A less talked about pandemic

The lives of about 50 million people worldwide have been shattered without any hope of recovery by Alzheimer’s or some other form of dementia. The number is increasing by about 10 million a year, according to the World Health Organisation.

In Portugal, around 200,000 people - more than twice as many women as men - have dementia. That’s the latest round figure from the non-profit, non-governmental organisation Alzheimer Europe.

At least as many people giving close care to family or friends with dementia have been heavily impacted by the disease, but in a very different way.

Dementia is a cruel syndrome or group of symptoms associated with an ongoing decline of brain functioning that usually develops slowly over years and sometimes without clear cause.

In general, carers only notice the symptoms some time after they break out as memory loss, attention deficits or other cognitive impairments are assumed to be part of the normal ageing process, says Dr Margarida Ferreira, a psychologist with the Portugal Alzheimer association.

“We might be a bit more forgetful as we grow older, but normally, after a while or with the help of a cue, we are still able to recall. So the tendency among close family and friends is usually to ignore early symptoms and only later, when something significant or dangerous happens, do they think that all might not be okay.” 

Dr Ferreira points out that close care-givers can be burdened with “physical, mental and emotional exhaustion.”

 In some cases, she says, “it is not only that  you are constantly supervising the person with dementia and helping them in their needs without any training or someone to share the care, but also that role inversion, as with a son taking care of a parent or a husband of a wife. This can add to the loss of someone you once knew differently.”

Care-giving can exhaust a carer’s ability to remain calm and be patient especially, for example, after repeatedly listening to the same talk over and over again. 

“This is generally because carers don’t have the time or support for their own personal needs, which includes comprehension and acceptance of the disease as well as managing their own feelings and expectations,” says Dr Ferreira. 

 “This lack of self-care and support, along with other factors, can in some cases lead to physical and mental health issues, such as anxiety and depression.

Portimão and Lagoa host the two local offices of the Portuguese national Alzheimer organization in the Algarve. This is where Dr Ferreira provides professional advice upon appointment to those in need, according to each specific situation.

“In some cases the main concern is the medication, in others personal care or specific behaviours,” she says.

Dr Ferreira (pictured above) suggests that caring family and friends experiencing fatigue should take advantage of the information available in English as well as Portuguese on the Alzheimer Portugal website:. https://alzheimerportugal.org

Here we quote directly from part of the website….

10 Steps to Becoming a Healthier Caregiver

Do you feel overwhelmed by caring for another person to the point of neglecting your physical, mental, and emotional well-being? If you don't take the time to take care of yourself and your needs you could be putting your life and health at risk.

Identify Changes as soon as Possible

Symptoms of dementia develop gradually. Whenever you notice significant changes in the person's memory, mood or behaviour, talk to your doctor. Don't delay. Some symptoms can be controlled.

Discover the Resources Available in the Community

Find out about the support, services and equipment available. Day centres and home support are some of the answers that can help you in providing care and in carrying out day-to-day tasks. 

Be Informed

As the disease progresses, it may be necessary to acquire specific knowledge and skills to face the challenges that arise. Try to participate in workshops and other training actions, with specific and diversified content, which can help you understand and better deal with the changes in behaviour and personality that accompany the disease. 

Seek Help

Trying to do everything yourself can lead to exhaustion. Seek support from family, friends and available resources in the community. Help lines and support groups are some of the resources that can help you find comfort and safety. If stress becomes disabling, seek professional help.

Take Care of Yourself

Pay attention to your diet, exercise and rest as much as possible.Watching your health will make you a better caregiver.

Control Your Stress Level

 Stress can lead to physical disturbances (blurred vision, gastrointestinal disturbances, high blood pressure) and behavioural changes (irritability, lack of concentration, changes in appetite). Be aware of your symptoms. Use relaxation techniques that make you feel better and talk to your doctor.

