Dementia Care in India
What is Dementia?
As per World Health Organization (WHO), Dementia is a syndrome usually of a chronic or progressive nature in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behavior, or motivation.
Change of care with Stages of Dementia or Alzheimer’s
A painful truth of Alzheimer’s and Dementia is that the illness gets unmanageable outside assisted-living whether at home or in a Dementia or Alzheimer’s care unit. Subjective debilitation prompts worry with essential exercises like going to the toilets, or washing, or something as straightforward as getting dressed. More awful, an individual with Alzheimer’s or Dementia probably won’t be secure at home.
Stage 1: HOME-Healthcare for Dementia or Alzheimer’s
India has strong family ties and cultural values. NEMA believes that care should be provided at home as far as one can. NEMA supports this endeavor by its
- Respite care plan, where elders could stay at NEMA Elder Home for a short time to provide relief to caregivers as and when required.
- By providing trained care attendants at the home of an elder under its Home-healthcare care plan.
The progression of Alzheimer’s Disease or Dementia requires care for loved ones. Depending on someone’s stage of Alzheimer’s/ Dementia, and ability to function, the level of required care and supervision can change.
In later stages of the Demetria or Alzheimer’s, patients need more care and assistance than family or relatives can provide at home. This can eventually lead to some form of residential care in a dementia care unit. This is where assisted-living, memory care, Dementia care, Alzheimer’s care option come into play Assisted-living in a NEMA Dementia or Alzheimer’s care unit may be the best option. It provides care best for the needs of the elder by combining housing, hospitality, and health care. However, these are considerations that the caregivers and their families find difficult to discuss or plan due to social stigma or pressure. However, it just is the best option, crucial to maximizing those twilight years, even for someone with Alzheimer’s or Dementia.
Stage 2: Assisted-living at ElderCare home
Assisted-living facilities to provide sufficient care for individuals in the earlier stages of Alzheimer’s disease and Dementia. They may not have any medical problems but do need much support in Activities of Daily Living (ADLs). However, much intensive support will be required for Instrumental Activities of Daily Living (IADLs).
This assisted-living can be given with low care staff to resident ratio, for example, one trained staff may support up to six residents. The patients stay in a private room or small apartments. The apartments could be shared too. At this age, sharing a room may not be advisable staff is available 24 X 7. This type of living arrangement is ideal for someone who can be mostly independent. Nurses could support appointments with doctors and arrange transport too. Multiple activities are also offered at assisted-living facilities. They have large community areas or dining rooms where residents can spend time and enjoy meals too.
Stage 3: Memory (Dementia/ Alzheimer’s) Care Units
These are special care units or Alzheimer’s Care Units that have been designed specially to take of Dementia patients, requiring a higher level of skilled care and supervision. It could be a wing within an assisted-living facility or nursing home, or operate as stand-alone residences or an institution. Dementia or Alzheimer’s care units are designed to provide a safe & structured environment with set routines to minimize stress levels for people with Dementia or Alzheimer’s. They offer the same facilities as assisted-living care homes but the level of supervision may be higher. The care team is trained to manage Dementia patients with activities intended to stimulate memory, and possibly slow the disease’s progression. Daily activities may include music, arts and crafts, indoor games, exercises, yoga, etc.
Families may be confused as to where they should go. They have a choice between, traditional nursing homes, large institutions providing dementia care in India or small scale home-like dementia care units, or continued care retirement homes providing assisted-living as well as dementia or Alzheimer’s care.
All kind of care is available in Delhi NCR more so in medical hub of Gurgaon, enough to confuse anyone. While intuitional care is available in southern Gurgaon with large set-ups, boutique dementia with personalized care is available in only two setups.
Difference between institutional care & special Dementia or Alzheimer’s care unit:
Traditionally, patients with dementia stay in institutions or nursing homes that follow a medical-somatic approach without specialization of dementia care.
SCUs are specially designed for patients with dementia, implying resident security and safety through locking systems, signposts, and communal living areas. The care staff is trained to deal with behavioral and psychological symptoms of dementia (BPSD), a heterogeneous collection of behaviors, and non-cognitive symptoms occurring in the course of dementia. This specialization results in better-organized care offered by SCUs compared to traditional nursing homes and in more family involvement Further family has an option to choose from Dementia/Alzheimer’s care units with large wards and small-scale, homelike Dementia care in India units 6–12 patients like NEMA Eldercare. Care providers in these dementia units emphasize on long-term care for normalization of daily life.
The Dementia/Alzheimer’s Care units follow is a non-drug treatment of dementia symptoms to reduce the behavioral and psychological problems associated with dementia. Further sub-division is possible in the Dementia/Alzheimer’s care units to separate patients with severe agitation and disruptive behavior and for those with mild BPSD.
The physical environment plays an important role in the care of dementia patients. Dementia patients with more privacy express less anxiety and aggression. Patients of a large institution show higher levels of aggression than those living in the less institutionalized settings of the Dementia/Alzheimer’s care unit with a homely environment. Patients in home-like dementia car units show different outcome characteristics, namely a greater decline in functional status, expressive language skills, and social skills than those in a traditional nursing home or intuition.
Continuing Care Retirement Communities
Ever-increasing care needs due to progressive conditions in Dementia often necessitate a change in living environments. A person with Dementia or Alzheimer’s may move for their home to assisted-living care unit to the Dementia/Alzheimer’s care unit and finally to an institution or a nursing home. It is quite difficult to orient and familiarizes oneself with new settings every time. It comes with a new care team as well who may take time to understand the individual.
NEMA prides itself in designing India’s one of the few Continued Care Retirement Home/ community. NEMA believes in the concept of ‘Ageing in place’. There is no change in the environment as the rooms are customized as per the resident’s requirement. Designed by International Architects and interior designers, these homes take care of Dementia patients with all in-built features like color coded spacious hallways, accessible spaces with ramps and elevators, grab bars, multiple gates to secure, personalized care plans, alert systems, etc. Care level can be changed as the disease progresses and the resident is not required to move. This is the most preferred option for anyone with Dementia or Alzheimer’s. Very expensive in the west, our facility is affordable to all.
What do you check in a Dementia care unit?
- Where is the facility? Is it close to me, in the city or outskirts of the city?
- How far is it from my place?
- How accessible is it from Airport or railway station?
- What is the setting? Is it a quiet or noisy environment?
- Is it in the green area facing a park or in the vicinity?
- Is it an institute or small specialized dementia unit?
- What’s the environment within? Is it a homelike or a nursing home/ hospital?
- Is it just a dementia care unit or it can take care till the end of life?
- Will I need to shift at a later stage of life?
- Does it have a multi-specialty hospital close-by?
- Who owns and operates the unit? Are the healthcare staff like doctors, nurses, or a businessman?
- How well are they connected with doctors who may need to be reached out?
- How good is the team? Do they provide personalized care?
- How well is staff trained?
- Do they have a psychologist?
- What special services do they provide?
- Does the environment promote independence?
- How safe and secure is the place?
- How are residents treated? Talk to them.
- How is food? Is there a nutritionist or dietitian who can be consulted?
- What activities are they involved in? Look at the weekly activity chart.
- Can the wandering be prevented in their premises?
- Are there specific activities offered for residents with memory impairment?
What is the quality of the rooms and the building?
- What’s the facility, furniture within the room?
- Are washrooms safe with grab bars?
- Is the facility accessible with wheelchairs?
- Does it have ramps and elevators?
- How good is lighting and what is the view?