Grandma Rose, a retired school principal, suddenly began acting unlike herself.
Her behaviour shifted in ways no one could ignore, marking the quiet beginning of a lifetime struggle.
Her condition kept degenerating over months, characterised by uncoordinated utterances, mixing up words and people, and a steadily slipping memory.
Confusion grew within the household as family members wondered what exactly had gone amiss.
A few thought it was a spiritual attack. But then, who would want to “attack” an 80-year-old woman?
The mystery persisted until a doctor finally recognised the troubling symptoms of Alzheimer’s dementia, a devastating disease of the brain that affects the mind.
The diagnosis brought immediate shock and sadness, emotions swirling through Chinedum, her daughter’s heart.
She knew her mother would permanently need constant care and support to navigate this new reality.
In a “twinkle of an eye’’, a once iron lady would have to be dependent on people for the rest of her life.
Initially, Grandma Rose stayed in the comfort of her beautiful home with domestic helps attending to her needs.
However, it became increasingly difficult to get dedicated caregivers in her own environment.
Stress mounted as Chinedum eventually brought her to live with her, managing daily tasks, medications, and watching a once-strong woman fade into vulnerability.
Emotions ran deep, from love, exhaustion to guilt, helplessness and more, each day testing Chinedum’s strength.
However, Chinedum discovered that love and patience remained the most powerful connections, transcending the boundaries of forgetting.
“My mother was a beautiful woman, physically and in character, who lived meticulously—maintaining a disciplined lifestyle.
“A retired school principal, strict, intelligent, agile all prim and proper.
“Her sharp decline began unexpectedly, marking a confusing transformation in her personality,’’ Chinedum recalls.
As the disease advanced, the clinical manifestation of the pathology altered Grandma Rose’s perception of reality.
“The family witnessed heartbreaking changes.
“Constant mentions of needing to go home, bizarre accusations, wandering out of the house, disorientation, and moments of complete memory loss.
“She would eat and not remember what she had eaten.
“One day, mummy looked at me and said, ‘I don’t know who you are.’ I was confused,” Chinedum shares, her voice tinged with pain, coming to the realisation that the physical demands of handling an adult with cognitive impairment presents unending challenges.
“To get her to bathe and brush her teeth was and is still a tug of war.
“Yet, amidst the confusion, moments of pure human connection would also emerge.
“Sometimes, she would smile and say, ‘You are my mother, sister, brother,’ whichever one entered her mouth.
“She would bless me and say I am special.
“Sometimes during interaction while feeding or bathing her, she would say ‘I like you,’ followed by a compliment in our native language—I mara nma, meaning ‘You are beautiful’,’’ Chinedum continues.
According to the World Health Organisation (WHO), dementia is a condition that affects memory, thinking, and the ability to perform daily activities.
It is an umbrella term for a collection of symptoms caused by underlying physical diseases or injuries that damage nerve cells in the brain (such as Alzheimer’s disease).
It is caused by different diseases that damage the brain and gets worse over time.
Because this physical damage disrupts how brain cells communicate, it impairs mental abilities like memory, thinking, reasoning, and behavior, eventually interfering with daily activities.
Although more common after age 65, it is not an inevitable part of ageing.
Dr Matthias Kwenin, a Consultant Family Physician at Rightresults Diagnostic Centre, Lekki, Lagos State, notes that early-onset dementia affects people below age 65, while late-onset dementia affects those above 65.
However, he notes that dementia is not necessarily a result of old age, because somebody could be 90 years old and free of dementia, whereas another person could be 50 and have it.
“So there isn’t an age limit at all, because people with Down syndrome could get dementia at the age of 25 or 30,’’Kwenin states.
He lists other possible causes to include head trauma, illness, extreme grief, or stress.
“One could have a car accident, bang his head, and get bleeding that causes problems to the brain,” he notes.
On diagnosing and managing the condition, Kwenin states that dementia is incurable, progressive, and irreversible.
According to him, medication does not cure the condition but can help slow down its progression.
Family members and close friends are usually the ones to pick up the early signs.
“Dementia has no cure. That is why, when you catch it early and start medication, it helps slow it down.
“Without medication, dementia can worsen rapidly, leading to severe symptoms like aggression and self-harm.
“The goal of treatment is to prevent the condition from deteriorating too quickly. You just have to manage it,” Kwenin explains.
Looking at the cultural frameworks and economic strains, Dr Oluwatoyin Adeyemi, another physician, highlighted the critical need for dementia advocacy in Nigeria.
She emphasises that no fewer than 55 million people globally and an estimated 10 million annually in Nigeria live with dementia.
The challenges of caregiving within extended families and the economic strain on caregivers are exhausting, she notes.
Proffering solutions, Adeyemi calls for actionable plans, including equipping primary health care centres (PHCs), community-based awareness campaigns, and training caregivers.