Accept the Evolution of the Disease 

The needs of People with Dementia change over time and with the evolution of the disease. Demands may exceed your responsiveness. Knowing the resources of the community - day centres, home support services and homes - can facilitate the decision to share the provision of care with others.

Make Decisions of a Legal and /  or Financial Nature

Plan ahead in advance. Know your rights and those of the Person with Dementia, as well as the legal procedures to be followed after diagnosis and during the course of the illness. Involve, whenever possible, the person with dementia and the closest family members.

Value Yourself and don't Blame Yourself

Remember that your care makes a difference and that you are doing the best you can. Don't blame yourself for not being able to do everything yourself. Even though care may no longer be provided by you, as the disease progresses, you can continue to ensure that the person is well cared for and feels safe.

Talk to your Doctor Regularly

Make time for yourself, get regular routine checkups, and listen to what your body tells you. Watch out for exhaustion, stress, sleep disturbances and changes n n appetite and behaviour. Ignoring these symptoms can seriously affect your physical and mental health.

The Care-giver in Stress.. ..

10 Warning Signs:

 1.  Denial about the disease, its evolution and its effects on the diagnosed person.

    “I know my mom will get better.”

2.  Anger toward the person with dementia or other people, anger that there is no cure, or by the lack of understanding of others.

   “If he asks the same question again, I scream!”

3.  Social isolation, withdrawal from friends and loss of interest in activities that before he liked to do.

   “I don't feel like hanging out with anyone anymore.”

4.   Anxiety about having to face one more day about the future.

    “What will happen when he needs more care than I can give?”

 5.   Depression that affects well-being and the ability to cope with everyday challenges. 

     “I don't want to know anymore.”  

 6.   Exhaustion feeling that it seems impossible to carry out the necessary daily tasks.

      “I'm too tired for this.”

7.   Insomnia caused by an endless list of worries.

    “What if during the night he gets up and falls?”

8.   Irritability that translates into bad mood and provokes negative responses and reactions.

     " Leave me alone!”

  9.   Lack of concentration that impairs day-to-day activities

      “I've been so busy I forgot I had an appointment.”

10.   Health problems that begin to compromise physical and psychological well-being.

      “I don't remember the last time I felt good.”

 

To contact Alzheimer Portugal offices in Portimão and Lagoa: 

From Monday to Friday: 9.30 to 12.30

+351 965 276 690  

geral.algarve@alzheimerportugal.org

What you don’t need to know about COVID foreign travel

For those who are utterly confused or bored by the international travel rules due to the COVID pandemic, the good news is that from 4.0 am on Wednesday 30th June Brits can go to more green list countries, including the tiny Pitcairn Islands situated in the middle of the vast South Pacific Ocean. Or they can go to the British Antarctic Territory, an enormous frozen wilderness that stretches from an iceberg-strewn coastline to the South Pole.

Travellers will not have to quarantine upon returning to the UK from these green list countries, although those who have been to the Antarctic might want to spent a couple of weeks sitting at home in front of a warm fireplace.

The bad news is that easyJet don’t run low-cost flights to the Pitcairns, which at last count had a total population of 67. Nor does Ryanair fly to the Antarctica Territory, which has no native inhabitants and only about 250 researchers and support staff.

 The very much more accessible and attractive Portuguese island region of Madeira is now also on the green list, although very strangely the Azores archipelago is on amber along with mainland Portugal. 

One of the few things the British government has made clear is that the likes of Madeira are on a green “watch” list, meaning they could suddenly be downgraded to amber. Such an outrageous U-turn forced many Brits to cut short visits to Portugal in early June and go scrambling home at great inconvenience and extra cost to avoid quarantine. 

Many of Prime Minister Boris Johnson’s critics say he is both a buffoon and bonkers because instead of following the science as he claims, he is following his own dodgy political agenda. Portugal's minister of foreign affairs described one of Johnson's decisions regarding air travel as "absurd" and "illogical."

