The Express Tribune hi five - May 17

Ms MAY 17, 2015

ISSUE NO. 152

Still Ammi How a daughter copes with her mother’s progressive dementia

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What’s in a name?

Changing your name after marriage

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inside En vogue — Shimmer & shine

Domestic goddess —

Spicy chicken and mushroom stroganoff

Section In-Charge: Dilaira Dubash Sub-Editors: Amna Hashmi Nisma Chauhan Designer: Umar Waqas Feedback: women@tribune.com.pk

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The elegant Maheen Karim

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The buzz

THE EXPRESS TRIBUNE, MAY 17, 2015

A daughter opens her heart about her mother’s dementia and how others in similar situations can cope

By Farahnaz Zahidi

“So what exactly is wrong with your mother?”

This is a question I kept hearing for seven years. Initially, I would reply, “She has let herself go after my father’s death” or that “she is depressed.” My responses have kept changing over time, as I learnt, unlearnt and relearnt about my mother’s condition, because what she was going through was much more than just melancholy or depression. The shock of my father’s death had triggered the progressive disease called dementia.

My mother showed no symptoms earlier in her life that could have indicated she could be prone to dementia. All I remember is that in her forties, she developed insomnia and began relying on sleeping pills. She often forgot where she had left the keys. There would also be bouts of paranoia wherein she felt she was being watched by someone or that someone was trying to harm her. My family and I shrugged them off, thinking

she was overly cautious. Throughout this time, Ammi remained functional, meticulously managing her home, family and relationships.

Her dementia began progressing after an emotional trauma at a later stage in life, in her case the loss of a spouse and so, the deterioration began. Within months, she seemed to have aged by a decade. She was at a loss for words — literally. Having lost one parent already, we — my siblings and I, all adults — felt a double loss. We kept calling on psychiatrists and urging Ammi to stay strong. But today, we understand that she was never weak — she was just not well.

Since then, her dementia has drastically progressed. While all the medical information one might require is available on the internet, personal details on how you can deal with dementia are sparse. It is amongst the most common ailments of old age but unfortunately goes undiagnosed and misunderstood in our society. While, I know some of my family members will

disapprove of me writing about this private family ordeal, someone must speak out to create awareness regarding this debilitating condition. With this, I hope to offer support to patients, family members and caregivers who share what my precious mother and family went through and are going through on a daily basis. Since knowing Ammi, she would have wanted me to share anything that could help others.

“You say she has dementia but remembers your name?”

How does one explain to an unassuming friend or relative what exactly dementia is.

Most people don’t take it seriously unless you call it Alzheimer’s disease. We have all heard about Alzheimer’s so I suppose it rings a bell but in reality, the two conditions are very different. According to the National Institute on Ageing (NIA) USA, dementia is a mental disorder that affects communication and physical performance adversely while Alzheimer’s specifically hampers the parts of the brain responsible for memory, language and thought control.

Memory loss is, nonetheless, one of the main aspects of dementia. It isn’t just the names and faces of people that a patient forgets. For instance, one of the key tests our geriatric specialist (an old age specialist, in layman terms) ran on Ammi involved asking if she remembered which day it was and if

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THE EXPRESS TRIBUNE, MAY 17, 2015

A few silver linings and things to do Here is what you can do to help yourselves and your loved ones through their illnesses:

• Balance and manage your work and families well and take care of yourself physically and spiritually, otherwise you end up being of no use to your loved one.

she could tell the time on the clock. When she couldn’t, her dementia was confirmed.

With one’s thinking affected, basic functions start getting compromised, specially language, vocabulary and communication.

A patient knows what an object such as a spoon or a glass is for and uses it as well but has forgotten what it is called. He or she knows if she has a headache but has forgotten to call it a headache. They know what they feel like eating but forget the name of the fruit, vegetable or dish.

But what is truly amazing is that in most cases, the patient’s consciousness does not alter until the very last stages. Even if Ammi struggles with my name, she knows who I am.

