karuwaki logo

My Mother and Alzheimer’s disease (Shivani Nandi Ph.D.)

April 25, 2021, 8:52 a.m. by Shivani Nandi Ph.D. ( 653 views)

Share via WhatsApp

Faced with a request from a dear childhood friend that was impossible to turn down, I agreed to delve into some long forgotten painful memories to write something about dementia and Alzheimer's disease period. While there are countless websites available on the internet for anyone who wants to understand the basics of this horrible memory robbing disease, I will introduce some useful and well written resources later on. But before doing that, I believe it will be more relevant to pen downsome personal experience of seeing my mother succumb to this ailment almost 37 years ago.

When I was around 17 or 18 years old some of my friends who would sometimes visit me, pointed out to me that my mother was behaving a bit strangely. I shrugged it off saying that she was too overworked in school and was thus quite preoccupied with teaching, grading etc. But such irregularities in her memories started to occur much too frequently which were beyond the realms of mere absent-mindedness... As was quite common in those days, my mother used to manage the household, cook as well as pack my tiffin box for school and college, and upon her return from a day’s work at her school would cook dinner for us. My father visited us during the weekends since it was too far to commute from Khurda or Jatni.

The imperceptible changes in Ma started to loom larger with time. It was like an ever-lengthening shadow that would not shorten with the rise of a new day. Come dinner time she would call us to the table, and we would find that even though she told us she was making rice, dal and one vegetable or fish dish, we would find that she had only made the rice and half cooked dal. Baba and I would be visibly impatient and express our frustration. Such behavior of ours, we noticed would make her even more confused and distressed, and it was as if she was falling apart under the pressure of our trying to supervise what she was doing as we made her complete the cooking. It was as if she was striving through a thick fog to extract those memories such as the simple steps of preparing dal. She would look so guilty and sad and flustered and just terribly unhappy. My father and I would then take over the rest of the cooking.

It did not help that there did not seem to be other friend’s parents going through the same problems. Or at least if they did, I did not know of it. And in my repertoire of English language vocabulary, there was of course no appearance yet of the word Dementia or Alzheimer’s disease!Then stories started to filter in from my mother's colleagues that in the middle of teaching a class to high school students, my mother would stop and get completely confused and be unable to continue with the lesson. Neither my father nor I could understand what was happening to her and started to get upset and impatient with her - over and over again.

We found it difficult to accept that something was seriously wrong with her and kept hoping that one fine day it would all be fine. This is quite common in family members as we would come to know later and still happens with almost every family when faced with a similar situation. Added to our difficulty was that there was no awareness or information about the disease at that time, and nothing thus to prepare us for what was happening to mother.

alzheimer-association |Shivani Nandi Ph.D. |karuwakispeaks

As time went by, he found himself in the role of a primary caregiver. The demeanor of this man who was well known for his quick temper and stern impatience, gradually changed to kindness and gentleness as he looked after her with the utmost care and affection and tried to decipher her quotidian needs. As she gradually lost her ability to perform her activities of daily living (ADL) such as bathing, grooming, feeding herself, and did less and less around the house, my father stepped in to take on these tasks upon himself to help her bathe and wear the sari, made sure she was clothed appropriately depending on the weather. To help feed her patiently while she would sit vacantly staring at her food. He would clean her up when in the later stages, before the accident – she became incontinent and I don’t’ have a single memory of ever seeing him grumble or complain or shout with impatience. When her walk gradually turned to a slow shuffle, he slowed his usual long and rapid strides to match hers and showed no resentment whatsoever when she would forget who he is. But there would come some profoundly insightful responses if we asked her who baba was and she would respond “he is someone who takes good care of me”

alzheimer-association |Shivani Nandi Ph.D. |karuwakispeaks

I will try to summarize some of her symptoms into categories so that if there are any of you out there facing a similar situation, you can start to have a general understanding about this disease and what it does to the person. And if through this I can make a difference to even one of you then I would consider it worth my while.