The UK government’s handling of overseas travel during the pandemic continues to infuriate economically battered airlines, tour operators, the great many businesses in Portugal and elsewhere dependent on tourism, as well as fully vaccinated Brits longing to join loved-ones abroad.

Plenty of frustrated people who have been under tight restrictions for months are desperate to get away. Sadly, the coronaviris pandemic is not going away, not anytime soon anyway.

As in the UK, citizens across the European Union are being advised to grab a jab. EU countries have also agreed a coordinated approach to international travel.

The Portuguese government says it is taking “all necessary public health measures to protect the entire population as well as visitors.”

Essential and non-essential travel is allowed on flights to and from all EU member states, Schengen associated counties, and a number of more distant nations including the United States, the United Kingdom, Israel, Thailand, Australia, New Zealand and Japan.

The usual tests are required 72 or 48 hours before flights. Children under the age of 12 do not require test results, and from 1st July an EU digital COVID certificate will be acceptable from all EU travellers.

European countries, particularly Germany, have voiced concerns about welcoming British visitors as the prevalence of the so-called Delta variant rises and spreads. Even in the Algarve, some of the recent rising COVID cases have been attributed to foreign visitors.

From a British or EU traveller’s perspective, popping over to Pitcairn or Antarctica may be tempting, but a more relaxed visit to green Madeira, or even the amber Azores or mainland Portugal, are probably a better option.   

Madeira

The dark side of ‘green list’ travel

Faro Airport departure area on Sunday 

Photo by Tonia Christensen

 

Many British visitors to Portugal are counting the cost of having to rush home early amid the chaos created by the British Government’s sudden U-turn on its ‘green list’ travel arrangement.

 

Among them is Tonia Christensen, who came to the Algarve, not to enjoy a getaway sunshine holiday, but to visit at long last her elderly mother who has dementia.

 

“I was last able to visit my mother in September 2020. I planned to do so in January and again in March this year, but easyJet cancelled the two-way flights both times because of the COVID travel ban,” said Tonia.

 

“I booked again with easyJet as soon as it was announced that Portugal was on the new ‘green list’ when Britain lifted its overseas ban on May 17.”

 

Never mind that the cost of flights immediately soared, daughter and mother were desperate to see each other. Tonia, who had been fully vaccinated, as was her mother, resigned from a London university-based job to make the one-week trip.

 

The required PCR test before her departure last Friday would have cost £175 in Wimbledon, in the closest test centre to her home, so she made the one hour journey to Croydon where the cost was £80.

 

Shortly before she was about to fly from London Gatwick to Faro, the British Government suddenly downgraded Portugal to the ‘amber list.’ That meant Tonia would have to quarantine for 10 days upon returning home. That would not be possible because she had agreed to take up another sensitive job in London shortly after her one-week Algarve visit.

 

She had no practical choice other than to reschedule her return flight to Sunday. The airline said no seats were available on Monday. No refund on the original return flight was available, so she had to pay again in full for the rescheduled Sunday flight.

 

Now she would only be able to see her mother for one full day instead of a week.

 

The flight was not full but there was an hour’s wait in line at Faro for a previously-booked hire car. The receptionist mentioned without apology that the car’s fuel tank was empty. That might have been a concern for first-time visitors, but Tonia speaks Portuguese and is familiar with the whereabouts of local petrol stations.

 

The joy of getting together with her mother again was wonderful, but severely dented when amid all the COVID restriction confusion Tonia realised she would have to take a lateral flow COVID test before flying home, as well as a PCR test within 72 hours of arrival in London.

 

By the time she had emerged from Faro airport with a car last Friday evening, the test centres in various Algarve localities were already closed for the weekend. All phone calls to test centres went unanswered.

 

Local newspaper reports warned that long queues for COVID testing at Faro airport meant that passengers had to wait for hours and in some cases missed their outgoing flights in doing so.

Even though lateral flow testing is supposed to be rapid, the reported long queues were confirmed in a phone call eventually answered by a very busy COVID centre official at the airport. The cost would be €30. 