Social skills remain intact until the advanced stages so even if they don’t recognise visitors, patients generally make normal, pleasant and general conversation. However, they do realise something is not quite right with their memory and try to cover it up with generic responses. Often when someone asks Ammi if she recognises them, she smiles and says “How could I not?” She has forgotten their name but is aware that it is someone she knows and that it would be rude to admit she didn’t recognise them.

In a strange way, it is comforting to know that your loved one still feels the important things in life: a connection with other humans and the Almighty. The ability to laugh, cry and experience pain and joy are blessings that stay with the patient until the dementia progresses beyond limits.

“I have forgotten how to walk!”

In the advanced stages of dementia,

things start getting serious with various symptoms (sometimes irreversible) manifesting themselves. For instance, one morning Ammi stood up and wouldn’t walk forward. “I don’t know how to walk,” she kept repeating while we urged her to take a step, eventually giving up and letting her return to bed. Ironically, the next morning, she was walking again, with support as per normal. The doctors attributed this to a “mini stroke” which admittedly frightened us but we were assured that such episodes are common during old age. Over time, we learned to watch out for sudden changes in Ammi’s personality, behaviour or body language for possible signs of mini strokes and to deal with them accordingly.

A patient suffering from dementia often forgets how to chew and swallow. They can no longer gulp down food and water as normally as they used to. The result can be not eating enough, which may lead to wastage and eventually starvation if nutrition is not given to the body by alternate means.

Another complication of this is Aspiration Pneumonia, which happens when food particles enter the lower airways, causing repeated bacterial infection. The patient can also lose bladder control and forget how to exercise basic functions like passing stool or urine, which we take for granted. The result is urinary tract infection, among many other, related problems.

“But life goes on.” Or does it?

Life does not go on — at least not for the caretaker of someone with a progressive mental illness. Just recently, I texted a friend

Understanding dementia Dementia is caused when the brain cells fail to communicate with each other. Damaging of nerve cells that may occur in several areas of the brain is why dementia affects people differently, depending on the area that is affected. However, even though the symptoms may vary, some of the common ones include: Cognitive changes: - Memory loss - Difficulty communicating or finding words

who has experienced a similar situation with a loved one and although we hadn’t spoken in months, she immediately understood how I felt. I told her that I was breaking and she said, “It does things to you. It alters you in strange ways.”

Truer words have never been spoken.

The helplessness of a parent — someone whom you have grown looking up to — is perhaps one of the worst heartaches in the world. Not only must you watch them suffer but the child inside of you dies bit by bit, no matter how old you are. Accepting that the person who raised you is no longer functional or needs an attendant or a nurse for the most menial of tasks is extremely difficult. Accepting that someone who loved food will never again eat by mouth due to the risk of aspirating and must be fed via a feeding peg in the abdomen is tough.

Accepting that they will be bed-bound and catheterised for their remaining days takes a toll on you too. In the midst of managing nursing staff, memorising sheets of medication and managing doctor appointments, one forgets that life was ever normal.

It took me a while to accept that in so many ways, my mother is exactly like an infant.

We make her do exercises and play games with her that will improve her motor skills.

We sing her nursery rhymes and songs that she enjoys. Her needs, now, are very basic, just like a child’s. But through it all, what still remains is that: she is our Ammi.

Farahnaz Zahidi is a Senior Sub-editor at The Express Tribune. She tweets @FarahnazZahidi

- Difficulty with complex tasks - Difficulty with planning and organising - Difficulty with coordination and motor functions - Problems of disorientation Psychological changes: - Personality changes - Inability to reason behaviour - Inappropriate behaviour - Paranoia - Agitation - Hallucinations

• Breaks are a must, as is taking turns if there is more than one caretaker.

It is at times like these that one thanks God profusely for the family values that help us stick together.

• Try to spread awareness about dementia and similar disorders among your social orbit. There is still a general lack of knowledge and social attitudes need improving. For starters, tell visitors, politely, that they cannot discuss the patient’s condition in front of them.

• Choose good doctors who can be reached at any time. Have numbers and contacts of nursing staff ready.

