Frequently asked questionsGeneral:
How can I do something myself? Make sure that you are fully informed of all the possibilities available. There are facilities for crisis assistance, care programmes for those who live at home, and there are facilities for day care, admittance to a nursing home or a specialised Korsakov section of a nursing home and protected living units.
How do I explain the consequences of the Korsakov syndrome to my contacts? It is easier to explain the behaviour of the patient if you have a good understanding of the affliction. Much results from the loss of control over the lifestyle of the patient. It is known that confabulation, easily becoming upset, irritation, aggressiveness, loss of control, memory loss and apathy are caused by the syndrome of Korsakov. Personal neglect is also a symptom, in addition to a flattening of the personality.
I want to leave my husband, but then there is no one to care for him and I can't reconcile that with my conscience? You can do everything (to persuade your husband to allow you) to arrange help before you leave. If your husband will not accept that either, it will be extra hard for you. At a certain moment you will have to think of yourself, it can not continue endlessly or until you collapse. You have your own life and the right to choose that. If possible with help from others, keep an eye on the situation remotely so that you can intervene if the situation escalates.
Is it inherited? No, the syndrome of Korsakov is not inherited. However it is true that the susceptibility for addiction recurs in some families. The experts are not yet certain whether that results from precondition or from following the wrong example.
Is it possible to diagnose the syndrome of Korsakov with a CT brain scan? Is it possible to see whether brain cells are dead using a CT scan? It is not possible to diagnose the syndrome of Korsakov using a CT scan. Neurological and neuropsychological investigation is always necessary, supplemented by observation of the daily behaviour. To make the matter more complex: it is often not possible with a CT scan to see the brain damage one might expect from Korsakov. This does however not imply that there is no question of Korsakov. On the basis of observation and other investigation it is possible to establish Korsakov. Damage to nerve cells can not be seen on a CT scan. The method is too imprecise. It is possible to see that a part of the brain is reduced in size compared with the rest, or in comparison with what might be expected from a patient of similar sex and age. This is called atrophy. In Alzheimer's disease that often means that nerve cells are dead. With alcoholics and also Korsakov patients it is not clear why that happens, because we often see that the brain volume increases if there is no alcohol consumption for a long period. An MRI scan is a procedure which provides better brain photos and sometimes such good images that it seems as if the brain is exposed before your eyes.
Is it true that use of vitamins can help prevent Korsakov? Yes, that is true.
Is Korsakov caused by alcohol or poor nutrition? The digestive system and the liver are damaged by alcohol such that the nutrients are not properly absorbed and stored. In addition people eat less and less as they drink more and more. Usually there is a combination of factors in play. The most important is self neglect, or more precisely: stopping eating. Alcohol inhibits the appetite, not surprisingly because it is a rich source of calories. For more information, refer to the brochures or specialist literature.
My husband mistreats the children/me. Can I have him removed from home? Generally speaking, this is not possible. You will have to take action as described above. You can engage a confidential agent via the general practitioner if it concerns mistreatment of the children, or temporarily live with others or in a secure home.
My husband says that he has reasons for his misuse of alcohol and that he is unable to do anything about it. This is absolutely never the case and it is a misplaced alibi. Of course there can be many reasons for his sorrow or worries. Getting drunk will not help though, because it does not solve anything. On the contrary, drinking is a completely wrong approach because it generates an additional problem.
My parents have a drinking problem, who can I discuss it with? See if you are helped by the website http://www.drankjewel.nl/
My partner drinks too much, but rejects help. What can I do? Generally there is not much you can do. Legally no one can be forced against his will to undergo treatment or to be admitted, and if someone is unwilling then little can be done. However if the situation through their addiction becomes so serious that this becomes a danger for themselves or others, then it is possible to start a legal procedure under the law BOPZ (Special admission psychiatric hospitals) for a legal authorization to get the patient forcibly admitted. The general practitioner of the patient can apply this procedure. The mental capacity of the patient may be so reduced that he or she can not be admitted of their free will, (because you have to understand what you agree to) but they may not resist. In that case the patient can be admitted under article 60 of the BOPZ. This also can be arranged by the general practitioner (GP). In very urgent situations a forced admittance can take place via a detention order. This is also arranged by the GP and, because of the urgency, in his absence by a locum doctor.
