Dementia does not always announce itself with dramatic outbursts or sudden health crises.
More often, it arrives like twilight, quietly blurring the sharp edges of a life once clearly seen. It begins with misplaced keys, progresses to missed appointments, and eventually steals the most sacred data we possess, the visual layout of our own lives.
Recognising the changing faces of dementia both the literal faces of our loved ones as the disease alters their expressions, and the shifting identity of the condition itself is one of the most profound challenges a family can face. It is a journey of learning to connect when words fail, and finding love in the spaces where memory used to live.
According to neurologist Dr Donald Shitemi, dementia is not a disease itself but a group of symptoms caused by conditions that damage brain cells, affecting memory, thinking, behaviour and the ability to carry out everyday activities. Alzheimer’s disease is the most common type, accounting for 60% to 80% of all cases, and is characterised by high levels of specific protein build-ups inside and outside brain cells.
The second most prevalent type is vascular dementia, which occurs due to microscopic bleeding or blood vessel blockages in the brain. Other forms include Lewy body dementia, which involves abnormal protein deposits affecting movement and thinking, and frontotemporal dementia.
When an individual experiences the brain changes of multiple types simultaneously, it is referred to as mixed dementia.
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Dr Shitemi says normal ageing may involve forgetting a word before remembering it later or occasionally missing an appointment. A person with dementia, however, may repeatedly ask the same questions, struggle to recognise familiar faces, become confused about the date or location, or even forget how to perform routine tasks such as preparing a meal or paying bills.
One of the most worrying symptoms, he notes, is wandering. “We often receive patients who have wandered away from home and become lost while walking in neighbourhoods they have known for years. They may be unable to remember their address or even recognise where they are. This is frightening both for the patient and the family,” he says.
Doctors say several factors increase the risk of dementia, including advanced age, high blood pressure, diabetes, smoking, obesity, hearing loss, physical inactivity and a family history of certain neurological conditions.
Early diagnosis is equally important.
Although there is currently no cure for most forms of dementia, medications and supportive therapies can help manage symptoms, slow progression in some cases and improve quality of life.
For many families, however, dementia changes life in ways they never imagined.
For Mary Achieng’, caring for her 78-year-old father has become a full-time responsibility. She first noticed something was wrong when he repeatedly forgot family gatherings and insisted he had never been told about them.
“At first we laughed about it because we thought it was simply old age,” she recalls.
“But things became more serious when he left the house one morning for what he said was a short walk and never came back. We spent hours searching before someone found him several kilometres away. He couldn’t remember where he lived.
“Since then, the family has installed locks, ensured someone is always with him and labelled important items around the house to help him navigate daily life.
“The hardest part is watching someone who raised you slowly lose memories of people and places he loved. Some days he recognises us immediately, and on others he asks who we are. It is heartbreaking, but we have learnt to be patient and reassure him instead of arguing,” she says.
Health experts say families should seek medical attention if memory problems begin affecting daily activities or are accompanied by changes in personality, confusion, poor judgment or difficulty communicating. Beyond medical treatment, emotional support is essential.
Caregivers often experience stress, anxiety and exhaustion, making support groups and respite care invaluable.
Forgetfulness may sometimes be part of growing older, but persistent memory loss that disrupts daily life should never be ignored.
Acting early could make all the difference for both patients and the families who love them.