Emergency medicines and numbers of ambulances are a must.

• Try and develop an inclusive culture when it comes to older people in society. They need not be isolated and confined to their room.

• Spend as much time with them as possible. Company, care and encouragement can result in surprising improvement.

• Learn to retain the good counsel and support you get from understanding friends and relatives.

Ignore patronising attitudes and unsolicited advice. Each patient is different and each family’s situation varies.

• It helps to stay positive in such a situation and remember the good times. Keep telling yourself that your loved one has, for the most part, led a full life and that their present state doesn’t define who they are or were.

• Talk to others who have been through the same. You will realise that many other people have gone through this and you are not alone.

• Cherish this time. It will pass, as will the exhaustion. Enjoy the physical warmth, love and the prayers of your parent.

• Most importantly, do not give up on someone just because they are old.

Even if you cannot cure the disease, there is so much you can do to make them feel comfortable and feel loved.

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En vogue

Dazzle this season in Sumaira Hanif Khanani’s latest collection Photography and art direction: Umair bin Nisar Designer: Sumaira Hanif Khanani Make-up: Rhyan Thomas Model: Areeba Habib

THE EXPRESS TRIBUNE, MAY 17, 2015

THE EXPRESS TRIBUNE, MAY 17, 2015

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Lifestyle

Whenever someone asks us who we are, our immediate response is to mention our name. Our name is our identity, given to us at birth. For most of us girls, it is this identity which we are associated with and associate ourselves with, up until the day we get married. The post-marriage surname change is perhaps one of the most significant wedding rituals, almost like a rite of passage of sorts. It is something women are simply conditioned to do, without giving a second thought. But times are now changing. Over the past few years, more and more modern women have started to unpack the norm, questioning its religious and cultural significance.

After all, it is a matter of personal choice, right?

Wrong! Unfortunately, most women in Pakistan adhere to the practice because they are under the misconception that their religion requires it, when in fact, it has absolutely no religious basis. On the contrary, most religious authorities argue the merits of retaining the maiden name so as to preserve a woman’s lineage and identity, which stems from her father and not her husband. Therefore, if we follow the right contexts, it is obvious that rendering the name change as necessary and reluctance to do it as haram, is incorrect and extreme, one way or another.

Religion aside, there is immense pressure on women to adopt her husband’s name from a cultural point of view. “I briefly considered keeping my maiden name after marriage but the idea was not met very positively by my family,” says 25-year-old Aisha Nadeem whose parents felt that this would make Aisha seem ‘overly progressive’ and ‘not willing to commit’ to her in-laws.

There was also some superstition attached to their ideology as her grandmother claimed that retaining Aisha’s maiden name would bring misfortune to the marriage. “I didn’t believe any of this but had to comply,” adds Aisha.

Unsurprisingly, several women willingly go along with the practice for reasons other than the fear of

THE EXPRESS TRIBUNE, MAY 17, 2015

society and in-laws. A common reasoning is the issue of practicality when it comes to starting a family as the children bear the father’s name and their mother, ideally, should also. Some women even claim that their new name sounds better, especially true in cases wherein the in-laws hail from the social elite. For these women, adopting the family name becomes a source of pride. At the other end of the spectrum are women like 30-year-old Sobia Ali who find the name change to be romantic. “I have always felt like when the wife changes her name and attaches it to her husband’s, it makes him happy,” says Sobia. “Whether others find it romantic or simply a chauvinistic practice, I don’t know. But I feel that changing my name brought me closer to my spouse.”

According to Diana Boxer, a linguistics professor at the University of Florida, the decision of changing the surname reflects male dominance through society.

After conducting a series of studies on the practice in 2005, Diana concluded that, “Understanding naming traditions is important because they give clues about underlying social patterns and shifts in attitudes about the expected roles of women.” She also suggested that people have a blasé attitude and question what’s in a name when in fact, there is a lot more to it. “Linguistics symbols tell us how people are treated in society,” she adds.

