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My grandmother is a 65-year-old retired teacher. Lately, she has been experiencing memory problems, such as forgetting appointments, misplacing keys, and struggling to recall the names of familiar people. What could it be and is there anything that could be done

Answered by Rishav Koirala, psychiatrist and researcher

Age-related cognitive changes are common, and some degree of forgetfulness is considered a normal part of aging. Chronic stress can lead to cognitive difficulties, and addressing stress management techniques may help improve memory. Sleep disturbances, such as sleep apnea or insomnia, can also impair cognitive function, and optimizing sleep quality can have a positive impact. 

If your grandmother is on some medication regimen, there are some drugs that may be affecting her memory. So a review of her medication is essential. Additionally, addressing any underlying medical conditions and ensuring proper nutrition can play a crucial role in memory improvement.

With the aging population in Nepal, the prevalence of cognitive disorders, including dementia, has been on the rise. In the context of dementia, individuals may experience a distorted sense of temporal orientation, emphasizing past memories while struggling to remember or anticipate the future. This temporal disorientation can lead to a sense of ‘wandering’ through time, where past experiences become more accessible, while future events and plans become increasingly elusive. 

As a result of this temporal disorientation, individuals experiencing memory problems may also find it challenging to remember tasks or work that was in progress, which can be disruptive and disorienting. This issue can further compound the difficulties associated with dementia, as individuals may ‘lose track’ of their ongoing tasks, adding to their sense of temporal disorientation and causing frustration and confusion. Understanding and addressing these challenges are essential in providing appropriate care and support to individuals with dementia.

Moreover, it’s crucial to recognize that the person looking after the patient, such as family members or caregivers, may experience significant emotional and psychological challenges. The constant adjustments and uncertainties brought about by dementia can lead to caregiver anxiety, stress, and burnout. Caregivers often grapple with the demanding responsibilities of ensuring the patient’s safety, providing emotional support, and managing the daily care routine, all while witnessing the progressive decline of their loved one's cognitive function. Recognizing and addressing the caregiver’s well-being is a vital aspect of holistic care for individuals with dementia, as it helps ensure the patient receives the best possible support while also maintaining the caregiver’s own mental and emotional health.

To determine the exact cause and appropriate interventions, it is crucial for your grandmother to seek a comprehensive evaluation from a healthcare professional, be it a psychiatrist, neurologist, or geriatrician, who can provide a tailored assessment and guidance for her specific situation. Early intervention and support can significantly affect the management of memory issues, irrespective of their underlying cause, and may involve addressing temporal disorientation and providing a supportive environment for individuals with dementia.

When you look good, you feel good. A little makeup can boost your confidence level when something feels off (and don’t we all have those days). Asmi Shrestha, a professional makeup artist and owner of the studio Glamour by Asmi in New Baneshwor, Kathmandu runs us through the basics of makeup while offering some helpful tips on how to take care of our skin. 

 What is the most important thing to keep in mind while buying makeup products? 

You need a good solid base to begin with so investing in proper moisturizer and primer is crucial. It’s also important to make sure your makeup items don’t clash with one another so keep a basic color palate in mind. Also, not every brand will suit you so you have to find out what works for you. I recommend you avoid dupes and invest in good quality products. 

 As a makeup artist, what is the one thing you recommend for those wanting to experiment with makeup?

I’d like to tell people to take care of their skin first and then choose makeup that helps enhance their features. Cleanse your skin every day. Test products before you buy them to ensure it doesn’t lead to rashes or breakouts. You can’t compromise on essentials like face serums, eye creams, moisturizers, and sunscreens. Then, for everyday makeup, consider investing in a good concealer for coverage, mascara to brighten your eyes, blush for a radiant complexion, and a solid lipstick to complete your look. 

 How important is it to understand your skin type before applying any makeup? 

Different skin types have different needs so you must use products that don’t hamper your skin and aggravate your skin issues, should you have any.  Dry skin needs a dewy base, like a good product with cream oil and a thick moisturizer. Oily skin, on the other hand, needs a mattifying product for a clear look. A primer is also essential so as not to clog your pores even further. I recommend a foundation-setting powder to most of my clients because it helps the makeup to stay in place for a long time. Those who have sensitive skin should stay away from makeup products or visit a dermatologist before putting anything on the skin. 

 How do you select the right foundation and concealer shades for different skin tones?

There are three main skin tones, warm, cool, and neutral. In Nepal, you often come across neutral and warm skin tones. Look at the labels for words like Neutral Cool (NC), Neutral (N), and Warm (W) to find the right shade for your skin tone. You can choose one or two shades lighter than your skin tone, apply it to your jawline, and wait for five min to check for oxidation. Likewise, for concealer, you can pick one that’s two shades lighter than your foundation. If it blends seamlessly, that shade is your perfect match. 

Can you share some makeup tricks?

Blending is the most challenging part of makeup but it can make or break your look. Good blending gives you a defined look and can highlight your best features. So practice it well. For eye makeup, use a concealer first for a matt finish. If you want your lipstick to look nice and last long, apply a lip balm before putting on lipstick, and also use a lip liner to enhance the shape of your lips. Highlighting and contouring play major roles in enhancing your facial features. To add a little structure to your face, contour the jawline, lower cheeks, and forehead. Use a highlighter where natural light hits your face, especially on the cheekbones, bridge of your nose, under brows, and chin.