  1. •Disorientation to time and place:She would wander off to a neighbor's home and not find her way back. Soon we would hear a knock on the door and find that a kind neighbor has brought ma home after they found her wandering in our neighborhood.
  2. •Difficulty with Language:We came to notice that she would be unable to complete a sentence properly, she would keep asking the same things over and over again. She would gradually shut herself away from any conversation and withdrew into a shell. And yet she never, ever, ever lost her sweet gentle smile until the very end.
  3. •Short-term and Abnormal memory Loss:She would sometimes forget what she did just a few minutes ago and ask us again. As time went by, she would, for example, look at a key vacantly not knowing how to insert it into the lock to open it. She would often ask my friend what her name was even though she had seen her through the years. She would at times ask if she has eaten dinner a few minutes after finishing her meal and would often repeat the same question several times during the day. She would frequently lose her watch or keys to the main door, or forget her handbag in the rickshaw after paying him. Her capacity for abstract and complex thought started to fade.
  4. •Difficulty performing familiar tasks:She would not be able to carry out simple tasks - being an excellent and fast cook, she found herself unable to cook a meal to completion. She would look confused when changing the sheets on the bed, or when washing clothes and would have trouble cleaning up the house or organizing things. A couple of times when I had some friends over, my mother had forgotten to make the rice to go with the rest of the dishes.
  5. •Misplacing items:She would frequently lose her watch, her handbag, her keys etc. Or forget her handbag in various places at home and at her school.
  6. •Changes in mood:Her cheerful disposition started to fade little by little and she would have a tight, anxious look about her. Her eyes wore a faraway look and her expression one of withdrawal from society. She would become visibly upset if Baba and I showed annoyance with her and would try to communicate to us, but the words did not make much sense. It would take a while to calm her down. We also noticed in later years that anything disturbing showing on television would in turn agitate her and then it would take a while to soothe her.

We would come to know much later that she had developed glaucoma and was suffering from severe pain from the high intraocular pressure inside her eyes. She was prescribed some eyedrops to reduce the tension. But her eyesightmust have already been affected and it was this vision loss that drew her eventually to the brightness of a candle during a power outage in our Cuttack home in the 8th or 9th year of her suffering from Alzheimer’s disease. My father was in the shower and when he came out, found her sari engulfed in cruel flames that she did not even have the judgement to take off. Her frail body sustained over 40% wounds that never healed. A month later after being brought to Delhi to be cared for at my brother and sister-in laws place, an ignorant surgeon carried out skin graft from her thighs to heal some of the deep burns on her hands - but neither did not wounds heal nor did the grafted area.You cannot treat or heal a person who has lost the conscious will…

My mother passed away from her grievous burn injuries about a year later. I was away in Japan doing my Ph.D. at that time. For the next couple of years I completely shut off all memories of my childhood and youth in Orissa as it was inextricably linked with my mother. Eventually though I found myself involved with the Alzheimer Association in Kyoto in Japan where I volunteered with translating their website and monthly newsletters into English for an international audience. I became aware how important it was to increase awareness of this disease and the plight of caregivers. The role of the Alzheimer Association’s all over the world is to create awareness, to advocate for patients as well as their caregivers, improve the quality of lives of the patients as well as caregivers. And one of the umbrella organizations that serves this very purpose is Alzheimer’s disease International (ADI)headquartered in London. There are 100 member countries as of now of ADI and within each of these are several local chapters. For example the Alzheimer’s and Related Disorders Society of India (ARDSI) which was founded in the early 1990s has 23 chapters including one in Bhubaneswar.In time I would participate in several conferences of ADI (Alzheimer Disease International) held in various countries and in one of these in 1999 in Johannesburg in South Africa I would happen to meet my future husband.

TYPES OF DEMENTIA

The most important thing to know is that not all symptoms of dementia are due to normal aging. Also dementia itself is not the disease but the general term to describe cognitive impairment serious enough to hinder activities of daily living. Benign forgetfulness arising out of Benign Senescence which is a gentler decline is quite different from any of the various forms of dementia listed below. However, forgetting people’s names and who authored Wuthering Heights, or for that matter losing one’s keys is due to gradual age related decline in memory without pathological significance. It’s the abnormal kind of forgetfulness that should be followed up by a medical evaluation. Abnormal forgetfulness can range from forgetting the way home while driving or walking, driving to work and then taking the bus back home because you can’t recall that you drove to work in the first place, forgetting that you had breakfast or lunch an hour ago and having a second one, not recognizing all of a sudden the function of a key (not just misplacing a key), forgetting the name of a spouse or loved one. The types of dementia are:

  1. 1-Alzheimer’s Dementia
  2. 2-Lewy Body Dementia
  3. 3-Vascular Dementia
  4. 4-Frontal Temporal Dementia
  5. 5-Mixed Dementia