 

Tonia’s only option then was to leave her mother on Sunday morning, hours earlier than planned, in order to be sure to get a test and not miss her flight home before the 4.00 am Tuesday June 8 deadline. 

 

Her flight back, as were many others from Faro, was delayed by frustrated and confused queuing crowds. 

 

“I sat on the plane on the tarmac for more than one and a half hours, surrounded by tired screaming children. We were waiting for passengers who had been unable to get through the check-in on time. The Captain informed us that he had been instructed by easyJet to wait for all the remaining passengers.”

 

That wasn’t the end of the chaos, explained Tonia. 

 

“Immigration at London Gatwick wouldn’t let me through because I hadn’t previously booked my second day PCR COVID test. I had to agree to and pay on the spot for a government home test before being allowed to proceed. That was another £88. Total cost just for testing: nearly £200.

 

“All this despite filling in passenger location cards for both the Portuguese and UK authorities so they knew exactly where I was!”

 

She was back in London, but the travel nightmare wasn’t quite over yet. There were no trains running into the city from Gatwick. In all, returning  home from Portugal turned out to be a 12-hour trip!

 

Meanwhile, responding to Portugal having been taken off the green travel list, top Portuguese health officials insisted that the British Government’s claims about increased rates of COVID infections and the prevalence of the Nepal mutation in Portugal were based on misinformation or lies. 

 

Tourism 2021 off to a good start

 

Tourism 2021 has started well in Portugal, particularly in the Algarve where it’s economically vital.

Things are looking good for June, on into July and well beyond.

For the last two weeks of May following the easing of lockdowns and travel bans, visitors from abroad have been enjoying themselves in the warm sunshine. Many tourist-orientated businesses have reopened, many jobs revitalised and the economy in general is on the way to recovery.

“We are off to a strong start and the numbers for June could be close to the numbers pre-COVID, if not exceeding them,” Daniel de Adro, vice-president of the Algarve Regional Tourism Board, told the UK magazine Travel Weekly.  

The Algarve is now in a good position to dismiss 2020, “the lost year,” he added.

UK visitor numbers in the Algarve, which normally represent half of all airport arrivals to the region, fell by 85% last year compared to 2019. International arrivals at Faro airport dropped overall by 74%.

While it may be an exaggeration to say that holiday demand for the region suddenly “exploded” on being placed on the “green list” by England, Scotland, Wales, and Northern Ireland, it certainly gave Portugal plenty of exposure.

Among the first UK arrivals in May were singing superstar Rod Stewart (76) and his wife Penny Lancaster. They hired a private jet to bring them here. They shared their joy of staying at the luxurious Vila Vita resort in Porches, Lagoa, on Instagram. News of their visit, together with photographs of the couple languishing in beautiful surroundings, were then published in the Daily Mail newspaper.

Things could be better, of course, especially for hotels in Portugal that have not yet been able to properly prepare to take advantage of the increase in the numbers of bookings that for open hotels have   exceeded expectations. Some hotels that have been at a standstill for a year and a half will not be ready to reopen until later in June.

The full operation of the hotels is "dependent on the stability of the markets that send tourists, particularly the British and the domestic market that may be affected by a possible setback caused by the pandemic, " Elidérico Viegas president of the Association of Hotels and Tourist Enterprises in the Algarve (AHETA) told the Portuguese Lusa news agency.

“If these factors continue, we can expect that this summer will be much better than last year and hope that in September, with the start of the high golf season, demand will be close to normal,” he said.

“If this growth outlook is met, the region will be able to prepare itself for “a year of some recovery in 2022.” As for 2023, there are expectations “of a return to almost normality.” 

Elidérico Viegas added. “The mass vaccination of the Algarve’s population is the best way of guaranteeing the safety of people who want to choose the Algarve as their destination."

