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DEMENTIA: ENGAGING SOCIETIES AROUND THE WORLD. Smt. Nirmala Narula President, ARDSI, Delhi Chapter Vice Chairperson, National Body. Understanding Dementia and Caring for the Victims Support for Family Care Givers (In Terms of Facilities of Day Care) Alternative (New) Drug Treatments.

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Dementia engaging societies around the world

DEMENTIA: ENGAGING SOCIETIES AROUND THE WORLD

Smt. Nirmala Narula

President, ARDSI, Delhi Chapter

Vice Chairperson, National Body



Dementia
DEMENTIA

  • Worldwide - 24.3 million.

    • doubles every 20 years.

  • Developing countries.

    • 60% of people with dementia live here

    • prevalence of dementia ranges from 0.8% to 3.5%.

      (Courtesy WHO)


  • Dementia Results in

    • Lack of alertness

    • Anxiety due to inner security

    • Drawing curtain on reasoning

    • Abuse of elderly-highest in afternoon and night

  • Dementia has

    • No set pattern like cancer and other disease

    • Become an important health issue

    • Thrown new challenges to caregivers/policy planners

    • Many causes


Causes of dementia
Causes of Dementia

  • Alzheimer’s Disease 60%

  • Vascular Dementia 15%

  • Alzheimer’s + Vascular 10-15%

  • Others 15-10%


  • Dementia Victims : Conventions

    • Dignity and respect in old age and providing reasonable access to suitable health services besides government.

      • Under International Law

        • Universal declaration of human rights

      • International Covenant of

        • Civil and Political Rights.

        • Economic and Social Rights


  • Inter Covenant Rights

    • Cultural

    • Social

    • Economic

  • Elimination of all forms of discrimination against women

  • Rights of persons with disabilities which include AD.

  • African Human Rights Law, helps the elderly women in every sphere.

  • Agencies commitment to dedicate:

    • Help Age - Financial commitment/staff resource

    • UN - Human Rights- international law/violation

    • GOI - Recognized dementia

  • Together we have to show impact of care giving.


  • Diagnosis and Treatment, Role of GP’s

    • Lack of trained doctors.

    • Subject of dementia should be in medical curriculum.

    • Train doctors to identify types of dementia.

  • Life Style Intervention

    • Providing a community based resource

    • Respite centre

    • Hired trained personnel

    • Model respite centres reduce family burden

    • Hired care givers are expensive

  • Day Care Center

    • Provide respite during the day


Un study life expectancy
UN Study : Life Expectancy

  • 1901 23 years

  • 1951 32 years

  • 1981 52 years

  • 1996 62 years

  • 2020 70 years

  • 2030 ⅓ of world population will be 60+

  • 2050 1% will be 60+, 15% will be 80+



  • Solution? members.

    • Special care giving for ADL :

      • Treat with dignity

      • Emotional understanding

    • Early Memory Loss?

      • Requires interaction with others

      • Enjoys outings and activities – this strengthens memory

      • Needs to talk/socialize


Day care to relieve family caregivers
DAY– CARE TO RELIEVE FAMILY CAREGIVERS members.

  • Day care services leave younger earning members free.

  • Provisions of health care services/day care complement the health services in general.

  • Respite for care giver?

    • ‘Home aide’ or a trained care giver needs respite.

    • Moving the person to a facility - not common, therefore aide needs respite.

    • To a primary care giver, real respite - a short while away/short vacation.


  • Most care givers will not take respite for: members.

    • Admission of failure/guilt.

    • Personal attachment.

    • Doctors to suggest options to the families.

  • Is respite the answer?

    • Effect of respite on people with dementia - unpredictable.

    • New friendships/varying activities improve their cognitive abilities.

    • Some might slump when taken back home.

    • Governments in most countries beginning to realize the importance


Training of professional caregivers
Training of Professional Caregivers members.

  • Training of Professionals Care givers

    • Following should help running these centers.

      • Senior, retired administrative personal

      • Trained Social Workers

      • Trained Care Givers

      • Trained Nurses

      • Medical Team of consultants.

      • Voluntary Social Workers.

  • Adult Day care

    • Provide good alternative to nursing homes.

    • Volunteers can be engaged in

      • Support groups

      • Day care centre

      • Home visits.


  • Support Groups members.

    • Volunteers/facilitators for day care services to be responsible for:

      • Bringing hope and help

      • Address concerns and questions.

      • Avoiding isolation of individuals’ early stages of AD.

      • Being aware “It is not a stigma to be a participant” in their program

  • Advantages of day care

    • People with early memory loss still desire

      • Socialization

      • Involvement in the community.

    • Old people need maximum attention during day.

    • Allows younger earning members to be free for work.


Alternative new drug treatments in alzheimer s
ALTERNATIVE (NEW) DRUG TREATMENTS IN ALZHEIMER’S members.

  • Alzheimer’s disease- neurodegenerative disease - stems from beta amyloid

  • Primary factor being age – three compound designed to combat AD – under study.

  • Research for a secretase inhibitors to prevent amyloid build up by inhibiting enzymes.

  • At present four commonly used drugs to treat symptom of AD.

    • Aricept

    • Razadync

    • Exselon

    • Namends


  • Future Treatment (Medical) members.

    • New drug called Rember (methylthioninum chloride)

      • Being tried on patients with moderate AD.

      • Found twice more effective then Aricept.

      • Attacks “tau” which promote tangles as opposed to amyloid plaques.

      • Can slow the progress of As for 19 months.

      • Can have side effect – diarrhea.

      • Phase 3 trial is expected

  • Non Medical

    • Gentle exercise (Tai chi) and pet therapy

    • Gross cultural innovative programs:

      • Music

      • Art

    • Stimulating programs by recreational therapists and social workers.

    • Care giving guidance on handling ADL persons with different background.


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