Dementia – a precipitous bane
By
Dr Madhura Mandlik
Resident Doctor
Seth G S Medical College and KEM Hospital, Mumbai.
Dementia is a common term for a phenomenon leading to memory loss that is debilitating enough to hamper day-to-day life. WHO estimates that around 55 million people have dementia, and more than half of them live in middle-income countries. Dementia contributes to increased disability and dependency. Most people, especially in middle-income countries, are taken care of by informal caregivers.
Alzheimer’s is the most common form of dementia worldwide. Other forms include vascular, Lewy body, and Parkinson’s plus, to name a few.
The Alzheimer’s and Related Disorders Society of India (ARDSI) has estimated that around 4.4 million people live with Alzheimer’s in India. Sadly, only 10% are diagnosed and 10% are treated. The burden of dementia will increase in the future due to increased life expectancy. This is a chronic disease with a 10-year survival rate after diagnosis. But most are not diagnosed, are not given the optimal care needed, and also do not have the means to seek this care. The working population and their second generation bear the brunt of this.
Many issues continue to grapple with our society in terms of dementia. The first is a lack of awareness, which furthers the denial. Educated individuals still refuse to accept that their mother, father, or older relative is suffering from dementia. There is still a stigma against it, whether by labeling such people as not sane or just calling it old age.
Another important aspect is the cost of treatment. Most medicines would average in the thousands, and not all would have proximity to government hospitals. Most of those suffering from dementia need an attendant, and owing to the increasing working class, this need remains. The expenditure for hiring a caregiver is also high, as is the number of facilities giving dedicated care to dementia patients, which is low and expensive.
What can we do to improve this?
Caring for people with dementia can begin right at home and extend to the healthcare level.
The concept of a home care advisor was put forth by a study done in Goa. It entailed
Basic education about dementia and its features
Education about common behavior problems and how they can be managed
Support for the caregiver, for example, for an elderly caregiver living alone with the patient in activities of daily living
Referral to psychiatrists or the family doctor when behavior problems are severe and warrant medication intervention.
Networking of families to enable the formation of support groups.
Advice regarding existing government schemes for elders
The ARDSI also put forth a report and made recommendations at the healthcare level.
We, as humans, have this beautiful book on empathy and love. Dementia is a disease that can take away a lot of things, but love stays, and with the right care and support, we can only help people with dementia have a better journey.
By
Dr Madhura Mandlik
Resident Doctor
Seth G S Medical College and KEM Hospital, Mumbai.
References:
World Health Organization. Dementia: A Public Health Priority. World Health Organization. 2012. [Last accessed on 2019 Apr 25]. Available from: http://apps.who.int/iris/handle/10665/75263 .
Dias A, Patel V. Closing the treatment gap for dementia in India. Indian J Psychiatry. 2009;51:S93–7
https://ardsi.org/pdf Dementia%20India%20Strategy%20Report%202018.pdf