TYPES OF DEMENTIA

Alzheimer’s Dementia

Alzheimer’s disease is the most common form of dementia, affecting 60-80% of dementia cases and is a progressive loss of brain function which affects memory, thinking, communications, behavior, perception, personality, cognitive skills, and ability to learn and carry out basic daily activities. The greatest risk factor is age and the vast majority of affected persons are over the age of 65 but about 5% of persons can get it in their 40s and 50s when it is called early-onset Alzheimer’s disease. While the symptoms may start with mild cognitive impairment, but over time persons with dementia lose the ability to take care of themselves and to carry out a conversation. They may lose their ability to eat and walk when motor functions are affected. These changes are attributed to changes in the brain which are due to the formation and accumulation of abnormal deposits of proteins called amyloid plaques and tangles made from tau protein. The brain cells lose their ability to function and communicate with one another and eventually die. The disease progress from mild to moderate to severe. The cause of the disease is as yet unknown but ample research points to a series of complex cascade effect of changes occurring in the brain over a period of time.

Important: Alzheimer’s disease is not a normal part of aging. There is currently no cure, but a few federally approved symptomatic treatments are available.

Some useful links about the progression of the disease are given below

  1. Inside the Brain: Unraveling the Mystery of Alzheimer’s Diseasehttps://www.youtube.com/watch?v=9sLTglkfduw
  2. Understanding Alzheimer’s Disease (AD)https://www.youtube.com/watch?v=jBvWadjjwXs
  3. Inside the Brain: A tour of how the mind works by the Alzheimer Association. It is in two parts and shows the functioning of normal brain and the effects on it from Alzheimer’s disease https://www.alz.org/alzheimers-dementia/what-is-alzheimers/brain_tour

The warning signs of AD are: difficulty performing familiar tasks, problems with language, recent memory loss (abnormal memory loss e.g. forgetting the name of spouse or children, forgetting that one went to work by car and taking the train back home, forgetting to find the way back to the house), disorientation of time and place and poor or decreased judgment, changes in mood or behavior and personality. The neurons near the hippocampus get affected first which is why learning and short-term memory gets affected.

The Figure below from the website of the Alzheimer’s disease International (ADI) explains visually the 10 warning signs of dementia and is quoted for educational purposeshttps://www.alz.co.uk/info/early-symptoms

alzheimer-association |Shivani Nandi Ph.D. |karuwakispeaks

Stages of AD: Mild AD, Moderate AD, and Severe AD. Each stage relates to which parts of the brain is affected as the disease spreads.

MCI- Mild cognitive Impairment – memory changes in younger persons without being accompanied by changes in personality or other problems associated with AD https:// www.mayoclinic.org/diseases-conditions/ mild-cognitive-impairment/ symptoms-causes/ syc-20354578#:~:text =Mild%20cognitive%20impairment%20(MCI)%20is, than%20normal %20age%2Drelated %20changes.

Lewy Body Dementia

This form of dementia is often underdiagnosed since it resembles more common forms of dementia such as Alzheimer’s disease and Parkinson’s disease because of the motor symptoms like stiffness, shuffling walk, problem with balance and falls and lack of facial expression. LBD is accompanied by memory problems, confusion and other cognitive impairment that overlap with AD. There can also be visual hallucinations, excessive daytime drowsiness, and in about 50% of the cases is associated with a condition called rapid eye movement (REM) sleep disorder. In patients with LBD, there are abnormal deposits of a protein called alpha-synuclein which form into clumps inside certain areas of the brain that control memory and movement.

LBD refers to both Parkinson’s disease dementia and dementia with Lewy bodies

Vascular Dementia

This is considered to be the second most common type of dementia after Alzheimer’s disease and can either develop soon after a single major stroke with disruption of blood supply to the brain, or can happen over time due to a series of infarcts or small strokes. This form of cognitive disorder is called vascular cognitive impairment (VCI), which includes mild deficits as well as dementia. [ For a detailed explanation of VCI please see this article:https: //www.dementia.org.au/ files/ helpsheets/ Helpsheet-DementiaQandA14-VascularCognitiveImpairment_english.pdf ] Symptoms are memory loss, confusion, difficulty in executive functions, communications and judgment, difficulty in speaking, restlessness and agitation, wandering at night, and reduced ability to carry out activities of daily living. The symptoms vary depending on which part of the brain has been affected by impaired blood flow and can be clear cut if they appear suddenly following a stroke.

Vascular dementia is closely related to cardiovascular diseases and is potentially preventable by monitoring risk factors such as hypertension, high cholesterol, high blood sugar and smoking.