Portugal is accelerating its vaccination rollout nationwide with 30-year-olds starting on June 6 and 40-year-olds from June 20. The health authorities are also ramping up testing, targeting schools, vulnerable populations like asylum seekers, and crowded areas such as central train stations in Lisbon.

Pharmacies in Lisbon already offer a free antigen test every 15 days. “We must act in a preventative, proactive manner, to break chains of transmission,” Health Secretary  Lacerda Sales said.

Portugal has been lifting restrictions in a step-by-step loosening of the rules underway since April after four months of stringent lockdown.

While cases have since remained relatively stable nationwide at around 300 to 600 new cases per day, Lisbon saw a steeper rise in May, particularly among young adults, the health secretary said.

It came as no surprise that many of the thousands of football supporters who descended on the northern city of Porto for the Chelsea vs Manchester City UEFA Champions League Final indulged in the region’s best known commodity. Regardless of the excellence of Douro Valley wines, the sheer quantities consumed by many fans created enthusiasm that at times was somewhat excessive but didn’t call for much police intervention.

A potentially much more damaging event was a threatened strike by the airports and border security police force, SEF. It could have severely disrupted inbound and outbound visitors, but the strike has been abandoned.

Meanwhile Portugal’s economic recovery has been fast and strong since the country started easing its COVID-19 lockdown in mid-March, Economy Minister Pedro Siza Vieira told Reuters.   Growth this year may exceed the government’s forecast of 4%, he said.

The economy slumped by 7.6% last year. The government predicted in April this year that the economy would grow 4% in 2021.

“We are envisaging more favourable growth,” Siza Vieira said, pointing to the ongoing resumption of tourism as a significant factor. Tourism accounted for nearly 15% of gross domestic product before the pandemic.

 

Coping with dementia: protection

Generally speaking, people over the age of 18 are able to exercise their rights personally and freely, fulfill their obligations and look after their assets themselves.

However, there are citizens who, for a variety of reasons cannot consciously and freely exercise these functions without the support or intervention of another person. The Lei do Maior Acompanhado regime is intended precisely for the latter. The law’s aim is to preserve the independence that the person still has and, as far as possible, to increase it. In this sense, a court, after examining all the evidence provided at a hearing and with reference to medical information, will decide which actions the individual can and must continue to practice freely and those which, for their own protection, must be carried out by or with the help of an accompanying person. There are certain acts that the accompanying person may only perform after obtaining the court's specific authorisation.

Living Wills

Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. Advance directives guide choices for doctors and caregivers if you are in the late stages of dementia, terminally ill, seriously injured, in a coma, or near the end of life. Living wills have no power after death.

Advance directives are not just for older adults. Unexpected end of life situations can occur at any age, therefore it is important for all adults to prepare these documents.

By planning ahead, you can obtain the medical care you specifically want, avoid unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf.

I’m here!

"Estou Aqui" bracelets are specially designed for people who, depending on their age or pathology, may become disorientated or unconscious, even momentarily, when in public. The bracelets are designed to assist in safety and to ensure a speedy reunion with a relative or acquaintance. Activation can be made by the user themselves or by a third party through the option “request Institution / Carer”.

The bracelet is made up of a comfortable fabric tape and a metal plate with an alphanumeric code and the inscription; "Call/Ligue 112". The bracelet is free, personal and non-transferable. To obtain a bracelet you must register on the website and then go to the designated police station to collect and activate it.

For more on this: https://estouaquiadultos.mai.gov.pt/Pages/Home.htm



ALZHEIMER’S PORTUGAL

The information in Portugal Newswatch’s three special reports this week has been provided by Alzheimer’s Portugal, a national, non-profit organization dedicated to giving advice to people with any form of dementia, members of their families and carers.

The organisation’s official website: https://alzheimerportugal.org/pt/

Facebook https://www.facebook.com/alzheimerportugal.org

Alzheimer’s Portugal has offices backed by municipalities in many parts of the country. Face-to-face consultations with specialists can be arranged by appointment: 

https://alzheimerportugal.org/pt/onde-estamos