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Wanted: more care for dementia

Serena Josephine M.
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Ten million. That is the estimated number of people in India who will have dementia by 2050, up from the current 3.8 million.

While this is a scary projection, experts say that what is even scarier is the lack of awareness and specialised care for the disease, one that mainly affects the elderly. Specialised care centres for holistic treatment are a must, especially in a metro like Chennai, they say.

Dementia, said S. Nambi, a senior city-based psychiatrist, is an illness that leads to the deterioration of all higher mental functions including memory, judgement and decision-making due to a gradual loss of functional nerve cells.

“There is loss of inhibition, irritability, topographic disorientation, forgetting the identity of relatives, irrelevant talk and some patients even turn violent at times,” he said. He stressed the need to improve awareness of dementia among the public.

“The prevalence of dementia is 3 to 4 per cent in urban and rural Tamil Nadu among those aged above 60 years. Persons aged 60 years and above have a 5 per cent risk of developing dementia, and this jumps to 20 per cent when they cross 80 years. As people live longer and age further, there is an increasing risk of non-communicable diseases and dementia is now a huge public health problem. Alzheimer’s disease one of the major forms of dementia,” said R. Sathianathan, vice chairman of Alzheimer’s and Related Disorders Society of India.

More than the incidence though, what doctors are worried about is the massive shortage of caregivers. The World Alzheimer’s Report 2013 said the epidemic of Alzheimer’s was creating a shortage of caregivers and that families lacked support to cope with the disease. It calls for additional support to lessen the burden on the individual and said that dementia needed to be a public health priority.

“Often, the spouse takes care of the patient and usually they tend to get burned out by the constant, everyday cycle of caring. What we need are residential or day-care centres,” Dr. Sathianathan said.

These centres could be set up by the government and provide holistic care for those with dementia, and should have an occupational therapist and psychologist. The centres should also provide speech therapy, medical assistance and relaxation, he said. “There should be mental stimulation and somebody to interact with patients on a regular basis,” he said.

Caregivers like Ramaa Kashyap, a social development specialist, said area-wise drop-in centres for the elderly would help immensely.

As she was single with no close family and had a full-time job, she found it difficult to care for her 82-year-old mother and could not find suitable caregivers. Her mother used experiences mild confusion, she said.

“I can engage a person to take care of her but often, they are not reliable. I hired a young girl once but at one point my mother told me she was being hit on the head. There should be drop-in centres where senior citizens can spend time and meet people of their age,” she said.

Dr. Nambi said that a few countries had dementia centres. “The government and NGOs should come forward and start such centres to provide care — either short-term or long-term — to those with dementia,” he said.

Doctors also stressed the need to recognise early memory impairment and the need to frequently screen people aged above 60. Some drugs can help arrest the disease in its early stages, they said.

Doctors underscore urgent need for centres that offer holistic treatment to deal with illness

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