Frontal Temporal Dementia

This type of dementia primarily affects the frontal and temporal lobes of the brain which are the areas that are generally associated with language, behavior and personality. The onset in FTD is more rapid than in Alzheimer’s disease and initial symptoms involve change in personality, planning, social functioning and judgement. Persons with this disease may behave uncharacteristically and make rude personal remarks to strangers or may show excessive happiness and excitement.

Mixed Dementia

When Alzheimer’s and vascular cognitive impairment (VCI) coexist with all their respective hallmark pathologies, it gives rise to the condition of mixed dementia. The symptoms may follow a pattern similar to Alzheimer’s or vascular dementia or be a combination of both. Brain autopsies show that 45 percent of people with dementia have signs of both vascular dementia and AD

HALLMARKS OF AD:

  1. Presence of amyloid plaques in the spaces between the brain nerve cells (first described by Alois Alzheimer in 1906 who observed these changes in a 52 year old woman patient. These plaques are made up of toxic insoluble protein called beta-amyloid. It is not known whether plaques themselves cause AD or if they are a by-product of the disease process.
  2. Also present are neurofibrillary tangles which are from misfolded protein.
  3. Loss of neurotransmitters resulting in loss of connection between cells
  4. Shrinkage of the brain

CURRENT RESEARCH ON AD

  1. Identifying Early changes in the brain through biomarkers (biomarkers are indicators e.g. substances that appear in cerebrospinal fluid or urine or blood that indicate presence or progression over time of disease
  2. Research has found that a high percentage of people with MCI go on to develop AD than (about 8 out of 10 with MCI go on to develop AD) but research doesn’t explain why some with MCI don’t go on to develop AD – exciting research questions now are 1. Can MCI be prevented or its progression to AD delayed/arrested?

•Difference between dementia and AD

  1. Dementia is not a disease. It is merely a description of behaviors or symptom that could possibly lead to Alzheimer’s, which is a disease. It is one of the most common form of dementia. Other dementias can be caused by other illnesses, medications, B12 and thyroid deficiency and a host of other reasons why one may present with dementia but it may not be Alzheimer’s disease. It’s thus important that if someone is presenting such symptoms are seen by a neurologist or geriatric specialist to have a series of diagnostic tests that may consider the AD diagnosis.
  2. Alzheimer’s is a family disease. It affects everyone in the family. Not only the couple’s relationship change, but the effects on children, friends, rest of family
  3. Executive functions – e.g. balance a cheque book, not remembering why they came into a room.
  4. Loss of reason and judgement – accusing people of stealing their wallets, keys etc.
  5. Very important aspect of caring for a person with dementia is not to be caught up on the skills that have been lost due to the disease, but what is still left or what the PWD is still capable of doing. Allow/Encourage them to continue to do what they are capable of doing

BEHAVIORS:

In people living with dementia (referred to as “they or them” or PWD: Persons with Dementia), changes in behaviors are a common challenge to their caregivers and loved ones. Whatever the cause, challenging behaviors are often the most significant symptom of dementia and when it comes to managing behaviors, good non-pharmacological intervention is pivotal to successfully avoid unnecessary institutionalization and hospitalization due to drastic behavior changes. The use of non-pharmacological behavioral management should always be the first line of treatment and the use of pharmacological or medications to manage behaviors should be reserved for when non-pharmacological methods fail. The links below provide useful resources in understanding the different stages of the disease, as well as behavioral changes.

https://www.alz.org/help-support/caregiving/stages-behaviors

https://www.helpguide.org/articles/alzheimers-dementia-aging/alzheimers-behavior-management.htm

Some examples of abnormal behavior are listed below.

Wandering: : It is said that more than half of the persons with dementia will wander, and since they may be disoriented and not remember their name and address, it can be quite dangerous.

Caregivers should allow wandering. As long as the wandering is safe it can actuallybe a good thing. Wandering is an opportunity for the person with dementia to get exercise, be occupied, decrease restlessness and may result in better sleep at night. Better sleep at night helps overall mental status and wellness in addition to giving the caregiver a better rest. Wandering can manifest itself in various ways and below are some examples how some caregivers have responded to it.

a.Person with dementia wantto leave to “go home”: Reassure them, but do not try to contradict them. Here are some examples that offer insights on how to distract a person with dementia who is determined to wander.

