One Day Sensitization program for the Family care giver of the Demented Elderly

Alzheimer's and Related Disorders Society of India (ARDSI) – Hyderabad Deccan and Memory Clinic, NIMS and  in association with Chetana Medical Trust organized "One Day Sensitization program for the Family Care Giver of the Demented Elderly” on November 12, 2011 Saturday, 9:30 AM – 5PM, at Conference Hall, 1st floor, Millennium Block, NIMS.

The session, attended by 40, commenced with a warm welcome from Dr.Suvarna Alladi, Additional Professor, Dept of Neurology NIMS and President, ARDSI Hyd Deccan who wished all the participants and explained the aim of this program which is to sensitize the community and to take best care of Demented elderly.

Dr.Suvarna Alladi explained the need for training family members apart from diagnosis and prescription, as the family plays a vital role in dealing with the Disease. The topics covered in her presentation were - Dementia, Symptoms and types of Dementia, different stages of Dementia, effects and prevalence rate of Dementia.
She described the different stages and effects of Dementia and the role of the family remembers to prevent the same. She covered in detail regarding the Dementia, Symptoms of Dementia such as memory loss, problem with language, disorientation of time and place, decision making, misplacing things, loss of initiative, behavior changes like aggressiveness, irritation, serious, sometimes using abuse language etc. Types of dementia such as alzhemers, vascular and lewy bodies and Fronto-temporal dementia. Stages of dementia such as early, middle and advanced stages. Few root cause such as deficiency of Vitamin B12, Thyroid, urinary infections, brain tumor also leads to Dementia. Identifying and treatment will rule out and overcome the problem.  
Dr Suvarna Alladi spoke about the incidence of dementia and using practical examples, the problems faced by persons with dementia, progression of the disease and importance of early identification and intervention. She addressed concerns of senior citizens by explaining the differences between normal and abnormal forgetfulness, and early signs of dementia.

She also explained with particle examples and said do not ask wrong questions to the patients like “Tell me who am I, What is my name, What is our relationship”. She also talked about the common problems like memory loss faced by the dementia persons. It is important to identify the disease at early stage to avoid the severe problems.

She also emphasized that should not ask wrong or funny questions to patients. We should talk them with helping words which help them to respond us easily.

Functional Rehabilitation of Persons with Dementia:
Ms. Rukhsana Ansari, Secretary of ARDSI Hyd Deccan gave a presentation on Functional Rehabilitation for Patients with dementia.

She explained with practical examples to manage the problems faced by the patients. Functional turn down will leads to frustration, dependency, helplessness, lacking the role in the family etc. The main aim is to retain functional abilities and make them to lead normal life. One needs to recognize the process of reverse ontogeny that starts of by loss of declarative memory, followed by loss of procedural memory and finally primitive skills. Instrumental Activities of Daily Living (IADLSs) are affected first followed by Basic ADLS and with this knowledge; carers can setup milestones to help patients maximize their functional potential.

Caregivers should extend their support and make them to lead normal and routine life. They should always think from the point of the patient and make the life ease. Caregivers should concentrate more on Feeding, dressing and toiletries. And need to arrange the proper devices if necessary.

Environmental modifications, assistive devices, can be used to reduce incontinence, improve feeding, walking etc. Simple changes such as proper night lighting, labelling, removing clutter, cueing, maintaining an activity schedule, timed voiding help in making significant improvements in patient's daily life.

Sharing of carer experience: Mr. Guru Raj, family caregiver narrated his experience with his mother who was affected with dementia and have been taken care of by the family for 10 years. He explained that special care needs to be taken with respect to basic hygiene and toileting. To reduce caregiver stress, it is essential to have an alternate caregiver who can share the responsibilities. It is important to spend quality time with patient and include outings in the daily/weeklyschedule such as visits to the park, temple etc. Patients shouldn't be coerced into doing anything as this will increase their frustration. Rather a loving and supportive environment should be provided to persuade them. He concluded by asking carers to not focus on the tragic nature of the disease but to develop the courage to accept the circumstances and work towards improving the quality of life.

Communication: Ms. Santhoshi Kumari, Psychologist, Memory Clinic, NIMS took the session on communicating with people with dementia. She explained
differences between verbal and non verbal communication. Common communication problems faced included naming, recall, slowness in speech e.t.c. People with dementia have an insight in to the problems they face and to avoid affecting their sense of self-worth and self-respect, we should provide them the environment and support to communicate effectively.

Some of the tips for better communication included use simple and short sentences, providing choices, taking consent from patient, informing the patient prior to any activity, refrain from talking in front of the patient about their condition , avoiding arguments and confrontation, avoiding baby-talk while encouraging them for any task. She summarized the session saying that we should show courtesy and concern to the patients and actively engage in supportive communication.

Understanding Behaviour: Ms.M.Shilaja (Psychologist, Memory Clinic  NIMS Hospital, Hyderabad), gave a presentation on Understanding Behavior of Dementia patient.

She said that persons with dementia typically lose logical thinking and also lose track of the conversation after a while. He explained differences between normal forgetfulness and told that the symptoms of Dementia do not happen overnight but it is a progression and sequence of the disorder.

There is a continuous change in behavior, where the patient will lose reasoning and face lots of stress and may withdraw himself from others. He explained the reasons for sleep disturbance , wandering and provided practical solutions to deal with those problems

Geriatric problems: Dr. Y Satyanarayana Raju Head of the division of Geriatrics, NIMS, started with what is geriatrics and  Geriatric care for persons with Dementia
He explained the meaning and definition of Geriatric and told that People over the age of sixty-five have different degrees of disability and illness. Some have no problems at all, while others have many serious health concerns.

His  excellent talk covered tips for communicating with Dementia persons, missing symptoms (like cardiac failure, Parkinsonism, Arthritis, Cataracts),  strokes(he explained the symptoms of all type of) handling trouble behavior like wandering, agitation, repetitive speech, Paranoia and practical tips for managing incontinence, sleeplessness, bathing, and dressing.

Ms. Safiya Fathima, Psychologist and coordinator, ARDSI Hyd Deccan took a session on the importance of activities for Dementia patients and said that the family is the best source to determine the activties appropriate for the patient. Activities need to account for preferences of the patient and stage of dementia. She highlighted the point saying that Activities are as important as medicines. Activities should suit the person's preferences, their level of Dementia and also their interest and abilities and should give them a sense of happiness and confidence. She shared her experience with the patients at the Rehabilitation centre [run by ARDSI Hyd Deccan twice week] using different pictures and videos of the patients.

A question and answer session followed.

The event concluded with snacks and Tea.  Ms. Safiya Fathima , gave a concluding vote of thanks to all the Participants from various organizations like AASARA,Helpage India, Anuraag Human services (Home for the Aged), CarewellFoundation,Scenior citizens welfare Associan-Saidabad  and ARDSI Hyd Deccan staff  and Memory Clinic staff for making this event successful.



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