 Is there anything specific people tend to overlook while doing their makeup?

I believe it’s very important to use the right makeup tools. Different brushes are designed for different purposes. I recommend a beauty sponge to apply foundation. For liquid products like blush and contour, flat-top brushes are quite useful. As a makeup artist, I recommend you to have at least a fluffy brush, eye makeup brush, and brows brush in your makeup bag. After each use, make sure to clean and sanitize your brush. For thorough cleaning, you can use baby shampoo and olive oil. As for the beauty sponge, you need to wash it after every use and squeeze it properly otherwise the water will dilute your oil-based makeup.

Two years ago, at the age of 29, Bharat Badayar Joshi decided to run for the position of mayor in Parshuram Municipality, Dadeldhura. He won the election, defeating the frontrunner and former mayor. With the victory, Joshi also became the youngest mayor in the country. 

Joshi has a master's degree in atmospheric physics from the Chinese Academy of Sciences University in Beijing. Before joining public office, his plan was to go to Europe for higher studies. The decision to contest the mayoral election, he says, was a result of one incident that took place during the Covid-19 pandemic.   

Joshi was visiting his hometown to spend time with his family when the pandemic struck. As a result, his plan to go to Europe was indefinitely deferred. While the entire country was under a strict lockdown, Joshi’s mother needed medication for her thyroid condition.  

Joshi recalls having to scramble for days on end to secure the medicines for his mother. He experienced first hand the disparity in healthcare access. 

“The struggle that underprivileged people have to put up with just to get hold of essential medicines and healthcare moved me,” he says. “I couldn’t keep calm.” 

Joshi then decided to do something about it. He launched a social initiative called ‘We for Humanity’ with a primary focus on delivering medicines and healthcare services. His work didn’t go unnoticed, both from the residents of his towns and local leaders.  

He contested for the position of mayor with the Nepali Congress’s ticket and won with a huge margin. Since joining the office, Joshi has prioritized infrastructure development as a means to drive the economy of his hometown. 

Joshi says one of the major challenges faced by his town is a lack of proper roads and bridges. Almost every monsoon, flash floods and landslides have been damaging the local road network.  

“We need better roads and bridges to boost the local economy as well as the quality of life,” he says. 

Joshi also hasn’t forgotten about improving the healthcare access and education situation. He has started an ambulance service, upgraded local health facilities and introduced health insurance schemes for the poor and underprivileged. .

To improve education, particularly among girls, he has been organizing various programs aimed at pushing up literacy rate among girls. 

Joshi knows very well that to get things done he needs the support of other political parties. He also knows the provincial and central governments are also vital to attract development funds. Due to the power struggles and political rivalries, he says, many of his dream projects have been facing delays and unnecessary obstacles.  

“Local governments are under pressure to fulfill public aspirations, but the neglect of central government and constant political bickering have emerged as hindrance to development works,” he says.

But Joshi considers himself an optimist and thinks like one. He believes that opportunity often comes disguised in the form of a problem. In the face of adversity, he continues to boost economic growth and create opportunities for local residents. 

He has, for instance, set up a farmers' market with a cold storage chamber to help local farmers. He is also planning to electrify the entire town by forging a collaboration with the Nepal Electricity Authority.   

“We all must strive to fix the problems in our hands so that we can have a better future. We should not burden the future generations with the issues that could be addressed now,” says Joshi. 

Dengue is a viral infection caused by the dengue virus (DENV) and transmitted to humans through the bite of infected mosquitoes, according to the World Health Organization. Half of the world's population is now at risk of dengue with an estimated 100–400m infections occurring each year. Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. While many DENV infections are asymptomatic or produce only mild illness, DENV can occasionally cause more severe cases, and even death, per the United Nations health agency. 

In Nepal, dengue has emerged as a public health crisis. It has already spread in 76 districts infecting around 40,000 people so far this year and leaving many people dead. Hundreds of dengue infections in a day point at the gravity of the crisis. Favorable climatic conditions from the southern plains to the hills to even the Himalayan region have definitely contributed to this spread, apart from a general lack of awareness about the disease. Water stagnated in tyres, flower pots, air conditioning equipment, buckets, drums and puddles can be a breeding ground for Aedes mosquitoes that spread this disease through their bites. 

Preventive measures at household and community levels can go a long way in bringing dengue under control. This does not mean that local levels, provinces and the federal government should do nothing to address this health emergency. There’s a deepening feeling among the public that the governments–local, provincial and federal–have not been paying much attention to the outbreak because it does not afflict the ruling elites, given the health safeguards in place for them and easy availability of treatment. 

Through effective steps, the government should prove that this perception is wrong. 

This daily, through extensive reports, has tried to bring the attention of the government toward a public health delivery system that has become dysfunctional, by and large. At least in part, rising dengue infections are an indication of a disease afflicting this system. 

In turn, dengue is symptomatic of governance that has not been as effective as it should be in providing remedies for multiple ills plaguing Nepal and the Nepalis, from violation of national sovereignty to unabated corruption to rising market prices to increasing defense and security challenges. 

The challenges are formidable but they should not be insurmountable. Once again, the onus is on the government to take political parties, civil society, the people and other relevant actors into confidence and do whatever it takes to tide the country over the crises.