  1. Building a “fake” bus stop – A nursing home in Dusseldorf, Germany had several residents with dementia who would in the late afternoon hours claim that they “wanted to go home”. Some would even pack a bag and head toward the exit. The nursing staff came up with the ingenious idea of building a fake bus stop with the sign and a bench within the precincts of the nursing home where they would allow such residents to wander outside and wait at the fake bus stop. The make-believe worked very well since it was non-confrontational and made it seem as if the residents actually had autonomy. After sitting for a while at the benches they would forget the purpose why they were there and wander back into the home. Or a staff member would walk across and “invite” them in for a snack or dinner and they would happily return since by then they had forgotten why and where they wanted to go in the first place.
  2. Allow them to “buy a ticket” to get on the bus or airplane: Might have to allow them each and every day to believe that they are leaving tomorrow!
  3. Wander proof your home or their living space such as lock fences/doors if necessary. Provide a loop within the premises so they feel like they are going somewhere
  4. GPS device on the person seeking to leave: Below are a list of 10 Lifesaving location devices for persons with dementia:https://www.alzheimers.net/8-8-14-location-devices-dementia/

b.When the person with dementia want “to go to work”

  1. Build a pretend “work” area or office: for example, someone who was a director of nursing might be entirely satisfied sitting at a desk with blank papers and a pen “writing” orders. Or for someone who enjoyed working with tools, have some safe tools and let them work on it in a shed or workplace. If someone enjoyed reading, then give them access to books including coffee

Repetitive behaviors:If they are not harming anyone, just allow them to repeat away! This can manifest itself as repeating statements, repeating activities, repeating harmful behaviors to self or others. In the latter case ensure safety by removing any harmful objects from vicinity.

Agitation:This can manifest itself in behaviors such as paranoia and hallucinations, constant complaining, verbal aggression, clingy behavior (such as parent calls you 20 times daily and tells you that you have been abandoning him or her or feels agitated when you have to leave them for a short while), resistance to showers and hygiene

Refusal to Take Medication:Refusing medication can be problematic and the solutions are a bit tricky. Sometimes it is not possible to make them take their medication, in which case, the number of medications needs to be decreased to the bare minimum. On occasion it is necessary to simply give no medications.

a.Sometimes the refusal to take medications is caused by an inability to swallow, especially when someone has had a stroke or series of small strokes. They can’t always tell you that swallowing is a problem, because they can’t find the words to describe it. Also, overall behavioral symptoms can cause refusal to take medications

    1. One option is to mix the pills one at a time in some pudding or applesauce, which helps the pill be swallowed. Also, the person may be tricked into not noticing they are taking medicine when disguised in pudding or applesauce. BUT one needs to be very careful about which medications are crushable and which are not. Especially medications with an XR,SR, SA, or that type of designation after the name should not be crushed. This means that the medication is extended release, or sustained release, and the whole 24- hours’ worth of dosing is all in one pill designed to be released slowly throughout the day once absorbed. Altering the pill’s form would make it such that the 24 -hours’ worth of dosing is absorbed all at once. For example, if a blood pressure drug such as metoprolol XL is crushed, and the entire dose is absorbed at once, the person’s blood pressure could be dropped dangerously low after taking the crushed pill. While crushing and mixing in food is an option, it’s important to consult your doctor or pharmacist about which medications can be crushed and which cannot.
    2. Find a time of day when they are more accepting and cooperative of care.If you find that in the morning, they are more likely to cooperate with bathing, eating and medications, then ask their doctor to rearrange the dosing of the medications to fit that daily opportunity to give medications
    3. Try alternative dosing forms: Sometimes it’s possible to purchase medications which are not taken by mouthegTransdermal (through the skin) patches such as Exelon Patch® to help memory.
    4. If they refuse to take medications after trying ways such as crushing and / or camouflaging the medication in pudding and applesauce or finding a time of day when they are more accepting of care, then it’s time to decrease or entirely eliminate medications. At least 30% of medications taken by older persons are unnecessary
    5. See the link below for a very useful article on polypharmacy when a patient is taking too many medications
https://www.medbridgeeducation.com/blog/2019/ 08/ polypharmacy -why -medication -reconciliation -matters -to -nonprescribing-healthcare-providers/

Refusing food:There may come a stage in the progression of the disease when the person with dementia refuses to eat and may even spit out the food. Or even eat too much and often since they may forget that they have just eaten.

https://www.webmd.com/alzheimers/not-eating-drinking-alzheimers#1

ENVIRONMENTAL INTERVENTIONS

Follow a simple routine which is especially important for people who were quite structured in their lifestyles. Following a specific bedtime and doing the things each night in the same order – e.g. changing, brushing teeth, listening to soft music, getting into bed, dimming lights or reading/ looking at coffee table books (if the persons is a book lover). The routine should not be rigid but should be in the nature of a daily plan of what activity comes after what – hence if having the PWD assist you to lay the table is a part of the plan then they automatically may sense that it is followed by a meal and then cleaning up the table.