She stresses the lack of a National Dementia Strategy and the need for better data collaboration.
She also called for more geriatric clinics and the involvement of traditional and faith-based leaders.
“The extended family system in Nigeria is both a benefit and a challenge for elderly care.
“There is an urgent need to train more geriatricians and equip primary health care doctors to identify dementia signs early.’’
Adeyemi urges government, private sector, NGOs, and social enterprises to collaborate in raising awareness.
“If you go to every home, I’m sure you’re able to identify someone suffering from dementia.
“In Nigeria, most older adults live within an extended family system. Because it is seen as a given that families will care for the elderly, we don’t have many elderly care facilities around.
“This has taken a massive toll on the caregivers.”
She adds that economic shifts have also worsened the caregiving dynamic.
“With the worsening economic crisis where people have to go out to hustle, you can imagine how demanding it is taking care of someone at home with dementia when you also have to work at the same time.”
| Structural Challenges | Strategic Solutions |
| Severe deficit of specialised geriatric clinics and trained geriatricians. | Integrate geriatric medicine into core medical school curricula and retrain PHC doctors. |
| Economic strain forcing primary caregivers to balance work and intensive care. | Establish specialised elderly daycare centres for cognitive stimulation. |
| Lack of accurate record-keeping and data tracking. | Strengthen data collaboration and incentivise presentation at health facilities. |
| Structural misalignment under the Ministry of Youth and Social Development. | Shift administrative oversight of elderly homes to a dedicated, focused ministry. |
To address these deficits, systemic collaboration across multiple societal sectors is required.
“Government cannot do it alone, which is why we are relying on the private sector, NGOs, and social enterprises to come together and spread the word.
“We need to equip our primary health care centres so that they are able to identify the signs of dementia on time.”
She expands on the necessity of localising advocacy to dismantle cultural superstitions.
“We must invest in community-based awareness campaigns, including those taking place in churches.
“We need to involve our traditional and faith-based leaders because they see those suffering from dementia at the community level.
“They can influence people and say, ‘Oh, this is not a spiritual attack; this is actually something medical’.”
Furthermore, human resource development must adapt to clinical realities, Adeyemi advises.
“Caregiving is now a profession, and people need to get paid professionally to do it.
“We also need integrated elderly care services. There are very few geriatricians, and with brain drain, they are getting fewer.
“We can mitigate this by equipping medical officers at the primary health care level and teaching medical students about elderly care.”
Data inaccuracy remains a major impediment to policy design, she also identifies.
“Our data is not very accurate because we are not keeping proper records, and many people do not present at health facilities.
“Dementia is a whole spectrum that needs supportive, non-medical strategies alongside medical care,” she states.
Adeyemi also urges the government to move the oversight of elderly homes from the Ministry of Youth and Social Development to a more appropriate, dedicated ministry.
She emphasises that the current ministry handles a broad range of responsibilities, including sports and correctional centres, leaving elderly care without a focused approach.
She also suggests preventive approaches like daycare centres for the elderly to engage in activities that stimulate their brains.
Supporting this systemic approach, Anastacia Ojimba, a Consultant Public Health Physician at the Federal Medical Centre, Asaba, said there is an urgent need to prioritise social welfare for old people in Nigeria.
Ojimba, who calls for the establishment of more care homes, urges the public and government to encourage social welfare plans and programmes.
“Locking the old people up in a room or taking them to the cities are not the best options.
“The old people need to be taken to an environment that suits their condition, preferably care homes where professional caregivers are employed,” Ojimba says.
Lending her voice to the institutional call, the Director of MASC Care Home, Mrs Busola Shogbamimu, also calls for more advocacy and public awareness on dementia, decrying the poor knowledge among the populace.
As families like Chinedum’s navigate the complex, emotionally exhausting landscape of cognitive decline, Dr Esther Adegbolagun, Senior Registrar, Psychiatrist at Federal Neuropsychiatric Hospital, Yaba, asserts that family support and multi-disciplinary approach are key to managing dementia effectively.
No family should face the journey alone, as caring for a relative with dementia is demanding and can disrupt family harmony and stability.
She recommends a healthy lifestyle such as avoiding smoking, cutting alcohol, and controlling cholesterol, blood pressure and diabetes.
“Fish rich in omega-3, like Titus, may also help.”
She advises building routines around cognitive stimulation — reading, listening to radio or music — alongside proper medication use.
Rather than shout at a forgetful elderly relative, Adegbolagun advises gently repeating information in short, simple sentences.
“Validation therapy meets the person where they are emotionally, reducing frustration for everyone involved,” she says.
All in all, as many Nigerians begin to be aware of the dementia condition, Nigeria must transition from basic advocacy into structured, legislative, clinical and social actions to preserve the dignity of its aging populace. (NAN)