My partner drinks too much, what can I do? Try to maintain contact, also discuss the possible consequences of alcohol misuse. Go to the doctor with your partner. The doctor should refer you to the correct institute for adequate treatment. The appropriate institute can vary depending on where you live, it could be the regional psychiatric centre or the addiction bureau. These institutions will evaluate with you whether admittance or help at home is indicated. They are also aware of the possibilities in the different regions, for example, if there is a care programme in which the various authorities work together and if there is an opportunity for day care or day treatment. The selected approach is strongly dependent on whether or not your partner accepts help.
My partner drinks, we do everything we can to conceal that from others because we are deeply ashamed. No doubt easier said than done, but try to convince yourself that it is his responsibility, not yours. If anyone should be ashamed, it is certainly not you. On the contrary, you are a victim.
My partner will not accept help, help authorities will not accept us because he refuses. I need help urgently because I am desparate. What can I do? Try to get support for yourself, discuss the problem with those you trust. Don't stay in isolation, find people who can be of positive influence to your partner. If you can't get support from others, go to your GP and ask for help for yourself. He can refer you for guidance by the general social worker or by whichever authority has that task in your area.
My partner refuses any form of help. Living with him is for myself and/or the children such a burden that we can not continue. What can I do? In general the only thing you can do is file for divorce or separation. If you have your own home then this has the necessary financial consequences, dependent on the conditions of your marriage arrangement. If you rent your home then this will generally be awarded to the parent who cares for the children and the greatest chance is that you will be that parent.
Does the craving for alcohol disappear after long term abstinence? No, but those who have been addicted to alcohol for a long time can learn to become controlled drinkers. For more information refer to the brochure "The Syndrome of Korsakov" written by Klaas Arts.
Where can I get help? Your general practitioner (GP) is the first person to discuss the problems with. He is also aware of the Social Help Authorities. He can refer you to, for example, the RIAGG (Regional mental heath care), CAD (Consultation bureau for alcohol and drugs) or social workers.
What is the syndrome of Korsakov? The syndrome of Korsakov is caused by a serious deficiency of vitamin B1, thiamine. The Russian psychiatrist Sergei S. Korsakov described between 1887 and 1889 the consequences of this in a series of articles. The permanent damage can only be determined after the patient has stopped drinking for several months and has resumed normal nutrition. These can amongst others be: loss of memory, behaviour problems, lack of planning capacity, telling stories which are not true but which the patient himself believes (confabulation) and disturbances of the nervous system (poly neuropathy). In addition the digestive system can be damaged as well as some organs such as the liver. There can be different causes for the thiamine deficiency which causes the syndrome of Korsakov. In the Netherlands this occurs almost exclusively with alcoholics.
Apart from memory, are other brain functions affected? Are also organs in the body damaged by alcohol? Yes, in addition to the memory, changes in other organs can occur, such as the heart, liver, pancreas or nervous system resulting in speech, movement, feeling and sight deficiencies.
Treatment:
How is admittance arranged? In the Netherlands admittance can only be arranged by the Indication Committee following referral by the GP.
What is the best way to help a Korsakov patient? •· Try as far as possible to stop or reduce the alcohol consumption. •· Try to ensure good nutrition. •· Try, if possible, to have the patient tested after he or she has been dry for at least 2 months. •· Try to persuade the patient to attend suitable day treatment if that is available in your area. •· Avoid endless discussion on topics you will not agree on. •· Try to maintain a fixed daily structure. •· Offer matters that have to be done as fact and not as a question. •· Don't offer to many different choices because it is difficult for the patient to make decisions. Offer two choices only. •· Do not give complicated instructions, offer them in small parts and in a logical sequence. •· Accept wishes and demands that can be accomplished. •· Try to be as neutral as possible in the approach, as friendliness and respect will be difficult under the circumstances.
Can patients be accommodated outside nursing homes? Yes, dependent upon the patient, there are regional institutes for protected living (RIBW) offering homes and possibility for day care.
Living:
What forms of living are available?
•· Regional institutions for protected living •· Nursing homes and psychiatric hospitals •· Small unit homes
Miscellaneous
How do I get the information? From the brochure "Het syndroom van Korsakov" available from the Korsakov Kenniscentrum. Order via info@korsakovkenniscentrum.nl cost euro 6,25 excluding postage.
The booklet "Zorgprogramma Korsakovsyndroom" is recommended, published by the Korsakov Kenniscentrum.
Is there a "partners in distress" forum where I can exchange experiences with others? No, but you can come in contact with others through the guest book. We strive to answer questions in the guest book personally. |
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