Resulting from Diana’s research, there has also been a wave of feminists discouraging women from changing their names as it usurps them off their identities. For feminists, this signals women’s submission to their husbands and reinforces the idea that women are inferior to men. “When women change their surnames, they reinforce the idea that their identity is only dependent on that of a man,” declares 23-year-old Anaya Fahd. This in return feeds into the idea that a woman can only be known relationally to a man, defined as someone’s wife, sister, daughter or mother.

“Agreed that the maiden name is also derived from the father but by choosing to keep it after marriage, I proactively took a stand to preserve the identity that I had for the past 23 years instead of giving it up to please society,” she adds.

For 38-year-old gynaecologist Aleena Malik, there was much more than feminism that dissuaded her from acquiring a new name post-marriage. “I didn’t want to go through the long process of changing all my legal documents and identification papers, simply because society expected me to,” says Aleena, adding that it could have compromised her professional success.

“Ex-colleagues or classmates, or perhaps recruitment companies searching for me on social networks by my maiden name would have never found me,” she adds.

Another grave concern is what becomes of a woman’s name in the event of a divorce. For 35-year-old Sabeen Muzaffar, it was very impractical and emotionally taxing to have to get all her legal documents edited back to her maiden name, following her divorce from her first husband. Many women believe that giving at least some thought to divorce when getting married is advisable as it only helps ease the emotional trauma in case there is one.

Whether a woman chooses to maintain, change or hyphenate her name after getting married is a completely personal matter and no one should have the right to make this decision for her. Nonetheless, it is interesting to see alternative practices emerging in Pakistani society, even if it is questioning a practice that has been followed blindly for centuries.

Mehreen Ovais is an alumna of Manchester Business School and Lahore University of Management Sciences. She is passionate about writing and journalism. She tweets as @mehreenovais

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THE EXPRESS TRIBUNE, MAY 17, 2015

By Hirra Pervaiz

Spicy chicken and mushroom stroganoff

A side of veggies Chicken and mushrooms chunks sautéed in a delicious stroganoff sauce and served with pasta

Ingredients • Chicken (diced) 2 cups • Black pepper powder 1 tsp • Oil 2 tbsp • Salt 1 tsp • Worcestershire sauce 1 tsp • Dijon mustard paste 1 tbsp • Medium-sized onion (chopped) 1 • Garlic cloves (minced) 4 — 5

• Button mushrooms (sliced) 1 cup • Tomato paste 2 tbsp • Butter 2 tbsp • Flour 2 tbsp • Chicken stock 2 cups • Paprika 1 tsp • Chili flakes 1 tsp • Thyme (dried) 1/2 tsp • Cream 1/2 cup • Flat noodles 1 pack • Fresh coriander (chopped) for garnish

Method • Pat the chicken breasts dry and cut them into chunks of about two inches each. Season the chunks with salt, black pepper, worcestershire sauce, mustard paste and oil before frying. Cook the chunks in about two to three tablespoons of oil, at medium heat, until they become golden-brown in colour. Once fried, allow the chunks to cool on a glass plate.

• In the same pan, add one more tablespoon of oil and sauté the onions in it until they become translucent. Add in the garlic for fragrance, followed by the sliced mushrooms. Add a pinch of salt and pepper for taste and cook for about five minutes or until the mushrooms acquire a brown colour.

• Pour in the tomato paste and stir the mixture thoroughly for about two minutes. Then, make a well in the centre of the pan and add in the butter and flour there, stirring continuously. Cook the mixture until the raw taste of the flour is gone.

• Add the chicken stock and mixture it in until all the ingredients have combined together.

Pour the remaining seasoning and sauces and allow the sauce to cook until it thickens and bubbles slightly.

• Add the chicken and cook for another five to 10 minutes.

• In the meantime, prepare the pasta. For best results, make sure the noodles are boiled through.

• Pour in the cream into the stroganoff sauce and adjust the salt and pepper, according to taste.

Allow the sauce to simmer some more before placing in on top of a bed of noodles. Garnish the dish with freshly chopped coriander leaves and serve warm. Your strognoff is now ready!

