Devise strong strategy to care for the elders with dementia, say experts

Healthcare professionals reiterated the need for governments to bring together the whole society in raising awareness and providing help for patients and families of those who suffer from degenerative disorders

Decoding dementia: Devise strong strategy to care for the elderly, say experts

Asha and Praveen Bhosle (names changed) have been living at Aarambh, a residential care centre for the elderly at Powai in Mumbai, for a month now. While Asha has been diagnosed with dementia, Praveen suffers from Alzheimer’s. Their family made a decision to hand them over to professional carers to improve the quality of their lives.

“My mother is 75 and father, 79. It is ironic that they suffer from same ailments. Diagnosing their illnesses was a task in itself. After their conditions were diagnosed, we sought help accordingly,” said Sachin (name changed), their son.

While the Bhosle couple is well taken care of, many elders who suffer from mental illnesses do not get the right treatment and support because of the nature of these ailments. In most cases, confusion and forgetfulness caused by dementia is dismissed as part of natural aging process. Experts said medical help is sought only after the cases get extreme.

Dr Sheilu Sreenivasan, founder president of Dignity Foundation and Dignity Lifestyle Retirement Township, said the primary reason for this is lack of awareness. “Almost 4% of people above 60 are afflicted by dementia. Though this is a very high number, people’s knowledge about the condition is next to zero. Most families simply consider dementia as memory loss due to ageing,” she explained.

Alzheimer’s disease is the most common form of dementia and may contribute to 60–70% of cases, said World Health Organization (WHO).

Sachin explained how their parents became different individuals over a short period of time right in front of his eyes.

“We started noticing behavioural changes in my mother about a year ago. She was just becoming very reclusive. And then she used to say things like, ‘You are not giving me food’, 10 minutes after her meal. She would get violent. My father, on the other hand, started forgetting routine matters such as where to walk and even urinate. Then he couldn’t recognise anyone, including me. While they can both remember past events, neither can recollect the recent ones,” he said.

Prasad Bhide, the founder of Aarambh, said creating awareness is the need of the hour and governments need to step in to make a change. “Precious time in seeking help for dementia patients is lost because people don’t know something is wrong with them. There is aid available for the elderly who suffer from degenerative disorders, but how many people know about it? Governments, at the centre and state-levels, need to create more awareness about the programmess run under the ministry of social justice. Only then can there be more care centres and caregivers for dementia,” he asserted.

In a similar vein, Dr Sreenivasan said, “Day care centres for the elderly are listed as eligible for aid. However, I do not know of a single centre that receives aid. Without aid, more centres cannot be built. The only way to improve the quality of lives of these people is by giving them adequate professional care and support.”

Dr Imran Ansari is a resident doctor with Dignity Lifestyle Township, Neral, which is a residential care centre for the old and also for people with dementia. He is optimistic about the fact that lives of dementia patients can be improved with professional care. “There is no cure for dementia. However, we can slow down the progress of dementia through yoga and counselling. The patients need our care and understanding.”

Another factor that keeps people away from professional care centres is the cost. Dr. Harish Shetty, psychiatrist at LH Hiranandani Hospital, Powai, said, “Dementia care centres can help the patients to a great extent, but a lot of people don’t avail of this option due to high cost. There has to be some form of sustained aid so that more people can seek help and not shy away because of cost.”

Sailesh Mishra, founder of Silver Innings, an assisted elder care home which has a special project named A1 Snehanjali, meant for dementia, said, “Governments, corporates, NGOs, health care professionals –  the society as a whole – needs to rethink the strategy to give boost to the elderly. We should come together and create a society that is friendly towards the elderly.”

Sachin, meanwhile, reiterated the need to sensitise the entire society about mental illnesses. “When our parents’ condition started deteriorating, the whole family tried to take care of them. The trouble was we just didn’t know how to. Counselling should be made available not just for dementia patients, but also to their families. It’s heart-breaking when our parents don’t know who we are.”

What is dementia?

Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and ability to perform everyday activities

Though dementia mainly affects older people, it is not a normal part of ageing

Worldwide, around 47 million people have dementia, and there are 9.9 million new cases every year.

Alzheimer’s disease is the most common form of dementia and may contribute to 60–70% of cases

Dementia is one of the major causes of disability and dependency among older people worldwide

Dementia has physical, psychological, social, and economical impact on carers, families and society

Source: WHO

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Stages of dementia

Dementia affects each person in a different way, depending upon the impact of the disease and the person’s personality before becoming ill. The signs and symptoms linked to dementia can be understood in three stages.

Early stage: The early stage of dementia is often overlooked, because the onset is gradual. Common symptoms include:

  • Forgetfulness
  • Losing track of the time
  • Becoming lost in familiar places

Mid stage: As dementia progresses, the signs and symptoms clearer. These include:

  • Becoming forgetful of recent events and people’s names
  • Getting lost within one’s home
  • Having increased difficulty in communication
  • Needing help with personal care
  • Experiencing behaviour changes, including wandering and repeated questioning

Late stage: Late-stage dementia is one of near total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. The symptoms include:

  • Becoming unaware of the time and place
  • Having difficulty recognising family, relatives and friends
  •  Having an increasing need for assisted self-care
  •  Having difficulty walking
  • Experiencing behaviour changes that may escalate and include aggression