A person on a wheelchair with a companion.
An infirmed person with a companion. Photo by Josh Appel on Unsplash

Rajinder and Saroj’s Story

Rajinder*, a 68-year-old first-generation Indian immigrant, and Saroj*, 65, a first-generation immigrant, are a married couple living in Ohio. They are now retired. Rajinder worked with the US Postal Service and Saroj was a Retail Manager at a grocery chain.  They have one adult daughter, Neerja*, who lives close by and has a family with two young children. Saroj has noticed recently that Rajinder has become forgetful to the extent that he forgets to keep track of monthly bills. He repeatedly repeats questions and statements and is often confused about time and places. Saroj is worried about him and approached us for advice. 

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Question: What is causing Rajinder to behave in this fashion?

Dr. Sharma: Saroj, it seems Rajinder is showing early signs of dementia or Alzheimer’s disease but a proper diagnosis needs to be done by your primary care provider.  You must consult them soon and discuss Rajinder’s symptoms. Dementia is a general term for a set of symptoms that affect cognitive (thinking) abilities, memory, and behavior. It is typically caused by physical disorders that affect the brain. Alzheimer’s Disease is a specific type of dementia. It is a progressive and irreversible neurodegenerative disorder that mainly affects memory and cognitive functions thereby affecting activities of daily living and social functioning. Alzheimer’s is the most common cause of dementia, accounting for 50-70% of all dementia cases.

Question: Why do you say Rajinder may have Alzheimer’s?

Dr. Sharma: Saroj, there are ten early signs of Alzheimer’s, some of which you have mentioned and others, you may or may not have noticed. These are: 

1. Loss of memory that is disrupting daily life; you did mention that Rajinder is forgetful, 

2. Difficulty solving problems; he seems to have difficulty keeping track of and paying the monthly bills; 

3. Difficulty completing familiar tasks—for example, have you noticed any problems with him grocery shopping or performing other such tasks? 

4. Confusion with time and place as you have mentioned; 

5. Trouble understanding visual images and spatial relationships – which your primary care provider will determine; 

6. Problems with speaking or writing words – which your primary care provider will determine; 

7. Misplacing objects and inability to go back to find them again;

8. Decreased judgment – which your primary care provider will determine; 

9. Withdrawal from social activities, and 

10. Changes in mood and personality.  

The Montreal Cognitive Assessment (MoCA) Test and other tests conducted by your primary care provider can test all these. Rajinder can also do a self-assessment using MoCA. Administering the MoCA takes approximately 10 minutes. The total possible score is 30 points, and a score of 26 or above is considered normal.

Question:  What can I do to help?

Dr. Sharma:  Saroj, consulting your primary care provider will be the first step. Second, you have to be strong. All of us face stressors which can be acute life events or chronic stressors. One of the chronic stressors is persistent life difficulties. Living with and caring for someone with Alzheimer’s is a life-altering persistent life difficulty. You must prepare your body and mind for this challenge. You must take care of your health and be a pillar of support for Rajinder if he indeed has Alzheimer’s. Thirdly, brain teasers and brain exercises will help Rajinder and you should encourage him to do those and you can do those with him. For example, you can play chess with him. 

Finally, you must accept this change if he indeed has Alzheimer’s. The process of acceptance may take time but it will surely come.  You must rely on your faith system and hold on to whatever you have faith in. It is going to help you.  You may get sad and it is alright to be sad but do not let that sadness consume you.  Remember you have many roles to play in life such as that of a grandmother to your grandchildren.  If you feel the need, you can seek help from a professional counselor. Support from your daughter will be invaluable in this crisis.

Question: Can Rajinder be cured?

Dr. Sharma: Medical science is progressing by leaps and bounds every day. This is a hot topic for research these days. However, currently, there is no “cure” for Alzheimer’s but there are medications that can reduce its progression.  Your primary care provider or geriatrician who they refer to may be able to prescribe these for Rajinder if he indeed has Alzheimer’s.

Question: Can Indian philosophy help me in any way?

Dr. Sharma: Yes, Saroj, in Indian philosophy, the Bhagavad Gita in its 13th Chapter, Verse 9, talks about “janma-mṛtyu-jarā-vyādhi-duḥkha-doṣānudarśanam” or even-mindedness in the perception of birth, death, old age and disease. Buddha was also motivated to spiritual life by realizing the realities of disease, old age, and death. Indian philosophy also talks about meditation and strengthening the mind through vichara (thoughts). Vedic philosophy talks about the ever-changing nature of maya (illusion). So, it advocates for attachment to a nonchanging supreme consciousness. Meditation and yoga may also help you find peace and the strength to deal with such situations. 

Question: Can you refer me to some additional resources in this area?

Dr. Sharma: Here are some additional resources from where you can find more information:

If you have questions, reach out to Dr. Sharma at editor@indiacurrents.com 

*Names have been changed to protect identities. 



Manoj Sharma, MBBS, Ph.D., MCHES® is an Indian-American global public health expert, author, and educator who has written several books and publications on mental health and wellness. He answers queries...