Yield: Serves 6 — 8 Preparation time: 15 minutes Cooking time: 30 minutes

A rich pasta dish is everything you might be craving right now but let’s not forget that it probably isn’t too high on the nutritional value scale — unless you count all those calories, of course. How about you up the healthy quotient and serve your stroganoff with some deliciously healthy boiled vegetables? Not only will they make for a great side to dunk into the stroganoff sauce, they will also add some more colour to the dish. Choose from the following list: • • • • • •

Broccoli Baby carrots Baby corn Leek New potatoes White radish

The butter rice alternative If you wish, you can serve the stroganoff with some fragrant butter rice instead of the usual pasta. You even have the option of choosing between plain butter rice and seasoned butter rice! Follow this recipe if you prefer the latter.

Ingredients • • • • • • • •

Butter 40 grammes Garlic cloves (crushed) 2 Ginger (finely grated) 2 Rice 2 cups Bay leaves (dried) 3 Chicken stock 3 cups Frozen peas and corn 1/2 cup Fried shallots 1/4 cup

Method • In a large saucepan, melt the butter and cook the garlic and ginger in it for about one minute.

• Add the rice, bay leaves and chicken stock to the pan and bring the mixture to a boil on medium-low heat. Let it simmer for about 10 minutes with the top left open.

• Stir in the peas and corn into the saucepan and remove it from heat. Allow the rice to cool for 10 minutes, remove the bay leaves and mix the remainders with a fork.

• Season with salt, pepper and fried shallots before serving.

SOURCE: WWW.TASTE.COM

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My segment at the FPW.

Fashion Designer

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You may have heard everything about bullying, but did you know that you could be making your child a bully without even knowing it? Yup, it is surprising how well-intentioned parents like you could unknowingly sabotage your own efforts toward raising kind and happy children through your daily actions. As bullying starts and ends with an imbalance of power, too much or too little of it makes one want to gain more power. But it’s never too late to mend your ways. Read and understand these simple ways in which you may be pushing your child towards bullying and how you can rectify it:

Gossiping: If you don’t want to raise a mean child then don’t act like one!

Children hear everything. Therefore, if you don’t want to include your child in a conversation then don’t even have it within their earshot. Agree or not, gossiping is indirect bullying and children are quick to pick up how their parents talk.

Too busy to care: If you want your child to be caring and understanding, then you should express your love and affection towards them yourself. A simple ‘I love you’ or a hug and kiss can go a long way in encouraging positive displays of healthy intimacy. Show them you care so they can show others that they care.

‘I hate my…’: You may want to whine about your job or the extra pounds you have been trying to lose, but your attitude reflects on how you view the world and whining only makes you seem helpless.

When children, who think of parents as their ‘heroes’ watch them act helpless, they tend to feel powerless too. The loss of power is often channelled in gaining power through bullying. So let your children be children and save the negative talk by channelising it into a hobby you may love or simply, directing it elsewhere.

the PIA fashion show.

Not old enough: No matter how mature the children today may be, treating them as mini-adults is not always the best idea.

Fully disclosing financial burdens, family illnesses or work issues just adds layers of stress to their young minds which many children exert via bullying.

Overscheduling your children’s activities: Despite the presence of a fast moving environment, piling your child’s routine with activities to do one after the other is not smart. It’s important for a child to be able to explore his passion by providing him/ her with unstructured free time to catch some rest! You must understand that over-scheduling quickly leads to stress, anxiety, anger and aggression which pave the way for bullying.

Wincing, waiting and watching: To let your child know that bullying isn’t ok, it is important for you to practice what you preach.

Every time you ignore something bad that you could have prevented with words or actions, you add to bullying. As your child is learning how to react to life through your actions, you have to be pretty careful yourself.

Teach sharing but don’t force it: We have grown up listening to the phrase ‘sharing is caring’ but don’t realise that sharing is a skill learnt over time.

Ripping a toy out of your child’s hand and handing it to another child is a bad idea.

Forced sharing only results in a feeling of powerlessness which makes children search for other means to gain power.

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