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I received a call from a distressed daughter seeking care for her father 9 years ago: my first Korsakoff client. The number now runs to double digits.
© Danielle Robertson Consulting Pty Ltd t/as DR Care Solutions
This Brain Awareness Week (11 to 15 March 2024)[1], we’re sharing information on Korsakoff syndrome (Korsakoff’s) and my experience in finding quality care for those living with it.
About the name
The condition is named after Sergei Korsakoff, the Russian neuropsychiatrist who described it during the late 19th century. As you read on, it won’t surprise you that its nomenclature comes from the country with the highest rates of alcoholism in the world.
What is it?
Korsakoff’s is brain damage caused by the excessive consumption of alcohol over a long period of time. Only some excessive drinkers develop the condition and medical researchers do not know why some are more susceptible to it than others.
What they do know is that it is related to thiamine (vitamin B1) levels. Some excessive drinkers become thiamine deficient and low levels of thiamine kills brain cells.
Most of us source our thiamine from eating healthy food. Excessive drinkers may become thiamine deficient because:
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They overlook healthy eating as alcohol gives them energy.
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Alcohol disrupts thiamine processing in their body, preventing its use or absorption.
With the exception of one woman in her early 70s, most of my Korsakoff clients have been men in their late 60s and 70s. Sadly, many of them former health practitioners.
What sort of brain damage?
Over time the condition affects those areas deep within the brain that support our ability to form new memories and learn new information. Old memories can also be affected.
Other symptoms include:
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Personality changes;
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Making up stories to fill gaps in memory (confabulation);
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Seeing or hearing things that aren’t there (hallucinations); and
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Lack of insight into the condition[2].
As you can imagine, these symptoms are very challenging for family members to manage.
Caring for Korsakoff clients
In my experience, the inability to take in new information and the aggressive behaviour are the hardest symptoms to manage.
For example, after lengthy conversations the client may agree to move to residential care and then, within minutes, have no recollection of the conversation or agreement. And at any moment, there can be an outburst of aggressive behaviour, verbal but also occasional physical aggression.
I usually work with the person holding the Enduring Guardianship and / or Powers of Attorney. Commonly, they are estranged from my client as they can no longer tolerate their behaviours yet have to make the difficult decisions around ensuring their loved one remains safe and well cared for.
Residential care is invariably the only option as 24/7 in-home care with specialised staff is costly and consistency in staff is difficult to find.
The challenges mount when residential care homes refuse to take the person because of their aggressive behaviour and the need to meticulously manage their (often) anti-psychotic and other medication.
By law, administering anti-psychotic medication involves time-consuming record keeping and many residential care homes avoid it by not accepting applications for residency.
Also, where the client is mobile, care needs to be taken to avoid residential homes located within easy walking distance of bottle shops, clubs or pubs.
Call on us to find care
If you are needing care for a loved one with Korsakoff's, call on us to find quality care that meets your loved one’s needs.
The information in this blog is not to be taken as medical advice. Please speak to your GP or Geriatrician.
Need help caring for a loved one? Please feel free to call me, Danielle Robertson, at any time for an initial discussion on how to set up the right care, support and assistance at the right time and in the right place.
Resources
[1] Brain Foundation: Brain Awareness Week
[2] For more information, visit Dementia Australia: Alcohol Related Brain Injury and Wernicke-Korsakoff Syndrome