  1. Keep rooms neat and uncluttered
  2. Make tasks or ADL’s (activity of daily living) simpler by eliminating choices. E.g. If someone is confused as what to wear, simply take out the clothes for them and keep at a place they can see. Likewise, if they insist on wearing the same clothes every day, buy two or three identical sets so you can wash the rest. Put toothpaste out on the brush so it is a cue to brush teeth.
  3. In the earlier stage of the disease caregiver can talk through the process by giving simple directions as how to put on the socks or shirt.
  4. Placing a shower stool in the shower and adding a hand shower can help the person relax and make the process of bathing less intimidating compared to having a showerhead direct water to the top of the head which they are not able to see.

Encourage activities that they took pleasure in the past

  1. 1-Music and art: music and art therapy have been known to be useful for some people and helps calm them. Especially listening to the kind of music the PWD has been used to in their past
  2. 2-Reading or Watching old movies
  3. 3-Listening to books on tape
  4. 4-Cooking or housekeeping – allow them to assist with cooking, preparing, chopping, laying the table, clearing up the table, folding away the laundry
  5. 5-The comfort of a pet such as a dog or cat if they love animals
  6. 6-Knitting or Gardening if they were interested in any of these in the past
  7. 7-When they lose the ability to speak and let their needs known, which will happen at later stage of the disease, it’s helpful to keep a daily caregiver log or journal if caregiving is being shared so information regarding foods eaten, fluids consumed and activities, bowel movements, medication usage cane be noted.
  8. 8-If someone is unwilling to do something, try distracting them, or say that you need their help to do it or say “let’s try this together” which will make them feel valued
  9. 9-Involve them in activities they loved to do – e.g. cooking, knitting, baking (procedural memory stays longer and so a person with dementia can actually skillfully use a knife or a knitting needle well after the short term memory has gone). Involve them in say folding the laundry away, laying the table. Replace expensive tableware for attractive plastic ones.
  10. 10-Use favorite music when agitated or look through an art book together if the PWD is fond of art. Or go through a family album with photos of the PWD and other family members.Some women PWD respond to a stuffed toy and can hold it for hours babying it and talking to it. Use that as a distraction if it works.
  11. 11-If suspicions of theft are focused on a particular object that is frequently mislaid, such as a wallet for example, try keeping a duplicate item on hand to quickly allay the patient’s fears
  12. 12-Repetitious behavior is when the PWD continues to ask the time, or says he/she wants to go home, asks for a loved one who is already dead or asking when a family member will return, keeps saying that some object is lost etc. One way to redirect their behavior is to suggest something like “oh by the way, I am thinking of either past chicken curry or pasta for dinner. Which would you prefer?” Or ask “I am going to prepare dinner, could you help me chop some vegetables/lay the table etc.”
  13. 13-Since PWD continue to have their long-term memory ask them some question about what they enjoyed in the past. If a doctor, ask “oh tell me about when you were a doctor” or to a former teacher “what did you teach at school” etc.
  14. 14-From a caregiver: “interact with them as if bringing up a child. My mother is usually irritable and would take a while to fall asleep. I remembered when I was trying to put my little daughter to sleep and she wouldn’t comply, I lay next to her, put my arms around her and talked to her in a low voice. To my surprise, my mother who was talking in a loud voice until then, dropped her voice and started to croon at me and even took an end of her blanket to cover me. Within minutes her face relaxed and she looked peaceful”.

-Shivani Nandi Ph.D.

She grew up in Cuttack, Orissa and did her schooling at St. Joseph's Girls High School and later studied in Ravenshaw College and Delhi University. She lived in Japan for her advanced studies and work for 13 years.

She has a PhD in Japanese studies from Graduate Univ for Advanced Studies in Kyoto.

Worked as medical writer for Eisai Pharmaceutical Company and with a medical communications company in Tokyo.

Represented the Japanese Alzheimer Association at the ADI (Alzheimer Disease International Conference) for several years as well as volunteered at a local long term care nursing home in Kyoto for many years.

She has an MPhil in Chemistry and Advanced Diploma in Japanese language from Delhi University.

Currently, she is a freelance professional Japanese translator/interpreter in the US.


Comments (0)