, the word CAREGIVER denotes treating specialists and supporting medical staff. In other countries the sufferers are exclusively family responsibility, the person who is most attached to the sufferer, is given the role of a caregiver. Such persons start from a ZERO or even a below zero level of skill required to look after a person whose concepts and reactions are now skewed by the massive destruction of many parts of the brain. Therefore, they take time to play the full role of a trained nurse. Strong will, devotion, desire to learn, patience to remain cool, ever ready to help any time of the day and the night, ability to correctly guess any other disease setting in, to report in details about the status of health and behaviour of the patient to the attending medical expert, to be careful while talking to the visitors about the AD sufferer, as such persons are very sensitive to their self esteem and do not like to be shown any pity by any one. They show annoyance and resistance even to the caregiver for some time, till they forget what had happened. Perhaps this forgetfulness is misused by the family members of many sufferers that they take liberty with them in behaving and caring. Many well wishers ask the a series of questions and this annoys the AD victims.

The AD is not life threatening, sufferers take food in their normal quantities, digestion is as it always has been, but metabolism is affected. The drugs given to slow down the progressiveness of AD and the psycho drugs given to calm down and to control behaviour, appear to have side effects on assimilation of nutrients. Therefore a diet rich in proteins, vitamins, minerals, essential fatty acids and micro nutrients, is very important. Proper rest, body posture, massage, exercise (as much as comfortable level permits) sleep and hygiene are the things that need regularity and careful indulgence of the garegiver and assistance given to him/her by family members.

The secret of success is the ability to be the self of the sufferer of Alzheimer’s Disease and at the same time be himself too.

For one or two generations, the families of AD sufferers should not expect and help worth the name from the governments and the society, in terms of emotional, medical, monetary and moral support. This is the characteristics of the societies of the old world where a person gets help at funeral and recognition at post death functions. So it is the solo show of the family and close relatives.

Effect of virgin coconut oil therapy on Alzheimer’s patient.

Effect of virgin coconut oil therapy on Alzheimer’s patient.

Report prepared by patient’s husband, Dr. B.S.Rawat, retd Principal Scientist (NDRI- ICAR)

Mrs. Sundara Devi Rawat, my wife, is taking 20-25 ml virgin coconut oil daily for treatment and control of her disease, Alzheimer’s dementia, for the last about one year. The results are positive. She was in the middle of the second stage of the disease when VCI was introduced in addition to her usual medicines. Her memory and brain power has revived to some extent in the ensuing areas:

  • Likes to talk with known persons, and can recall few such words that were forgotten,
  • Has regained the sense of understanding what others say gives a smiles of welcome,
  • Has developed her own signs to indicate need to go to toilet,
  • Enjoys taking bath and washes her hair, feet and arms herself,
  • Recognizes her chair, wheel chair and bed, goes to any of these herself,
  • Cooperates in changing clothes, combing hair and putting on socks and foot wear,
  • Eats rice and daal with her own hands,
  • Enjoys soft music,
  • Misses her caregiver and maid when either of them is absent for an hour or so without telling  her,
  • Responds to bidding good-by by departing visitors.

Alzheimer’s Disease

Alzheimer’s Disease

Different surveys in India reveal that about 20% of old persons are under the risk of suffering from Alzheimer’s disease. This disease is a silent demon that attacks the brain of a person so slowly that two years pass when the afflicted person him/herself realizes something is going wrong with her/his memory, decision making, understanding and expressing.

When second stage sets, the brain has shrunk, neuron cells are wilted and their capacity to receive, analyze, transfer and transmit information is not only weakened but also corrupted. Physical health deteriorates, psychological health enters a stage of inability to behave in the way the person used to. It seems as if there is a dense fog in the brain and the person is unable to sense anything around.

This inability devastates the very being of an individual, his dignity is destroyed. There are very few lucky individuals who are taken good care of. Their only hope rests on the spouse who is loving, caring and devoted (a rare phenomenon in contemporary world where sharing and caring is considered “the other person’s duty”. Though rare, there are such caring persons).

Good care giving is the only medicine that makes life dignified for the AD sufferers.

On the onset of the third stage, the victim is totally dependent on others for her/his   every day needs, from rising up in the morning to going to bed and having a very disturbed pattern of sleep. The senses totally get diminished to almost zero. The body is living, taking and digesting food, the excreta are passed out but there is no control over this activity. The care-giver has to look after the hygiene of the person.

Experts say this disease has about 2-4 years of first stage, 3-6 years of second stage and 2-plus years of third stage, it is virtually impossible to have a single care-giver all through. Assistance of a properly trained nurse is the only way. Unfortunately, our country has not a single training centre for Alzheimer’s disease nursing and even not a single specialized A.D. care centre in any hospital. The government’s intensive efforts are concentrated around AIDS and Cancer only, as both are fatal and the former is contagious. Though self acquired, it is a social problem. Alzheimer’s is no less a social problem. It does not only destroy the health and dignity of the patient, but of the whole family whose daily life-style is permanently changed and negatively affected. There are millions of such families in the country.

The AD sufferer is a brain invalid, this invalidity is much more devastating than physical invalidity and yet the AD patient is not recognized as one, thus he/she is deprived of the privileges granted to various categories of other invalids.

It is therefore, imperative that the following steps be immediately taken for the sake of the grandparents of the nation who have definitely contributed to its advancement:

  1. On the lines of the AIDS Societies working in the departments of Health and Social Welfare of the State governments, there should also be Alzheimer’s disease Societies.
  2. There should be a fully equipped diagnostic AD care centre at every government hospital and medical college which has a department of Neurology. This AD Centre should also serve as a training centre for specialized train of AD nurses and of family care-givers.
  3. There should also be a non-government society of AD families for mutual support, for exchange of experiences, for spreading public awareness and for raising funds to help patients from fund-deprived families for their diagnosis, medication, and care.
  4. Finally, there should be an exhaustive enumerate survey of AD patients to make the state level registry of Alzheimer’s disease.
  5. Alzheimer’s patients should be declared brain invalid and given same facilities and benefits as other groups of invalids.

It is the sacred duty of every socially oriented person to work for the benefit of AD sufferers to the extent possible and create a public awareness and feeling of belonging.