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Living with Dementia

An Overview Of Wernicke-Korsakoff Syndrome

  • - Alcohol related dementia - Wernicke-Korsakoff Syndrome
  • Oct 30, 2011
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  • Viewed: 2663
Tags: | alcohol abuse | ataxia | karl wernicke | korsakoff's psychosis |

If caught early enough, WKS is a preventable, treatable disease. Treatment consists of thiamine replacement therapy, sometimes along with other vitamins.  Dosages may vary and should be monitored closely by a physician.  If alcoholic consumption stops and treatment is properly administered, individuals with early-stage WKS can expect a marked recovery and may be capable of learning simple, repetitive tasks.

However, the person’s confusion may take some time to subside and even incomplete recovery of memory can take up to a year.  In the later stages, if damage to the brain is irreversible, individuals are likely to have lasting problems with memory and gait (for example, lack of muscle coordination and numbness or weakness in limbs).

Family Issues
Caring for a family member who has WKS or alcohol-related dementia presents multiple challenges for family caregivers. Lasting symptoms of dementia and other neurological problems are difficult conditions under even the best circumstances. Bizarre behaviors may be interpreted by the family as a continuation of “binge” drinking, even if the person has stopped drinking.

Individuals with a history of alcohol abuse have often isolated themselves from their families and loved ones.  Strained relationships are common in families of alcoholics. As a caregiver,  you may feel resentful of caring for a parent or spouse with a life-long history of alcohol abuse. In addition, it may be hard to convince the impaired person to give up drinking, since most WKS-affected individuals have been long-term alcoholics.  Discuss with a physician or mental health professional effective strategies for preventing a loved one from drinking. Ironically, people with WKS can be quite apathetic and seldom demand alcohol, yet are likely to accept it if offered.

Families should enlist the help and support of mental health professionals or case workers who have experience in working with alcoholism.  Family meetings or support groups also may be helpful in bringing together additional family members to assist the WKS person. A case manager or family counselor can help the family sort through issues and help arrange appropriate support services. In severe cases or when the family is unable to provide appropriate care, a residential facility may be sought. Nursing homes which provide special dementia care should be considered for a confused WKS patient.

Research indicates that alcoholism often runs in families.  Having additional family members who are alcoholic increases the burden of care. Some research has shown that a person whose parent has a history of alcoholism may have an inherited susceptibility to alcohol addiction and alcohol-related neurological problems (peripheral neuropathies).  Such findings suggest that people in alcoholic families need to take special precautions to avoid excessive use of alcohol in order to reduce their own risk of alcohol-related health problems.

Caring for the Person with WKS
It is important to ensure that the affected person continues to abstain from drinking alcohol and that the person maintains a balanced diet with adequate thiamine intake. However, even if the person stops drinking and replenishes thiamine, symptoms of the disease (e.g., problem behaviors, agitation, lack of coordination, learning deficits) may continue. In an abstinent (i.e., sober) WKS patient, these symptoms must be recognized as part of the disease caused by irreversible damage to the brain and nervous system.

Family caregivers should take precautions to ensure the safety of the person with WKS, as well as others in the household. The confused or disoriented individual should not be left alone. Supervision is required to ensure that the person does not wander away from home, leave the stove on or the water running.

Short-term memory problems mean that the confused person may repeat the same question again and again.  Coping with frequent repetition often involves a trial and error approach and a combination of strategies.  First, be patient and deliver responses in a calm manner. The confused person will pick up on your mood and may become more frustrated if your voice is loud or angry.  In addition, place reminders in the house to help the person feel more secure. Label inside doors and drawers with words or pictures. Write notes (e.g., dinner is at 6:00 pm). Another strategy is to distract the person with another topic or activity (e.g., a short walk, reminiscing over an old photo, etc.).

If the person continues to be agitated,  symptoms should be discussed with a physician, neurologist or psychiatrist.  Medications may be available to help control outbursts or anxiety.

Just as important, it is essential that the caregiver get some support and time off from constant caregiving demands. Make sure you leave some time to attend to your own needs, including eating well, getting enough sleep and getting regular medical check-ups. A home care worker, friend or family member may be needed to provide periodic respite assistance to help your loved one and to relieve the stress on you, the family caregiver.

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